Transgenderism and Intersexuality in Childhood and Adolescence: Making Choices presents an overview of the research, clinical insights, and ethical dilemmas relevant to clinicians who treat intersex youth and their families. Exploring gender development from a cross-cultural perspective, esteemed scholar Peggy T. Cohen-Kettenis and experienced practitioner Friedemann Pfäfflin focus on assessment, diagnosis, and treatment issues. To bridge research and practical application, they include numerous case studies, definitions of relevant terminology, and salient chapter summaries.

Atypical Sexual Differentiation

Atypical sexual differentiation


Under ordinary circumstances each step in the sexual differentiation process is contingent upon and consistent with the former. In intersex conditions, there are incongruities between one or more steps in sexual differentiation (chromosomal, gonadal, hormonal, or genital). At a certain point the development deviates from the normal male or female route (Table 3.1). Prevalence figures for intersex conditions are not known. Depending on the definition of intersex, population estimates range from 0.1 to 2% (Blackless et al., 2000).

TABLE 3.1 Chromosomes, Gonads, Sex Hormones, and Genital Structures in Men, Women, and Some Intersex Conditions

At fertilization, when chromosomal sex is established, an unusual chromosome configuration may develop. Examples of such configurations are karyotypes of 47,XXY (Klinefelter Syndrome, KS) or 45,XO (Turner ...

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