Ten years ago a group of experts assembled in Chicago to develop a consensus on the management of conditions previously described as intersex. The consequences of this consensus have been far reaching, including a change in nomenclature, the development of greater collaboration across geographical boundaries, and a move towards greater involvement of patients and parents. Moreover, an international registry was established, as well as research and clinical networks. This book brings together a thorough overview on all these topics. Furthermore, the major technological advances in diagnostic genetic and biochemical capabilities over the past 10 years are outlined in detail. Offering a comprehensive update on various aspects of disorders of sex development (DSD), this book will be essential reading to all clinicians who are involved in delivering health care to patients with a DSD, as well as scientists involved in biomedical research related to DSD.
The rapid advances in medicine over the last 50 years have totally changed the outlook for children with disorders of sex development (DSD), but there is still much to learn. This book crystallizes the combined experience of a leading dedicated unit over 25 years in delivering expert medical and surgical care to children with DSD in a holistic environment. It documents the most recent advances in the molecular biology and embryology of sex development, and describes each disorder in detail. The clinical presentation and approach to diagnosis are described both for babies and for children presenting later in childhood or at adolescence. The chapters on management highlight all the latest knowledge and include the shared wisdom of the authors on current controversies, such as the timing of surgical treatment. Finally, the authors describe their short-, medium-, and long-term outcomes, which demonstrate the strengths of holistic team management.
Providing core information on pediatric surgery, this book serves as a supplement to standard pediatric surgical textbooks. It offers pearls of wisdom that will help those who participate in pediatric surgical care, as well as to provide state-of-the-art insights based on physiological principles, literature reviews, and clinical experience. This book is an ideal tool to help readers prepare for questions they will be asked on ward rounds, in the OR, or in oral exams. The depth of exploration is intended for medical students, residents in pediatrics and pediatric surgery, pediatric surgical trainees, pediatric nurse practitioners, primary care pediatricians, and family practitioners.
This book provides a state of the art review on the care and treatment of and current scientific knowledge on gender dysphoria (GD) and disorders of sex development (DSD). The book elucidates the history, the present situation, and the newest developments and future perspectives in both research on GD and DSD and the clinical management of individuals with GD and DSD of all ages. With contributions from a selection of leading scientists and established clinicians in the field of GD and DSD, this is a unique and comprehensive book focusing on the etiology and developmental trajectories of GD and DSD regarding gender identity development, psychiatric comorbidity, classification dilemmas, ethical dilemmas in treatment, influences of societal stigmatization, and discussion of the medical and psychological implications and outcomes of treatment, and providing treatment guidelines for individuals with GD and DSD (distinct guidelines each for children, adolescents, and adults). By presenting not only an historic overview and the current state of the art, but also challenges for the future, the book aims to demonstrate the need for further research and to stimulate the development and improvement of the clinical care of individuals with GD and DSD.
Although pediatric surgery is a distinct and evolving specialty, it still remains an integral part of most general surgical and paediatric medical practice. Nevertheless, surgery in children does differ from adult practice in various fundamental ways, and there are key physiological and anatomical differences that constantly need underlining. Progress and improvement in outcome has also been rapid but it is sometimes difficult for practitioners to keep themselves up-to-date with the usual surgical or paediatric text books. This book will give a concise overview of all important topics and is designed to provide information in order to recognise the common surgical conditions; namely typical symptoms and signs, investigation and then treatment management. It will also provide an anatomical and physiological background to aid understanding, in addition to emphasising logical, and where possible, evidence-based practice by the use of flow charts, tables and algorithms. Authored by an international range of leading contributors, this is the first book of its kind to offer comprehensive coverage to this topic in a quick reference, pocket-book format.
