{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T10:47:44Z","timestamp":1787741264877,"version":"build-2784847793"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,10,9]],"date-time":"2021-10-09T00:00:00Z","timestamp":1633737600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,10,9]],"date-time":"2021-10-09T00:00:00Z","timestamp":1633737600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"The Special Fund of the Pediatric Medical Coordinated Development Center of Beijing Hospitals Authority","award":["XTYB201808"],"award-info":[{"award-number":["XTYB201808"]}]},{"name":"The National Key Research and Development Program of China","award":["2016YFC0901505"],"award-info":[{"award-number":["2016YFC0901505"]}]},{"name":"The testosterone undecanoate treatment research based on the real world DSD cohort","award":["Z20110005520061"],"award-info":[{"award-number":["Z20110005520061"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Orphanet J Rare Dis"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>46, XY disorders of sex development (46, XY DSD) are congenital disorders with 46, XY chromosomal karyotype but inconsistent gonadal\/phenotypic sex. One of the biggest concerns for parents and clinicians is the gender assignment. However, there is no standard uniform of care nor consensus at present. We sought to evaluate the current treatment's rationality and provide a reference basis for the gender reassignment in 46, XY DSD patients with a specific diagnosis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We conducted a cross-sectional survey of gender role with the Pre-school Activities Inventory (PSAI), the Children's Sex Role Inventory (CSRI) in 46, XY DSD patients and set up control groups comparison. Psychiatrist assessed gender dysphoria in patients\u2009\u2265\u20098-year-old with the criteria of diagnostic and statistical manual of mental disorders, 5th edition (DSM-5).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>A total of 112 responders of 136 patients participated in this study (82.4%, aged 2\u201317.8\u00a0years, median age: 4-year-old). The follow-up period was from 6\u00a0months to 10\u00a0years (median: 2\u00a0years). Twenty-five females were reassigned to the male gender after a specific diagnosis (16\/25 (64%) in 5 alfa-reductase-2 deficiency (5\u03b1-RD2), 5\/25 (20%) in partial androgen insensitivity syndrome (PAIS), 4\/25 (16%) in <jats:italic>NR5A1<\/jats:italic>gene mutation). Male gender assignment increased from 55.3 (n\u2009=\u200962) to 77.7% (n\u2009=\u200987). The median PSAI score was similar to the control males in <jats:italic>5\u03b1-RD2<\/jats:italic>, PAIS, and <jats:italic>NR5A1<\/jats:italic> gene mutation groups (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05); while identical to the control females in complete androgen insensitivity syndrome (CAIS) and <jats:italic>CYP17A1<\/jats:italic> gene mutation groups (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). PSAI score of children raised as male was higher than those of CAIS and CYP17A1 groups raised as female (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). CSRI scale showed no statistical differences in the consistency of gender roles and reassigned gender between 46, XY DSD patients and control groups (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). None of the patients over 8-year-old (n\u2009=\u200944) had gender dysphoria.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The reassigned gender in 46, XY DSD patients is consistent with their gender role during early childhood. None of them had gender dysphoria. The molecular diagnosis, gonadal function, and the gender reassignment are congruent within our Chinese cohort. Long-term follow-up and more evaluation are still required.