Gender identity, gender assignment and reassignment in individuals with disorders of sex development: a major of dilemma

Fisher, A. D.; Ristori, J.; Fanni, E.; Castellini, G.; Forti, G.; Maggi, M.

doi:10.1007/s40618-016-0482-0

Cited by 100Sexual Differentiation and DisordersLGBTQ Health, Identity, and PolicyGenetic and Clinical Aspects of Sex Determination and Chromosomal Abnormalities

Gender identity, gender assignment and reassignment in individuals with disorders of sex development: a major of dilemma

Open access

Fisher, A. D., Ristori, J., Fanni, E., Castellini, G., Forti, G., Maggi, M.·2016·Journal of Endocrinological Investigation

DOI 10.1007/s40618-016-0482-0

Open this paper in CoChat — free account Open PDF

Abstract

Introduction Disorders of Sex Development (DSD) are a wide range of congenital conditions characterized by an incongruence of components involved in sexual differentiation, including gender psychosexual development. The management of such disorders is complex, and one of the most crucial decision is represented by gender assignment. In fact, the primary goal in DSD is to have a gender assignment consistent with the underlying gender identity in order to prevent the distress related to a forthcoming Gender Dysphoria. Historically, gender assignment was based essentially on surgical outcomes, assuming the neutrality of gender identity at birth. This policy has been challenged in the past decade refocusing on the importance of prenatal and postnatal hormonal and genetic influences on psychosexual development.Aims (1) to update the main psychological and medical issues that surround DSD, in particular regarding gender identity and gender assignment; (2) to report specific clinical recommendations according to the different diagnosis.Methods A systematic search of published evidence was performed using Medline (from 1972 to March 2016). Review of the relevant literature and recommendations was based on authors' expertise.Results A review of gender identity and assignment in DSD is provided as well as clinical recommendations for the management of individuals with DSD.Conclusions Given the complexity of this management, DSD individuals and their families need to be supported by a specialized multidisciplinary team, which has been universally recognized as the best practice for intersexual conditions. In case of juvenile GD in DSD, the prescription of gonadotropin-releasing hormone analogues, following the World Professional Association for Transgender Health and the Endocrine Society guidelines, should be considered. It should always be taken into account that every DSD person is unique and has to be treated with individualized care. In this perspective, international registries are crucial to improve the understanding of these challenging conditions and clinical practice, in providing a better prediction of gender identity.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Integrity signals

