{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T10:06:10Z","timestamp":1789639570855,"version":"4.0.0"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n A\n BSTRACT<\/jats:sc>\n <\/jats:title>\n \n Background:<\/jats:title>\n Gender assignment is a central and often urgent decision in the management of differences of sex development (DSD). With growing emphasis on patient-centered care, there is an increasing need to evaluate how early gender assignment and surgical decisions influence long-term outcomes. This national multicenter study aimed to describe the DSD spectrum in India and assess gender trajectory, psychosocial well-being, and clinical outcomes into adolescence.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n This retrospective cohort included individuals who underwent surgical correction for DSD during infancy or childhood. Clinicians completed a structured pro forma capturing demographic characteristics, DSD diagnosis, treatment, complications, final sex assignment, gender identity outcomes, adolescent and parental agreement scores, psychological comorbidities, and fertility status. Data were analyzed using descriptive statistics, Chi-square tests, nonparametric correlations, and simplified logistic regression, with significance set at\n P<\/jats:italic>\n < 0.05.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Thirty patients (median age of 13 years) were included. Sex of rearing was significantly associated with final sex (\n \u03c7<\/jats:italic>\n 2<\/jats:sup>\n = 14.46,\n P<\/jats:italic>\n = 0.00014), and DSD type showed an even stronger association (\n \u03c7<\/jats:italic>\n 2<\/jats:sup>\n = 26.19,\n P<\/jats:italic>\n = 2.9 \u00d7 10\n \u22125<\/jats:sup>\n ). Parental agreement correlated strongly with adolescent gender agreement (\u03c1 = 0.66,\n P<\/jats:italic>\n = 0.0012), while gender dysphoria correlated negatively with parental agreement (\u03c1 = \u22120.39,\n P<\/jats:italic>\n = 0.033). Gender agreement did not differ by sex of rearing (\n P<\/jats:italic>\n = 0.51). Surgical complications occurred in 26.7% and psychological comorbidities in 23.3%. Overall, 86.7% of adolescents affirmed with their assigned gender.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n This study provides essential long-term outcome data from India, demonstrating that most early gender assignments remain stable, while a minority experience dysphoria requiring reassessment. The findings underscore the need for ongoing family-centered, multidisciplinary follow-up into adolescence and beyond.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/jiaps.jiaps_451_25","type":"journal-article","created":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T07:00:35Z","timestamp":1782457235000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Long-term Outcomes of Gender Decisions in Differences of Sex Development (DSD) from an Indian Perspective: A Multicenter Study"],"prefix":"10.4103","author":[{"given":"Shilpa","family":"Sharma","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pradnya S.","family":"Bendre","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, B. J. Wadia Hospital for Children, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandip Kumar","family":"Rahul","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, All India Institute of Medical Sciences, Deoghar, Jharkhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amar","family":"Shah","sequence":"additional","affiliation":[{"name":"Amardeep Multispeciality Children Hospital and Research Centre, Ahmedabad, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santosh B.","family":"Kurbet","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, KAHER\u2019s J. N. Medical College, Belagavi, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramesh","family":"Babu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arka","family":"Banerjee","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, B. J. Wadia Hospital for Children, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rupesh","family":"Keshri","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, All India Institute of Medical Sciences, Deoghar, Jharkhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anirudh","family":"Shah","sequence":"additional","affiliation":[{"name":"Amardeep Multispeciality Children Hospital and Research Centre, Ahmedabad, Gujarat, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,6,19]]},"reference":[{"key":"R1-20260706","doi-asserted-by":"crossref","first-page":"e488","DOI":"10.1542\/peds.2006-0738","article-title":"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. 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