SEX REASSIGNMENT - A CHALLENGING PROBLEM - CURRENT MEDICAL AND ISLAMIC GUIDELINES

Sexual ambiguity is a complex and often confusing medical problem. In addition to the life-threatening adrenal crises which may accompany so me forms, ambiguity of the genitalia may lead to incorrect sex assignm ent by parents and/or health personnel. Children who present to medica l attention beyond the neonatal period constitute a challenging proble m due to the grave consequences of this condition. Thirty cases in who m sex reassignment was indicated were seen at King Khalid University H ospital, Riyadh, over a 10-year period. Of these, 27 (90%) were geneti c females (20 were 21- and seven were, 11-hydroxylase deficient) and t hree (10%) were genetic males (two partial androgen insensitive and on e Sa-reductase deficient). All genetic males who were incorrectly assi gned as females accepted reassignment. But 9 out of 27 (33%) of the ge netic females who were incorrectly assigned as males refused reassignm ent. Preference for male sex assignment, delayed diagnosis and sociocu ltural circumstances seem to be the contributing factors for refusal. A national consensus about this important issue strengthened by the ex isting religious recommendations is demanded.