{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T18:38:25Z","timestamp":1790879905424,"version":"4.1.0"},"reference-count":49,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2018,3,29]],"date-time":"2018-03-29T00:00:00Z","timestamp":1522281600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2018,3,29]],"date-time":"2018-03-29T00:00:00Z","timestamp":1522281600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"funder":[{"DOI":"10.13039\/100011102","name":"European Union Seventh Framework Programme","doi-asserted-by":"crossref","award":["305373 [FP7\/2007-2013]"],"award-info":[{"award-number":["305373 [FP7\/2007-2013]"]}],"id":[{"id":"10.13039\/100011102","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["jsm.jsexmed.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Information on the psychosexual outcome of individuals with disorders of sex development (DSDs) and intersex conditions is of great importance for sex assignment at birth of newborns with DSD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>To assess gender change and gender dysphoria in a large sample of individuals with different DSDs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A cross-sectional study was conducted in 14 European centers with 1,040 participants (717 female-identifying and 311 male-identifying persons and 12 persons identifying with another gender) with different forms of DSD. The cohort (mean age\u00a0= 32.36 years, SD\u00a0= 13.57) was divided into 6 major subgroups: women with 45,X DSD and variants (Turner syndrome; n\u00a0= 325), men with 47,XXY DSD and variants (Klinefelter syndrome; n\u00a0= 219), women with XY DSD without androgen effects (n\u00a0= 107) and with androgen effects (n\u00a0=\u00a063), men with XY DSD (n\u00a0= 87), and women with 46,XX congenital adrenal hyperplasia (n\u00a0= 221). Data on psychosexual outcome were gathered by medical interviews and questionnaires.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcomes<\/jats:title>\n                  <jats:p>Gender change and gender dysphoria.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Although gender changes were reported by 5% of participants, only in 1% (3% if those with Klinefelter and Turner syndromes\u2014conditions in which gender issues are not prominent\u2014are excluded) did the gender change take place after puberty and was likely initiated by the patient. 39 participants (4%) reported gender variance: between male and female, a gender other than male or female, or gender queer, alternating gender roles, or a gender expression that differed from the reported gender. This group had lower self-esteem and more anxiety and depression than the other participants.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Implications<\/jats:title>\n                  <jats:p>Clinicians should be aware of and sensitive to the possibility that their patients with DSD not only might have transgender feelings and a desire to change gender, but also identify as different from male or female. The complexity of their feelings might require counseling for some patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Strengths and Limitations<\/jats:title>\n                  <jats:p>The study is unique in the large number of participants from many different clinics, with sizable numbers in most subgroups, and in the large number of aspects that were measured. However, the very broadness of the study made it impossible to focus in detail on gender issues. Also, there is a need for instruments specifically measuring gender dysphoria in individuals with DSD that take non-binary genders into account.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>To make appropriate gender care possible for people with DSD, the gender-normative and gender-variant development of children with DSD should be studied in longitudinal studies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1016\/j.jsxm.2018.02.021","type":"journal-article","created":{"date-parts":[[2018,3,30]],"date-time":"2018-03-30T10:40:20Z","timestamp":1522406420000},"page":"777-785","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":100,"title":["Gender Dysphoria and Gender Change in Disorders of Sex Development\/Intersex Conditions: Results From the dsd-LIFE Study"],"prefix":"10.1093","volume":"15","author":[{"given":"Baudewijntje P.C.","family":"Kreukels","sequence":"first","affiliation":[{"name":"Department of Medical Psychology and Medical Social Work , Amsterdam \u00a0 The Netherlands"},{"name":"VU