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13023-021-02039-1","type":"journal-article","created":{"date-parts":[[2021,10,10]],"date-time":"2021-10-10T19:35:43Z","timestamp":1633894543000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["One hundred twelve cases of 46, XY DSD patients after initial gender assignment: a short-term survey of gender role and gender dysphoria"],"prefix":"10.1186","volume":"16","author":[{"given":"Liping","family":"Hou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijun","family":"Fan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bingyan","family":"Cao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiajia","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonghua","family":"Cui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Polak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1262-7383","authenticated-orcid":false,"given":"Chunxiu","family":"Gong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,10,9]]},"reference":[{"issue":"2","key":"2039_CR1","doi-asserted-by":"publisher","first-page":"e488","DOI":"10.1542\/peds.2006-0738","volume":"118","author":"PA Lee","year":"2006","unstructured":"Lee PA, Houk CP, Ahmed SF, Hughes IA. International consensus conference on intersex organized by the Lawson Wilkins Pediatric Endocrine Society and the European Society for Paediatric Endocrinology. Consensus statement on management of intersex disorders. Pediatrics. 2006;118(2):e488\u2013500. https:\/\/doi.org\/10.1542\/peds.2006-0738.","journal-title":"Pediatrics."},{"issue":"7\u20138","key":"2039_CR2","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1515\/jpem-2014-0457","volume":"28","author":"MDS Oliveira","year":"2015","unstructured":"Oliveira MDS, de Paiva-e-Silva RB, Guerra-Junior G, Maciel-Guerra AT. Parents\u2019 experiences of having a baby with ambiguous genitalia. J Pediatr Endocrinol Metab. 2015;28(7\u20138):833\u20138. https:\/\/doi.org\/10.1515\/jpem-2014-0457.","journal-title":"J Pediatr Endocrinol Metab"},{"issue":"2","key":"2039_CR3","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1210\/jc.2011-1441","volume":"97","author":"B K\u00f6hler","year":"2012","unstructured":"K\u00f6hler B, Kleinemeier E, Lux A, Hiort O, Gr\u00fcters A, Thyen U, DSD Network Working Group. Satisfaction with genital surgery and sexual life of adults with XY disorders of sex development: results from the German clinical evaluation study. J Clin Endocrinol Metab. 2012;97(2):577\u201388. https:\/\/doi.org\/10.1210\/jc.2011-1441.","journal-title":"J Clin Endocrinol Metab."},{"issue":"Suppl 1","key":"2039_CR4","doi-asserted-by":"publisher","first-page":"S198","DOI":"10.5152\/TurkPediatriArs.2018.01818","volume":"53","author":"M Cetinkaya","year":"2018","unstructured":"Cetinkaya M, \u00d6zen S, Uslu S, G\u00f6n\u00e7 N, Acunas B, Ak\u0131nc\u0131 A, Satar M, Berbero\u011flu M. Diagnostic and therapeutic approach in newborns with ambiguous genitale with disorder of sex development: consensus report of Turkish Neonatal and Pediatric Endocrinology and Diabetes Societies. Turk Pediatr Ars. 2018;53(Suppl 1):S198\u2013208. https:\/\/doi.org\/10.5152\/TurkPediatriArs.2018.01818.","journal-title":"Turk Pediatr Ars"},{"key":"2039_CR5","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1016\/j.jpurol.2016.04.001","volume":"12","author":"PD Mouriquand","year":"2016","unstructured":"Mouriquand PD, Gorduza DB, Gay CL, Meyer-Bahlburg HF, Baker L, Baskin LS, et al. Surgery in disorders of sex development (DSD) with a gender issue: if (why), when, and how? J Pediatr Urol. 2016;12:139\u201349.","journal-title":"J Pediatr Urol"},{"issue":"3","key":"2039_CR6","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1159\/000442975","volume":"85","author":"PA Lee","year":"2016","unstructured":"Lee PA, Nordenstr\u00f6m A, Houk CP, Ahmed SF, Auchus R, Baratz A, Baratz Dalke K, Liao LM, Lin-Su K, Looijenga LH III, et al. Global disorders of sex development update since 2006: perceptions, approach and care. Horm Res Paediatr. 