Our multidisciplinary team manages disorders of sexual development within an ethical framework and educates parents to assist them in making informed decisions.
Disorders of sexual differentiation (DSD) result from discordance between chromosomes, anatomical sex and hormones. If a problem occurs during the process of sexual differentiation, a baby’s sex can be difficult to determine based on the appearance of the external genitalia.
Traditionally, these conditions are treated by independent specialists: endocrinologists, gynecologists, geneticists and psychologists. To promote and foster collaboration, Texas Children's Hospital has created an internationally recognized Program for Disorders of sexual Differentiation. Our multidisciplinary team of ethicists, psychologists, urologists, gynecologists, endocrinologists, geneticists, and psychologists collaborate to determine diagnosis, appropriate hormonal and surgical treatments, and sex assignment.
Our primary goal is to enhance the quality of life for children with DSD and their parents by effectively utilizing all the resources of Texas Children’s Hospital in an integrated care model. Our multidisciplinary team works daily to achieve this by involving and educating parents so you are comfortable making decisions within an ethical framework. The following patients are good candidates for evaluation by our multidisciplinary team:
Babies born with variations in the appearance of their genitalia, which makes it difficult to tell whether they are boys or girls
Children who might have chromosomes or hormones that differ from what is expected for their assigned sex
Children who might have problems developing during puberty
Children with any of the following diagnoses:
Ambiguous genitalia
Androgen insensitivity syndrome
Congenital adrenal hyperplasia
Disorders of sexual differentiation with ovotesticular component
Genetic disorders of gonadal determination
Genetic syndromes that result in unexpected hormone production
Gonadal dysgenesis
Klinefelter syndrome
Ovary or testis on one side and ovotestis on contralateral side
Turner syndrome
What We Offer
Our team of experts – which includes ethicists, urologists, gynecologists, surgeons, endocrinologists, geneticists, and psychologists – can:
Recommend an appropriate course of treatment
Work with your patients and their parents to decide sex of rearing
Evaluate the patient’s capacity for normal sexual function
Determine timing of surgery
Support a stable sexual identity for the child
We know that gender assignment decisions are difficult for parents, so parental involvement in the decision-making process for sex assignment or sex of rearing is a major component of our approach. Parents are provided with all of the diagnostic results and a significant amount of time is spent explaining the meaning of the test results.
You are given the opportunity to ask the opinion of each respective specialist concerning the most appropriate sex assignment before making a decision. The psychologist participates in these discussions to ensure that you, as the parents, understand the information presented to you.
In addition to presenting information, our team members frequently encourage parents to voice questions or concerns, engage with us in dialog, and review the information. We make clear that sex assignment or sex of rearing in these cases encompasses the most likely gender role, sexual function, and reproductive function based on the biologic data. We always stress the uncertainty about such sex assignments and explain that sexual orientation cannot be predicted for any child with perfect accuracy by either the family or physician.
In cases in which the sex is not clear, families may opt to delay performing definitive genital surgery.
Request a Consultation
Parents who would like to schedule a consultation with our team of experts should ask their primary care provider or pediatrician to make a referral. Your doctor should fill out this form and fax it back to us at 832-825-9068.