Registry

Crossref · 10.1007/s40618-016-0482-0

Cites

201 of 201 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

A meta-analysis of 35 studies of classic 21OH deficiency showed an average final height of 1.38 standard deviations below the population norm.
“A meta-analysis of 35 studies of classic 21OH deficiency showed an average final height of 1.38 standard deviations below the population norm.72”
From Congenital adrenal hyperplasia (2017) · cites this paper as [72]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2013) · doi:10.1176/appi.books.9780890425596 · Cited by 116,369 · see citing works
Brain development during childhood and adolescence: a longitudinal MRI study
Giedd, J. N., Blumenthal, J., Jeffries, N. O., Castellanos, F. X., Liu, H., Zijdenbos, A., Paus, T., Evans, A. C., & Rapoport, J. L. (1999) · Nature Neuroscience · doi:10.1038/13158 · Cited by 5,552 · see citing works
A gene from the human sex-determining region encodes a protein with homology to a conserved DNA-binding motif
Sinclair, A. H., Berta, P., Palmer, M. S., Hawkins, J. R., Griffiths, B. L., Smith, M. J., Foster, J. W., Frischauf, A., Lovell-Badge, R. H., & Goodfellow, P. N. (1990) · Nature · doi:10.1038/346240a0 · Cited by 3,234 · see citing works
Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7
Coleman, E., Bockting, W. O., Botzer, M., Cohen‐Kettenis, P. T., Cuypere, G. D., Feldman, J., Fraser, L., Green, J., Knudson, G., Meyer, W. J., et al. (2012) · International Journal of Transgenderism · doi:10.1080/15532739.2011.700873 · Cited by 3,145 · see citing works
Consensus Statement on Management of Intersex Disorders
Lee, P. A., Houk, C. P., Ahmed, S. F., Hughes, I. A., & in collaboration with the participants in the International Consensus Conference on Intersex organized by the Lawson Wilkins Pediatric Endocrine Society and the European Society for Paediatric Endocrinology (2006) · Pediatrics · doi:10.1542/peds.2006-0738 · Cited by 2,324 · see citing works
Male development of chromosomally female mice transgenic for Sry
Koopman, P. A., Gubbay, J., Vivian, N., Goodfellow, P. N., & Lovell-Badge, R. H. (1991) · Nature · doi:10.1038/351117a0 · Cited by 2,193 · see citing works
Organic Causes of Erectile Dysfunction in Men Under 40
Ludwig, W. W., & Phillips, M. (2013) · Urologia Internationalis · doi:10.1159/000354931 · Cited by 2,156 · see citing works
ORGANIZING ACTION OF PRENATALLY ADMINISTERED TESTOSTERONE PROPIONATE ON THE TISSUES MEDIATING MATING BEHAVIOR IN THE FEMALE GUINEA PIG <sup>1</sup>
PHOENIX, C. H., GOY, R. W., GERALL, A. A., & YOUNG, W. C. (1959) · Endocrinology · doi:10.1210/endo-65-3-369 · Cited by 1,934 · see citing works
Handbook of clinical neurology
(1986) · Journal of Neuroimmunology · doi:10.1016/0165-5728(86)90030-5 · Cited by 1,848 · see citing works
Congenital adrenal hyperplasia due to steroid 21-hydroxylase deficiency: an Endocrine Society Clinical Practice Guideline.
Speiser, P. W., Azziz, R., Baskin, L. S., Ghizzoni, L., Hensle, T. W., Merke, D. P., Meyer-Bahlburg, H. F. L., Miller, W. L., Montori, V. M., Oberfield, S. E., et al. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2009-2631 · Cited by 1,484 · cited 12× · see citing works
“%) of 46,XX patients with CAH raised as females develop a female gender identity later on [24].”
BackgroundInfluential
Consensus statement on management of intersex disorders
Hughes, I. A. (2005) · Archives of Disease in Childhood · doi:10.1136/adc.2006.098319 · Cited by 1,414 · see citing works
Sexual dimorphism of brain developmental trajectories during childhood and adolescence
Lenroot, R. K., Gogtay, N., Greenstein, D. K., Wells, E. M., Wallace, G. L., Clasen, L. S., Blumenthal, J. D., Lerch, J., Zijdenbos, A. P., Evans, A. C., et al. (2007) · NeuroImage · doi:10.1016/j.neuroimage.2007.03.053 · Cited by 1,309 · see citing works
Global Disorders of Sex Development Update since 2006: Perceptions, Approach and Care
Lee, P. A., Nordenström, A., Houk, C. P., Ahmed, S. F., Auchus, R. J., Baratz, A. B., Dalke, K. B., Liao, L., Lin‐Su, K., Looijenga, L. H. J., et al. (2016) · Hormone Research in Paediatrics · doi:10.1159/000442975 · Cited by 1,292 · see citing works
Endocrine Treatment of Transsexual Persons:An Endocrine Society Clinical Practice Guideline
Hembree, W. C., Cohen‐Kettenis, P. T., de Waal, H. A. D., Gooren, L. J., Meyer, W. J., Spack, N. P., Tangpricha, V., & Montori, V. M. (2009) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2009-0345 · Cited by 1,029 · see citing works
A sex difference in the human brain and its relation to transsexuality
Zhou, J., Hofman, M. A., Gooren, L. J., & Swaab, D. F. (1995) · Nature · doi:10.1038/378068a0 · Cited by 779 · see citing works
Reframing sexual differentiation of the brain
McCarthy, M. M., & Arnold, A. P. (2011) · Nature Neuroscience · doi:10.1038/nn.2834 · Cited by 728 · see citing works
The organizational–activational hypothesis as the foundation for a unified theory of sexual differentiation of all mammalian tissues
Arnold, A. P. (2009) · Hormones and Behavior · doi:10.1016/j.yhbeh.2009.03.011 · Cited by 625 · see citing works
Testosterone Formation and Metabolism During Male Sexual Differentiation in the Human Embryo
Siiteri, P. K., & Wilson, J. D. (1974) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem-38-1-113 · Cited by 598 · see citing works
Androgen insensitivity syndrome
Hughes, I. A., Davies, J. D., Bunch, T., Pasterski, V., Mastroyannopoulou, K., & MacDougall, J. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60071-3 · Cited by 556 · see citing works
Untitled work
Chamberlain (2005) · doi:10.1016/j.neubiorev.2004.11.004 · Cited by 529 · see citing works
Early Androgens Are Related to Childhood Sex-Typed Toy Preferences
Berenbaum, S. A., & Hines, M. (1992) · Psychological Science · doi:10.1111/j.1467-9280.1992.tb00028.x · Cited by 481 · see citing works
Factors Associated With Desistence and Persistence of Childhood Gender Dysphoria: A Quantitative Follow-Up Study
Steensma, T. D., McGuire, J. K., Kreukels, B. P. C., Beekman, A. J., & Cohen‐Kettenis, P. T. (2013) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2013.03.016 · Cited by 478 · see citing works
Desisting and persisting gender dysphoria after childhood: A qualitative follow-up study
Steensma, T. D., Biemond, R., de Boer, F., & Cohen‐Kettenis, P. T. (2011) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104510378303 · Cited by 458 · see citing works
Disorders of sex development: a new definition and classification
Hughes, I. A. (2008) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2007.11.001 · Cited by 440 · see citing works
Androgen and psychosexual development: Core gender identity, sexual orientation, and recalled childhood gender role behavior in women and men with congenital adrenal hyperplasia (CAH)
Hines, M., Brook, C. G. D., & Conway, G. S. (2004) · The Journal of Sex Research · doi:10.1080/00224490409552215 · Cited by 437 · see citing works
Gender dysphoria and gender change in chromosomal females with congenital adrenal hyperplasia
Dessens, A. B., Slijper, F. M. E., & Drop, S. L. S. (2005) · Archives of Sexual Behavior · doi:10.1007/s10508-005-4338-5 · Cited by 425 · see citing works
Delayed Puberty
Palmert, M. R., & Dunkel, L. (2012) · New England Journal of Medicine · doi:10.1056/nejmcp1109290 · Cited by 408 · see citing works
Male-to-Female Transsexuals Have Female Neuron Numbers in a Limbic Nucleus
Kruijver, F. P. M., Zhou, J., Pool, C. W., Hofman, M. A., Gooren, L. J., & Swaab, D. F. (2000) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.85.5.6564 · Cited by 404 · see citing works
Sexual differentiation of the human brain: Relation to gender identity, sexual orientation and neuropsychiatric disorders
Bao, A., & Swaab, D. F. (2011) · Frontiers in Neuroendocrinology · doi:10.1016/j.yfrne.2011.02.007 · Cited by 379 · see citing works
Williams Textbook of Endocrinology
Niculescu, D. (2008) · Acta Endocrinologica (Bucharest) · doi:10.4183/aeb.2008.127 · Cited by 373 · see citing works
Fertility Rates in Female Patients with Congenital Adrenal Hyperplasia due to 21-Hydroxlyase Deficiency
Mulaikal, R. M., Migeon, C. J., & Rock, J. A. (1987) · New England Journal of Medicine · doi:10.1056/nejm198701223160402 · Cited by 358 · see citing works
Psychosexual Development of Women with Congenital Adrenal Hyperplasia
