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Reproductive System Disorder: Ambiguous Genitalia

By HERWriter
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Ambiguous genitalia refers to a condition questioning a child’s sex according to American Pediatric Surgical Association (APSA). Mayo Clinic wrote with ambiguous genitalia, the genitals may not be well-formed or babies may have external sexual organs that don’t match the internal sexual organs.

APSA stated humans normally have 46 chromosomes and two sex chromosomes. Boys have one X and one Y chromosome and girls have two X chromosomes and no Y chromosome.

Male and female sexual organs develop from the same fetal tissue. Children’s Hospital Boston said that fetal tissue becomes either a penis or clitoris. The presence of male hormones causes male organs to develop and their absence causes female organs to develop. Disrupt this process and ambiguous genitalia can develop.

The National Institutes of Health (NIH) said ambiguous genitalia in genetic females (babies with two X chromosomes) usually have the following characteristics:

- An enlarged clitoris that looks like a small penis

- A urethral opening along, above, or below the surface of the clitoris

- A closed labia or one that may look like a scrotum

- A lump in the labia that looks like a scrotum

- A hidden vagina

There are several causes of ambiguous genitalia in genetic females, including congenital adrenal hyperplasia. NIH said certain forms of this genetic condition cause the adrenal glands to make excess male hormones. Prenatal exposure to male hormones like progesterone and anabolic steroids is another, wrote Mayo Clinic.

Ambiguous genitalia in genetic males (babies with one X and one Y chromosome) may have the following characteristics wrote Mayo Clinic:
- The urethra doesn't fully extend to the penile tip

- An abnormally small penis with the urethral opening closer to the scrotum

- The absence of one or both testicles in what appears to be the scrotum

Causes of ambiguous genitalia in genetic males include congenital adrenal hyperplasia or abnormalities with testes or testosterone. Children’s Hospital Boston added androgen insensitivity syndrome.

Here, developing genital tissue can’t respond to normal male hormone levels. Or there's 5alpha-reductase deficiency, an enzyme deficiency, that impairs normal male hormone production. Another could be prenatal exposure to female hormones like estrogen.

Children’s Hospital of Wisconsin said treatment includes corrective surgery to remove or create reproductive organs appropriate for the child’s gender. Treatment may also include hormone replacement therapy (HRT).

Corrective surgery can preserve normal sexual function and create more natural-looking genitals, wrote the Mayo Clinic. For example, with a hidden vagina, surgery can help with sexual function later, or surgery to reconstruct an incomplete penis may improve appearance and make erections possible.

Children’s Hospital of Wisconsin warned that some born with ambiguous genitalia may have normal reproductive organs allowing them to live normal, fertile lives. Others may experience difficulty conceiving a child or infertility.


"Ambiguous genitalia: MedlinePlus Medical Encyclopedia." National Library of Medicine - National Institutes of Health. N.p., n.d. Web. 21 Mar. 2012. http://www.nlm.nih.gov/medlineplus/ency/article/003269.htm

"APSA Family Site | Ambiguous Genitalia." APSA Family Site | Home. N.p., n.d. Web. 21 Mar. 2012. http://www.pediatricsurgerymd.org/AM/Template.cfm?Section=List_Of_Conditions&TEMPLATE=/CM/ContentDisplay.cfm&ContentID=1313

"AUAF - Urology A-Z - Ambiguous Genitalia." AUAF - Home. N.p., n.d. Web. 21 Mar. 2012.

Add a Comment1 Comments

If you are a parent of an infant with any of the above conditions, it may be hard to not listen to a surgeon say he/she has the answer...
I urge you to wait, there is no hurry and research the issue and seek the advice of the transgender community, transgender rights community and those who had such surgery and now feel angry at their parents and betrayed, distrustful of all physicians and healthcare professionals, and depressed that they will never be "normal" or have a chance to experience their own lives with what they were born with rather than what some surgeon made them into.
This is not a simple issue and a simple solution of surgery is outmoded, unnecessary and even morally and ethically wrong.
In order to make the parents and relatives feel better, the surgeon is listened to... how do they know? And what are they basing the recommendation for surgery on... their own prejudices, religious beliefs, what they were taught in medical school by another well-meaning but misguided professor/surgeon?
How many post-op transgendered patients came to the medical school to offer a different point of view? Ask the surgeon. None? Then what the hell do they know? Only their own narrow-band of thinking.
It's time that parents become aware that with chemicals in the environment, previous genetic problems or issues, and even God's hand, depending on your own belief system, that "Ambiguous Genitalia" can occur, but who says its a "Reproductive System Disorder"?
Anyone hearing that will react with my God I/we have to do something! Doctor what can be done?
Well start by saying you need an independent voice in the consultation room. You need to not panic. You need information, education and networking with those who have had "Reproductive System Disorder surgery".
You may make a different decision.
Think about it.

March 23, 2012 - 7:21pm
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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