In front of you is the bathroom, turn left into the men's toilet, or turn right into the women's toilet.
This will not be a problem for others, but it traps Xiao qian, who is in his twenties.
Ta (Note: based on psychological sex rather than biological sex, the same below) stunned, a female friend on the side pulled ta into the women's restroom.
It was really unpleasant, Xiao Qian threw away his hand and ran away, and tears flowed down the ground.
"Am I a boy or a girl?"
On the ID card registration, Xiaoqian's gender is male, but from the perspective of biological sex, ta's chromosome is not like the general male 46, XY, but 46, XX/46, XY chimeric type, which is one of the disorders/differences of sex developemt (hereinafter referred to as DSD).
Some people will always refer to Xiaoqian as "intersex people", but he prefers to use the English abbreviation IS (Intersex Intersex) to refer to his group.
According to preliminary statistics, the prevalence of DSD worldwide is about 1 in 1500, of which about 1/5 000 is DSD with obvious genital sex unknown.
Since being exposed to the first DSD patient in 2010, Dr. Lu Yiqing from the Department of Urology at Shanghai Children's Hospital has been treating an increasing number of similar patients.
So far, the hospital's MDT team (multidisciplinary team) has been able to diagnose more than 100 patients with DSD per year.
The detection rate of patients with DSD is increasing – of course, this is not necessarily directly related to whether the incidence of DSD has increased, but on the other hand, patients and their families have increased their awareness of such diseases and their willingness to seek medical treatment is much more urgent.
DSD refers to a congenital state due to abnormal development of chromosomes, gonads, or sex anatomy, and is a type of disease with a broad spectrum of diseases, different pathophysiological changes, and different clinical manifestations. It contains abnormalities of internal and external genital development due to various congenital factors.
Typing and performance of DSDs
Source: Chinese Expert Diagnosis and Treatment Consensus on Gender Dysplasia
Image credit: Occasional Healing Productions
Some people think they are boys, but they menstruate during adolescence, are diagnosed with two sets of reproductive systems, and fall into the confusion of gender cognition; some people suddenly find themselves with a disease when they are about to get married, and are forced to break up with their lovers; some people want to choose girls when faced with gender selection, but are forced to become boys at the request of their families; some people are fired by the company because the gender of the IDENTITY card does not match the gender of their choice.
Self, family, and society are entangled in many lines, and they feel confused and tired, constantly looking for their place in the crowd.
They have to think: Who am I? What is my gender? Who decides my gender?
Hard-to-tell secrets
Xiao Qian sent a photo, thin, pale skin, big eyes, wearing a JK uniform skirt with a navy collar.
Ta did not want to mention his age, the photo is about twenty people. He likes to wear beautiful little skirts and also likes The British Men's Vest Suit. The purpose of Xiaoqian's clothes is - "regardless of gender, how to be comfortable and how to come".
Seven years ago, Xiaoqian was still a "big boss" in his own mouth.
In 2014, in the third year of Xiaoqian Vocational High School, compared with boys of the same age, the throat knot was less obvious and there was no beard. The other boys jumped again in middle and high school, but their height barely changed. For these, Xiaoqian has not cared.
Until the summer of 2014, Xiaoqian's stomach suddenly hurt, and the intimate parts of the lower body were bleeding. After a long time, afraid that his parents would worry, he went to the hospital alone, "I think I must have cancer or terminal illness, I guess I will not live long."
On the day of the results, the doctor advised Xiaoqian that it was best to contact his family to accompany him, and he decided to bear the "envisaged terminal illness" alone on the pretext that the family was working in the field.
Originally, Xiaoqian thought that he was ready to take on everything, but when the doctor explained to Ta that he had two sets of reproductive systems, Xiaoqian's heart was a little cold. The word "intersex" hit Xiao Qian, like an alien, distant and psychedelic, "how could it be?".
Dizzy, Xiaoqian walked out of the hospital. It was already the end of November, and it was snowing heavily in Jinan.