Zucker, K. J., Bradley, S. J., Oliver, G., Blake, J. M., Fleming, S., & Hood, J. E. (1996) · Hormones and Behavior · doi:10.1006/hbeh.1996.0038 · Cited by 347 · see citing works
Discordant Sexual Identity in Some Genetic Males with Cloacal Exstrophy Assigned to Female Sex at Birth
Reiner, W. G., & Gearhart, J. P. (2004) · New England Journal of Medicine · doi:10.1056/nejmoa022236 · Cited by 345 · see citing works
The Development of an Internalized Homonegativity Inventory for Gay Men
Mayfield, W. A. (2001) · Journal of Homosexuality · doi:10.1300/j082v41n02_04 · Cited by 344 · see citing works
An examination of some basic sexual concepts: the evidence of human hermaphroditism.
Money, J., Hampson, J., & HAMPSON, J. L. (1955) · PubMed · Cited by 343 · see citing works
Gender Change in 46,XY Persons with 5α-Reductase-2 Deficiency and 17β-Hydroxysteroid Dehydrogenase-3 Deficiency
Cohen‐Kettenis, P. T. (2005) · Archives of Sexual Behavior · doi:10.1007/s10508-005-4339-4 · Cited by 332 · see citing works
Sexual orientation in women with classical or non-classical congenital adrenal hyperplasia as a function of degree of prenatal androgen excess
Meyer-Bahlburg, H. F. L., Dolezal, C., Baker, S. W., & New, M. I. (2008) · Archives of Sexual Behavior · doi:10.1007/s10508-007-9265-1 · Cited by 326 · see citing works
Psychological outcomes and gender-related development in complete androgen insensitivity syndrome
Hines, M., Ahmed, S. F., & Hughes, I. A. (2003) · Archives of Sexual Behavior · doi:10.1023/a:1022492106974 · Cited by 320 · see citing works
Management of Intersexuality
Diamond, M. (1997) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.1997.02170470080015 · Cited by 308 · see citing works
Endocrinology: Adult and Pediatric
(2016) · Elsevier eBooks · doi:10.1016/c2012-1-03052-4 · Cited by 305 · see citing works
A sex difference in the hypothalamic uncinate nucleus: relationship to gender identity
Garcı́a-Falgueras, A., & Swaab, D. F. (2008) · Brain · doi:10.1093/brain/awn276 · Cited by 301 · see citing works
Gender Role Behavior, Sexuality, and Psychosocial Adaptation in Women with Congenital Adrenal Hyperplasia due to<i>CYP21A2</i>Deficiency
Frisén, L., Nordenström, A., Falhammar, H., Filipsson, H., Holmdahl, G., Janson, P. O., Thorén, M., Hagenfeldt, K., Möller, A., & Nordenskjöld, A. (2009) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2009-0636 · Cited by 276 · see citing works
Effects of Prenatal Sex Hormones on Gender-Related Behavior
Ehrhardt, A. Α., & Meyer‐Bahlburg, H. F. L. (1981) · Science · doi:10.1126/science.7209510 · Cited by 269 · see citing works
Sexual differentiation of the brain and behavior
Swaab, D. F. (2007) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2007.04.003 · Cited by 255 · see citing works
Summary of Consensus Statement on Intersex Disorders and Their Management
Houk, C. P., Hughes, I. A., Ahmed, S. F., & Lee, P. A. (2006) · PEDIATRICS · doi:10.1542/peds.2006-0737 · Cited by 254 · see citing works
Gender Identity Outcome in Female-Raised 46,XY Persons with Penile Agenesis, Cloacal Exstrophy of the Bladder, or Penile Ablation
Meyer‐Bahlburg, H. F. L. (2005) · Archives of Sexual Behavior · doi:10.1007/s10508-005-4342-9 · Cited by 245 · see citing works
Sexual behavior in adolescent and adult females with congenital adrenal hyperplasia
Dittmann, R., Kappes, M. E., & Kappes, M. H. (1992) · Psychoneuroendocrinology · doi:10.1016/0306-4530(92)90054-b · Cited by 242 · see citing works
The Treatment of Adolescent Transsexuals: Changing Insights
Cohen‐Kettenis, P. T., de Waal, H. A. D., & Gooren, L. J. (2008) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2008.00870.x · Cited by 239 · see citing works
Effects on Gender Identity of Prenatal Androgens and Genital Appearance: Evidence from Girls with Congenital Adrenal Hyperplasia
Berenbaum, S. A., & Bailey, J. M. (2003) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2002-020782 · Cited by 238 · see citing works
Gender development in women with congenital adrenal hyperplasia as a function of disorder severity
Meyer-Bahlburg, H. F. L., Dolezal, C., Baker, S. W., Ehrhardt, A. A., & New, M. I. (2006) · Archives of Sexual Behavior · doi:10.1007/s10508-006-9068-9 · Cited by 234 · see citing works
Gender Dysphoria and Gender Change in Androgen Insensitivity or Micropenis
Mazur, T. (2005) · Archives of Sexual Behavior · doi:10.1007/s10508-005-4341-x · Cited by 230 · see citing works
Ambiguous Genitalia With Perineoscrotal Hypospadias in 46,XY Individuals: Long-Term Medical, Surgical, and Psychosexual Outcome
Migeon, C. J., Wisniewski, A. B., Gearhart, J. P., Meyer‐Bahlburg, H. F. L., Rock, J. A., Brown, T. R., Casella, S. J., Maret, A., Ngai, K. M., Money, J., et al. (2002) · PEDIATRICS · doi:10.1542/peds.110.3.e31 · Cited by 227 · see citing works
Prenatal Androgenization Affects Gender-Related Behavior But Not Gender Identity in 5–12-Year-Old Girls with Congenital Adrenal Hyperplasia
Meyer‐Bahlburg, H. F. L., Dolezal, C. L., Baker, S. W., Carlson, A. D., Obeid, J. S., & New, M. I. (2004) · Archives of Sexual Behavior · doi:10.1023/b:aseb.0000014324.25718.51 · Cited by 213 · see citing works
Swyer syndrome: presentation and outcomes
Michala, L., Goswami, D., Creighton, S. M., & Conway, G. S. (2008) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2008.01703.x · Cited by 213 · see citing works
A new look at the mechanisms controlling sex differentiation in mammals.
JOST, A. (1972) · PubMed · Cited by 213 · see citing works
Gender Change from Female to Male in Classical Congenital Adrenal Hyperplasia
Meyer‐Bahlburg, H. F. L., Gruen, R. S., New, M. I., BELL, J. J., Morishima, A., Shimshi, M., Bueno, Y., Vargas, I., & Baker, S. W. (1996) · Hormones and Behavior · doi:10.1006/hbeh.1996.0039 · Cited by 208 · see citing works
46,XY disorders of sex development (DSD)
Mendonca, B. B., Domenice, S., Arnhold, I. J. P., & Costa, E. M. F. (2008) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2008.03392.x · Cited by 207 · see citing works
Congenital hypogonadotropic hypogonadism and micropenis: Effect of testosterone treatment on adult penile size—Why sex reversal is not indicated
Bin-Abbas, B. S., Conte, F. A., Grumbach, M. M., et al. (1999) · The Journal of Pediatrics · doi:10.1016/s0022-3476(99)70244-1 · Cited by 203 · see citing works
Androgen Receptor Repeat Length Polymorphism Associated with Male-to-Female Transsexualism
Hare, L., Bernard, P., Sánchez, F. J., Baird, P. N., Vilain, E. J. N., Kennedy, T., & Harley, V. R. (2008) · Biological Psychiatry · doi:10.1016/j.biopsych.2008.08.033 · Cited by 203 · see citing works
CONSENSUS STATEMENT ON MANAGEMENT OF INTERSEX DISORDERS. INTERNATIONAL CONSENSUS CONFERENCE ON INTERSEX ORGANIZED BY THE LAWSON WILKINS PEDIATRIC ENDOCRINE SOCIETY AND THE EUROPEAN SOCIETY FOR PAEDIATRIC ENDOCRINOLOGY
Lee, P. A., & Houk, C. P. (2006) · Cited by 200 · see citing works
17β-Hydroxysteroid Dehydrogenase-3 Deficiency: Diagnosis, Phenotypic Variability, Population Genetics, and Worldwide Distribution of Ancient and de Novo Mutations1
Boehmer, A. L. M., Brinkmann, A. O., Sandkuijl, L. A., Halley, D. J. J., Niermeijer, M. F., Andersson, S., de Jong, F. H., Kayserili, H., Vroede, M. D., Otten, B. J., et al. (1999) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.84.12.6174 · Cited by 197 · see citing works
Early hormonal influences on childhood sex-typed activity and playmate preferences: Implications for the development of sexual orientation.
Berenbaum, S. A., & Snyder, E. (1995) · Developmental Psychology · doi:10.1037/0012-1649.31.1.31 · Cited by 194 · see citing works
Early androgen effects on aggression in children and adults with congenital adrenal hyperplasia
Berenbaum, S. A., & Resnick, S. M. (1997) · Psychoneuroendocrinology · doi:10.1016/s0306-4530(97)00049-8 · Cited by 190 · see citing works
Clinical, Hormonal, Behavioral, and Genetic Characteristics of Androgen Insensitivity Syndrome in a Brazilian Cohort: Five Novel Mutations in the Androgen Receptor Gene
Melo, K., Mendonca, B. B., Billerbeck, A. E. C., Costa, E. M. F., Inácio, M., Silva, F. A. Q., Leal, A. M. O., Latronico, A. C., & Arnhold, I. J. P. (2003) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2002-021658 · Cited by 188 · see citing works
From Mental Disorder to Iatrogenic Hypogonadism: Dilemmas in Conceptualizing Gender Identity Variants as Psychiatric Conditions
