1113:'s tragic story, told in both popular and medical publications, was widely interpreted by the public and many physicians as a cautionary tale of medical hubris, of the folly of attempting to foil nature with nurture, of the importance of early hormones on brain development, and the risks and limitations of surgery. Some clinicians proposed a moratorium on pediatric sex reassignment, particularly of undervirilized males as females, due to a lack of data that rearing or appearance of genitalia play a major part in gender identity development. Those clinicians encouraged delaying surgery until elected by adolescents to preserve sexual sensitivity.
1179:... outcomes from clitoroplasty identify problems related to decreased sexual sensitivity, loss of clitoral tissue, and cosmetic issues ... Feminising as opposed to masculinising genitoplasty requires less surgery to achieve an acceptable outcome and results in fewer urological difficulties... Long term data on sexual function and quality of life among those assigned female as well as male show great variability. There are no controlled clinical trials of the efficacy of early (less than 12 months of age) versus late surgery (in adolescence and adulthood), or of the efficacy of different techniques
657:
rates. Some surgeons, well aware of the immediate limitations and risks of surgery, feel that significant rates of imperfect outcomes are no scandal (especially for the more severe and disabling conditions). Instead they see these negative outcomes as a challenge to be overcome by improving the techniques. Genital reconstruction evolved within this tradition. In recent decades, nearly every aspect of this perspective has been called into question, with increasing concern regarding the
43:
773:. Although it seems obvious now that a doctor could not announce to an eight-year-old boy and his parents that "we have just discovered that you are 'really' a girl, with female chromosomes, and ovaries and uterus inside, and we recommend that you change your sex to match your chromosomes and internal organs," a few such events occurred around the world as doctors and parents tried to make use of new information.
1214:
surgical procedures are sources of concerns. There is no evidence regarding the impact of surgically treated or non-treated DSDs during childhood for the individual, the parents, society or the risk of stigmatization... Physicians working with these families should be aware that the trend in recent years has been for legal and human rights bodies to increasingly emphasize preserving patient autonomy.
1087:
information and counseling) to the radical (assigning a third sex or no sex at all to intersex infants). The idea that possession of abnormal genitalia in and of itself does not constitute a medical crisis was stressed. The claims of advocacy groups have been resisted. In response to a demonstration by members of the
Intersex Society of North America outside the annual conference of the
904:
of parents for an "early fix," and (4) the observation of many surgeons that connective tissue, skin, and organs of infants heal faster, with less scarring than those of adolescents and adults. However, one of the drawbacks of surgery in infancy was that it would be decades before outcomes in terms of adult sexual function and gender identity could be assessed.
1120:'s constitutional court limited the ability of parents to consent to genital surgery for infants with intersex conditions. A number of advocacy groups argue against many forms of genital surgery in childhood. In 2001, British surgeons argued for deferring vaginoplasty until adulthood on grounds of poor outcomes for women who were operated on as infants.
1223:
commentary stated that the purpose of the 2006 Consensus
Statement was to validate existing practices, "The authoritativeness and "consensus" in the Chicago statement lies not in comprehensive clinician input or meaningful community input, but in its utility to justify any and all forms of clinical intervention."
2991:
Mouriquand PD, Gorduza DB, Gay CL, Meyer-Bahlburg HF, Baker L, Baskin LS, Bouvattier C, Braga LH, Caldamone AC, Duranteau L, El
Ghoneimi A, Hensle TW, Hoebeke P, Kaefer M, Kalfa N, Kolon TF, Manzoni G, Mure PY, Nordenskjöld A, Pippi Salle JL, Poppas DP, Ransley PG, Rink RC, Rodrigo R, Sann L, Schober
1178:
It is generally felt that surgery that is carried out for cosmetic reasons in the first year of life relieves parental distress and improves attachment between the child and the parents. The systematic evidence for this belief is lacking. ... information across a range of assessments is insufficient
1132:
and others examined outcomes from early surgeries in individuals with XY variations, at one patient centre. The study has been used to support claims that "‘the majority of women...have clearly favored genital surgery at an earlier age" but the study was criticized by Baratz and Feder for neglecting
656:
have attempted to "fix" an increasing variety of conditions. Success has often been partial and surgery is often associated with minor or major, transient or permanent complications. Techniques in all fields of surgery are frequently revised in a quest for higher success rates and lower complication
1099:
Research on children with ambiguous genitalia has shown that a person's sexual body image is largely a function of socialization, and children whose genetic sexes are not clearly reflected in external genitalia can be raised successfully as members of either sexes if the process begins before 2 1/2
903:
Genital corrective surgeries in infancy were justified by (1) the belief that genital surgery is less emotionally traumatic if performed before the age of long-term memory, (2) the assumption that a firm gender identity would be best supported by genitalia that "looked the part," (3) the preference
858:
The most common intersex surgery offered in childhood was amputation of the clitoris and widening of the vaginal opening to make the genitals of a girl with CAH appear more conformed to the expectations. However, by the late 1950s surgical techniques for transforming assigned male at birth patients
1213:
There is still no consensual attitude regarding indications, timing, procedure and evaluation of outcome of DSD surgery. The levels of evidence of responses given by the experts are low (B and C), while most are supported by team expertise... Timing, choice of the individual and irreversibility of
1146:
In 2006, an invited group of clinicians met in
Chicago and reviewed clinical evidence and protocols, argued that and adopted a new term for intersex conditions: "Disorders of sex development" (DSD). More specifically, these terms refer to "congenital conditions in which development of chromosomal,
1022:
which could be improved with hormones rather than surgery, and over the next decade a couple of reports suggested adult outcome as males was not as bad as expected for the boys with micropenis who had not had surgery. Although textbooks were slower to reflect the change, few reassignment surgeries
768:
As the number of children with intersex conditions referred to Lawson
Wilkins' new pediatric endocrinology clinic at Hopkins increased, it was recognized that doctors "couldn't tell by looking" at the external genitalia, and many errors of diagnosis based on outward appearance had led to anomalous
2156:
Survey of patients treated with older management, including 5 with micropenis reassigned and raised as women. Gender identity was concordant with sex of assignment in all. Women with CAIS were satisfied with genitalia, men and women who had had micropenis were universally dissatisfied, but sexual
930:
were most uncritically accepted in academic opinion, in most children's hospitals, and by society at large. In this context, enhancing the ability of people born with abnormalities of the genitalia to engage in "normal" heterosexual intercourse as adults assumed increasing importance as a goal of
2109:
and 9% were deceased (2 from suicide). Of the 96 located, eligible adults, 78% consented to participate (18 women born with complete undervirilization, 18 women born with partial undervirilization, 21 men with partial virilization, 5 women born with micropenis, and 13 men born with micropenis).
1196:
In a study in Lübeck conducted between 2005 and 2007 ... 81% of 439 individuals had been subjected to surgeries due to their intersex diagnoses. Almost 50% of participants reported psychological problems. Two thirds of the adult participants drew a connection between sexual problems and their
1183:
Data presented in recent years suggests that little has changed in practice. Creighton and others in the UK have found that there have been few audits of the implementation of the 2006 statement, clitoral surgeries on under-14s have increased since 2006, and "recent publications in the medical
1086:
was the most influential and persistent, and advocated postponing genital surgery until a child is old enough to display a clear gender identity and consent to the surgery. Recommendations from these voices ranged from the unexceptionable (ending shame and secrecy, and providing more accurate
1038:(CAH), and unsatisfactory sexual outcomes in adult women with CAH. Many endocrinologists were becoming skeptical that reassignment of genetic males to females was just a matter of learning and appearance, or that the newer clitoral reductions would be more successful than clitoral recessions.