He remembers the snowflakes falling down one by one, and the gray sky is deep, as if it is a future that he can't see.
There is a word in the hometown dialect called "two cutters", which is used to describe a boy who has "no masculinity", and when he thinks of this word, he panics and does not know what to do. He is also worried, afraid that his parents will dislike himself, or even do not want himself, dare not say, can not say.
Small thousand men's and women's clothing pictures
Image source: Courtesy of the interviewee
A boy who has been doing it for more than ten years, how can it suddenly not be?
Lu Yiqing told "occasional cure" that 60% to 70% of DSD patients may be born with obvious abnormalities in the external genitalia. But there are others who are born without explicit features, but only because of delays in menstruation or accidental abnormalities during other surgical procedures. There are also some patients who are even able to "smoothly" pass puberty, but are screened out when they go to the hospital to see a doctor because of long-term infertility in adulthood. This means that patients may find themselves having problems with DSD at any time, rather than the neonatal period as people usually think.
Asakusa discovered the secrets of the body during adolescence.
In the fifth grade, she overheard her parents say that her chromosome was XY, and she didn't understand what it meant. Once cleaning up the room, she found a test report she had done earlier, which was indeed the "XY chromosome" as her parents said.
In his second biology class, Asakusa learned what the "Y chromosome" means — usually only males have "Y chromosomes" if they are of male sex. Since then, she has begun to secretly observe the difference between herself and other girls, and has become sensitive and suspicious.
Adolescent girls will always make small talk, "When are you going to menstruate" and "Will your stomach hurt when you come to menstruation?" Asked, Asakusa was nervous and embarrassed, did not know how to answer the call, compared with the same age girls, she did not come to the menstrual holiday.
In junior high school, the throat knot gradually bulged. Classmates joked, "Hey! I see your throat knotted!"
She teased herself to ease her embarrassment, "Oh I'm going to change sex." She was afraid of being discovered by her classmates and made it a habit to walk with her chin down.
"Asakusa, your voice is so good." Classmates praised her, and she was very happy.
"But your voice is very much like a women's clothing gangster."
Asakusa knew that his classmates were not malicious, but privately repeated the recording and research, "How to sound 'like a girl'".
Sensitively nibbling on Asakusa's heart, she wanted to talk to someone, but she didn't dare to tell anyone else because she "didn't know what other people would think about it."
She also wanted to ask her parents, "What the hell is going on?" But it is difficult to speak to the lips.
Difficult to speak of, unable to tell, Kochi and Asakusa are trapped in the loneliness created by their illness.
You are always our child
In 2015, for most of the year after getting the diagnosis results, Xiaoqian locked himself in the house, paralyzed himself by drinking alcohol, and slept when he was drunk.
In the dream, the parents abandoned ta after learning that the child had DSD, and XiaoQian cried and shouted to try to keep it.
After waking up crying, ta's heart was empty, drunk himself, and he slept again.
Later, Xiaoqian's liver hurt badly, he went to the doctor alone, and was told that he needed surgery, the operation fee was too expensive, and this teenage child simply could not make up enough.
No way, he decided to tell his parents. Xiaoqian did not explain the chromosome thing, but said that the ultrasound B showed that there was a uterus in the body, the heart was uncomfortable, the secret drinking was too much, the liver hurt badly, and it needed treatment.
"I'm sorry, but I blame you for making you look like this." The mother cried and hugged her and kept blaming herself.
"Don't be afraid, we'll cure you if you're sick," the father reassured, "no matter what, you're our child."
Xiao Qian stood next to him with his head bowed, overwhelmed, facing his mother's self-blame, he never felt that it was his mother's fault.
The pathogenesis of DSD is complex. Environmental contamination, parents carrying related genes, genetic mutations, taking medications such as "transsexual pills" during pregnancy, or not taking hormonal drugs such as progesterone as prescribed by a doctor can all precipitate illness.