University Medical Center Amsterdam , Amsterdam \u00a0 The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgit","family":"K\u00f6hler","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr P\u00e4diatrie m.S. P\u00e4diatrische Endokrinologie CVK , Berlin \u00a0 Germany"},{"name":"Charit\u00e9 Universit\u00e4tsmedizin , Berlin \u00a0 Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Nordenstr\u00f6m","sequence":"additional","affiliation":[{"name":"Division of Pediatric Endocrinology , Stockholm \u00a0 Sweden"},{"name":"Department of Women's and Children's Health , Stockholm \u00a0 Sweden"},{"name":"Karolinska Institutet , Stockholm \u00a0 Sweden"},{"name":"Karolinska University Hospital Solna , Stockholm \u00a0 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Roehle","sequence":"additional","affiliation":[{"name":"Koordinierungszentrum Klinische Studien (KKS) , Berlin \u00a0 Germany"},{"name":"Charit\u00e9 Universit\u00e4tsmedizin Berlin , Berlin \u00a0 Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ute","family":"Thyen","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Kinder- und Jugendmedizin Universit\u00e4t zu L\u00fcbeck , L\u00fcbeck \u00a0 Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Bouvattier","sequence":"additional","affiliation":[{"name":"Assistance Publique H\u00f4pitaux de Paris , Paris \u00a0 France"},{"name":"H\u00f4pital Bic\u00eatre , Paris \u00a0 France"},{"name":"Paris Sud University , Paris \u00a0 France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annelou L.C.","family":"de Vries","sequence":"additional","affiliation":[{"name":"Department of Child Psychiatry , Amsterdam \u00a0 The Netherlands"},{"name":"VU University Medical Center Amsterdam , Amsterdam \u00a0 The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peggy T.","family":"Cohen-Kettenis","sequence":"additional","affiliation":[{"name":"Department of Medical Psychology and Medical Social Work , Amsterdam \u00a0 The Netherlands"},{"name":"VU University Medical Center Amsterdam , Amsterdam \u00a0 The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"on behalf of the dsd-LIFE group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2018,3,29]]},"reference":[{"key":"2023012309382637100_bib1","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1007\/978-1-4419-1465-1_24","article-title":"Gender identity and stereotyping in early and middle childhood","author":"Halim","year":"2010","journal-title":"Handbook of gender research in psychology"},{"key":"2023012309382637100_bib2","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1177\/1359105305051417","article-title":"The interaction between young people with atypical gender identity organization and their peers","volume":"10","author":"Wilson","year":"2005","journal-title":"J\u00a0Health Psychol"},{"key":"2023012309382637100_bib3","doi-asserted-by":"crossref","DOI":"10.1176\/appi.books.9780890425596","article-title":"Diagnostic and statistical manual of mental disorders","author":"American Psychiatric Association","year":"2013"},{"key":"2023012309382637100_bib4","first-page":"244","article-title":"Exploring the diversity of gender and sexual orientation identities in an online sample of transgender individuals","volume":"49","author":"Kuper","year":"2012","journal-title":"J\u00a0Sex Res"},{"key":"2023012309382637100_bib5","doi-asserted-by":"crossref","first-page":"95","DOI":"10.3109\/09540261.2015.1106446","article-title":"Non-binary or genderqueer genders","volume":"28","author":"Richards","year":"2016","journal-title":"Int Rev Psychiatry"},{"key":"2023012309382637100_bib6","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.yfrne.2011.03.001","article-title":"Sexual differentiation of human behavior: effects of prenatal and pubertal organizational hormones","volume":"3","author":"Berenbaum","year":"2011","journal-title":"Front Neuroendocrinol"},{"key":"2023012309382637100_bib7","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/s13293-015-0022-1","article-title":"Early androgen exposure and human gender development","volume":"6","author":"Hines","year":"2015","journal-title":"Biol Sex Differ"},{"key":"2023012309382637100_bib8","doi-asserted-by":"crossref","first-page":"e488","DOI":"10.1542\/peds.2006-0738","article-title":"Consensus statement on management of intersex disorders. International Consensus Conference on Intersex","volume":"118","author":"Lee","year":"2006","journal-title":"Pediatrics"},{"key":"2023012309382637100_bib9","doi-asserted-by":"crossref","first-page":"e710","DOI":"10.1542\/peds.2014-1088","article-title":"Changes