1222:
and Ellen Feder criticized that omission, stating that issues have barely changed in two decades, with "lack of novel developments", while "lack of evidence appears not to have had much impact on physicians' confidence in a standard of care that has remained largely unchanged." Another 2016
689:(Alexandria, 2nd – 3rd centuries), describes in section LXIX (On Hermaphrodites) of his sixth book four types of intersex and how to "cure" three of them by surgically removing the "useless parts". In the next section (LXX, On Extirpation of the Nympha and Cauda Pudendi) he deals with
1081:
A more abrupt and sweeping re-evaluation of reconstructive genital surgery began about 1993, triggered by a combination of factors. One of the major factors was the rise of patient advocacy groups that expressed dissatisfaction with several aspects of their own past treatments. The
919:, the lessening of many social barriers and inhibitions related to sexual behavior, and social acknowledgment of women's sexuality. In this era, genes and hormones were thought not to have a strong influence on any aspect of human psychosexual development, gender identity, or
2363:
Eight of 14 genetic males who were born with exstrophy and unsalvageable penis, assigned and raised as females, spontaneously reassigned themselves to male sex as they grew up. This outcome suggests XY infants with exstrophy but normal testes should not be raised as
1923:
Restatement of the classic surgeon's arguments that (1) complications are being reduced by newer techniques, and (2) that surgery should optimally be performed even earlier (by 2 months of age) to take advantage of the estrogenized state of the tissue in early
3329:
1201:
A 2016 Australian study of persons born with atypical sex characteristics found that "strong evidence suggesting a pattern of institutionalised shaming and coercive treatment of people". Large majorities of respondents opposed standard clinical protocols.
1141:
if surgery were performed later, or (3) that significant technical improvements that were expected to improve outcomes had occurred in the 13 or 14 years between when they underwent early childhood surgery and when it might have been deferred until after
2941:
Lee PA, Nordenström A, Houk CP, Ahmed SF, Auchus R, Baratz A, Baratz Dalke K, Liao LM, Lin-Su K, Looijenga LH, Mazur T, Meyer-Bahlburg HF, Mouriquand P, Quigley CA, Sandberg DE, Vilain E, Witchel S, and the Global DSD Update
Consortium (2016-01-28).
958:
was irreparably malformed or "too small to stand to urinate or penetrate a vagina," because the surgeons claimed to be able to construct vaginas where none existed. The majority of these genetic males who were reassigned and surgically converted had
1290:
On July 28, 2020, Lurie
Children's Hospital became the first children's hospital in the United States to cease medically unnecessary, cosmetic surgery on intersex infants and publicly apologize to past intersex individuals harmed by such surgeries.
1263:
In April 2015, Malta became the first country to recognize a right to bodily integrity and physical autonomy, and outlaw non-consensual modifications to sex characteristics. The Act was widely welcomed by civil society organizations.
883:
surgery to new levels of success and safety. These specialized surgeons began to repair wider varieties of birth defects at younger ages with better results. Earlier correction reduced the social "differentness" of a child with a
1197:
history of surgical treatment. Participating children reported significant disturbances, especially within family life and physical well-being – these are areas that the medical and surgical treatment was supposed to stabilize.
1108:
In addition to ignoring patients' voices, physicians involved in intersex care had embarrassingly little long-term outcome data to support their claims. In 1997 a patient account was published which could not be ignored.
1069:
By 1990, biological factors were being reported for a wide variety of human behaviors and personality characteristics. The idea that culture accounted for all the differences between men and women seemed as obsolete as
616:, with the development of political advocacy groups united by a human qualified analysis, and in the last decade by doubts as to efficacy, and controversy over when and even whether some procedures should be performed.
1275:
published a report documenting the negative effects of medically unnecessary surgeries on intersex children in the US, as well as the pressure placed on parents to consent to the operations without full information.
3337:
776:
Genital reconstructive surgery at that time was primarily performed on older children and adults. In the early 1950s, it consisted primarily of the ability to remove an unwanted or nonfunctional gonad, to bring a
632:
described how a hermaphrodite could inherit "either as male or female, according to that kind of sexe which doth prevaile." Single cases have been described by legal cases sporadically over the centuries.
1618:
Piaggio LA. Congenital
Adrenal Hyperplasia: Review from a Surgeon's Perspective in the Beginning of the Twenty-First Century. Front Pediatr. 2014;1:50. Published 2014 Jan 2. doi:10.3389/fped.2013.00050
1287:
published a report on the situation of intersex persons in
Denmark and Germany and launched a campaign for intersex human's rights: "First, Do No Harm: ensuring the rights of children born intersex".
622:, Canon and common law referred to a person's sex as male, female or hermaphrodite, with legal rights as male or female depending on the characteristics that appeared most dominant. The foundation of
982:
later reported that Reimer failed to identify as female since the age of 9 to 11, making the transition to living as a male at age 15. The specific case of David Remier and his rejection of female
1218:
A 2016 paper on "Surgery in disorders of sex development (DSD) with a gender issue" repeated many of the same claims, but without reference to human rights norms. A commentary to that article by
978:) who had lost his penis to a surgical accident. This experiment proved not to be as successful as Money claimed. David Reimer grew up as a girl, but never identified as one. Academic sexologist
811:
in the new "Psychohormonal
Research Unit" at Hopkins, and his partners, John and Joan Hampson, analyzed these assignments and reassignments in an attempt to learn the timing and sources of
1014:. Nevertheless, in the 1980s several factors began to induce a decline in the frequency of certain types of genital surgery. Pediatric endocrinologists had realized that some boys with
1768:
Details of techniques for feminizing surgery from the first two decades, including an explanation of how the size of the phallus is the most important aspect of assignment decisions.
1096:
The Academy is deeply concerned about the emotional, cognitive, and body image development of intersexuals, and believes that successful early genital surgery minimizes these issues.
714:
conditions was relatively primitive, based on identifying the type of gonad(s) by palpation or by surgery. Since ability to determine even the type of gonads in infancy was limited,
696:
In 1779, in England, a seven-year-old intersex child, initially assigned female, underwent the first recorded surgery during modern times, resulting in their reassignment as male.
3142:
3413:
931:
medical management. Many felt that a child could not become a happy adult if his penis was too small to insert in a vagina, or if her vagina was too small to receive a penis.
2856:
2081:. All infants with complete undervirilization (i.e., female external genitalia) were raised as girls. Of the 43 with micropenis, 12 were reassigned as female and underwent
1061:
continued on boys with severe hypospadias and the other conditions outlined above, with continued modifications and refinements intended to reduce unsatisfactory outcomes.
1400:
Markantes G, Deligeoroglou E, Armeni A, Vasileiou V, Damoulari C, Mandrapilia A, Kosmopoulou F, Keramisanou V, Georgakopoulou D, Creatsas G, Georgopoulos N (2015-07-10).
278:
2157:
function was better in men than women. Outcomes suggest infant reassignment to female and surgery does not produce an improved adult satisfaction with sexual function.
1151:
is atypical." The term has been controversial and not widely adopted outside clinical settings: the World Health Organization and many medical journals still refer to
1026:
In the 1980s research in both animals and humans began to provide evidence that sex hormones play an important role in early life in promoting or constraining adult
261:
3360:"OII-Europe applauds Malta's Gender Identity, Gender Expression and Sex Characteristics Act. This is a landmark case for intersex rights within European law reform"
3302:
2452:
Meyer-Bahlburg H, Migeon C, Berkovitz G, Gearhart J, Dolezal C, Wisniewski A (2004). "Attitudes of Adult 46,XY Intersex Persons to Clinical Management Policies".
3486:
1675:
A report from Hopkins from the mid-1980s, describing varied approaches for variations of feminizing surgery, including a case of sex reassignment for micropenis.
2898:
1260:
won the first successful case brought against a surgeon for non-consensual surgical intervention. The Regional Court of Cologne, Germany, awarded her €100,000.
3359:
1010:
Throughout the 1980s pediatric surgery textbooks recommended female assignment and feminizing reconstructive surgery for XY infants with a severely inadequate
745:
infants with this variation were surviving and could be operated upon. A conflation was then established between life-saving treatment and cosmetic surgeries.