2016;85(3):158\u201380. https:\/\/doi.org\/10.1159\/000442975.","journal-title":"Horm Res Paediatr"},{"issue":"6","key":"2039_CR7","doi-asserted-by":"publisher","first-page":"942","DOI":"10.1111\/bju.13771","volume":"119","author":"S Garnier","year":"2017","unstructured":"Garnier S, Maillet O, Cereda B, Ollivier M, Jeandel C, Broussous S, Lopez C, Paris F, Philibert P, Amouroux C, et al. Late surgical correction of hypospadias increases the risk of complications: a series of 501 consecutive patients. BJU Int. 2017;119(6):942\u20137. https:\/\/doi.org\/10.1111\/bju.13771.","journal-title":"BJU Int"},{"issue":"1","key":"2039_CR8","first-page":"20","volume":"3","author":"DU Ya-song","year":"1995","unstructured":"Ya-song DU, Lin-yan SU, Xue-rong LI. A preliminary study on gender role behavior assessment of preschool children. Chin J Clin Psychol. 1995;3(1):20\u20132.","journal-title":"Chin J Clin Psychol"},{"issue":"1","key":"2039_CR9","first-page":"95","volume":"24","author":"PENG Xiu-ping","year":"2016","unstructured":"Xiu-ping PENG, Feng YANG, Bin-gan YAN. Psychometric analysis of the Children\u2019s Sex Role Inventory in Chinese Culture. Chin J Clin Psychol. 2016;24(1):95\u20139.","journal-title":"Chin J Clin Psychol"},{"key":"2039_CR10","unstructured":"American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed. 2013. http:\/\/psychiatryonline.org\/doi\/book\/10.1176\/appi.books.9780890425596."},{"issue":"1","key":"2039_CR11","doi-asserted-by":"publisher","first-page":"120","DOI":"10.1046\/j.1464-410x.2000.00354.x","volume":"85","author":"SF Ahmed","year":"2000","unstructured":"Ahmed SF, Khwaja O, Hughes IA. The role of a clinical score in the assessment of ambiguous genitalia. BJU Int. 2000;85(1):120\u20134. https:\/\/doi.org\/10.1046\/j.1464-410x.2000.00354.x.","journal-title":"BJU Int"},{"key":"2039_CR12","doi-asserted-by":"publisher","first-page":"419","DOI":"10.3389\/fped.2018.00419","volume":"6","author":"TP Hemesath","year":"2019","unstructured":"Hemesath TP, de Paula LCP, Carvalho CG, Leite JCL, Guaragna-Filho G, Costa EC. Controversies on timing of sex assignment and surgery in individuals with disorders of sex development: a perspective. Front Pediatr. 2019;6:419. https:\/\/doi.org\/10.3389\/fped.2018.00419.","journal-title":"Front Pediatr"},{"issue":"4","key":"2039_CR13","doi-asserted-by":"publisher","first-page":"639","DOI":"10.1016\/j.chc.2011.07.002","volume":"20","author":"HF Meyer-Bahlburg","year":"2011","unstructured":"Meyer-Bahlburg HF. Gender monitoring and gender reassignment of children and adolescents with a somatic disorder of sex development. Child Adolesc Psychiatr Clin N Am. 2011;20(4):639\u201349. https:\/\/doi.org\/10.1016\/j.chc.2011.07.002.","journal-title":"Child Adolesc Psychiatr Clin N Am"},{"issue":"2","key":"2039_CR14","doi-asserted-by":"publisher","first-page":"199","DOI":"10.4158\/EP14351.RA","volume":"21","author":"A Saraswat","year":"2015","unstructured":"Saraswat A, Weinand JD, Safer JD. Evidence supporting the biologic nature of gender identity. Endocr Pract. 2015;21(2):199\u2013204. https:\/\/doi.org\/10.4158\/EP14351.RA.","journal-title":"Endocr Pract"},{"key":"2039_CR15","doi-asserted-by":"publisher","DOI":"10.6064\/2012\/834967","author":"AB Wisniewski","year":"2012","unstructured":"Wisniewski AB. Gender development in 46, XY DSD: influences of chromosomes, hormones, and interactions with parents and healthcare professionals. Scientifica (Cairo). 2012. https:\/\/doi.org\/10.6064\/2012\/834967.","journal-title":"Scientifica (Cairo)"},{"issue":"11","key":"2039_CR16","doi-asserted-by":"publisher","first-page":"1207","DOI":"10.1007\/s40618-016-0482-0","volume":"39","author":"AD Fisher","year":"2016","unstructured":"Fisher AD, Ristori J, Fanni E, Castellini G, Forti G, Maggi M. Gender identity, gender assignment and reassignment in individuals with disorders of sex development: a major of dilemma. J Endocrinol Invest. 