[lbo-talk] clitoral reduction - U.S. data

[joanna bujes]

Over the last 40 or so years there have been more than a few articles 
and chapters written about how to manage cases of ambiguous genitalia. 
Almost all of them offer advice which is based on the work of John 
Money, and at first, John and Joan Hampson, later with Anka Ehrardt. 
These investigators, studying intersexed individuals, basically had 
extrapolated from their clinical research several concepts which they 
thought would lead to better management 1 
<http://www2.hawaii.edu/PCSS/online_artcls/intersex/management.html#lst_1>, 
2 
<http://www2.hawaii.edu/PCSS/online_artcls/intersex/management.html#lst_2>, 
10 
<http://www2.hawaii.edu/PCSS/online_artcls/intersex/management.html#lst_10> 
While not using these exact words, the following precepts developed:

1. Individuals are psychosexually neutral at birth.

2. Since the appearance of the genitalia is considered crucial, surgery 
should reduce genital ambiguity. For females, any large clitoris is to 
be reduced or removed; for males with less than an adequate penis, since 
it is easier to make a vulva and vagina than a functional penis, the 
preferred surgical approach is sex reassignment.

3. These basic rules should hold regardless of etiology of the genital 
ambiguity (or trauma).

4. There should be no change of gender after 2 years of age.

Over time the limits to what constituted a large clitoris came 
arbitrarily to be one greater than .9 cm. and a small penis sufficient 
to warrant surgery was one smaller than 2.5 cm. (e.g.3-7 
<http://www2.hawaii.edu/PCSS/online_artcls/intersex/management.html#lst_3>).

For more, see

http://www2.hawaii.edu/PCSS/online_artcls/intersex/management.html

Joanna