Once the physical examination and diagnostic tests for have been performed, the doctor or physician may suggest a gender for the baby on the basis of the information gathered from the tests.
The suggestion will be made after taking into consideration a number of factors, including:
- Genetic disorder causes
- The genetic sex of the baby
- The future sexual and reproductive potential of the infant
- Probable gender identity as an adult
- The anatomy of the child
A discussion will be held with the parents, and a decision will be arrived at with the consent of the concerned family.
In some cases, however, it may be extremely difficult or impossible to assign a gender to an infant. Doctors may also be unable to predict the long-term implications of the disorder.
Having an interdisciplinary support group consisting of psychologists, endocrinologists, gynaecologists, surgeons, geneticists, urologists, and social workers may be helpful for ambiguous genitalia treatment.
The support medical team will be able to provide long-term guidance and support as well as multidisciplinary care to both the patient and the parents.
Treatment for ambiguous genitalia
Depending on the cause and symptoms, treatment might include corrective surgery or hormone replacement therapy. Parents are encouraged to think about the benefits of each treatment option as well as the possible risks and side effects before arriving at a decision.
In this day and age, most heart attacks can be treated successfully. It is important to note that a patient’s survival depends on how quickly they are treated. Quick thinking is even more crucial if the patient has a history of heart disease.
Having a multidisciplinary team as mentioned earlier can help parents feel more confident about the treatment approach that they choose.
1. Corrective surgery
Doctors may recommend surgery for babies with abnormal genitalia under two circumstances: to preserve normal sexual function or to create genitals that appear normal.
For example, for ambiguous external genitalia in girls, surgery to normalize sexual function may be required if a girl’s vagina is hidden under her skin. Whereas for boys, surgical treatment may be recommended to reconstruct an incomplete penis and make erections possible. In either case, it is unlikely that the doctor will recommend surgery during the neonatal period.
In case of an imminent threat to a newborn child’s health such as the absence of a urinary opening or the presence of malignant tissue, however, doctors may naturally schedule an immediate surgery.
Genital cosmetic surgeries, on the other hand, are typically offered when the parents of the infant are incredibly distressed.
Misconceptions of cosmetic genital surgeries
A lot of parents who give birth to children with this condition believe that fixing the condition earlier is the most practical solution as a child without an assigned gender may struggle to fit into society.
This is, however, a flawed notion.
Cosmetic genital surgery does not guarantee that a child will grow up to be physically, emotionally or sexually healthy.
Majority of doctors are, therefore, opposed to performing cosmetic genital surgery.
Surgically configuring the genitals of an infant may sometimes interfere with the biological functions of the child. The child may grow up to have sexual dysfunction or may experience diminished sexual sensation and in some cases, even chronic pain.
Parents are, therefore, increasingly advised to delay such cosmetic surgeries and wait until the patient is old enough to make the decision themselves. Moreover, the results of the procedure may not always be satisfactory, and in some cases, repeat surgery may have to be performed.
2. Hormone replacement therapy
Hormonal treatment like surgery may be delayed until the infant or patient is of an appropriate age. In case the doctors think there is an imminent threat to the child’s health. However, hormonal therapy may be started immediately.
Newborns with classic Congenital Adrenal Hyperplasia (CAH), for example, need to start endocrinologic therapy soon after birth. If left untreated, it can cause a number of symptoms including heart rhythm problems, very low blood sodium levels, low blood glucose, low blood pressure, vomiting, shock and/or coma and in some cases even death.
Elective sex hormone treatments, conversely, are administered to the child only after they have reached the age of puberty.
The administration of exogenous sex hormones carries a number of risks and may even result in behavioural the and physiologic changes in the child. As a result, doctors prefer to wait and allow patients to decide what risks they would like to assume.
3. Ongoing support and care
Besides the obvious physical symptoms, this condition can also have considerable social and emotional implications on the patient or the child.
Ongoing support and care is, therefore, crucial and needs to be included as a part of the treatment plan.
Patients need to be given the benefit of full disclosure of their medical condition. Working with a psychologist will also help the child navigate and cope with the challenges of the situation. Apart from this, the child also needs to be regularly monitored and screened for any complications such as cancer.
Treatment options for ambiguous external genitalia include corrective surgery and/or hormone replacement therapy.
Normally, in the case of genital cosmetic surgeries and elective hormone treatments, doctors would recommend waiting until the patient or child reaches the age of puberty before starting treatment.
Consult a gynaecologist online on MFine to evaluate treatment options for ambiguous genitalia
Ambiguous genitalia can be a challenging condition for both parents and children to deal with. Parents should, however, try to invite open discussions with their child and answer their questions as honestly and clearly as possible. Treat the child’s questions and concerns with respect and let them know that your love for them is unconditional!
When parents can come to terms with their own feelings, it gives the child reassurance and helps counteract feelings of fear, confusion, anxiety and sadness in the child. So always try to celebrate your child for who they are!