2016;39(11):1207\u201324. https:\/\/doi.org\/10.1007\/s40618-016-0482-0.","journal-title":"J Endocrinol Invest"},{"key":"2039_CR17","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.yhbeh.2016.08.008","volume":"86","author":"N Callens","year":"2016","unstructured":"Callens N, Van Kuyk M, van Kuppenveld JH, Drop SLS, Cohen-Kettenis PT, Dessens AB, Dutch Study Group on DSD. Recalled and current gender role behavior, gender identity and sexual orientation in adults with disorders\/differences of sex development. Horm Behav. 2016;86:8\u201320. https:\/\/doi.org\/10.1016\/j.yhbeh.2016.08.008.","journal-title":"Horm Behav."},{"key":"2039_CR18","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1016\/j.jpsychores.2016.12.002","volume":"92","author":"BS Khorashad","year":"2017","unstructured":"Khorashad BS, Roshan GM, Reid AG, Aghili Z, Hiradfar M, Afkhamizadeh M, Talaei A, Aarabi A, Ghaemi N, Taghehchian N, et al. Sexual orientation and medical history among Iranian people with Complete Androgen Insensitivity Syndrome and Congenital Adrenal Hyperplasia. J Psychosom Res. 2017;92:55\u201362. https:\/\/doi.org\/10.1016\/j.jpsychores.2016.12.002.","journal-title":"J Psychosom Res"},{"key":"2039_CR19","doi-asserted-by":"publisher","first-page":"89","DOI":"10.2147\/AHMT.S259168","volume":"11","author":"FJO Boucher","year":"2020","unstructured":"Boucher FJO, Chinnah TI. Gender dysphoria: a review investigating the relationship between genetic influences and brain development. Adolesc Health Med Ther. 2020;11:89\u201399. https:\/\/doi.org\/10.2147\/AHMT.S259168.","journal-title":"Adolesc Health Med Ther"},{"issue":"3","key":"2039_CR20","doi-asserted-by":"publisher","first-page":"e710","DOI":"10.1542\/peds.2014-1088","volume":"134","author":"Z Kolesinska","year":"2014","unstructured":"Kolesinska Z, Ahmed SF, Niedziela M, Bryce J, Molinska-Glura M, Rodie M, Jiang J, Sinnott RO, Hughes IA, Darendeliler F, et al. Changes over time in sex assignment for disorders of sex development. Pediatrics. 2014;134(3):e710\u20135. https:\/\/doi.org\/10.1542\/peds.2014-1088.","journal-title":"Pediatrics"},{"issue":"5","key":"2039_CR21","doi-asserted-by":"publisher","first-page":"777","DOI":"10.1016\/j.jsxm.2018.02.021","volume":"15","author":"BPC Kreukels","year":"2018","unstructured":"Kreukels BPC, K\u00f6hler B, Nordenstr\u00f6m A, Roehle R, Thyen U, Bouvattier C, de Vries ALC, Cohen-Kettenis PT, dsd-LIFE group. Gender dysphoria and gender change in disorders of sex development\/intersex conditions: results from the dsd-LIFE study. J Sex Med. 2018;15(5):777\u201385. https:\/\/doi.org\/10.1016\/j.jsxm.2018.02.021.","journal-title":"J Sex Med"},{"issue":"6","key":"2039_CR22","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1186\/s13293-015-0022-1","volume":"26","author":"M Hines","year":"2015","unstructured":"Hines M, Constantinescu M, Spencer D. Early androgen exposure and human gender development. Biol Sex Differ. 2015;26(6):3. https:\/\/doi.org\/10.1186\/s13293-015-0022-1.","journal-title":"Biol Sex Differ"},{"issue":"6","key":"2039_CR23","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1016\/j.jpag.2007.03.096","volume":"20","author":"M Szarras-Czapnik","year":"2007","unstructured":"Szarras-Czapnik M, Lew-Starowicz Z, Zucker KJ. A psychosexual follow-up study of patients with mixed or partial gonadal dysgenesis. J Pediatr Adolesc Gynecol. 2007;20(6):333\u20138. https:\/\/doi.org\/10.1016\/j.jpag.2007.03.096.","journal-title":"J Pediatr Adolesc Gynecol"},{"issue":"2","key":"2039_CR24","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1016\/j.yfrne.2011.02.006","volume":"32","author":"M Hines","year":"2011","unstructured":"Hines M. Prenatal endocrine influences on sexual orientation and on sexually differentiated childhood behavior. Front Neuroendocrinol. 