3431:
2684:
3383:
2251:
2105:) and 64 were raised as boys (some had surgery). They attempted to locate and survey all patients for outcome information. They located 73%, but 12% were
3285:
2122:
Wisniewski AB, Migeon CJ (2000). "Long-term perspectives for 46,XY patients affected by complete androgen insensitivity or congenital micropenis".
1250:
92:
3511:
1045:
continued to be recommended and performed throughout the 1990s on most virilized infant girls with CAH, as well as infants with ambiguity due to
3330:"Making depathologization a matter of law. A comment from GATE on the Maltese Act on Gender Identity, Gender Expression and Sex Characteristics"
3175:
2281:
1441:
Lobe TE, Woodall DL, Richards GE, Cavallo A, Meyer WJ (1987). "The complications of surgery for intersex: changing patterns over two decades".
3387:
1607:
This was the standard work on intersex conditions until the middle of the 20th century, and helped establish the reputation of Johns Hopkins.
765:. Within a decade, most intersex cases could be accurately diagnosed and their future development predicted with some degree of confidence.
2027:"46,XY Intersex individuals: phenotypic and etiologic classification, knowledge of condition, and satisfaction with knowledge in adulthood"
1325:
3586:
3251:
1860:
1649:
Oesterling JE, Gearhart JP, Jeffs RD (1987). "A unified approach to early reconstructive surgery of the child with ambiguous genitalia".
3209:
1402:"Callo: The first known case of ambiguous genitalia to be surgically repaired in the history of Medicine, described by Diodorus Siculus"
3151:
1253:
and Special Rapporteur on Torture have all published reports calling for changes to clinical practice and an end to harmful practices.
915:, recognition of the value of sexuality in people's lives, the separation of sexuality from reproduction by increasing availability of
583:
974:
published his influential text on the development of gender identity, and reported successful reassignment at age 22 months of a boy (
3281:
2085:; 31 were raised as boys and treated with extra testosterone. Causes of partial undervirilization with ambiguity included defects of
2794:
1184:
literature tend to focus on surgical techniques with no reports on patient experiences". A 2014 civil society submission to the
518:
70:
3561:
3236:
2911:
2735:
2694:
2264:
1363:
E Coke, The First Part of the Institutes of the Laws of England, Institutes 8.a. (1st Am. Ed. 1812) (16th European ed. 1812).
1272:
1103:
Management and understanding of intersex conditions has significantly improved, particularly over the last several decades...
443:
346:
637:
is the first to record medical procedures associated with intersex gender affirmation surgery in his account of the life of
2711:
1030:
sexual behavior and even gender identity. Examples of apparent androgen determination of gender identity in XY people with
448:
256:
216:
87:
58:
3439:
476:
3303:"Nuremberg Hermaphrodite Lawsuit: Michaela "Micha" Raab Wins Damages and Compensation for Intersex Genital Mutilations!"
3188:
2057:
Between 1953 and the 1980s (i.e., all patients who were above 21 in 2000) 183 infants and children had been seen in the
1861:"David Reimer and John Money Gender Reassignment Controversy: The John/Joan Case | The Embryo Project Encyclopedia"
1846:
726:. Most of Young's intersex patients were adults willingly seeking his help with physical problems of genital function.
628:
2917:
1083:
1058:
986:
despite being socialized and medicalized as a girl showed gender identity as inherent to a person. The surgeries and
859:
to their preferred genitals were being developed in response to requests for such surgery from transgender patients.
828:
3144:
On the management of differences of sex development. Ethical issues relating to "intersexuality".Opinion No. 20/2012
3333:
1794:
1401:
107:
1042:
3391:
2074:
1839:
Gaetano P (15 November 2011). "David Reimer and John Money Gender Reassignment Controversy: The John/Joan Case".
1046:
762:
418:
285:
268:
3616:
2216:
1300:
1088:
1035:
934:
By 1970, surgeons still considered it easier to "dig a hole" than "build a pole", but had abandoned "barbaric"
730:
642:
576:
428:
413:
221:
191:
153:
125:
97:
19:
2101:, and multiple congenital anomalies. Of the 114 patients with ambiguity, 50 were raised as female (most with
138:
80:
3621:
3461:
2178:
1637:
An example of a now-obsolete recommendation to consider reassigning a boy with severe micropenis as a girl.
1277:
1232:
1031:
358:
353:
333:
316:
251:
133:
1373:
Greenberg J (1999). "Defining Male and Female: Intersexuality and the Collision Between Law and Biology".
2325:"Discordant sexual identity in some genetic males with cloacal exstrophy assigned to female sex at birth"
1137:(1) not having surgery at all might be an option; (2) they might have had lower rates of reoperation for
378:
328:
2025:
Migeon CJ, Wisniewski AB, Brown TR, Rock JA, Meyer-Bahlburg HF, Money J, Berkovitz GD (September 2002).
1034:
in the Dominican Republic had been published, along with reports of masculinized behavior in girls with
3536:
2883:
2813:
2712:""DSD is a Perfectly Fine Term": Reasserting Medical Authority through a Shift in Intersex Terminology"
987:
486:
388:
306:
298:
273:
3270:
Discrimination and violence against individuals based on their sexual orientation and gender identity
3255:
3224:
1246:
1185:
1167:
argue that the term DSD was designed to "reinstitutionalise" medical authority over intersex bodies.
999:
569:
555:
438:
433:
403:
383:
363:
241:
2309:
1716:
994:. Reimer later went public with his story to discourage similar medical practices. He later died by
2110:
Roughly half of the patients had a satisfactory understanding of their condition; half wanted more.
2106:
2026:
1702:
Hester JD (2004). "Intersex(es) and informed consent: How physicians' rhetoric constrains choice".
1320:
927:
423:
408:
398:
393:
373:
368:
65:
2407:
943:
641:. Modern ideas of medicalization of intersex and birth defects can be traced to French anatomist
609:
246:
143:
2197:
3140:
2667:
2058:
1711:
876:
707:
613:
323:
185:
3252:
Eliminating forced, coercive and otherwise involuntary sterilization, An interagency statement
2814:"Childhood surgery for ambiguous genitalia: glimpses of practice changes or more of the same?"
3512:"Denmark and Germany: Authorities failing to protect intersex children from invasive surgery"
2994:"Surgery in disorders of sex development (DSD) with a gender issue: If (why), when, and how?"
2505:"Misrepresentation of Evidence Favoring Early Normalizing Surgery for Atypical Sex Anatomies"
1386:
1284:
658:
112:
75:
54:
1257:
2727:
2612:
2098:
1129:
699:
In the United States genital reconstructive surgery was pioneered between 1930 and 1960 by
686:
508:
471:
226:
3487:"'A baby cannot provide ... consent': Calif. lawmakers denounce infant intersex surgeries"
3094:"The human rights of intersex people: addressing harmful practices and rhetoric of change"
8:
2383:. National Organization of Circumcision Information Resource Centers (NOCIRC). 2007-02-13
2066:
1810:
1725:
1310:
1305:
844:
840:
808:
638:
619:
148:
23:
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of the 1960s. In its application to children with intersex conditions, this thesis that
3298:
3169:
2944:"Global Disorders of Sex Development Update since 2006: Perceptions, Approach and Care"
2877:
2682:
2650:
2589:
2564:
2537:
2504:
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2402:
2349:
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2147:
2090:
2004:
1961:
1737:
1268:
1050:
920:
703:
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1910:
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1996:
1953:
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1423:
1382:
1242:
1238:
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868:
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Demand for surgery increased dramatically with better understanding of the condition
605:
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236:
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2008:
1965:
1741:
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1988:
1945:
1906:
1806:
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1583:
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Institutions like the Swiss National Advisory Commission on Biomedical Ethics, the
991:
947:
670:
634:
1574:
Warren C (2014). "Gender reassignment surgery in the 18th century: A case study".
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Swiss National Advisory Commission on Biomedical Ethics NEK-CNE (November 2012).
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3010:
2993:
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Holmes M (2011). "The Intersex Enchiridion: Naming and Knowledge in the Clinic".
