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Disorders of sex development comprise a group of diagnoses that represent significant and controversial management difficulties, such as those relating to gender assignment, genital surgery and risk of gonadal malignancy or future gender dysphoria. These issues arise on the background of a diagnosis that is often fraught with psychological trauma for patients and their families. There have been many changes in the medical approach to management in recent years; however, more research is required. This should focus on achieving accurate diagnosis in the first case, and on following outcomes to advise best practice. Finally, rational dialogue between multidisciplinary care providers, ethicists and patients and their families will only lead to improved care for these children.
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Hewitt et al. (2009) studied this question.
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