Gender Assignment Surgery

Gender Assignment Surgery-52
Being transgender also isn't about anatomy or sexual orientation; it's about internally identifying with a gender status — which could be masculine, feminine, agender or gender fluid — that is different than the one culturally assigned to you based upon your physical characteristics.While some people may never publicly acknowledge their transgender status, others may decide to live as their desired gender — and that could mean changing how they express their gender through transitioning.

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Early surgery for maximizing the gender-appropriate appearance of the external genitalia was recommended to facilitate gender-appropriate rearing.

This policy was later extended to 46, XY cases with nonhormonal genital abnormalities (, Ref. In the original formulation of the optimal-gender policy, consideration of the sexual differentiation of the brain did not play a role because nothing was known about it at that time, and the intersex data then available were interpreted as showing that “psychologically, sexuality is undifferentiated at birth and that it becomes differentiated as masculine or feminine in the course of various experiences of growing up” (10), which is often referred to by others ( (14) demonstrated that perinatal sex hormones had a major organizing effect on the sexual differentiation of brain and behavior in guinea pigs, and these observations were soon replicated in other species.

Thus, the key issues in the gender-assignment debate are the mechanisms involved in the development of gender identity.

To what degree do prenatal hormones predispose an individual for a certain gender identity, and to what extent do postnatal social and psychological factors shape its development?

The Intersex Society of North America (4), a support group of mostly adult persons with intersexuality founded in 1994, has published recommendations that center on the avoidance of genital surgery—because of the potential consequences for sexual functioning—without the patient’s informed consent, “unless it is absolutely necessary for the physical health and comfort of the intersexual child,” and declare it “imperative that intersexuals learn of their status in a properly supportive emotional environment.” Similarly, a growing number of medical clinicians have begun to question prevailing practices of intersex management (, Refs. To evaluate such recommendations, we have to place them in historical context and review their empirical basis.

The present comments are mostly confined to the gender question.

Transitioning is often two-fold: a social transition, such as new clothing, a new name and new pronouns; and a medical transition, with treatments such as hormone therapy and surgical procedures.

Depending on the needs and wants of each individual, transitioning may include both social and medical transitions; just one of the two; or for those who eschew gender completely, neither.

Similar observations were reported by Rösler and Kohn (20) on the syndrome of 17β-HSD deficiency.

Critics ( questioned, however, whether direct sex-hormone effects on the brain could be the sole or even the major mechanism underlying this late gender change; it seemed likely that other psychosocial and psychological mechanisms also contributed.


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