Meyer‐Bahlburg, H. F. L. (2009) · Archives of Sexual Behavior · doi:10.1007/s10508-009-9532-4 · Cited by 182 · see citing works
Management of disorders of sex development
Hiort, O., Birnbaum, W., Marshall, L., Wünsch, L., Werner, R., Schröder, T., Döhnert, U., & Holterhus, P. (2014) · Nature Reviews Endocrinology · doi:10.1038/nrendo.2014.108 · Cited by 181 · see citing works
Congenital adrenal hyperplasia I: Gender-related behavior and attitudes in female patients and sisters
Dittmann, R., Kappes, M. H., Kappes, M. E., Börger, D., Stegner, H., Willig, R. P., & Wallis, H. R. E. (1990) · Psychoneuroendocrinology · doi:10.1016/0306-4530(90)90065-h · Cited by 180 · see citing works
The biology of human psychosexual differentiation
Gooren, L. J. (2006) · Hormones and Behavior · doi:10.1016/j.yhbeh.2006.06.011 · Cited by 173 · see citing works
Regional gray matter variation in male-to-female transsexualism
Eileen Luders, A., Sánchez, F. J., Christian Gaser, B., Toga, A. W., Narr, K. L., Hamilton, L. S., & Vilain, E. J. N. (2009) · NeuroImage · doi:10.1016/j.neuroimage.2009.03.048 · Cited by 172 · see citing works
Sex Matters during Adolescence: Testosterone-Related Cortical Thickness Maturation Differs between Boys and Girls
Bramen, J. E., Hranilovich, J. A., Dahl, R. E., Chen, J. Z.-J., Rosso, C., Forbes, E. E., Dinov, I. D., Worthman, C. M., & Sowell, E. R. (2012) · PLoS ONE · doi:10.1371/journal.pone.0033850 · Cited by 169 · see citing works
Sexual function in women with complete androgen insensitivity syndrome
Minto, C. L., Liao, K. L.-M., Conway, G. S., & Creighton, S. M. (2003) · Fertility and Sterility · doi:10.1016/s0015-0282(03)00501-6 · Cited by 165 · see citing works
Small Penis and the Male Sexual Role
Reilly, J. M., & Woodhouse, C. R. J. (1989) · The Journal of Urology · doi:10.1016/s0022-5347(17)38818-3 · Cited by 164 · see citing works
A Long-term Outcome Study of Intersex Conditions
Warne, G. L., Grover, S. R., Hutson, J., Sinclair, A. H., Metcalfe, S. A., NORTHAM, E. A., Freeman, J. L., & Institut, M. C. R. (2005) · Journal of Pediatric Endocrinology and Metabolism · doi:10.1515/jpem.2005.18.6.555 · Cited by 163 · see citing works
Androgen resistance
Hughes, I. A., & Deeb, A. (2006) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2006.11.003 · Cited by 163 · see citing works
Sexual Function and Surgical Outcome in Women with Congenital Adrenal Hyperplasia Due to CYP21A2 Deficiency: Clinical Perspective and the Patients’ Perception
Nordenström, A., Frisén, L., Falhammar, H., Nyström, H. F., Holmdahl, G., Janson, P. O., Thorén, M. C., Hagenfeldt, K., & Nordenskjöld, A. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2009-2639 · Cited by 160 · see citing works
Ablatio penis: Normal male infant sex-reassigned as a girl
Money, J. (1975) · Archives of Sexual Behavior · doi:10.1007/bf01541887 · Cited by 159 · see citing works
The Concept of gender identity disorder in childhood and adolescence after 39 years
Money, J. (1994) · Journal of Sex & Marital Therapy · doi:10.1080/00926239408403428 · Cited by 157 · see citing works
Sex steroid-related genes and male-to-female transsexualism
Henningsson, S., Westberg, L., Nilsson, S., Lundström, B., Ekselius, L., Bodlund, O., Lindström, E., Hellstrand, M., Rosmond, R., Eriksson, E., et al. (2005) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2005.02.006 · Cited by 156 · see citing works
The transsexual brain – A review of findings on the neural basis of transsexualism
Smith, E. S., Junger, J., Derntl, B., & Habel, U. (2015) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2015.09.008 · Cited by 153 · see citing works
Novel Associations in Disorders of Sex Development: Findings From the I-DSD Registry
Cox, K., Bryce, J., Jiang, J., Rodie, M., Sinnott, R., Alkhawari, M., Arlt, W., Audı́, L., Balsamo, A., Bertelloni, S., et al. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-2918 · Cited by 152 · see citing works
Male-to-Female Transsexuals Show Sex-Atypical Hypothalamus Activation When Smelling Odorous Steroids
Berglund, H., Lindström, P., Dhejne, C., & Savic, I. (2007) · Cerebral Cortex · doi:10.1093/cercor/bhm216 · Cited by 151 · see citing works
Male Pseudohermaphroditism due to 17β-Hydroxysteroid Dehydrogenase 3 Deficiency: Diagnosis, Psychological Evaluation, and Management
Mendonca, B. B., Inacio, M., Arnhold, I. J. P., Costa, E. M. F., Bloise, W., Martin, R. M., Denes, F. T., Silva, F. A. Q., Andersson, S., Lindqvist, A., et al. (2000) · Medicine · doi:10.1097/00005792-200009000-00003 · Cited by 139 · see citing works
Increased cross-gender identification independent of gender role behavior in girls with congenital adrenal hyperplasia: results from a standardized assessment of 4- to 11-year-old children
Pasterski, V., Zucker, K. J., Hindmarsh, P. C., Hughes, I. A., Acerini, C., Spencer, D., Neufeld, S., & Hines, M. (2015) · Archives of Sexual Behavior · doi:10.1007/s10508-014-0385-0 · Cited by 127 · see citing works
Changes Over Time in Sex Assignment for Disorders of Sex Development
Kolesińska, Z., Ahmed, S. F., Niedziela, M., et al. (2014) · PEDIATRICS · doi:10.1542/peds.2014-1088 · Cited by 124 · see citing works
Evaluation of Retained Testes in Adolescent Girls and Women with Complete Androgen Insensitivity Syndrome
Nakhal, R. S., Hall-Craggs, M. A., Freeman, A., et al. (2013) · Radiology · doi:10.1148/radiol.13121068 · Cited by 122 · see citing works
Psychological Aspects of the Treatment of Patients with Disorders of Sex Development
Gardner, M., Cohen‐Kettenis, P. T., & Sandberg, D. E. (2012) · Seminars in Reproductive Medicine · doi:10.1055/s-0032-1324729 · Cited by 114 · see citing works
Suboptimal psychosocial outcomes in patients with congenital adrenal hyperplasia: epidemiological studies in a nonbiased national cohort in Sweden
Strandqvist, A., Falhammar, H., Lichtenstein, P., Hirschberg, A. L., Wedell, A., Norrby, C., Nordenskjöld, A., Frisén, L., & Nordenström, A. (2014) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-3326 · Cited by 111 · see citing works
Approach to Assigning Gender in 46,XX Congenital Adrenal Hyperplasia with Male External Genitalia: Replacing Dogmatism with Pragmatism
Houk, C. P., & Lee, P. A. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2010-0714 · Cited by 111 · see citing works
Disorders of sex development: update on the genetic background, terminology and risk for the development of germ cell tumors
Cools, M., Looijenga, L. H. J., Wolffenbuttel, K. P., & Drop, S. L. S. (2009) · World Journal of Pediatrics · doi:10.1007/s12519-009-0020-7 · Cited by 111 · see citing works
What Causes Low Rates of Child-Bearing in Congenital Adrenal Hyperplasia?
Meyer-Bahlburg, H. F. L. (1999) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.84.6.5718 · Cited by 110 · see citing works
Early androgen effects on interest in infants: evidence from children with congenital adrenal hyperplasia
Leveroni, C. L., & Berenbaum, S. A. (1998) · Developmental Neuropsychology · doi:10.1080/87565649809540714 · Cited by 107 · see citing works
Congenital adrenal hyperplasia II: Gender-related behavior and attitudes in female salt-wasting and simple-virilizing patients
Dittmann, R., Kappes, M. H., Kappes, M. E., Börger, D., Meyer‐Bahlburg, H. F. L., Stegner, H., Willig, R. P., & Wallis, H. R. E. (1990) · Psychoneuroendocrinology · doi:10.1016/0306-4530(90)90066-i · Cited by 105 · see citing works
Correlation between genotype, phenotype and sex of rearing in 111 patients with partial androgen insensitivity syndrome
Deeb, A., Mason, C., Lee, Y. S., & Hughes, I. A. (2005) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2005.02298.x · Cited by 105 · see citing works
Human sex-determination and disorders of sex-development (DSD)
Bashamboo, A., & McElreavey, K. (2015) · Seminars in Cell and Developmental Biology · doi:10.1016/j.semcdb.2015.10.030 · Cited by 104 · see citing works
The Postnatal Gonadotropin and Sex Steroid Surge—Insights from the Androgen Insensitivity Syndrome
Quigley, C. A. (2002) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.87.1.8265 · Cited by 104 · see citing works
A cytogenetic survey of 14,835 consecutive liveborns
Maeda, T., Ohno, M., Matsunobu, A., Yoshihara, K., & Yabe, N. (1991) · The Japanese Journal of Human Genetics · doi:10.1007/bf01876812 · Cited by 103 · see citing works
The EFS and ESSM Syllabus of Clinical Sexology
