{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T05:36:33Z","timestamp":1793424993746,"version":"4.5.0"},"reference-count":45,"publisher":"Walter de Gruyter GmbH","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Intersex\/Disorders\/Differences of sex development conditions have been recognized for millennia. An organized approach was adopted in the 1960\u201370s using the philosophy that gender identity was fluid and malleable. Consequences of this approach were the lack of disclosure, stigmatization, and excessive surgery to \u201cnormalize\u201d the genitalia. Often this led to quality of life issues for those patients. There have been many modifications in approach since then to avoid the problems noted. There is consensus on many of these changes (e.g. disclosure) but continued controversy on others (e.g. the benefits of early surgery). This review summarizes the historical context and the current areas of consensus and controversy.<\/jats:p>","DOI":"10.1515\/jpem-2022-0582","type":"journal-article","created":{"date-parts":[[2023,1,11]],"date-time":"2023-01-11T17:50:57Z","timestamp":1673459457000},"page":"234-241","source":"Crossref","is-referenced-by-count":10,"title":["DSD\/intersex: historical context and current perspectives"],"prefix":"10.1515","volume":"36","author":[{"given":"Peter A.","family":"Lee","sequence":"first","affiliation":[{"name":"Penn State College of Medicine, Penn State Hershey Medical Center , Hershey , PA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Mazur","sequence":"additional","affiliation":[{"name":"Jacobs School of Medicine and Biomedical Sciences, University of Buffalo, State University of New York, John R. Oistei Children\u2019s Hospital , Buffalo , NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher P.","family":"Houk","sequence":"additional","affiliation":[{"name":"Medical College of Georgia, Augusta University Medical Center , Augusta , GA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2023,1,12]]},"reference":[{"key":"2023033123251305589_j_jpem-2022-0582_ref_001","doi-asserted-by":"crossref","unstructured":"DeVun, L. Heavenly hermaphrodites: sexual difference at the beginning and end of time. Postmedieval 2018;9:132\u201346. https:\/\/doi.org\/10.1057\/s41280-018-0080-8.","DOI":"10.1057\/s41280-018-0080-8"},{"key":"2023033123251305589_j_jpem-2022-0582_ref_002","unstructured":"Greenberg, J. Defining male and female: intersexuality and the collision between law and biology. Ariz Law Rev 1999;41:277\u20138."},{"key":"2023033123251305589_j_jpem-2022-0582_ref_003","doi-asserted-by":"crossref","unstructured":"Wilkins, L. Abnormalities of sec differentiation. Classification, diagnosis, selection of rearing and treatment. Pediatrics 1960;26:846\u201357. https:\/\/doi.org\/10.1542\/peds.26.5.846.","DOI":"10.1542\/peds.26.5.846"},{"key":"2023033123251305589_j_jpem-2022-0582_ref_004","unstructured":"Jost, A. Problems of fetal endocrinology: the gonadal and hypophyseal hormones. Recent Prog Horm Res 1953;8:379\u2013418."},{"key":"2023033123251305589_j_jpem-2022-0582_ref_005","unstructured":"Rey, RA, Houk, CP, Witchel, S, Lee, PA. Disorders of sex development. Chapter 14. In: Gardner, DG, Shoback, D, editors. Greenspan\u2019s basic and clinical endocrinology, 10th Edition, LANGE medical book. New York: McGraw Hill; 2018:501\u201347 pp."},{"key":"2023033123251305589_j_jpem-2022-0582_ref_006","doi-asserted-by":"crossref","unstructured":"Del Valle, I, Buonocore, F, Duncan, AJ, Lin, L, Barenco, M, Parnaik, R, et al.. A\u00a0genomic atlas of human adrenal and gonad development. Welcome Open Res 2017;2:25. https:\/\/doi.org\/10.12688\/wellcomeopenres.11253.2.","DOI":"10.12688\/wellcomeopenres.11253.1"},{"key":"2023033123251305589_j_jpem-2022-0582_ref_007","unstructured":"Lee, PA, Bangalore Krishna, K, Houk, CP, Rogol, AD, Witchel, SF. Disorders of sex development. Chapter 6. In: Allen, DB, Nadeau, K, Kappy, MS, Geffner, M, editors. Pediatric practice: endocrinology, 3rd edit. Pediatric endocrinology: essentials for practice. New York: Academic Press. (McGraw-Hill Education); 2020:297\u2013338 pp."},{"key":"2023033123251305589_j_jpem-2022-0582_ref_008","doi-asserted-by":"crossref","unstructured":"Speiser, PW, Arlt, W, Auchus, SRJ, Baskin, LS, Conway, GS, Merke, DP, et al.. Congenital adrenal hyperplasia due to steroid 21-hydroxylase deficiency: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2018;103:4043\u201388. https:\/\/doi.org\/10.1210\/jc.2018-01865.","DOI":"10.1210\/jc.2018-01865"},{"key":"2023033123251305589_j_jpem-2022-0582_ref_009","unstructured":"Dreger, AD. Hermaphrodites and the medical invention of sex. Cambridge, MA: Harvard University Press; 1998:285 p."},{"key":"2023033123251305589_j_jpem-2022-0582_ref_010","doi-asserted-by":"crossref","unstructured":"Lee, PA, Houk, CP. Review of outcome information in 46,XX patients with congenital adrenal hyperplasia (CAH) raised male: what does it say about gender assignment? Int J Pediatr Endocrinol 2010;2010:982025.","DOI":"10.1186\/1687-9856-2010-982025"},{"key":"2023033123251305589_j_jpem-2022-0582_ref_011","doi-asserted-by":"crossref","unstructured":"Jones, HWJr. The saga of untreated congenital adrenal hyperplasia. 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