over time in sex assignment for disorders of sex development","volume":"134","author":"Kolesinska","year":"2014","journal-title":"Pediatrics"},{"key":"2023012309382637100_bib10","first-page":"2413","article-title":"Hypersexuality, paraphilic behaviors, and gender dysphoria in individuals with Klinefelter's syndrome","volume":"12","author":"Fisher","year":"2015","journal-title":"J\u00a0Sex Med"},{"key":"2023012309382637100_bib11","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1007\/s10508-010-9628-x","article-title":"A\u00a047,XXY female with gender identity disorder","volume":"39","author":"Khandelwal","year":"2010","journal-title":"Arch Sex Behav"},{"key":"2023012309382637100_bib12","article-title":"Gender dysphoria in Klinefelter's syndrome: three cases","author":"Davies","journal-title":"Aust Psychiatry"},{"key":"2023012309382637100_bib13","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1007\/s10508-005-4338-5","article-title":"Gender dysphoria and gender change in chromosomal females with congenital adrenal hyperplasia","volume":"34","author":"Dessens","year":"2005","journal-title":"Arch Sex Behav"},{"key":"2023012309382637100_bib14","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.yhbeh.2016.08.008","article-title":"Recalled and current gender role behavior, gender identity and sexual orientation in adults with disorders\/differences of sex development","volume":"86","author":"Callens","year":"2016","journal-title":"Horm Behav"},{"key":"2023012309382637100_bib15","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1007\/s10508-015-0493-5","article-title":"Gender development in Indonesian children, adolescents, and adults with disorders of sex development","volume":"44","author":"Ediati","year":"2015","journal-title":"Arch Sex Behav"},{"key":"2023012309382637100_bib16","doi-asserted-by":"crossref","first-page":"3432","DOI":"10.1210\/jc.2009-0636","article-title":"Gender role behavior, sexuality, and psychosocial adaptation in women with congenital adrenal hyperplasia due to CYP21A2 deficiency","volume":"94","author":"Fris\u00e9n","year":"2009","journal-title":"J\u00a0Clin Endocrinol Metab"},{"key":"2023012309382637100_bib17","doi-asserted-by":"crossref","first-page":"870","DOI":"10.4103\/2230-8210.192922","article-title":"Gender of rearing and psychosocial aspect in 46 XX congenital adrenal hyperplasia","volume":"20","author":"Gangaher","year":"2016","journal-title":"Indian J Endocrinol Metab"},{"key":"2023012309382637100_bib18","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1210\/jc.2006-1757","article-title":"Impaired sexual and reproductive outcomes in women with classical forms of congenital adrenal hyperplasia","volume":"92","author":"Gastaud","year":"2007","journal-title":"J\u00a0Clin Endocrinol Metab"},{"key":"2023012309382637100_bib19","first-page":"2703","article-title":"Psychosexual development in adolescents and\u00a0adults with disorders of sex development; results from the\u00a0German Clinical Evaluation Study","volume":"10","author":"J\u00fcrgensen","year":"2013","journal-title":"J\u00a0Sex Med"},{"key":"2023012309382637100_bib20","doi-asserted-by":"crossref","first-page":"182","DOI":"10.4103\/0019-5545.130504","article-title":"Mistaken gender identity in non-classical congenital adrenal hyperplasia","volume":"56","author":"Kukreti","year":"2014","journal-title":"Indian J Psychiatry"},{"key":"2023012309382637100_bib21","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1515\/JPEM.2005.18.2.125","article-title":"46,XX patients with congenital adrenal hyperplasia: initial assignment as male, reassigned female","volume":"18","author":"Lee","year":"2005","journal-title":"J\u00a0Pediatr Endocrinol Metab"},{"key":"2023012309382637100_bib22","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1515\/JPEM.2004.17.10.1367","article-title":"Gender role across development in adult women with congenital adrenal hyperplasia due to 21-hydroxylase deficiency","volume":"17","author":"Long","year":"2004","journal-title":"J\u00a0Pediatr Endocrinol Metab"},{"key":"2023012309382637100_bib23","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1007\/s10508-006-9068-9","article-title":"Gender development in women with congenital adrenal hyperplasia as a function of disorder severity","volume":"35","author":"Meyer-Bahlburg","year":"2006","journal-title":"Arch Sex Behav"},{"key":"2023012309382637100_bib24","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1515\/JPEM.2005.18.6.555","article-title":"A\u00a0long-term