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983:
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The 1970s and 1980s were perhaps the decades when surgery and surgery-supported
3562:"Children's Hospital Becomes First in U.S. to Apologize For Intersex Surgeries"
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Resolution 1952/2013, Provision version, Children's right to physical integrity
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1484:"Operations on Hermaphrodites and Castration in Byzantine Times (324–1453 AD)"
907:
In North American and European societies, the 1960s saw the beginning of the "
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3019:
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2842:
2745:
2528:
2473:
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Thomas DF (2004). "Gender assignment: background and current controversies".
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3414:"Malta passes law outlawing forced surgical intervention on intersex minors"
1840:
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2858:
Intersex Issues in the International Classification of Diseases: a revision
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2013:
Historical review of evolution of techniques for feminizing reconstruction.
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1110:
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165:
2683:
Australian Senate, Community Affairs References Committee (October 2013).
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1992:
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1509:
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2403:"Managing intersex: most vaginal surgery in childhood should be deferred"
2340:
2135:
2094:
893:
790:
533:
513:
1558:
2070:
1979:
Rink RC, Adams MC (1998). "Feminizing genitoplasty: state of the art".
1795:"Sex reassignment at birth. Long-term review and clinical implications"
1540:
Adams F, ed. (1844). "On Extirpation of the Nympha and Cauda Pudendi".
1015:
971:
964:
804:
678:
646:
623:
481:
2960:
2943:
2638:
1500:
1483:
42:
2451:
2061:
pediatric endocrine clinic who had an XY karyotype and complete under
1399:
889:
885:
750:
723:
503:
2686:
Involuntary or coerced sterilisation of intersex people in Australia
2376:
1880:"The Tragic Story Of David Reimer, The Boy Forced To Live As A Girl"
1603:
Genital Abnormalities, Hermaphroditism, and Related Adrenal Diseases
1091:
in October 1996, the academy issued a press statement stating that:
3432:"Surgery and Sterilization Scrapped in Malta's Benchmark LGBTI Law"
3046:
2897:
Jones T, Hart B, Carpenter M, Ansara G, Leonard W, Lucke J (2016).
2169:
1152:
1138:
1117:
911:", characterized by increased public interest and discussion about
832:
798:
711:
674:
33:
3587:"Intersex Care at Lurie Children's and Our Sex Development Clinic"
2990:
1440:
1116:
Similar controversy occurred in Europe and Latin America. In 1999
815:. In most of these patients, gender identity seemed to follow the
710:
in Baltimore and other major university centers. Understanding of
3268:
United Nations High Commissioner for Human Rights (May 4, 2015),
1897:
Passerini-Glazel G (1999). "Editorial: feminizing genitoplasty".
1011:
995:
831:
over biology became part of the intellectual underpinning of the
786:
782:
746:
700:
653:
210:
1053:, and some XY infants with severe genital birth defects such as
2812:
Creighton SM, Michala L, Mushtaq I, Yaron M (January 2, 2014).
939:
794:
778:
677:
people were performed at least from the seventh century on, in
545:
493:
2215:
1172:
Consensus Statement on Intersex Disorders and their Management
2282:"Pediatric management of ambiguous and traumatized genitalia"
955:
664:
2811:
938:
in favor of "nerve sparing" clitoral recession and promised
2221:"American Academy of Pediatrics Position on Intersexuality"
1205:
A 2016 follow-up to the 2006 Consensus Statement, termed a
824:
600:
is intertwined with the development of the specialities of
498:
2992:
J, Sibai H, Wisniewski A, Wolffenbuttel KP, Lee P (2016).
2073:. The 26 with complete undervirilization included 20 with
3223:
2625:
2565:"Consensus statement on management of intersex disorders"
2563:
Lee P. A., Houk C. P., Ahmed S. F., Hughes I. A. (2006).
2400:
2024:
836:
733:(CAH) and availability of a new treatment (cortisone) by
722:
were determined mainly by the appearance of the external
550:
2896:
2678:
2676:
954:
textbooks recommended sex reassignment for a male whose
2940:
1766:(3 ed.). . Chicago: Year Book Medical Publishers.
1648:
1481:
1023:
for isolated micropenis were carried out by the 1990s.
896:
malformation, or could save the life of an infant with
3384:"We celebrate Maltese protections for intersex people"
2710:
Davis G (3 August 2011). McGann PJ, Hutson DJ (eds.).
2259:'s failed sex reassignment). New York: HarperCollins.
2673:
1467:
Improved techniques will lower the complication rate.
1280:
passed a resolution condemning the practice in 2018.
2689:. Canberra: Community Affairs References Committee.
2252:
As Nature Made Him: The Boy Who Was Raised as a Girl
1845:. Arizona State University School of Life Sciences.
3286:
Office of the UN High Commissioner for Human Rights
1560:
The case of a boy, who had been mistaken for a girl
1344:
1064:
3297:
2174:"Hermaphrodites with Attitude Take to the Streets"
1896:
1783:. Baltimore: Johns Hopkins University Press, 1972.
1002:, financial instability, and a troubled marriage.
1792:
612:, with our increasingly refined understanding of
3608:
2198:"When Max Beck and Morgan Holmes went to Boston"
2121:
1632:Clinical Pediatric and Adolescent Endocrinology.
1251:Office of the High Commissioner for Human Rights
863:Rise of infant surgery and "nurture over nature"
2900:Intersex: Stories and Statistics from Australia
3282:Report of the UN Special Rapporteur on Torture
3208:, Commissioner for Human Rights (April 2015),
3047:"Still ignoring human rights in intersex care"
2322:
761:for treatment led to partial understanding of
3411:
3388:Organisation Intersex International Australia
3211:Human rights and intersex people, Issue Paper
2668:An Interview with Dr. Tiger Howard Devore PhD
1687:Hendrick M (1993). "Is it a Boy or a Girl?".
1630:"Disorders of the testes". In: Kaplan S, ed.
879:were universally admired for bringing infant
577:
2670:, We Who Feel Differently, February 7, 2011.
2401:Creighton S, Minto, Catherine (2001-12-01).
1326:(DoDI) 6130.03, 2018, section 5, 13f and 14m
853:determination of what sex should be assigned
789:or to change the position of the urethra in
741:and others around 1950. For the first time,
3372:
3351:
3040:
2759:
2502:
3462:"US: Harmful Surgery on Intersex Children"
3357:
3318:
3174:: CS1 maint: location missing publisher (
2186:
1754:
1523:Adams F, ed. (1844). "On Hermaphrodites".
1207:Global Disorders of Sex Development Update
990:on David Remier caused the development of
665:Surgical pioneering and constructed gender
584:
570:
3378:
3275:
3261:
3109:
3091:
3009:
2959:
2832:
2795:"Malta Bans Surgery on Intersex Children"
2703:
2588:
2536:
2428:
2348:
2245:
2042:
1978:
1715:
1499:
1477:
1475:
1417:
1372:
1170:On surgical rationales and outcomes, the
693:and how to remove the enlarged clitoris.
3424:
1686:
1627:
1123:
645:(1805–1861), who pioneered the field of
3245:
3229:Sexual health, human rights and the law
3217:
3182:
2934:
2906:. Cambridge, UK: Open Book Publishers.
2279:
2209:
1838:
1793:Diamond M, Sigmundson HK (March 1997).
867:By the 1960s, the young specialties of
851:(by checking gonads or chromosomes) to
661:implications of medical interventions.
620:Prior to the medicalization of intersex
3609:
3537:"The rights of children born intersex"
3324:
2792:
2765:
2558:
2556:
2192:
1935:
1701:
1573:
1556:
1482:Lascaratos J, Kostakopoulos A (1997).
1472:
1345:Raming I, Macy G, Bernard J C (2004).
1226:
1005:
827:or hormones. This apparent primacy of
681:possibly as early as the 2nd century.
3231:. Geneva: World Health Organization.
