Ovotesticular disorder of sexual development and gender dysphoria - how far can we go?

Introduction: Ovotesticular Disorder of Sexual Development (DSD) refers to an extremely rare form of DSD, where adult gender identity is unpredictable and variable at birth and may evolve as the child grows. Objectives: To review the literature regarding Ovotesticular DSD, gender atribution and gender dysphoria and reflect in how medical attitudes can impact patient's life's. To present a clinical case about an individual with 46 XX karyotype and with Ovotesticular DSD, which was surgically interventioned twice, so her phenotype could match with her genotype. Afterwards presenting symptoms of gender dysphoria. Methods: Review of the literature, using Google Scholar and Pubmed with the keywords: ovotesticular, DSD, gender dyshoria, medical intervention. Results: Data from small case series suggests that patients reared in either sex can be satisfied with their sex assignment, but gender dysphoria also may occur. The clinical case is about a 16 years old adolescent with 46XX karyotype and born with bilateral female and male gonads. It was decided by the medical team and her parents for the removal of dysgenetic gonads in early chilhood and for a vaginoplasty when she was 14 years old. From two years now, she has described what seem to be a case of Gender Dysphoria. Conclusions: Adult gender identity is difficult to predict in Ovotesticular DSD and therefore consensus andDSD advocacy groups have recommended that genital surgery be deferred until the child is old enough to confirm his or her gender identity. Medical intervention should be weighed very careful, unless it can be warmful. [ABSTRACT FROM AUTHOR]