Miles, S., Read, J., Wylie, K. R., & Veale, D. M. (2013) · Cited by 101 · see citing works
Disorders of Sex Development
Hutson, J. M., Grover, S. R., & Warne, G. L. (2012) · Springer eBooks · doi:10.1007/978-3-642-22964-0 · Cited by 100 · see citing works
A polymorphism of the CYP17 gene related to sex steroid metabolism is associated with female-to-male but not male-to-female transsexualism
Bentz, E.-K., Hefler, L., Kaufmann, U., et al. (2007) · Fertility and Sterility · doi:10.1016/j.fertnstert.2007.05.056 · Cited by 98 · see citing works
Specific Cerebral Activation Due to Visual Erotic Stimuli in Male-to-Female Transsexuals Compared with Male and Female Controls: An fMRI Study
Gizewski, E. R., Krause, E., Schlamann, M. U., Happich, F., Ladd, M. E., Forsting, M., & Senf, W. (2008) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2008.00981.x · Cited by 96 · see citing works
The sambia ?turnim-man?: Sociocultural and clinical aspects of gender formation in male pseudohermaphrodites with 5-alpha-reductase deficiency in Papua New Guinea
Herdt, G., & Davidson, J. M. (1988) · Archives of Sexual Behavior · doi:10.1007/bf01542051 · Cited by 95 · see citing works
Androgens and Gender Role Behaviour in Girls with Congenital Adrenal Hyperplasia (CAH)
Slijper, F. M. E. (1984) · Progress in brain research · doi:10.1016/s0079-6123(08)64451-9 · Cited by 93 · see citing works
A Comparative Study of Sexual Experiences
May, B., Boyle, M., & Grant, D. J. W. (1996) · Journal of Health Psychology · doi:10.1177/135910539600100406 · Cited by 93 · see citing works
Male Gender Identity in Complete Androgen Insensitivity Syndrome
T'Sjoen, G. G., Cuypere, G. D., Monstrey, S., Hoebeke, P. B., Freedman, F. K., Appari, M., Holterhus, P., Borsel, J. V., & Cools, M. (2010) · Archives of Sexual Behavior · doi:10.1007/s10508-010-9624-1 · Cited by 92 · see citing works
Outcome of congenital adrenal hyperplasia
Kuhnle, U., & Bullinger, M. (1997) · Pediatric Surgery International · doi:10.1007/bf01258714 · Cited by 92 · see citing works
Impaired Sexual Activity in Male Adults with Partial Androgen Insensitivity
Bouvattier, C. M., Mignot, B., Lefèvre, H., et al. (2006) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2006-0218 · Cited by 89 · see citing works
Psychosexual Development in Adolescents and Adults with Disorders of Sex Development—Results from the German Clinical Evaluation Study
Jürgensen, M., Kleinemeier, E., Lux, A., Steensma, T. D., Cohen‐Kettenis, P. T., Hiort, O., Thyen, U., & Köhler, B. (2012) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2012.02751.x · Cited by 88 · see citing works
Editorial: Gender dysphoria syndrome--the conceptualization that liberalizes indications for total gender reorientation and implies a broadly based multi-dimensional rehabilitative regimen.
Fisk, N. M. (1974) · PubMed · Cited by 87 · see citing works
Gender role behavior in children with XY karyotype and disorders of sex development
Jürgensen, M., Hiort, O., Holterhus, P., & Thyen, U. (2007) · Hormones and Behavior · doi:10.1016/j.yhbeh.2007.01.001 · Cited by 87 · see citing works
Surgical Progress Is Not the Answer to Intersexuality
Chase, C. (1998) · The Journal of Clinical Ethics · doi:10.1086/jce199809407 · Cited by 83 · see citing works
Sex Steroids and Variants of Gender Identity
Meyer‐Bahlburg, H. F. L. (2013) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/j.ecl.2013.05.011 · Cited by 83 · see citing works
Human RSPO1/R-spondin1 Is Expressed during Early Ovary Development and Augments β-Catenin Signaling
Tomaselli, S., Megiorni, F., Lin, L., Mazzilli, M. C., Gerrelli, D., Majore, S., Grammatico, P., & Achermann, J. C. (2011) · PLoS ONE · doi:10.1371/journal.pone.0016366 · Cited by 82 · see citing works
Two successful pregnancies in a 46,XY patient
Kan, A., Abdalla, H., & Oskarsson, T. (1997) · Human Reproduction · doi:10.1093/humrep/12.7.1434 · Cited by 82 · see citing works
Gender experience and satisfaction with gender allocation in adults with diverse intersex conditions (divergences of sex development, DSD)
Schweizer, K., Brünner, F., Handford, C., et al. (2013) · Psychology and Sexuality · doi:10.1080/19419899.2013.831216 · Cited by 81 · see citing works
Fetal feminization and female gender identity in the testicular feminizing syndrome of androgen insensitivity
Masica, D. N., Money, J., & Ehrhardt, A. Α. (1971) · Archives of Sexual Behavior · doi:10.1007/bf01541057 · Cited by 81 · see citing works
Pregnancies following ovum donation in gonadal dysgenesis
Cornet, D., Alvarez, S., Antoine, J.-M., et al. (1990) · Human Reproduction · doi:10.1093/oxfordjournals.humrep.a137092 · Cited by 81 · see citing works
Brook's Clinical Pediatric Endocrinology
Brook, C. G. D. (2019) · Wiley eBooks · doi:10.1002/9781119152712 · Cited by 80 · see citing works
Commentary on sexual orientation: Research and social policy implications.
Baumrind, D. (1995) · Developmental Psychology · doi:10.1037/0012-1649.31.1.130 · Cited by 78 · see citing works
The endocrinology of transsexualism: A review and commentary
Gooren, L. J. (1990) · Psychoneuroendocrinology · doi:10.1016/0306-4530(90)90041-7 · Cited by 78 · see citing works
Quality of life is less impaired in adults with congenital adrenal hyperplasia because of 21-hydroxylase deficiency than in patients with primary adrenal insufficiency: Quality of life in adult CAH patients
Reisch, N., Hahner, S., Bleicken, B., Flade, L., Pedrosa Gil, F., Loeffler, M., Ventz, M., Hinz, A., Beuschlein, F., Allolio, B., et al. (2011) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2010.03920.x · Cited by 78 · see citing works
Behavioral sexology: Ten cases of genetic male intersexuality with impaired prenatal and pubertal androgenization
Money, J., & Ogunro, C. (1974) · Archives of Sexual Behavior · doi:10.1007/bf01541485 · Cited by 77 · see citing works
Successful pregnancy in a patient with a 46,XY karyotype
Selvaraj, K., Ganesh, V. V., & Selvaraj, P. (2002) · Fertility and Sterility · doi:10.1016/s0015-0282(02)03242-9 · Cited by 77 · see citing works
Health-related quality of life in children with disorders of sex development (DSD)
Jürgensen, M., Lux, A., Wien, S. B., Kleinemeier, E., Hiort, O., & Thyen, U. (2014) · European Journal of Pediatrics · doi:10.1007/s00431-014-2264-z · Cited by 75 · see citing works
Gender Assignment for Newborns With 46XY Cloacal Exstrophy: A 6-Year Followup Survey of Pediatric Urologists
Diamond, D. A., Burns, J. P., Huang, L., et al. (2011) · The Journal of Urology · doi:10.1016/j.juro.2011.03.101 · Cited by 74 · see citing works
Steroidogenic Factor-1 and Human Disease
El‐Khairi, R., & Achermann, J. C. (2012) · Seminars in Reproductive Medicine · doi:10.1055/s-0032-1324720 · Cited by 74 · see citing works
Introduction: Gender Dysphoria and Gender Change in Persons with Intersexuality
Meyer‐Bahlburg, H. F. L. (2005) · Archives of Sexual Behavior · doi:10.1007/s10508-005-4335-8 · Cited by 71 · see citing works
Increased risk of gonadal malignancy and prophylactic gonadectomy: a study of 102 phenotypic female patients with Y chromosome or Y-derived sequences
Liu, A.-X., Shi, H., Cai, Z., et al. (2014) · Human Reproduction · doi:10.1093/humrep/deu109 · Cited by 71 · see citing works
Intersexuality and Gender Identity Differentiation
Zucker, K. J. (2002) · Journal of Pediatric and Adolescent Gynecology · doi:10.1016/s1083-3188(01)00133-4 · Cited by 68 · see citing works
Medical treatment in gender dysphoric adolescents endorsed by SIAMS–SIE–SIEDP–ONIG
Italian GnRH analogs study ONIG group, Fisher, A. D., Ristori, J., Bandini, E., Giordano, S., Mosconi, M., Jannini, E. A., Greggio, N. A., Godano, A., Manieri, C., et al. (2014) · Journal of Endocrinological Investigation · doi:10.1007/s40618-014-0077-6 · Cited by 67 · see citing works
Self-citation
Developmental endocrine influences on gender identity: implications for management of disorders of sex development.
Byne, W. M. (2006) · PubMed · Cited by 65 · see citing works
Sex Assignment in the Neonate With Intersex or Inadequate Genitalia
Reiner, W. G. (1997) · Archives of Pediatrics and Adolescent Medicine · doi:10.1001/archpedi.1997.02170470078014 · Cited by 65 · see citing works
Characterizing Early Psychosocial Functioning of Parents of Children with Moderate to Severe Genital Ambiguity due to Disorders of Sex Development
