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) Please share in detail your experiences with intersex children, including those diagnosed with
Congenital Adrenal Hyperplasia
I am a Pediatrician with a subspecialty of Neonatology. My limited experiences with Congenital Adrenal
Hyperplasia (CAH) and intersex cases comes from brief exposure to such hospital inpatients and
outpatient follow-ups over a 10 year professional period.

2.) What is the standard procedure that you must do with regards to the parent upon diagnosis that their
child is intersex?
Upon reaching a definitive diagnosis supported by appropriate diagnostic modalities to determine gender,
a Pediatrician is obliged to disclose accurate prognosis and treatment options.

3.) What life threatening symptoms are present that are associated with intersexuality?
There are no direct life threatening symptoms associated with intersexual conditions.

4) How are these symptoms treated?
Treatment will correspond to the respective symptom presented by the particular intersexual condition.
Example: “Social withdrawal” can be a manifestation of a physical abnormality, ei ambiguous sex
genitalia. Treatment thus can be non-invasive group therapy in this sense.

5.) Is being intersex hazardous to one's health in any way?
An intersex condition can not be an immediate health hazard but can affect normal social, physical and
psychological development

6.) Have you ever experienced conflict with the parents' preference of treatment of their intersex
I have not experienced initial conflict with parents preferences upon presentation of the condition. The
conflict usually arises later from family, social and legal pressures to resolve the gender issue as soon as
possible. Parents usually return for medical consultation after social and legal issues have been

7.) What do you do or how do you deal with the conflict?
As I have stated above, medical management would depend on the resolution of social and legal issues.
If the family, relatives and friends make a gender determination which is likewise a legal recourse then
the corresponding appropriate medical or surgical management will follow.

8.) In your personal experience, what reasons do parents usually cite in declining treatment or
opposing recommendation?
I do not have sufficient exposure and reaction data from parents of such conditions. I can only speculate
that the decision to intervene or not may be the result of medical, moral, social, cultural or any
combination of those realms.

9.) After diagnosis, what procedure/ treatment would you recommend to the parent of the intersex
child? When would you recommend this form of treatment? When would you recommend non-
The medical standard of treatment of CAH associated intersex conditions is steroid administration and
surgery. Non-treatment may prove fatal and is not an option. Management of intersex conditions caused
by other abnormal hormonal or genetic conditions have their respective management protocols. Non-
treatment is an option in a majority of cases.

10.) What treatment would you personally prefer parents would choose for their intersex children?
Management of CAH as I mentioned above is specific and non-optional. URGENCY of management of
other intersex conditions should be the foremost consideration. IMMEDIATE INTERVENTION if life
threatening conditions exist. DELAYED intervention whenever possible. NON-INTERVENTION with
appropriate social, physical, psychological and medical support can also be considered an option!

“It would be easier for the whole world to adjust to one than for one to
adjust to the preferences of all!”

Life is a jigsaw puzzle.
Everyone has a place in it.
We are all part of the same picture,
But have different shapes and sizes.
When someone is missing,
Life is not complete