2709:
2661:
1877:
1600:
1539:
1522:
1338:
1273:Interact Advocates for Intersex Youth
1155:traits or conditions. Academics like
3291:
2162:
1811:10.1001/archpedi.1997.02170400084015
1786:
1059:Masculinizing reconstructive surgery
849:determination of the baby's real sex
3198:
2553:
1849:from the original on 11 March 2023.
1605:. Baltimore: Williams and Wilkins.
967:(typically less than 1.5 cm).
477:Genital modification and mutilation
13:
2728:10.1108/S1057-6290(2011)0000012012
2377:"The Rights of the Intersex Child"
2093:, partial androgen insensitivity,
1726:10.1023/b:meta.0000025069.46031.0e
1704:Theoretical Medicine and Bioethics
1543:The Seven Books of Paulus Aegineta
1526:The Seven Books of Paulus Aegineta
1163:, and clinical psychologists like
629:Institutes of the Lawes of England
41:
14:
3633:
2466:10.1097/01.ju.0000117761.94734.b7
1393:
1347:A History of Women and Ordination
1084:Intersex Society of North America
1043:feminizing reconstructive surgery
3334:Global Action for Trans Equality
2168:
2037:(3): electronic pages, pp. e32.
1950:10.1111/j.1464-410x.2004.04709.x
1065:Patient advocacy groups speak up
108:Sex characteristics (legal term)
3579:
3554:
3529:
3504:
3479:
3454:
3405:
3134:
3085:
3034:
2984:
2948:Hormone Research in Paediatrics
2890:
2849:
2805:
2786:
2605:
2496:
2445:
2394:
2369:
2323:Reiner WG, Gearhart JP (2004).
2316:
2273:
2239:
2115:
2075:complete androgen insensitivity
2018:
1972:
1929:
1890:
1871:
1853:
1832:
1781:Man & Woman, Boy & Girl
1773:
1748:
1695:
1680:
1642:
1621:
1612:
1594:
1567:
1188:cited data from a large German
1047:androgen insensitivity syndrome
963:-type malformations or extreme
763:androgen insensitivity syndrome
3438:. 1 April 2015. Archived from
3412:Star Observer (2 April 2015).
2217:American Academy of Pediatrics
1550:
1533:
1516:
1434:
1366:
1357:
1301:Intersex medical interventions
1089:American Academy of Pediatrics
1036:congenital adrenal hyperplasia
998:, owing to suffering years of
731:congenital adrenal hyperplasia
673:"reconstructive" surgeries on
643:Isidore Geoffroy Saint-Hilaire
20:Intersex medical interventions
1:
2716:Advances in Medical Sociology
2298:10.1016/S0022-5347(01)68054-6
2065:, partial undervirilization (
1911:10.1016/s0022-5347(05)68987-2
1663:10.1016/S0022-5347(17)43508-7
1455:10.1016/S0022-3468(87)80119-7
3358:OII Europe (April 1, 2015).
3063:10.1016/j.jpurol.2016.05.017
3051:Journal of Pediatric Urology
3011:10.1016/j.jpurol.2016.04.001
2998:Journal of Pediatric Urology
2834:10.1080/19419899.2013.831214
2503:Baratz AB, Feder EK (2015).
2280:Diamond M (September 1999).
2179:Hermaphrodites with Attitude
2097:hypoplasia, timing defects,
1878:Ishak N (January 12, 2021).
1757:"Intersex". In: Ravitch MM,
1443:Journal of Pediatric Surgery
1278:California State Legislature
1233:Timeline of intersex history
1190:Netzwerk DSD/Intersexualität
1133:to inform respondents that:
1032:5-alpha-reductase deficiency
334:International Intersex Forum
134:Disorders of sex development
7:
3098:Reproductive Health Matters
2621:"Sex, health, and athletes"
2509:Archives of Sexual Behavior
1842:Embryo Project Encyclopedia
1755:Walsh PC, Scott WW (1979).
1546:. Vol. 2. p. 381.
1529:. Vol. 2. p. 381.
1294:
685:(c. 625 – c. 690), quoting
598:history of intersex surgery
329:Intersex Day of Remembrance
217:Civil society organizations
10:
3638:
2793:Dreger A (April 3, 2015).
1635:. Philadelphia: Saunders.
1230:
843:changed the management of
757:, and the availability of
274:Sex verification in sports
17:
3256:World Health Organization
3225:World Health Organization
3111:10.1016/j.rhm.2016.06.003
2521:10.1007/s10508-015-0529-x
2421:10.1136/bmj.323.7324.1264
1247:World Health Organization
1186:World Health Organization
823:more closely than it did
797:opening, and to remove a
3092:Carpenter M (May 2016).
2821:Psychology and Sexuality
2255:(the popular account of
1799:Arch Pediatr Adolesc Med
1588:10.1177/1363460714531270
1488:Urologia Internationalis
1331:
1321:Sex reassignment surgery
942:when the girls grew up.
66:Compulsory sterilization
3150:. Berne. Archived from
2408:British Medical Journal
2107:developmentally delayed
1944:(Supplement 3): 47–50.
1419:10.14310/horm.2002.1608
944:Pediatric endocrinology
610:pediatric endocrinology
3591:www.luriechildrens.org
2882:: CS1 maint: others (
2780:10.3366/soma.2011.0026
2581:10.1542/peds.2006-0738
2454:The Journal of Urology
2044:10.1542/peds.110.3.e32
1884:All That's Interesting
1779:Money J, Ehrhardt AA.
1689:Johns Hopkins Magazine
1216:
1199:
1181:
1144:
1106:
708:Johns Hopkins Hospital
706:and other surgeons at
614:sexual differentiation
519:Non-binary recognition
324:Intersex Awareness Day
186:Sexual differentiation
46:
3617:Intersex and medicine
3301:(December 17, 2015).
1993:10.1007/s003450050055
1285:Amnesty International
1231:Further information:
1211:
1194:
1176:
1135:
1124:Outcomes and evidence
1093:
809:clinical psychologist
785:, to repair a milder
222:Fictional characters
154:Medical interventions
113:Yogyakarta Principles
98:Medical interventions
45:
18:Further information:
2613:Rebecca Jordan-Young
2341:10.1056/nejmoa022236
2136:10.1055/s-2002-35376
2099:true hermaphroditism
1130:Heino Meyer-Bahlburg
877:children's hospitals
509:Anti-gender movement
279:at the Olympic Games
3622:Intersex in history
2089:synthesis, partial
2067:ambiguous genitalia
1657:(4 Pt 2): 1079–82.
1311:Intersex in history
1306:Intersex healthcare
1227:Recent developments
1006:Complications arise
988:hormone replacement
845:ambiguous genitalia
841:social construction
839:was a many-faceted
639:Callon of Epidaurus
205:Society and culture
24:Intersex in history
3466:Human Rights Watch
3436:The New York Times
3299:Zwischengeschlecht
2292:(3 Pt 2): 1021–8.
2286:Journal of Urology
2103:feminizing surgery
2091:gonadal dysgenesis
2083:feminizing surgery
1375:Arizona Law Review
1269:Human Rights Watch
1258:Christiane Völling
1051:gonadal dysgenesis
1018:had deficiency of
921:sexual orientation
704:Hugh Hampton Young
47:
3382:(April 2, 2015).
3328:(April 8, 2015).
3238:978-92-4-156498-4
3206:Council of Europe
3193:Council of Europe
2961:10.1159/000442975
2913:978-1-78374-208-0
2799:The Stranger SLOG
2737:978-0-85724-575-5
2696:978-1-74229-917-4
2639:10.1136/bmj.g2926
2615:, Peter Sonksen,
2266:978-0-06-019211-2
1938:BJU International
1763:Pediatric surgery
1628:Penny R. (1982).
1601:Young HH (1937).
1557:Thomas B (1787).
