Ethical aspects of gender assignment in ambiguous genitalia - congenital adrenal hyperplasia: a case report

Congenital adrenal hyperplasia (CAH) is an autosomal recessive disorder commonly caused by mutation of the CYP21A2 gene, resulting in deficiency enzyme required for cortisol synthesis cortex. In 90-95% cases, deficient 21-hydroxylase (21-OH), with incidence ranging from 1 5,000 to 15,000 live births across various ethnic and racial backgrounds. classical 21-OH (21-OHD) CAH, excessive androgen exposure fetus results virilization at birth.1
 The management ambiguous genitalia children CAH presents a unique ethically challenging decision-making dilemma medical team. Insensitive poorly informed statements made delivery room may cause long-term psychological problems families. It important refrain assigning gender until sufficient diagnostic information can be gathered. Parents, as guardians, supporting team must make decisions on behalf child, goal enabling child grow into healthy happy adult his or her assigned gender.2,3 We report case focusing ethical challenges genitalia.