2011;32(2):170\u201382. https:\/\/doi.org\/10.1016\/j.yfrne.2011.02.006.","journal-title":"Front Neuroendocrinol"},{"issue":"4","key":"2039_CR25","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1053\/j.semperi.2017.03.010","volume":"41","author":"DM Bakula","year":"2017","unstructured":"Bakula DM, Mullins AJ, Sharkey CM, Wolfe-Christensen C, Mullins LL, Wisniewski AB. Gender identity outcomes in children with disorders\/differences of sex development: predictive factors. Semin Perinatol. 2017;41(4):214\u20137. https:\/\/doi.org\/10.1053\/j.semperi.2017.03.010.","journal-title":"Semin Perinatol"},{"issue":"Pt A","key":"2039_CR26","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.jsbmb.2016.02.002","volume":"165","author":"RJ Auchus","year":"2017","unstructured":"Auchus RJ. Steroid 17-hydroxylase and 17,20-lyase deficiencies, genetic and pharmacologic steroid. J Steroid Biochem Mol Biol. 2017;165(Pt A):71\u20138. https:\/\/doi.org\/10.1016\/j.jsbmb.2016.02.002.","journal-title":"J Steroid Biochem Mol Biol"},{"issue":"8","key":"2039_CR27","doi-asserted-by":"publisher","first-page":"2287","DOI":"10.1007\/s10508-018-1281-9","volume":"47","author":"BS Khorashad","year":"2018","unstructured":"Khorashad BS, Roshan GM, Reid AG, Aghili Z, Moghadam MD, Khazai B, Hiradfar M, Afkhamizadeh M, Ghaemi N, Talaei A, et al. Childhood sex-typed behavior and gender change in individuals with 46, XY and 46, XX disorders of sex development: an iranian multicenter study. Arch Sex Behav. 2018;47(8):2287\u201398. https:\/\/doi.org\/10.1007\/s10508-018-1281-9.","journal-title":"Arch Sex Behav"},{"issue":"4","key":"2039_CR28","doi-asserted-by":"publisher","first-page":"1160","DOI":"10.1210\/jc.2018-01866","volume":"104","author":"R Loch Batista","year":"2019","unstructured":"Loch Batista R, In\u00e1cio M, Prado Arnhold IJ, Gomes NL, Diniz Faria JA, Rodrigues de Moraes D, Frade Costa EM, Domenice S, Bilharinho Mendon\u00e7a B. Psychosexual aspects, effects of prenatal androgen exposure, and gender change in 46, XY disorders of sex development. J Clin Endocrinol Metab. 2019;104(4):1160\u201370. https:\/\/doi.org\/10.1210\/jc.2018-01866.","journal-title":"J Clin Endocrinol Metab."},{"issue":"4","key":"2039_CR29","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1037\/\/0012-1649.37.4.451","volume":"37","author":"SK Egan","year":"2001","unstructured":"Egan SK, Perry DG. Gender identity: a multidimensional analysis with implications for psychosocial adjustment. Dev Psychol. 2001;37(4):451\u201363. https:\/\/doi.org\/10.1037\/\/0012-1649.37.4.451.","journal-title":"Dev Psychol"},{"issue":"3","key":"2039_CR30","doi-asserted-by":"publisher","first-page":"709","DOI":"10.1111\/jsm.12413","volume":"11","author":"AD Fisher","year":"2014","unstructured":"Fisher AD, Castellini G, Bandini E, Casale H, Fanni E, Benni L, Ferruccio N, Meriggiola MC, Manieri C, Gualerzi A, et al. Cross-sex hormonal treatment and body uneasiness in individuals with gender dysphoria. J Sex Med. 2014;11(3):709\u201319. https:\/\/doi.org\/10.1111\/jsm.12413.","journal-title":"J Sex Med"},{"issue":"4","key":"2039_CR31","doi-asserted-by":"publisher","first-page":"1001","DOI":"10.1016\/j.pcl.2015.04.013","volume":"62","author":"HJ Bonifacio","year":"2015","unstructured":"Bonifacio HJ, Rosenthal SM. Gender variance and dysphoria in children and adolescents. Pediatr Clin N Am. 2015;62(4):1001\u201316. https:\/\/doi.org\/10.1016\/j.pcl.2015.04.013.","journal-title":"Pediatr Clin N Am"},{"issue":"11","key":"2039_CR32","doi-asserted-by":"publisher","first-page":"4260","DOI":"10.1210\/jc.2016-1276","volume":"101","author":"AD Fisher","year":"2016","unstructured":"Fisher AD, Castellini G, Ristori J, Casale H, Cassioli E, Sensi C, Fanni E, Amato AM, Bettini E, Mosconi M, et al. Cross-sex hormone treatment and psychobiological changes in transsexual persons: two-year follow-up data. J Clin Endocrinol Metab. 