1501:10.1159/000282990
1243:Council of Europe
1239:Australian Senate
1055:cloacal exstrophy
1000:severe depression
961:cloacal exstrophy
909:sexual revolution
873:pediatric urology
869:pediatric surgery
833:feminist movement
817:sex of assignment
739:Frederick Bartter
716:sex of assignment
652:Since the 1920s,
606:pediatric urology
602:pediatric surgery
594:
593:
472:Children's rights
347:Rights by country
237:Intersex and LGBT
139:Genetic diagnosis
93:Malta declaration
88:Legal recognition
3629:
3601:
3600:
3598:
3597:
3583:
3577:
3576:
3574:
3573:
3558:
3552:
3551:
3549:
3548:
3533:
3527:
3526:
3524:
3523:
3508:
3502:
3501:
3499:
3498:
3493:. 28 August 2018
3483:
3477:
3476:
3474:
3473:
3458:
3452:
3451:
3449:
3447:
3428:
3422:
3421:
3409:
3403:
3402:
3400:
3399:
3390:. Archived from
3376:
3370:
3369:
3367:
3366:
3355:
3349:
3348:
3346:
3345:
3336:. Archived from
3322:
3316:
3315:
3313:
3312:
3307:
3295:
3289:
3288:, February 2013.
3279:
3273:
3272:
3265:
3259:
3249:
3243:
3242:
3221:
3215:
3214:
3202:
3196:
3195:, 1 October 2013
3186:
3180:
3179:
3173:
3165:
3163:
3162:
3156:
3149:
3138:
3132:
3131:
3113:
3089:
3083:
3082:
3038:
3032:
3031:
3013:
2988:
2982:
2981:
2963:
2938:
2932:
2931:
2929:
2928:
2922:
2916:. Archived from
2905:
2894:
2888:
2887:
2881:
2873:
2870:Morgan Carpenter
2863:
2853:
2847:
2846:
2836:
2818:
2809:
2803:
2802:
2790:
2784:
2783:
2763:
2757:
2756:
2754:
2752:
2707:
2701:
2700:
2680:
2671:
2665:
2659:
2658:
2617:Katrina Karkazis
2609:
2603:
2602:
2592:
2560:
2551:
2550:
2540:
2515:(7): 1761–1763.
2500:
2494:
2493:
2460:(4): 1615–1619.
2449:
2443:
2442:
2432:
2415:(7324): 1264–5.
2398:
2392:
2391:
2389:
2388:
2373:
2367:
2366:
2352:
2320:
2314:
2313:
2308:. Archived from
2277:
2271:
2270:
2243:
2237:
2236:
2234:
2233:
2219:(October 1996).
2213:
2207:
2206:
2196:(October 2015),
2190:
2184:
2183:
2166:
2160:
2159:
2124:Semin Reprod Med
2119:
2113:
2112:
2046:
2022:
2016:
2015:
1976:
1970:
1969:
1933:
1927:
1926:
1894:
1888:
1887:
1875:
1869:
1868:
1857:
1851:
1850:
1836:
1830:
1829:
1827:
1825:
1790:
1784:
1777:
1771:
1770:
1752:
1746:
1745:
1719:
1699:
1693:
1692:
1684:
1678:
1677:
1646:
1640:
1639:
1625:
1619:
1616:
1610:
1609:
1598:
1592:
1591:
1571:
1565:
1564:
1554:
1548:
1547:
1537:
1531:
1530:
1520:
1514:
1513:
1503:
1479:
1470:
1469:
1438:
1432:
1431:
1421:
1397:
1391:
1390:
1370:
1364:
1361:
1355:
1354:
1342:
1128:A 2004 paper by
992:gender dysphoria
948:child psychology
928:sex reassignment
671:Byzantine Empire
635:Diodorus Siculus
586:
579:
572:
30:
29:
3637:
3636:
3632:
3631:
3630:
3628:
3627:
3626:
3607:
3606:
3605:
3604:
3595:
3593:
3585:
3584:
3580:
3571:
3569:
3560:
3559:
3555:
3546:
3544:
3541:www.amnesty.org
3535:
3534:
3530:
3521:
3519:
3516:www.amnesty.org
3510:
3509:
3505:
3496:
3494:
3485:
3484:
3480:
3471:
3469:
3460:
3459:
3455:
3445:
3443:
3442:on 4 April 2015
3430:
3429:
3425:
3410:
3406:
3397:
3395:
3377:
3373:
3364:
3362:
3356:
3352:
3343:
3341:
3340:on July 4, 2015
3323:
3319:
3310:
3308:
3305:
3296:
3292:
3280:
3276:
3266:
3262:
3250:
3246:
3239:
3222:
3218:
3203:
3199:
3187:
3183:
3167:
3166:
3160:
3158:
3154:
3147:
3139:
3135:
3090:
3086:
3039:
3035:
2989:
2985:
2939:
2935:
2926:
2924:
2920:
2914:
2903:
2895:
2891:
2875:
2874:
2861:
2855:
2854:
2850:
2816:
2810:
2806:
2791:
2787:
2764:
2760:
2750:
2748:
2738:
2708:
2704:
2697:
2681:
2674:
2666:
2662:
2610:
2606:
2575:(2): e488–500.
2561:
2554:
2501:
2497:
2450:
2446:
2399:
2395:
2386:
2384:
2375:
2374:
2370:
2321:
2317:
2278:
2274:
2267:
2244:
2240:
2231:
2229:
2214:
2210:
2191:
2187:
2167:
2163:
2120:
2116:
2023:
2019:
1977:
1973:
1934:
1930:
1895:
1891:
1876:
1872:
1859:
1858:
1854:
1837:
1833:
1823:
1821:
1791:
1787:
1778:
1774:
1753:
1749:
1717:10.1.1.693.6468
1700:
1696:
1685:
1681:
1647:
1643:
1626:
1622:
1617:
1613:
1599:
1595:
1572:
1568:
1555:
1551:
1538:
1534:
1521:
1517:
1480:
1473:
1439:
1435:
1398:
1394:
1371:
1367:
1362:
1358:
1351:Scarecrow Press
1343:
1339:
1334:
1297:
1283:The same year,
1235:
1229:
1157:Georgiann Davis
1126:
1067:
1008:
984:gender identity
865:
829:social learning
813:gender identity
771:sex assignments
755:sex chromosomes
667:
590:
561:
560:
556:Sex differences
462:
454:
453:
349:
339:
338:
302:
291:
290:
206:
198:
197:
129:
118:
117:
61:
26:
12:
11:
5:
3635:
3625:
3624:
3619:
3603:
3602:
3578:
3553:
3528:
3503:
3478:
3453:
3423:
3404:
3371:
3350:
3317:
3290:
3274:
3260:
3244:
3237:
3216:
3197:
3181:
3133:
3084:
3057:(6): 436–437.
3033:
3004:(3): 139–149.
2983:
2954:(3): 158–180.
2933:
2912:
2889:
2848:
2804:
2785:
2758:
2736:
2702:
2695:
2672:
2660:
2604:
2552:
2495:
2444:
2393:
2368:
2315:
2312:on 2007-06-22.
2272:
2265:
2238:
2208:
2185:
2161:
2130:(3): 297–304.
2114:
2079:Swyer syndrome
2017:
1987:(3): 212–218.
1971:
1928:
1889:
1870:
1865:embryo.asu.edu
1852:
1831:
1805:(3): 298–304.
1785:
1772:
1747:
1694:
1679:
1641:
1620:
1611:
1593:
1582:(7): 872–884.
1566:
1549:
1532:
1515:
1494:(4): 232–235.
1471:
1433:
1412:(3): 459–461.
1392:
1365:
1356:
1353:. p. 113.
