Advice on the Management of Ambiguous Genitalia to a Young Endocrinologist From Experienced Clinicians

Jean D. Wilson, M.D.; Marco A. Rivarola, M.D.; Berenice B. Mendonca, M.D., Ph.D.; Garry L. Warne, A.M., M.B.B.S., F.R.A.C.P.; Nathalie Josso, M.D., Ph.D.; Stenvert L.S. Drop, M.D., Ph.D.; Melvin M. Grumbach, M.D.


Semin Reprod Med. 2012;30(5):339-350. 

In This Article


In my more than 50 years of practicing medicine, much has been learned about the pathophysiology of DSD in general and ambiguous genitalia in particular, and in many situations we have a much better idea how to diagnose, assign sex, and manage patients with ambiguous genitalia and other forms of DSD. At the same time we have markedly improved techniques both for classifying and diagnosing the various causes, for performing reconstructive surgery and for hormonal supplementation and promotion of fertility. The number of patients who are mismanaged or hidden away seems to have declined and hopefully will disappear in the future.