Responses

Download PDFPDF
Consensus statement on management of intersex disorders
Compose Response

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Statement of Competing Interests

PLEASE NOTE:

  • Responses are moderated before posting and publication is at the absolute discretion of BMJ, however they are not peer-reviewed
  • Once published, you will not have the right to remove or edit your response. Removal or editing of responses is at BMJ's absolute discretion
  • If patients could recognise themselves, or anyone else could recognise a patient from your description, please obtain the patient's written consent to publication and send them to the editorial office before submitting your response [Patient consent forms]
  • By submitting this response you are agreeing to our full [Response terms and requirements]

Vertical Tabs

Other responses

Jump to comment:

  • Published on:
    Variation vs. Disorder, Development vs. Differentiation

    Dear Editor,

    There is no doubt that language is contextual. Disorder as a term, while innocuously descriptive to one, may hold a negative connotation for another, especially those afflicted with whatever said disorder.

    Regarding brain sex, I agree with the Consensus Statement on Management of Intersex Disorders (CoSMID) that “Structure of the brain is not currently useful for gender assignment.” Quan...

    Show More
    Conflict of Interest:
    None declared.
  • Published on:
    ...no need for further confusions!

    Dear Editor,

    It is interesting to read the comments, proposals, agreements and disagreements on terminology related to “developmental” variations, with “functional” disorders of sexual properties. In medical use, the term “disorder” is explained as “an abnormal physical or mental condition”, like the “refraction disorder” what I have since 7 years of age. If you look at the contents of “The Merck Manual of Dia...

    Show More
    Conflict of Interest:
    None declared.
  • Published on:
    Praise is due too, but.............!

    Dear Editor,

    I have read the comments on the Consensus Statement with great interest. On the whole, I felt the document recommendations were to be commended and provide us with an excellent guide for optimal care, in particular with regard to surgical and psychological advice and support. However, I admit to being very uneasy about the way nomenclature was included in this meeting. Various CAH support grou...

    Show More
    Conflict of Interest:
    None declared.
  • Published on:
    Not as it seems

    Dear Editor,

    I can’t make a blanket statement whether intersex conditions are disorders or not, but I do feel strongly that no one else has the right to decide that for me. As a contributor to both Intersex hand-books it is still unclear to me how this consensus on terminology developed and who makes up the consensus group- authors or contributors. I do know that I was never asked to be, nor did I consent to be pa...

    Show More
    Conflict of Interest:
    None declared.
  • Published on:
    DSD support from a physician and mother

    Dear Editor,

    I am a physician and a mother. Sixteen years ago, when I learned that my daughter had complete androgen sensitivity syndrome (AIS), I reached for my textbooks with the confidence instilled by 10 years of medical training. Encountering the terms "intersex" and "pseudohermaphrodite," I was shocked and unnerved. Despite being a physician, it was not until 15 years after the AIS diagnosis that was I able t...

    Show More
    Conflict of Interest:
    None declared.
  • Published on:
    Disorder vs Intersex

    Dear Editor,

    I am concerned about the promotion of terminology that reinforces a notion of disorder for people who are intersexed. I prefer a term such as variation or atypicality.

    I am concerned that people who have not had access to proper diagnostic work-ups available now will be excluded from appropriate treatment: people such as myself who may have had experimental interventions many years ago, but b...

    Show More
    Conflict of Interest:
    None declared.
  • Published on:
    Children are not disorders

    Dear Editor,

    As the professor Milton Diamond wrote it, words can wound, there are cases where they can even kill.

    As a counsellor, my reference is always the experience of my clients and it is a personal, an ethical and a professional goal to understand them as they understand themselves.

    The intersexed people I know are all telling me that they got deeply destructive messages during their c...

    Show More
    Conflict of Interest:
    None declared.
  • Published on:
    Disorder a no no!

    Dear Editor,

    My first inclination that something was different was when a doctor doing a company insurance physical listed on the medical form that I was "exempt" from certain coverage because of a pre-existing medical condition as a result of hermaphroditic indicators. I ran out of that facility in shame. Later found that the scar on my groin was not the "cyst" I had been told was removed as an infant but a probable...

    Show More
    Conflict of Interest:
    None declared.
  • Published on:
    Respecting Self-Perception in a Patient Centered way

    Dear Editor,

    As Professor Milton Diamond wrote, words can wound. There are cases where they can even kill.

    As a gender therapist, sexologist and psychotherapist, who has become acquainted with intersexed/intergender persons, I have always stressed that my professional interactions with them must be within an ethical framework based on their personal narratives and insights with special emphasis on t...

    Show More
    Conflict of Interest:
    None declared.
  • Published on:
    DSD vs Intersex

    Dear Editor,

    With all the hoopla regarding using the term DSD as opposed to Intersex, I was hesitant to add my own two cents. However, after giving it a lot of thought I decided my opinion does matter. And what I have to say is as important as any other letter that is for or against the term DSD.