1336:
1335:
1333:
1330:
1329:
1328:
1323:
1318:
1316:Sex assignment
1313:
1308:
1303:
1296:
1293:
1228:
1225:
1149:anatomical sex
1125:
1122:
1105:
1104:
1101:
1097:
1066:
1063:
1020:growth hormone
1007:
1004:
980:Milton Diamond
936:clitorectomies
864:
861:
821:sex of rearing
807:, a pediatric
735:Lawson Wilkins
683:Paul of Aegina
666:
663:
592:
591:
589:
588:
581:
574:
566:
563:
562:
559:
558:
553:
548:
543:
541:Medical ethics
538:
537:
536:
531:
526:
521:
516:
511:
506:
496:
491:
490:
489:
479:
474:
469:
463:
460:
459:
456:
455:
452:
451:
446:
444:United Kingdom
441:
436:
431:
426:
421:
416:
411:
406:
401:
396:
391:
386:
381:
376:
371:
366:
361:
356:
350:
345:
344:
341:
340:
337:
336:
331:
326:
321:
320:
319:
314:
303:
297:
296:
293:
292:
289:
288:
283:
282:
281:
271:
266:
265:
264:
254:
249:
244:
239:
234:
229:
224:
219:
214:
207:
204:
203:
200:
199:
196:
195:
188:
183:
178:
173:
168:
163:
162:
161:
151:
146:
141:
136:
130:
124:
123:
120:
119:
116:
115:
110:
105:
103:Sex assignment
100:
95:
90:
85:
84:
83:
73:
71:Discrimination
68:
62:
53:
52:
49:
48:
38:
37:
9:
6:
4:
3:
2:
3634:
3623:
3620:
3618:
3615:
3614:
3612:
3592:
3588:
3582:
3567:
3563:
3557:
3542:
3538:
3532:
3517:
3513:
3507:
3492:
3488:
3482:
3467:
3463:
3457:
3441:
3437:
3433:
3427:
3419:
3418:Star Observer
3415:
3408:
3394:on 2015-07-04
3393:
3389:
3385:
3381:
3375:
3361:
3354:
3339:
3335:
3331:
3327:
3321:
3304:
3300:
3294:
3287:
3283:
3278:
3271:
3264:
3257:
3253:
3248:
3240:
3234:
3230:
3226:
3220:
3213:
3212:
3207:
3201:
3194:
3190:
3185:
3177:
3171:
3157:on 2015-04-23
3153:
3146:
3145:
3137:
3129:
3125:
3121:
3117:
3112:
3107:
3104:(47): 74–84.
3103:
3099:
3095:
3088:
3080:
3076:
3072:
3068:
3064:
3060:
3056:
3052:
3048:
3044:
3037:
3029:
3025:
3021:
3017:
3012:
3007:
3003:
2999:
2995:
2987:
2979:
2975:
2971:
2967:
2962:
2957:
2953:
2949:
2945:
2937:
2923:on 2016-09-14
2919:
2915:
2909:
2902:
2901:
2893:
2885:
2879:
2872:(eds.). 2014.
2871:
2867:
2860:
2859:
2852:
2844:
2840:
2835:
2830:
2826:
2822:
2815:
2808:
2800:
2796:
2789:
2781:
2777:
2774:(2): 87–114.
2773:
2769:
2762:
2747:
2743:
2739:
2733:
2729:
2725:
2721:
2717:
2713:
2706:
2698:
2692:
2688:
2687:
2679:
2677:
2669:
2664:
2656:
2652:
2648:
2644:
2640:
2636:
2632:
2628:
2627:
2622:
2618:
2614:
2608:
2600:
2596:
2591:
2586:
2582:
2578:
2574:
2570:
2566:
2559:
2557:
2548:
2544:
2539:
2534:
2530:
2526:
2522:
2518:
2514:
2510:
2506:
2499:
2491:
2487:
2483:
2479:
2475:
2471:
2467:
2463:
2459:
2455:
2448:
2440:
2436:
2431:
2426:
2422:
2418:
2414:
2410:
2409:
2404:
2397:
2382:
2378:
2372:
2365:
2360:
2356:
2351:
2346:
2342:
2338:
2335:(4): 333–41.
2334:
2330:
2326:
2319:
2311:
2307:
2303:
2299:
2295:
2291:
2287:
2283:
2276:
2268:
2262:
2258:
2254:
2253:
2248:
2242:
2228:
2227:
2222:
2218:
2212:
2205:
2204:
2199:
2195:
2189:
2181:
2180:
2175:
2171:
2165:
2158:
2153:
2149:
2145:
2141:
2137:
2133:
2129:
2125:
2118:
2111:
2108:
2104:
2100:
2096:
2092:
2088:
2084:
2080:
2076:
2072:
2068:
2064:
2060:
2054:
2050:
2045:
2040:
2036:
2032:
2028:
2021:
2014:
2010:
2006:
2002:
1998:
1994:
1990:
1986:
1982:
1975:
1967:
1963:
1959:
1955:
1951:
1947:
1943:
1939:
1932:
1925:
1920:
1916:
1912:
1908:
1905:(5): 1592–3.
1904:
1900:
1893:
1885:
1881:
1874:
1866:
1862:
1856:
1848:
1844:
1843:
1835:
1820:
1816:
1812:
1808:
1804:
1800:
1796:
1789:
1782:
1776:
1769:
1765:
1762:
1758:
1751:
1743:
1739:
1735:
1731:
1727:
1723:
1718:
1713:
1709:
1705:
1698:
1690:
1683:
1676:
1672:
1668:
1664:
1660:
1656:
1652:
1645:
1638:
1634:
1631:
1624:
1615:
1608:
1604:
1597:
1589:
1585:
1581:
1577:
1570:
1562:
1561:
1553:
1545:
1544:
1536:
1528:
1527:
1519:
1511:
1507:
1502:
1497:
1493:
1489:
1485:
1478:
1476:
1468:
1464:
1460:
1456:
1452:
1448:
1444:
1437:
1429:
1425:
1420:
1415:
1411:
1407:
1403:
1396:
1388:
1384:
1380:
1376:
1369:
1360:
1352:
1348:
1341:
1337:
1327:
1324:
1322:
1319:
1317:
1314:
1312:
1309:
1307:
1304:
1302:
1299:
1298:
1292:
1288:
1286:
1281:
1279:
1274:
1270:
1265:
1261:
1259:
1254:
1252:
1248:
1244:
1240:
1234:
1224:
1221:
1215:
1210:
1208:
1203:
1198:
1193:
1191:
1187:
1180:
1175:
1174:stated that:
1173:
1168:
1166:
1162:
1161:Morgan Holmes
1158:
1154:
1150:
1143:
1140:
1134:
1131:
1121:
1119:
1114:
1112:
1102:
1098:
1095:
1094:
1092:
1090:
1085:
1079:
1077:
1076:homosexuality
1073:
1072:psychotherapy
1062:
1060:
1056:
1052:
1048:
1044:
1039:
1037:
1033:
1029:
1028:sex-dimorphic
1024:
1021:
1017:
1013:
1003:
1001:
997:
993:
989:
985:
981:
977:
973:
968:
966:
962:
957:
953:
949:
945:
941:
937:
932:
929:
924:
922:
918:
917:contraception
914:
910:
905:
901:
899:
895:
891:
887:
882:
878:
874:
870:
860:
856:
854:
850:
846:
842:
838:
834:
830:
826:
822:
818:
814:
810:
806:
802:
800:
796:
793:, to widen a
792:
788:
784:
780:
774:
772:
766:
764:
760:
756:
753:to ascertain
752:
748:
744:
740:
736:
732:
727:
725:
721:
717:
713:
709:
705:
702:
697:
694:
692:
691:clitoromegaly
688:
684:
680:
676:
672:
662:
660:
655:
650:
648:
644:
640:
636:
631:
630:
625:
621:
617:
615:
611:
607:
603:
599:
587:
582:
580:
575:
573:
568:
567:
565:
564:
557:
554:
552:
549:
547:
544:
542:
539:
535:
532:
530:
527:
525:
522:
520:
517:
515:
512:
510:
507:
505:
502:
501:
500:
497:
495:
492:
488:
485:
484:
483:
480:
478:
475:
473:
470:
468:
467:Hermaphrodite
465:
464:
458:
457:
450:
449:United States
447:
445:
442:
440:
437:
435:
432:
430:
427:
425:
422:
420:
417:
415:
412:
410:
407:
405:
402:
400:
397:
395:
392:
390:
387:
385:
382:
380:
377:
375:
372:
370:
367:
365:
362:
360:
357:
355:
352:
351:
348:
343:
342:
335:
332:
330:
327:
325:
322:
318:
315:
313:
310:
309:
308:
305:
304:
300:
295:
294:
287:
284:
280:
277:
276:
275:
272:
270:
267:
263:
260:
259:
258:
255:
253:
250:
248:
245:
243:
240:
238:
235:
233:
230:
228:
225:
223:
220:
218:
215:
212:
209:
208:
202:
201:
194:
193:
189:
187:
184:
182:
181:Quigley scale
179:
177:
174:
172:
171:Phall-O-Meter
169:
167:
164:
160:
157:
156:
155:
152:
150:
147:
145:
142:
140:
137:
135:
132:
131:
127:
122:
121:
114:
111:
109:
106:
104:
101:
99:
96:
94:
91:
89:
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74:
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51:
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40:
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35:
32:
31:
28:
25:
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3594:. Retrieved
3590:
3581:
3570:. Retrieved
3568:. 2020-07-30
3565:
3556:
3545:. Retrieved
3543:. 9 May 2017
3540:
3531:
3520:. Retrieved
3518:. 9 May 2017
3515:
3506:
3495:. Retrieved
3490:
3481:
3470:. Retrieved
3468:. 2017-07-25
3465:
3456:
3444:. Retrieved
3440:the original
3435:
3426:
3417:
3407:
3396:. Retrieved
3392:the original
3374:
3363:. Retrieved
3353:
3342:. Retrieved
3338:the original
3320:
3309:. Retrieved
3293:
3277:
3269:
3263:
3247:
3228:
3219:
3210:
3200:
3184:
3159:. Retrieved
3152:the original
3143:
3136:
3101:
3097:
3087:
3054:
3050:
3045:(May 2016).