Suorsa, K. I., Mullins, A. J., Tackett, A., Reyes, K. J. S., Austin, P., Baskin, L., Bernabé, K., Cheng, E. Y., Fried, A., Frimberger, D., et al. (2015) · Journal of Urology · doi:10.1016/j.juro.2015.06.104 · Cited by 64 · see citing works
Practical approach to steroid 5alpha-reductase type 2 deficiency
Cheon, C. K. (2010) · European Journal of Pediatrics · doi:10.1007/s00431-010-1189-4 · Cited by 64 · see citing works
Psychosexual Development of Children and Adolescents with Hypospadias
Schönbucher, V. B., Landolt, M. A., Gobet, R., et al. (2008) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2007.00742.x · Cited by 62 · see citing works
Sexual Quality of Life of Individuals With Disorders of Sex Development and a 46,XY Karyotype: A Review of International Research
Schönbucher, V. B., Schweizer, K., & Richter‐Appelt, H. (2010) · Journal of Sex & Marital Therapy · doi:10.1080/00926231003719574 · Cited by 59 · see citing works
Hypersexuality, Paraphilic Behaviors, and Gender Dysphoria in Individuals with Klinefelter’s Syndrome
Fisher, A. D., Castellini, G., Casale, H., Fanni, E., Bandini, E., Campone, B., Ferruccio, N., Maseroli, E., Boddi, V., Dèttore, D., et al. (2015) · The Journal of Sexual Medicine · doi:10.1111/jsm.13048 · Cited by 59 · see citing works
Self-citation
Adult Consequences of Congenital Adrenal Hyperplasia
Arlt, W., & Krone, N. P. (2007) · Hormone Research in Paediatrics · doi:10.1159/000110615 · Cited by 58 · see citing works
Congenital adrenal hyperplasia: long-term evaluation of feminizing genitoplasty and psychosocial aspects
Gupta, D. K., Shilpa, S., Amini, A. C., Gupta, M., Aggarwal, G., Gupta, D., & Kamlesh, K. (2006) · Pediatric Surgery International · doi:10.1007/s00383-006-1765-x · Cited by 58 · see citing works
Disorders of Sex Development
Kim, K. S., & Kim, J.-W. (2012) · Korean journal of urology · doi:10.4111/kju.2012.53.1.1 · Cited by 58 · see citing works
MALE PSEUDOHERMAPHRODITISM WITH GYNAECOMASTIA DUE TO TESTICULAR 17‐KETOSTEROID REDUCTASE DEFICIENCY
Akesode, F. A., Meyer, W. J., & Migeon, C. J. (1977) · Clinical Endocrinology · doi:10.1111/j.1365-2265.1977.tb01336.x · Cited by 57 · see citing works
Sexual Quality of Life After Hormonal and Surgical Treatment, Including Phalloplasty, in Men with Micropenis: A Review
Callens, N., Cuypere, G. D., Hoecke, E. V., T'Sjoen, G. G., Monstrey, S., Cools, M., & Hoebeke, P. B. (2013) · The Journal of Sexual Medicine · doi:10.1111/jsm.12298 · Cited by 51 · see citing works
Hormone replacement in disorders of sex development: Current thinking
Hewitt, J. K., & Zacharin, M. (2015) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2015.03.002 · Cited by 49 · see citing works
Male Gender Identity in an XX Individual with Congenital Adrenal Hyperplasia
Meyer‐Bahlburg, H. F. L. (2008) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2008.00986_1.x · Cited by 48 · see citing works
Severity of virilization is associated with cosmetic appearance and sexual function in women with congenital adrenal hyperplasia: a cross-sectional study
van der Zwan, Y. G., Janssen, E. H. C. C., Callens, N., Wolffenbuttel, K. P., Cohen-Kettenis, P. T., van den Berg, M., Drop, S. L. S., Dessens, A. B., & Beerendonk, C. (2013) · The Journal of Sexual Medicine · doi:10.1111/jsm.12028 · Cited by 48 · see citing works
Gender assignment, reassignment and outcome in disorders of sex development: update of the 2005 consensus conference
Meyer-Bahlburg, H. F. L., Baratz Dalke, K., Berenbaum, S. A., Cohen-Kettenis, P. T., Hines, M., & Schober, J. M. (2016) · Hormone Research in Paediatrics · doi:10.1159/000442386 · Cited by 48 · see citing works
Puberty in disorders of somatosexual differentiation.
Hiort, O., Reinecke, S., Thyen, U., et al. (2003) · PubMed · Cited by 48 · see citing works
Human sex differentiation and its abnormalities
Migeon, C. J., & Wisniewski, A. B. (2003) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1053/ybeog.2003.0354 · Cited by 47 · see citing works
WNT4 is expressed in human fetal and adult ovaries and its signaling contributes to ovarian cell survival
Jääskeläinen, M. M., Prunskaite‐Hyyryläinen, R., Naillat, F., Parviainen, H., Anttonen, M., Heikinheimo, M., Liakka, A., Ola, R., Vainio, S. J., & Vaskivuo, T. E. (2009) · Molecular and Cellular Endocrinology · doi:10.1016/j.mce.2009.11.013 · Cited by 47 · see citing works
The human hypothalamus: basic and clinical aspects. Part II: neuropathy of the human hypothalamus and adjacent brain structures [handbook of clinical neurology; 3rd series vol. 2][series eds.: Aminoff, M.J., Boller F., Swaab, D. F.]
Swaab, D. F. (2004) · Cited by 45 · see citing works
Gender Identity in Disorders of Sex Development: Review Article
Yang, J. H., Baskin, L. S., & DiSandro, M. (2009) · Urology · doi:10.1016/j.urology.2009.07.1286 · Cited by 45 · see citing works
Sexual quality of life after total phalloplasty in men with penile deficiency: an exploratory study
Callens, N., Cuypere, G. D., T'Sjoen, G. G., et al. (2014) · World Journal of Urology · doi:10.1007/s00345-014-1283-8 · Cited by 45 · see citing works
Karyotyping, is it Worthwhile in Transsexualism?
Inoubli, A., Cuypere, G. D., Rubens, R., et al. (2010) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2010.02130.x · Cited by 45 · see citing works
Steroid 17β-hydroxysteroid dehydrogenase deficiency in man: An inherited form of male pseudohermaphroditism
Rösler, A. (1992) · The Journal of Steroid Biochemistry and Molecular Biology · doi:10.1016/0960-0760(92)90327-f · Cited by 44 · see citing works
Outcome Studies Among Men with Micropenis
Lee, P. A., & Houk, C. P. (2004) · Journal of Pediatric Endocrinology and Metabolism · doi:10.1515/jpem.2004.17.8.1043 · Cited by 41 · see citing works
A case report of successful pregnancy in a patient with pure 46,XY gonadal dysgenesis
Plante, B. J., & Fritz, M. A. (2008) · Fertility and Sterility · doi:10.1016/j.fertnstert.2008.04.043 · Cited by 41 · see citing works
Long-Term Outcomes in Males with Disorders of Sex Development
van der Zwan, Y. G., Callens, N., van Kuppenveld, J. H., et al. (2013) · The Journal of Urology · doi:10.1016/j.juro.2013.03.029 · Cited by 41 · see citing works
A Noncategorical Approach to the Psychosocial Care of Persons with DSD and Their Families
Sandberg, D. E., & Mazur, T. (2013) · Focus on sexuality research · doi:10.1007/978-1-4614-7441-8_5 · Cited by 40 · see citing works
Idiopathic Hydronephrosis: Diagnosis, Management and Outcome
OʼREILLY, P. H. (1989) · British Journal of Urology · doi:10.1111/j.1464-410x.1989.tb05247.x · Cited by 40 · see citing works
A model of delivering multi-disciplinary care to people with 46 XY DSD
Palmer, B. W., Wisniewski, A. B., Schaeffer, T. L., Mallappa, A., Tryggestad, J. B., Krishnan, S., Chalmers, L. J., Copeland, K. C., Chernausek, S. D., Reiner, W. G., et al. (2011) · Journal of Pediatric Urology · doi:10.1016/j.jpurol.2011.08.013 · Cited by 39 · see citing works
Psychiatric Approaches for Disorders of Sex Development: Experience of a Multidisciplinary Team
Özbaran, B., Özen, S., Damla, G., Özlem, K., Hüseyin, O., Ferda, Ö., Özgür, Ç., Serpil, E., Köse, S., Ali, A., et al. (2013) · Journal of Clinical Research in Pediatric Endocrinology · doi:10.4274/jcrpe.1044 · Cited by 39 · see citing works
The Human Hypothalamus. Basic and Clinical Aspects : part II: Neuropathology of the human hypothalamus and adjacent brain structures.
Swaab, D. F. (2004) · Data Archiving and Networked Services (DANS) · Cited by 38 · see citing works
Complexities of gender assignment in 17β-hydroxysteroid dehydrogenase type 3 deficiency: is there a role for early orchiectomy?
Chuang, J., Vallerie, A. M., Breech, L. L., Saal, H. M., Alam, S., Crawford, P., & Rutter, M. M. (2013) · International Journal of Pediatric Endocrinology · doi:10.1186/1687-9856-2013-15 · Cited by 36 · see citing works
Psychosexual Development in Children with Disorder of Sex Development (DSD) – Results from the German Clinical Evaluation Study
Jürgensen, M., Kleinemeier, E., Lux, A., Steensma, T. D., Cohen‐Kettenis, P. T., Hiort, O., & Thyen, U. (2010) · Journal of Pediatric Endocrinology and Metabolism · doi:10.1515/jpem.2010.095 · Cited by 35 · see citing works
Long-term psychosocial adjustments, satisfaction related to gender and the family equations in disorders of sexual differentiation with male sex assignment
Gupta, D., Gupta, D., Bhardwaj, M., et al. (2010) · Pediatric Surgery International · doi:10.1007/s00383-010-2661-y · Cited by 34 · see citing works