    As an intersexed child at the University of Chicago Hospital, several diagnoses were attached to me, none...

    Show More
    Conflict of Interest:
    None declared.
  • Published on:
    Disorders of sex development similar to more familiar disorders

    Dear Editor,

    As a member of the International Consensus Conference on Intersex, and an affected adult, I supported the new nomenclature, which replaces both "intersex" and "hermaphrodite" with "disorders of sex development" (DSDs). But it would be a mistake to consider "DSD" to be a synonym for either "intersex" or "hermaphrodite."

    Medical management of intersex has been treated as if it were utterly...

    Show More
    Conflict of Interest:
    None declared.
  • Published on:
    DSD and Identity

    Dear Editor,

    The Consortium on Disorders of Sex Development (“DSD Consortium”) has recommended that in venues where the medical care of infants is considered, the term "Disorders of Sex Development" and the initialism “DSD” be used in favor of the term “intersex.” While both “DSD” and “intersex” are “umbrella” terms (meaning that they encompass people born with a variety of discrete conditions but having important f...

    Show More
    Conflict of Interest:
    None declared.
  • Published on:
    The terms need to evolve

    Dear Editor,

    I believe it is fair to say that using terms like "sex" and "disorder" in medical nomenclature can be regarded confusing, as well as stigmatizing. It would be confusing because if a parent with a child seeking information typed "DSD" into a search engine on the internet (As people in this day and age do), there would be many things returned that would be irrelevant. If they typed "Disorders of Sex...

    Show More
    Conflict of Interest:
    None declared.
  • Published on:
    Was Variations of Reproductive Development considered?

    Dear Editor,

    The new intersex terminology scheme, based on Disorders of Sex Development (DSD) and discussed in the consensus statement by Hughes et al [1], seems to offer the following benefits:

    a) it covers a wide range of intersex conditions without using the archaic and stigmatising hermaphrodite and male/female pseudo- hermaphrodite terms, b) it should end the problem of the term intersex being used...

    Show More
    Conflict of Interest:
    None declared.
  • Published on:
    Thank you very much Dr. Diamond
    Dear Dr. Hazel Beh and Dr. Diamond,

    I wish to thank you both for your very well-written response which emphasizes the need for respecting the human dignity of the individuals who are going to be "managed" by the experts who follow these guidelines.

    Your willingness to treat us who are intersexed with respect has touched the hearts of many of us, including me. I agree with you wholeheartedly in your suggestion...

    Show More
    Conflict of Interest:
    None declared.
  • Published on:
    Re: Variations of Sex Development Instead of Disorders of Sex Development

    Dear Editor,

    I would like to thank Dr. Diamond for suggesting the use of VSD over DSD, as I don't like negative medical terms defining me. I'd rather be seen in a positive way with humanistic attributes.

    I’m frustrated living in our stereotypical 2-sex /2-gender medical and social system that permeates, controls, and dominates the world…since I’m living as a “variation” in my sex and my gender. When I was...

    Show More
    Conflict of Interest:
    None declared.
  • Published on:
    Variations of Sex Development Instead of Disorders of Sex Development

    Dear Editor,

    The late John Money, writing about intersexuality, appropriately said, "Words can wound. Medicine can be very cruel in diagnostic terms." He commented, "hermaphroditism or intersex are too stigmatizing for people born with a syndrome that affects the sex organs." Money therefore labeled sex development variations as "sex errors of the body" in his texts for parents and clinicians. He viewed the term...

    Show More
    Conflict of Interest:
    None declared.
  • Published on:
    Ambiguous terms still persist in the Consensus

    Dear Editor,

    In the last 30 years, our Group has followed-up more than 400 patients with disorders of sex development (intersex) and we have witnessed the difficulties for the patient and for the family in supporting the many hardships imposed by the diagnostic work-up and the choice of sex of rearing. Every professional who deals with this kind of patients must be aware that the terminology employed with the...

    Show More
    Conflict of Interest:
    None declared.
  • Published on:
    Re: Consensus statement on management of intersex disorders
    • Andrew N. Williams, Consultant Community Paediatrician
    • Other Contributors:
      • Dr Christopher Moudiotis

    Dear Editor,

    We found Hughes et al’s [1} consensus statement on the management of Intersex Disorders fascinating as it builds on an earlier article published by Ogilvy-Stuart and Brain in the ACD [2]. However both papers brought to mind a case described by the late-renaissance surgeon Ambrose Paré (1510-1590) which has continued to perplex us. The case is of a girl who suddenly became a man at fifteen year...

    Show More
    Conflict of Interest:
    None declared.