Assignment of Gender

In the past it was commonly expected to have the clinician document the newborn’s gender at time of birth. The physician was expected to make a judgement of the newborn’s identity, which was either male or female. There were some cases where it wasn’t initially easily identifiable. In those cases, the physician made their best guess. And, in some cases, the newborn appeared to be female only to develop male genitalia at puberty when an androgen jump-start triggered what looked like a “conversion” from female to male. [I’ll talk more about that tomorrow.] If the choice was not clear, the newborn was often assigned as a female and sometimes surgery was performed., Chromosomal, neural, hormonal, psychological, and behavioral factors can all influence gender identity. There seems to be a shift beginning, and current practice is changing. According to Medline Plus, many are now urging a delay for any surgery for as long as is healthy. Ideally, surgical change, if undertaken, will include the child, adolescent, or adult in the gender identity decision. This likely would include genetic and DNA/chromosomal studies.