Apparent Male Gender Identity in a Patient with Complete Androgen Insensitivity Syndrome
Kulshreshtha, B., Philibert, P., Marumudi, E., Khandelwal, S. K., Mehta, M., Audran, F., Paris, F., Sultan, C., & Ammini, A. C. (2009) · Archives of Sexual Behavior · doi:10.1007/s10508-009-9526-2 · Cited by 34 · see citing works
Male Pseudohermaphroditism: Long-term Quality of Life Outcome in Five 46,XY Individuals Reared Female
Mazur, T., Sandberg, D. E., Perrin, Μ. A., et al. (2004) · Journal of Pediatric Endocrinology and Metabolism · doi:10.1515/jpem.2004.17.6.809 · Cited by 31 · see citing works
Brook's Clinical Pediatric Endocrinology
Brook, C. G. D., Clayton, P., & Brown, R. S. (2009) · Wiley eBooks · doi:10.1002/9781444316728 · Cited by 30 · see citing works
Gender development in boys born with hypospadias
Sandberg, D. E., Meyer‐Bahlburg, H. F. L., Yager, T. J., Hensle, T. W., Levitt, S. B., Kogan, S. J., & Reda, E. F. (1995) · Psychoneuroendocrinology · doi:10.1016/0306-4530(95)00025-9 · Cited by 29 · see citing works
The Endocrinologist’s Office—Puberty Suppression: Saving Children from a Natural Disaster?
Sadjadi, S. (2013) · Journal of Medical Humanities · doi:10.1007/s10912-013-9228-6 · Cited by 28 · see citing works
“Any Decision is Better Than None” Decision-Making About Sex of Rearing for Siblings with 17β-Hydroxysteroid-dehydrogenase-3 Deficiency
Jürgensen, M., Hampel, E., Hiort, O., & Thyen, U. (2006) · Archives of Sexual Behavior · doi:10.1007/s10508-006-9034-6 · Cited by 27 · see citing works
Brain Development and Cognitive, Psychosocial, and Psychiatric Functioning in Classical 21- Hydroxylase Deficiency
Meyer‐Bahlburg, H. F. L. (2010) · Endocrine development · doi:10.1159/000321225 · Cited by 26 · see citing works
The Development of Sexuality and Eroticism in Human Kind
Money, J. (1991) · Springer eBooks · doi:10.1007/978-94-011-3078-3_6 · Cited by 26 · see citing works
The Development of Sexuality and Eroticism in Humankind
Money, J. (1981) · The Quarterly Review of Biology · doi:10.1086/412431 · Cited by 26 · see citing works
Size Matters: Experiences of Atypical Genital and Sexual Development in Males
Chadwick, P., Liao, L., & Boyle, M. E. (2005) · Journal of Health Psychology · doi:10.1177/1359105305053420 · Cited by 25 · see citing works
Gender assignment and hormonal treatment for disorders of sexual differentiation
Sharma, S., & Gupta, D. K. (2008) · Pediatric Surgery International · doi:10.1007/s00383-008-2232-7 · Cited by 25 · see citing works
Psychosocial Factors in Disorders of Sex Development in a Long-Term Perspective: What Clinical Opportunities are there to Intervene?
Nordenström, A. (2015) · Hormone and Metabolic Research · doi:10.1055/s-0034-1398562 · Cited by 25 · see citing works
Medical and Psychosexual Outcome in Women Affected by Complete Gonadal Dysgenesis
McCarty, B. M., Migeon, C. J., Meyer‐Bahlburg, H. F. L., et al. (2006) · Journal of Pediatric Endocrinology and Metabolism · doi:10.1515/jpem.2006.19.7.873 · Cited by 25 · see citing works
Embryology of the Female Genital Tract
Parmley, T. H. (1987) · Springer eBooks · doi:10.1007/978-1-4757-1942-0_1 · Cited by 24 · see citing works
Click-Evoked Otoacoustic Emissions in Children and Adolescents with Gender Identity Disorder
Burke, S., Menks, W. M., Cohen‐Kettenis, P. T., Klink, D. T., & Bakker, J. (2014) · Archives of Sexual Behavior · doi:10.1007/s10508-014-0278-2 · Cited by 24 · see citing works
Male Gender Identity in an XX Individual with Congenital Adrenal Hyperplasia
Jorge, J. C., Echeverri, C., Medina, Y., et al. (2007) · The Journal of Sexual Medicine · doi:10.1111/j.1743-6109.2007.00558.x · Cited by 23 · see citing works
Gender Identity Rather Than Sexual Orientation Impacts on Facial Preferences
Ciocca, G., Limoncin, E., Cellerino, A., Fisher, A. D., Gravina, G. L., Carosa, E., Mollaioli, D., Valenzano, D. R., Mennucci, A., Bandini, E., et al. (2014) · The Journal of Sexual Medicine · doi:10.1111/jsm.12633 · Cited by 22 · see citing works
Self-citation
Diagnosis of 17β-hydroxysteroid dehydrogenase deficiency
Bertelloni, S., Dati, E., & Hiort, O. (2008) · Expert Review of Endocrinology & Metabolism · doi:10.1586/17446651.4.1.53 · Cited by 21 · see citing works
Gender Identity and Gender Role in DSD Patients Raised as Females: A Preliminary Outcome Study
Ercan, O., Kutluğ, Ş., Uysal, Ö., Alikaşifoğlu, M., & Inceoglu, D. (2013) · Frontiers in Endocrinology · doi:10.3389/fendo.2013.00086 · Cited by 20 · see citing works
Phalloplasty: A Panacea for 46,XY Disorder of Sex Development Conditions with Penile Deficiency?
Callens, N., & Hoebeke, P. B. (2014) · Endocrine development · doi:10.1159/000363666 · Cited by 19 · see citing works
Disorders of Sex Development (DSD): Peer Relations and Psychosocial Well-Being
Bukowski, W. M., McCauley, E., & Mazur, T. (2015) · Hormone and Metabolic Research · doi:10.1055/s-0035-1549884 · Cited by 19 · see citing works
Self-Assessment of Genital Anatomy and Sexual Function Within a Belgian, Dutch-Speaking Female Population: A Validation Study
Bronselaer, G., Callens, N., Sutter, P. D., et al. (2013) · The Journal of Sexual Medicine · doi:10.1111/jsm.12326 · Cited by 17 · see citing works
Disorders of Sexual Development
McCann‐Crosby, B., & Sutton, V. R. (2015) · Clinics in Perinatology · doi:10.1016/j.clp.2015.02.006 · Cited by 17 · see citing works
Review of Current Surgical Techniques and Medical Management Considerations in the Treatment of Pediatric Patients with Disorders of Sex Development
DiSandro, M., Merke, D. P., & Rink, R. C. (2015) · Hormone and Metabolic Research · doi:10.1055/s-0035-1547292 · Cited by 16 · see citing works
Concordance of phenotypic expression and gender identity in a large kindred with a mutation in the androgen receptor
Hooper, H., de Figueiredo, B. C., Pavan‐Senn, C., de Lacerda, L., Sandrini, R., Mengarelli, J., Japp, K., & Karaviti, L. P. (2004) · Clinical Genetics · doi:10.1111/j.0009-9163.2004.00197.x · Cited by 15 · see citing works
Gender identity shows a high correlation with Prader score in patients with disorders of sex development (DSD) presenting in mid childhood
Chowdhury, T. K., Chowdhury, M. Z., Mili, F., Hutson, J. M., & Banu, T. (2014) · Pediatric Surgery International · doi:10.1007/s00383-014-3486-x · Cited by 15 · see citing works
Requirements for a multicentric multidisciplinary registry on patients with disorders of sex development
Hiort, O., Wünsch, L., Cools, M., et al. (2012) · Journal of Pediatric Urology · doi:10.1016/j.jpurol.2012.09.004 · Cited by 15 · see citing works
Androgen Insensitivity Syndrome: Management Considerations from Infancy to Adulthood.
Mj, C., Vu, B.-M. K., Axelrad, M. E., et al. (2015) · PubMed · Cited by 12 · see citing works
Outcome Studies Among Men With Micropenis
Lee, P. A., & Houk, C. P. (2005) · The Journal of Urology · doi:10.1016/s0022-5347(05)00079-0 · Cited by 9 · see citing works
Disorders of Sex Development and Atypical Sex Differentiation
Pasterski, V. (2008) · Wiley eBooks · doi:10.1002/9781118269978.ch12 · Cited by 7 · see citing works
The 17β-hydroxysteroid dehydrogenase type 3 deficiency: a case report of an 18-year patient and review of the literature.
Galdiero, M., Vitale, P., Simeoli, C., et al. (2013) · PubMed · Cited by 6 · see citing works
Psychosexual outcomes in three siblings with partial androgen insensitivity syndrome: impact of nature versus nurture
Joseph, A. A., Shabir, I., Marumadi, E., et al. (2013) · Journal of Pediatric Endocrinology and Metabolism · doi:10.1515/jpem-2013-0154 · Cited by 6 · see citing works
Hormonal abnormalities leading to disorders of sexual development
Kim, S. S., & Kolon, T. F. (2009) · Expert Review of Endocrinology & Metabolism · doi:10.1586/17446651.4.2.161 · Cited by 6 · see citing works
Assessing sex assignment concordance with genotype and phenotype
Suresh, D., Crawford, J. M., Axelrad, M. E., et al. (2013) · International Journal of Pediatric Endocrinology · doi:10.1186/1687-9856-2013-7 · Cited by 5 · see citing works
Disorder of sex development
Caravia, I. V., Rodriguez, M. G., Mendoza, R. C., et al. (2017) · Revista Cubana de Urología · Cited by 5 · see citing works
The Endocrinology of Sexual Behavior and Gender Identity
Gooren, L. J. (2015) · Elsevier eBooks · doi:10.1016/b978-0-323-18907-1.00124-4 · Cited by 4 · see citing works