Genetic Steroid Disorders, Second Edition targets adult and pediatric endocrinologists, clinical geneticists, genetic counselors, reproductive endocrinologists, neonatologists, urologists, and psychoendocrinologists. It is designed to assist these specialists in the diagnosis and treatment of steroid disorders. This revision includes a new chapter on "Gonadotropins, Obesity and Bone" and new research on non-invasive prenatal diagnosis with cell-free DNA. Chapters are thoroughly updated covering steroid disorders, the genetic bases for the disorder and case presentations, This definitive reference belongs in every medical library! - Presents a comprehensive, translational look at all aspects of genetic steroid disorders in one reference work - Provides a common language for endocrinologists, geneticists, molecular pathologists, and genetic counselors to discuss and diagnose genetic steroid disorders Saves clinicians and researchers time in quickly accessing the very latest details on genetic tests and diagnoses as opposed to searching through thousands of journal articles - Highlights significant discoveries with clinical relevance, presenting insight into which medications to use based on the genetic makeup of a patient - Teaches the best strategies and most effective use of genetic information in the patient counseling setting
This book is aimed at primary care providers who care for the pediatric age group (general pediatrician, the PCP working with pediatric patients, and family medicine providers) with the goal of covering the endocrine differential diagnosis of common signs and symptoms of possible endocrine disease as well as appropriate initial laboratory evaluation and interpretation. While multiple pediatric endocrine textbooks exist, most of them are heavy in coverage of physiology and rare diseases, with less discussion of practical steps in evaluation and diagnosis. This book distinguishes itself through a very practical approach. The first section is organized by presenting signs and symptoms, the second section is organized by laboratory interpretation, and the third section provides summaries of common pediatric endocrine disorders. Chapters are concise, providing critical clinical information including clinical pearls, common diagnoses and important points in patient counseling. Written by experts in the field, Endocrine Conditions in Pediatrics is a valuable resource that provides general pediatricians and other primary care providers with all of the information they need to provide superb patient care before transferring to a pediatric endocrinologist when necessary.
"When sociologist Georgiann Davis was a teenager, her doctors discovered that she possessed XY chromosomes, marking her as intersex. Rather than share this information with her, they withheld the diagnosis in order to "protect" the development of her gender identity; it was years before Davis would see her own medical records as an adult and learn the truth. Davis' experience is not unusual. Many intersex people feel isolated from one another and violated by medical practices that support conventional notions of the male/female sex binary which have historically led to secrecy and shame about being intersex. Yet, the rise of intersex activism and visibility in the US has called into question the practice of classifying intersex as an abnormality, rather than as a mere biological variation. This shift in thinking has the potential to transform entrenched intersex medical treatment. In Contesting Intersex, Davis draws on interviews with intersex people, their parents, and medical experts to explore the oft-questioned views on intersex in medical and activist communities, as well as the evolution of thought in regards to intersex visibility and transparency. She finds that framing intersex as an abnormality is harmful and can alter the course of one's life. In fact, controversy over this framing continues, as intersex has been renamed a 'disorder of sex development' throughout medicine. This happened, she suggests, as a means for doctors to reassert their authority over the intersex body in the face of increasing intersex activism in the 1990s and feminist critiques of intersex medical treatment. Davis argues the renaming of 'intersex' as a 'disorder of sex development' is strong evidence that the intersex diagnosis is dubious. Within the intersex community, though, disorder of sex development terminology is hotly disputed; some prefer not to use a term which pathologizes their bodies, while others prefer to think of intersex in scientific terms. Although terminology is currently a source of tension within the movement, Davis hopes intersex activists and their allies can come together to improve the lives of intersex people, their families, and future generations. However, for this to happen, the intersex diagnosis, as well as sex, gender, and sexuality, needs to be understood as socially constructed phenomena." -- Publisher's description
The increase in prevalence and visibility of sexually gender diverse (SGD) populations illuminates the need for greater understanding of the ways in which current laws, systems, and programs affect their well-being. Individuals who identify as lesbian, gay, bisexual, asexual, transgender, non-binary, queer, or intersex, as well as those who express same-sex or -gender attractions or behaviors, will have experiences across their life course that differ from those of cisgender and heterosexual individuals. Characteristics such as age, race and ethnicity, and geographic location intersect to play a distinct role in the challenges and opportunities SGD people face. Understanding the Well-Being of LGBTQI+ Populations reviews the available evidence and identifies future research needs related to the well-being of SDG populations across the life course. This report focuses on eight domains of well-being; the effects of various laws and the legal system on SGD populations; the effects of various public policies and structural stigma; community and civic engagement; families and social relationships; education, including school climate and level of attainment; economic experiences (e.g., employment, compensation, and housing); physical and mental health; and health care access and gender-affirming interventions. The recommendations of Understanding the Well-Being of LGBTQI+ Populations aim to identify opportunities to advance understanding of how individuals experience sexuality and gender and how sexual orientation, gender identity, and intersex status affect SGD people over the life course.
