The rapid advances in medicine over the last 50 years have totally changed the outlook for children with disorders of sex development (DSD), but there is still much to learn. This book crystallizes the combined experience of a leading dedicated unit over 25 years in delivering expert medical and surgical care to children with DSD in a holistic environment. It documents the most recent advances in the molecular biology and embryology of sex development, and describes each disorder in detail. The clinical presentation and approach to diagnosis are described both for babies and for children presenting later in childhood or at adolescence. The chapters on management highlight all the latest knowledge and include the shared wisdom of the authors on current controversies, such as the timing of surgical treatment. Finally, the authors describe their short-, medium-, and long-term outcomes, which demonstrate the strengths of holistic team management.

From the contents:<br />Introduction: SRY: sex determination

Embryology of the human genital tract
Steroidogenesis and androgen metabolism
Gender Identity: its origins and development
Abnormal embryology in DSD. DSD: XXDSD
XYDSD
Sex chromosomes aneuploidy DSD
Ovotesticular DSD
Mixed gonadal dysgenesis
Non-hormonal DSD
Syndromes and DSD with multiple anomalies. Clinical Presentations: Neonatal presentations
Clinical examination
Medical Imaging
Gender assignment
Mid childhood presentations
Adolescent/Adult presentations. Management: Investigations: Genetics, hormones and imaging
Ethical and Legal issues
Medical management of neonate
Surgical management in infancy
Laparoscopy in DSD
Counselling in infancy and childhood
Genetic counselling
Controversies about timing of treatment
Gynaecological management in adolescents and young adults
Medical management in adolescence
Psychological management beyond adolescence. Outcomes: Long-term follow up at Royal Children s Hospital
Long-term follow up a global perspective
The future for fertility.