Surgical, Patient, and Parental Considerations in the Management of Children with Differences of Sex Development

Purpose of Review: The goal of this review is to provide an overview of the controversies affecting care and outcomes of patients with disorders/differences of sex development (DSD). In recent years, there has been a significant paradigm shift in management of patients with DSD. Within this context, this review will then discuss key advances in DSD care. Recent Findings: Important controversies to be cognizant of when caring for patients with DSD include DSD nomenclature, gender assignment, and timing of surgery. Within the last two decades, there have been dramatic advances in surgical techniques, understanding of patients’ and parents’ experience, and knowledge about fertility potential and tumor risk. Based on these advances, the modern treatment paradigm recommends multidisciplinary care and shared decision-making. Summary: The care of patients with DSD is complex and ever-evolving. This review underscores the importance of multidisciplinary and individualized approach when caring for patients with DSD, with an emphasis on shared decision-making and psychosocial support.