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31 Issues L. & Med. 235 (2016)
Gender Identity Issues in Children and Adolescents

handle is hein.journals/ilmed31 and id is 243 raw text is: Gender Identity Issues in Children and Adolescents Quentin L. Van Meter, M.D., EC.P* Infants are assigned a gender in various ways. Most often assignment is made in the delivery room where it is common to hear It's a boy! or It's a girl! Prenatal genetic testing allows for pre-delivery determination. Ultrasound assessment of genitalia in the second and third trimester is also used. And to the parents and close family friends, facial and familial characteristics make some offspring unmistakable: that's my boy - a spittin' image of the old man. There are disorders of development of sexual identity Some of these disorders have a physical basis, and some have a psychological disorder of development and self-iden- tity. The physical disorders of sexual development are rare, and can make identification of male or female difficult. Physical Disorders of Sexual Development Examples include: 1. Male pseudo-hermaphrodite (the underdone male) 2. Female pseudo-hermaphrodite (the virilized female) 3. Mixed Gonadal Dysgenesis 4. True hermaphrodite 5. XX maleness 6. Cloacal defect Male Pseudo-Hermaphrodite These are genetic male infants who have a deficient response to androgens in utero. This deficient response can come from underproduction of androgens or from defects in androgen receptors. Underproduction of androgens in utero comes from either of two different enzyme deficiencies: 17-hydroxylase deficiency or 22-desmolase deficiency The adrenal and the gonad are lacking in the ability to convert androgen precursors to more effective forms of these hormones and so the expected virilization of the androgen-sensitive anlage does not occur completely * Van Meter Pediatric Endocrinology, PC. Disclosures: (1) Dr. Van Meter is a member of the speaker's bureau for the following companies: Endo, Abbvie, Novo Nordisk, Pfizer; (2) Dr. Van Meter is involved in clinical trials with Versartis. 235