outcome study of intersex conditions","volume":"18","author":"Warne","year":"2005","journal-title":"J\u00a0Pediatr Endocrinol Metab"},{"key":"2023012309382637100_bib25","doi-asserted-by":"crossref","first-page":"1871","DOI":"10.1007\/s10508-016-0750-2","article-title":"Gender Dysphoria in a 62-year-old genetic female with congenital adrenal hyperplasia","volume":"45","author":"Silveira","year":"2016","journal-title":"Arch Sex Behav"},{"key":"2023012309382637100_bib26","doi-asserted-by":"crossref","first-page":"e191","DOI":"10.4158\/EP14179.CR","article-title":"Divergent gender identity in three siblings with 46XX karyotype and severely virilizing congenital adrenal hyperplasia caused by a novel CYP11B1 mutation","volume":"20","author":"Bin-Abbas","year":"2014","journal-title":"Endocr Pract"},{"key":"2023012309382637100_bib27","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.jsbmb.2016.03.033","article-title":"Long term outcomes in 46, XX adult patients with congenital adrenal hyperplasia reared as males","volume":"165","author":"Khattab","year":"2017","journal-title":"J\u00a0Steroid Biochem Mol Biol"},{"key":"2023012309382637100_bib28","doi-asserted-by":"crossref","first-page":"982025","DOI":"10.1186\/1687-9856-2010-982025","article-title":"Review of outcome information in 46,XX patients with congenital adrenal hyperplasia assigned\/reared male: what does it say about gender assignment?","volume":"2010","author":"Lee","year":"2010","journal-title":"Int J Pediatr Endocrinol"},{"key":"2023012309382637100_bib29","doi-asserted-by":"crossref","first-page":"935","DOI":"10.4103\/2230-8210.102994","article-title":"Male genitoplasty for 46 XX congenital adrenal hyperplasia patients presenting late and reared as males","volume":"16","author":"Sharma","year":"2012","journal-title":"Indian J Endocrinol Metab"},{"key":"2023012309382637100_bib30","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1007\/s10508-005-4341-x","article-title":"Gender dysphoria and gender change in androgen insensitivity or micropenis","volume":"34","author":"Mazur","year":"2005","journal-title":"Arch Sex Behav"},{"key":"2023012309382637100_bib31","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1007\/s10508-009-9526-2","article-title":"Apparent male gender identity in a patient with complete androgen insensitivity syndrome","volume":"38","author":"Kulshreshtha","year":"2009","journal-title":"Arch Sex Behav"},{"key":"2023012309382637100_bib32","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1007\/s10508-010-9624-1","article-title":"Male gender identity in complete androgen insensitivity syndrome","volume":"40","author":"T'Sjoen","year":"2011","journal-title":"Arch Sex Behav"},{"key":"2023012309382637100_bib33","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1007\/s10508-005-4339-4","article-title":"Gender change in 46,XY persons with 5alpha-reductase-2 deficiency and 17beta-hydroxysteroid dehydrogenase-3 deficiency","volume":"34","author":"Cohen-Kettenis","year":"2005","journal-title":"Arch Sex Behav"},{"key":"2023012309382637100_bib34","first-page":"1629","article-title":"Psychosexual outcome among Iranian individuals with 5\u03b1-reductase deficiency type 2 and its relationship with parental sexism","volume":"13","author":"Khorashad","year":"2016","journal-title":"J\u00a0Sex Med"},{"key":"2023012309382637100_bib35","article-title":"Satisfaction with multidisciplinary care of adolescents and adults with disorders of sex development (DSD) in six European countries (dsd-LIFE)","author":"Thyen","journal-title":"Submitted (BMC Health Serv Res)"},{"key":"2023012309382637100_bib36","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1186\/s12902-017-0198-y","article-title":"Participation of adults with disorders\/differences of sex development (DSD) in the clinical study dsd-LIFE: design, methodology, recruitment, data quality and study population","volume":"17","author":"Roehle","year":"2017","journal-title":"BMC Endocr Disord"},{"key":"2023012309382637100_bib37","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1007\/s10508-016-0702-x","article-title":"Measuring gender dysphoria: a multicenter examination and comparison of the Utrecht Gender Dysphoria Scale and the Gender Identity\/Gender Dysphoria Questionnaire for Adolescents and Adults","volume":"45","author":"Schneider","year":"2016","journal-title":"Arch Sex Behav"},{"key":"2023012309382637100_bib38","first-page":"38","article-title":"From gender variance