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When infants are born with an ambiguous or unclear gender should they be assigned to and physically altered become one the other?

It's crucial to understand the following points:

* Ambiguous genitalia: This refers to a range of conditions where a child's external genitalia might not fit typical male or female presentations. These conditions are relatively rare and have various underlying causes.

* Sex assigned at birth (SAAB): This is the gender assigned based on initial observations of the child's genitals.

* Gender identity: This is a person's deeply felt sense of being male, female, both, neither, or something else. It is distinct from SAAB and can be different.

* Intersex: This is a general term used to describe individuals born with variations in their sex characteristics. It's important to remember that intersex is not a disease or disorder, but a natural variation in human biology.

Ethical and Medical Considerations:

* Lack of consensus: There is no universal agreement on how to approach these situations. Some experts advocate for immediate surgical intervention to "normalize" the child's appearance, while others strongly oppose this practice, arguing that it can cause harm and infringe on the child's right to self-determination.

* Medical necessity: If a medical condition requires immediate intervention, surgery might be necessary. However, purely cosmetic surgeries for ambiguous genitalia are highly controversial.

* Delayed decision-making: Many experts believe that surgery should be delayed until the child is old enough to understand their gender identity and make informed decisions about their body.

* Informed consent: It's ethically crucial to obtain informed consent from the child (when they are capable) or from their parents or legal guardians, ensuring they fully understand the potential risks and benefits of any intervention.

The Importance of Individualized Approach:

* Comprehensive evaluation: Each child's case should be assessed by a multidisciplinary team including pediatricians, endocrinologists, surgeons, psychologists, and social workers.

* Focus on well-being: The primary goal should be the child's well-being and ensuring their physical and mental health.

* Support and education: Families should receive comprehensive support and education to help them navigate this complex situation.

It is essential to remember:

* Intersex individuals are a diverse group, and their experiences vary widely.

* There is no single "right" way to handle these situations.

* The approach should be individualized, informed by medical necessity, and respectful of the child's future autonomy.

Resources:

* Intersex Society of North America (ISNA): https://www.isna.org/

* The Organization Intersex International Australia (OII Australia): https://www.oii.org.au/

* The World Professional Association for Transgender Health (WPATH): https://www.wpath.org/

Please note: This information is not a substitute for professional medical advice. If you have concerns about a child's health, please consult with a healthcare professional.