Flagged first, then by citations

Research works printed but not linked: 1

DiSandro M, Merke DP, Rink RC (2015) Review of current sur- gical techniques and medical management considerations in the treatment of pediatric patients with disorders of sex develop- ment. Horm Metab Res 47:321-328

Sorted by citations

Congenital adrenal hyperplasia
El-Maouche, D., Arlt, W., & Merke, D. P. (2017) · The Lancet · doi:10.1016/s0140-6736(17)31431-9 · Cited by 669 · see citing works

Gender identity disorder (GID) in adolescents and adults with differences of sex development (DSD): A systematic review and meta-analysis
Babu, R., & Shah, U. S. (2020) · Journal of Pediatric Urology · doi:10.1016/j.jpurol.2020.11.017 · Cited by 107 · see citing works
Clinician Judgment in the Diagnosis of Gender Identity Disorder in Children
Ehrbar, R. D., Witty, M. C., Ehrbar, H. G., et al. (2008) · Journal of Sex & Marital Therapy · doi:10.1080/00926230802219398 · Cited by 30 · see citing works
Faculty Opinions recommendation of Psychosexual outcome of gender-dysphoric children.
Levine, S. B., & Scott, D. (2009) · Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature · doi:10.3410/f.1146970.604076
V41 NEW REFINEMENTS IN MALE-TO-FEMALE SEX REASSIGNMENT SURGERY
PEROVIC, S. V., Djinovic, R. P., & Milosavljević, M. (2009) · European Urology Supplements · doi:10.1016/s1569-9056(09)61058-7
Sex reassignment
Bockting, W. O. (2015) · The International Encyclopedia of Human Sexuality · doi:10.1002/9781118896877.wbiehs436

Authors: Fisher, A. D., Ristori, J., Fanni, E., Castellini, G., Forti, G., & Maggi, M.
Affiliations: University of Florence (IT)
Corresponding author: Maggi, M.
ORCID: Fisher, A. D.
Ristori, J.
Castellini, G.
Maggi, M.
Venue: Journal of Endocrinological Investigation
Publisher: Springer Science and Business Media LLC
Published: 2016-06-10
Volume: 39
Issue: 11
Pages: 1207-1224
ISSN: 0391-4097 (ISSN-L)
1720-8386
DOI: 10.1007/s40618-016-0482-0
OpenAlex: W2413072702
Cited by: 100
References: 201
Citations by year: 2026: 7 · 2025: 10 · 2024: 14 · 2023: 5 · 2022: 15 · 2021: 14 · 2020: 10 · 2019: 8 · 2018: 6 · 2017: 8 · 2016: 3
FWCI: 0.75
Type: journal article
Language: en
Open access: green
hdl.handle.net
Licence: other-oa
www.springer.com/tdm (unspecified)
Locations: Journal of Endocrinological Investigation (publishedVersion)
PubMed (publishedVersion)
Florence Research (University of Florence) (submittedVersion, other-oa)
Topics: Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Sexual Differentiation and Disorders
Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic and Clinical Aspects of Sex Determination and Chromosomal Abnormalities
Keywords: disorders of sex development, gender identity, gender assignment, gender reassignment, gender dysphoria, psychosexual development, GnRH analogues, intersex, multidisciplinary care, clinical guidelines
MeSH terms: Gender Identity, Humans, Disorders of Sex Development, Gender-Affirming Procedures, Sex Reassignment Procedures

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Gender identity, gender assignment and reassignment in individuals with disorders of sex development: a major of dilemma

Abstract

Integrity signals

Claims the paper makes

Claims other papers make about this one

Self-check

Cites

Cited by

Related

Record

About these checks