3036:
3001:
2997:
2986:
2951:
2947:
2936:
2925:. Retrieved
2918:the original
2899:
2892:
2866:Mauro Cabral
2857:
2851:
2827:(1): 34–43.
2824:
2820:
2807:
2798:
2788:
2771:
2768:Somatechnics
2767:
2761:
2749:. Retrieved
2719:
2715:
2705:
2685:
2663:
2630:
2624:
2607:
2572:
2568:
2512:
2508:
2498:
2457:
2453:
2447:
2412:
2406:
2396:
2385:. Retrieved
2380:
2371:
2362:
2332:
2329:N Engl J Med
2328:
2318:
2310:the original
2289:
2285:
2275:
2257:David Reimer
2250:
2241:
2230:. Retrieved
2226:Intersex Day
2224:
2211:
2203:Intersex Day
2201:
2188:
2177:
2164:
2155:
2127:
2123:
2117:
2087:testosterone
2063:virilization
2056:
2034:
2030:
2020:
2012:
1984:
1981:World J Urol
1980:
1974:
1941:
1937:
1931:
1922:
1902:
1898:
1892:
1883:
1873:
1864:
1855:
1841:
1834:
1822:. Retrieved
1802:
1798:
1788:
1780:
1775:
1767:
1764:
1760:
1756:
1750:
1710:(1): 21–49.
1707:
1703:
1697:
1688:
1682:
1674:
1654:
1650:
1644:
1636:
1633:
1629:
1623:
1614:
1606:
1602:
1596:
1579:
1575:
1569:
1559:
1552:
1542:
1535:
1525:
1518:
1491:
1487:
1466:
1449:(7): 651–2.
1446:
1442:
1436:
1409:
1405:
1395:
1378:
1374:
1368:
1359:
1346:
1340:
1289:
1282:
1266:
1262:
1255:
1236:
1220:Alice Dreger
1217:
1212:
1206:
1204:
1200:
1195:
1189:
1182:
1177:
1171:
1169:
1165:Tiger Devore
1147:gonadal, or
1145:
1136:
1127:
1115:
1111:David Reimer
1107:
1080:
1068:
1040:
1025:
1009:
976:David Reimer
969:
933:
925:
906:
902:
898:spina bifida
881:birth defect
866:
857:
852:
848:
803:
775:
767:
759:testosterone
728:
698:
695:
668:
659:human rights
651:
627:
618:
597:
595:
529:Third gender
524:Queer theory
419:South Africa
311:
190:
176:Prader scale
166:Orchidometer
158:
76:Human rights
59:legal issues
55:Human rights
27:
15:
3380:Carpenter M
3258:, May 2014.
2722:: 155–182.
2247:Colapinto J
2095:Leydig cell
2077:and 6 with
1576:Sexualities
1381:: 277–278.
946:, surgery,
791:hypospadias
751:karyotyping
749:assays and
534:Transgender
429:Switzerland
414:New Zealand
269:Researchers
144:Definitions
128:and biology
3611:Categories
3596:2021-09-13
3572:2021-09-13
3547:2019-08-23
3522:2019-08-23
3497:2019-03-01
3472:2019-03-01
3398:2015-07-03
3365:2015-07-03
3344:2015-07-03
3311:2015-12-21
3161:2015-07-19
3041:Feder EK,
2927:2016-08-29
2569:Pediatrics
2387:2007-09-14
2381:nocirc.org
2232:2017-07-03
2071:micropenis
2031:Pediatrics
1016:micropenis
972:John Money
965:micropenis
805:John Money
679:Alexandria
647:teratology
624:common law
514:Non-binary
482:Disability
312:of surgery
301:and events
286:Television
242:Literature
149:Healthcare
3170:cite book
3120:0968-8080
3071:1477-5131
3020:1477-5131
2970:1663-2818
2878:cite book
2843:1941-9899
2746:1057-6290
2633:: g2926.
2529:0004-0002
2474:0022-5347
1712:CiteSeerX
1267:In 2017,
1256:In 2011,
1249:, and UN
1209:stated,
1041:However,
952:sexuality
913:sexuality
890:club foot
886:cleft lip
743:virilized
724:genitalia
701:urologist
504:Androgyny
359:Australia
354:Argentina
213:(antonym)
3491:NBC News
3326:Cabral M
3227:(2015).
3128:27578341
3079:27349148
3043:Dreger A
3028:27132944
2978:26820577
2751:27 April
2647:24776640
2619:(2014).
2599:16882788
2547:25808721
2490:25087899
2482:15017234
2439:11731376
2364:females.
2359:14736925
2306:10458424
2249:(2000).
2194:Holmes M
2152:24189578
2144:12428209
2053:12205282
2009:38395121
1966:10666170
1958:15086442
1924:infancy.
1919:10210422
1847:Archived
1761:., eds.
1742:42681926
1734:15180094
1691:: 10–16.
1428:26188239
1406:Hormones
1295:See also
1153:intersex
1142:puberty.
1139:stenosis
1118:Colombia
970:In 1972
799:clitoris
712:intersex
687:Leonidas
675:intersex
654:surgeons
461:See also
379:Colombia
317:timeline
257:Military
252:Religion
126:Medicine
34:Intersex
3446:4 March
2655:2198650
2590:2082839
2538:4559568
2430:1121738
2350:1421517
2059:Hopkins
2001:9666547
1819:9080940
1671:3656565
1510:9253124
1463:3612461
1192:study:
1012:phallus
996:suicide
940:orgasms
795:vaginal
787:chordee
783:scrotum
781:into a
747:Hormone
720:rearing
669:In the
389:Germany
307:History
299:History
211:Endosex
192:more...
159:history
81:reports
3306:(text)
3235:
3126:
3118:
3077:
3069:
3026:
3018:
2976:
2968:
2910:
2841:
2744:
2734:
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2545:
2535:
2527:
2488:
2480:
2472:
2437:
2427:
2357:
2347:
2304:
2263:
2170:Beck M
2150:
2142:
2069:), or
2051:
2007:
1999:
1964:
1956:
1917:
1899:J Urol
1824:15 May
1817:
1740:
1732:
1714:
1669:
1651:J Urol
1508:
1461:
1426:
1387:896307
1385:
1241:, the
1100:years.
950:, and
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