Classification: News

December 1997


Discussion of intersex children in Dialogues in Pediatric

Woodhouse, Christopher R. J. 1997. Quality of Life in Children and Adolescents:
A Urologist's Point of View. Dialogues in Pediatric Urology 20 (11):7-8.

"Perhaps the most contentious area at present is the problem of gender
assignment in intersex infants. The long-held views of urologists and endocrinologists
are under vigorous attack in the American press and on the Internet. There
may be little understanding by laymen of these problems.

There may be no right answer about sex of rearing. There may be better
surgical techniques now than 20 years ago. It may seem wrong to send a
child with an obvious phallus to a girls school. Nonetheless, if there
are a significant number of individuals who feel that the childhood surgery

a mutilation with a poor physical and emotional outcome, there must
at least be a pause for thought. It is interesting to note that while the
western world tends toward rearing as female in difficult cases, virtually
all intersex patients in India are raised as male. Is this not an area
where quality of life becomes a paramount consideration?"


Richard Erlich, in his Guest Editor's introduction to this issue on
"Quality of Life Research in Children: Fashion or Future?" notes that:

"When it comes to quality of life and the psychosocial consequences
of diseases and abnormalities in pediatric urology, there is a blank in
the literature. Some highly specialized urologists have considerable clinical
experience in long-term pediatric urology. In scientific terms, however,

know hardly anything about our patients' life satisfaction, their self-esteem
and body image, their coping and social support, their sexuality, and their
expectations of us. We do not know the impact of scars, sometimes uncountable
operations and hospitalizations, the dependency on a catheter, and the
restrictions of fluid intake. As a consequence, we do not know how and
when to offer help beyond the scope of urology."

To which we former intersex patients can only say, "Amen."