The studies, which appear in the online version of the September issue of Pediatrics, could help families and doctors make better therapeutic and counseling decisions about gender assignment, says lead researcher Claude Migeon, M.D., a pediatric endocrinologist at Johns Hopkins Children's Center.
Migeon and his colleagues recruited their study subjects from the archives of the pediatric endocrinology clinic at Johns Hopkins, where their subspecialty was founded in the mid-1940s. Because many of the clinic's patients have reached adulthood, researchers are now able to gauge the outcome of gender assignment choices made decades ago among what may be the world's largest cohort of intersex patients. Researchers judged success or of gender assignment on a variety of psychological, physical and sociological factors.
In the first study, researchers interviewed, reviewed the history of and examined 39 people 21 years of age or older seen at Hopkins as infants or children with genital ambiguity. The patients all had a genetically male, XY genotype and a genetic intersex syndrome that causes the abnormal formation of an extremely small phallus, with the urethral opening on the underside, where it would be located on a female.
Although historically there has been controversy over which is the best gender assignment for these children, they are often assigned to female gender by parents and doctors, undergoing surgeries and hormone treatments, to be reared as girls.