to gender dysphoria","author":"Steensma","year":"2013"},{"key":"2023012309382637100_bib39","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1037\/0022-3514.89.4.623","article-title":"Simultaneous administration of the Rosenberg Self-Esteem Scale in 53 nations: exploring the universal and culture-specific features of global self-esteem","volume":"89","author":"Schmitt","year":"2005","journal-title":"J\u00a0Pers Soc Psychol"},{"key":"2023012309382637100_bib40","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/S0022-3999(01)00296-3","article-title":"The validity of the Hospital Anxiety and Depression Scale. An updated literature review","volume":"52","author":"Bjelland","year":"2002","journal-title":"J\u00a0Psychosom Res"},{"key":"2023012309382637100_bib41","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1111\/j.1600-0447.1983.tb09716.x","article-title":"The Hospital Anxiety and Depression Scale","volume":"67","author":"Zigmond","year":"1983","journal-title":"Acta Psychiatr Scand"},{"key":"2023012309382637100_bib42","first-page":"1","article-title":"ESS Round 6 Source Questionnaire","author":"European Social Survey","year":"2012"},{"key":"2023012309382637100_bib43","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1007\/s10508-013-0140-y","article-title":"Gender identities and gender dysphoria in the Netherlands","volume":"43","author":"Kuyper","year":"2014","journal-title":"Arch Sex Behav"},{"key":"2023012309382637100_bib44","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1007\/s10508-014-0452-6","article-title":"Prevalence of gender nonconformity in Flanders, Belgium","volume":"44","author":"Van Caenegem","year":"2015","journal-title":"Arch Sex Behav"},{"key":"2023012309382637100_bib45","first-page":"56","article-title":"Gender experience and satisfaction with gender allocation in adults with diverse intersex conditions (divergences of sex development, DSD)","volume":"5","author":"Schweizer","year":"2014","journal-title":"Psychol Sex"},{"key":"2023012309382637100_bib46","article-title":"dsd-LIFE Group. Psychological support for individuals with differences of sex development (DSD)","author":"Bennecke","journal-title":"Submitted for publication"},{"key":"2023012309382637100_bib47","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1055\/s-0032-1324729","article-title":"Psychological aspects of the treatment of patients with disorders of sex development","volume":"30","author":"Sandberg","year":"2012","journal-title":"Semin Reprod Med"},{"key":"2023012309382637100_bib48","first-page":"2201","article-title":"Partial treatment requests and underlying motives of applicants for gender affirming interventions","volume":"12","author":"Beek","year":"2015","journal-title":"J\u00a0Sex Med"},{"key":"2023012309382637100_bib49","article-title":"dsd-LIFE Consortium. Disorders of differences of sex development? Views of affected individuals on DSD terminology","author":"Bennecke","journal-title":"Submitted for publication"}],"container-title":["The Journal of Sexual Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1743609518301437?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1743609518301437?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/jsm\/article-pdf\/15\/5\/777\/48588523\/jsm_15_5_777.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jsm\/article-pdf\/15\/5\/777\/48588523\/jsm_15_5_777.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T10:10:21Z","timestamp":1674468621000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jsm\/article\/15\/5\/777\/6980489"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3,29]]},"references-count":49,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2018,3,29]]},"published-print":{"date-parts":[[2018,5,1]]}},"URL":"https:\/\/doi.org\/10.1016\/j.jsxm.2018.02.021","relation":{},"ISSN":["1743-6109","1743-6095"],"issn-type":[{"value":"1743-6109","type":"electronic"},{"value":"1743-6095","type":"print"}],"subject":[],"published-other":{"date-parts":[[2018,5]]},"published":{"date-parts":[[2018,3,29]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Gender Dysphoria and Gender Change in Disorders of Sex Development\/Intersex Conditions: Results From the dsd-LIFE Study","name":"articletitle","label":"Article Title"},{"value":"The Journal of Sexual Medicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jsxm.2018.02.021","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2018 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.","name":"copyright","label":"Copyright"}]}}