2016;101(11):4260\u20139. https:\/\/doi.org\/10.1210\/jc.2016-1276.","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"2039_CR33","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1016\/j.ecl.2016.02.001","volume":"45","author":"J Olshan","year":"2016","unstructured":"Olshan J, Eimicke T, Belfort E. Gender incongruity in children with and without disorders of sexual differentiation. Endocrinol Metab Clin N Am. 2016;45(2):463\u201382. https:\/\/doi.org\/10.1016\/j.ecl.2016.02.001.","journal-title":"Endocrinol Metab Clin N Am"},{"issue":"4","key":"2039_CR34","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1007\/s10508-005-4339-4","volume":"34","author":"PT Cohen-Kettenis","year":"2005","unstructured":"Cohen-Kettenis PT. Gender change in 46, XY persons with 5 alfa-reductase-2 deficiency and 17alpha-hydroxysteroid dehydrogenase-3 deficiency. Arch Sex Behav. 2005;34(4):399\u2013410. https:\/\/doi.org\/10.1007\/s10508-005-4339-4.","journal-title":"Arch Sex Behav"},{"issue":"4","key":"2039_CR35","doi-asserted-by":"publisher","first-page":"347","DOI":"10.4274\/jcrpe.galenos.2020.2020.0009","volume":"12","author":"F G\u00fcrb\u00fcz","year":"2020","unstructured":"G\u00fcrb\u00fcz F, Alkan M, \u00c7elik G, Bi\u015fgin A, \u00c7ekin N, \u00dcnal \u0130, Topalo\u011flu AK, Zorludemir \u00dc, Avc\u0131 A, Y\u00fcksel B. Gender identity and assignment recommendations in disorders of sex development (DSD) patients: 20 years\u2019 experience and challenges. J Clin Res Pediatr Endocrinol. 2020;12(4):347\u201357. https:\/\/doi.org\/10.4274\/jcrpe.galenos.2020.2020.0009.","journal-title":"J Clin Res Pediatr Endocrinol"}],"updated-by":[{"DOI":"10.1186\/s13023-022-02296-8","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2022,3,29]],"date-time":"2022-03-29T00:00:00Z","timestamp":1648512000000}}],"container-title":["Orphanet Journal of Rare Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13023-021-02039-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13023-021-02039-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13023-021-02039-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,30]],"date-time":"2022-03-30T06:04:59Z","timestamp":1648620299000},"score":1,"resource":{"primary":{"URL":"https:\/\/ojrd.biomedcentral.com\/articles\/10.1186\/s13023-021-02039-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,9]]},"references-count":35,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["2039"],"URL":"https:\/\/doi.org\/10.1186\/s13023-021-02039-1","relation":{"correction":[{"id-type":"doi","id":"10.1186\/s13023-022-02296-8","asserted-by":"object"}]},"ISSN":["1750-1172"],"issn-type":[{"value":"1750-1172","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,9]]},"assertion":[{"value":"13 May 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 September 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 October 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 March 2022","order":4,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":5,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":6,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1186\/s13023-022-02296-8","URL":"https:\/\/doi.org\/10.1186\/s13023-022-02296-8","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The Ethics Committee of Beijing Children's Hospital affiliated with Capital Medical University approved this study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Consent was obtained from all patients for publication.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All the authors declare that there is no conflict of interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interest"}}],"article-number":"416"}}