Whether it is prenatal diagnosis or comprehensive and meticulous examination after birth, only some of the causes of the child can be diagnosed. In Lu Yiqing's office, many times, the doctor cannot clearly determine the exact cause of the child.
His parents took Xiaoqian to see the doctor many times. Doctors said that Xiaoqian secreted more estrogen than androgens most of the time, and chose the biological sex for girls, compared to boys, surgery is easier, low risk and low cost.
Xiaoqian felt that what the doctor said was reasonable, his voice was more childlike, his appearance was also more feminine, and he would be mistaken for a "tomboy" before. The psychiatrist also gave some advice after talking with him.
For how to give advice to patients, Shi Huirong, a doctor in the Gynecology Department of the First Affiliated Hospital of Zhengzhou University, has accumulated a set of experience, and doctors will consider the patient's wishes, physical and psychological conditions, family conditions, and future life.
After seeing the doctor, Xiaoqian only had one feeling, to quickly end these chaos. "It's either boys or girls in society, but I'm like a monster."
"Let's try being a girl first." Kosen has cosed Akiyama, a character in the Japanese manga "Light Voice Girl", a girl with black hair and waist, good singing, shy and timid, afraid to talk about horror or pain.
Small thousand cos diagram
For "to be a boy", Xiaoqian has no obsession. Neither did the parents, who said, "As long as you are healthy and safe." But privately, the child will be gently reminded not to let relatives know about this matter.
Xiao Qian obediently responded.
When going to meet relatives, Xiaoqian will dress up as a boy. Only when he meets a new acquaintance, he will dress up as a girl according to his own ideas.
Switching outfits back and forth will make Xiaoqian distressed, "I have been cheating on others, I have a sense of guilt, and I am quite tired, only when I return home can I be my true self, but I don't want to cause trouble to my parents."
In the past, fathers used to call Xiaoqian "small", which means "son" in the local dialect. When the mother mentions Xiaoqian outside, she will also say "my son" how.
After learning of Xiaoqian's decision, the parents' address to Xiaoqian became "child" or nickname. When the mother goes shopping and sees beautiful clothes, she will take pictures and ask Xiaoqian if she wants to buy one, and she will also give Xiaoqian a common sense of women's life, such as how to take care of herself during menstruation and how to wear underwear.
But Xiao Qian still glimpsed the reef from under the calm and waveless water.
Fathers have always been accustomed to self-digestion of stress, and after learning that their children are ill, their fathers began to take the initiative to walk their dogs, and they were always walking small thousands of people before.
Xiaoqian knew the reason why his father walked his dog. When he was a child, once his father took the puppy out to play, and Xiaoqian pretended to be a ninja and played a game of stalking. Hiding behind a tree, he saw his father sitting on a rock sighing, with a sad expression on his face, and the puppy saying something all the time—one of the few ways he could vent.
Qiqi once told Xiaoqian what happened to her, she (note: based on psychological sex rather than biological sex, the same below) grew up as a boy, not much different from other boys in appearance, but there is a crack in the private part, unable to stand and urinate. Later, Qiqi found that her chromosome was XX and wanted to become a girl, but the family preferred sons to daughters, and in order to break her ideas, they directly took her to surgery and continued to be boys. My sister's boyfriend also canceled the marriage contract because of this incident.
"It's my fault," is the most spoken sentence.
In the IS mutual aid group, Luo Yu talked about his parents. She (note: based on psychological sex rather than biological sex, the same below) is a 46, XX type DSD, but has masculine characteristics and wants to continue to be a girl. At that time, she wanted to have surgery for more than a year, but the family only cared about her brother's marriage, completely ignored Luo Yu's affairs, and asked her for money every month. Feeling that she was not being treated as part of the family, she left home to live alone and saved up for her own surgery.
The mother of a child with DSD also asked for help, talking about her children who were a few months old, and her mother-in-law and husband did not want children anymore.
"What should I do?" she asked.
The family is only the first hurdle that patients need to face, and they have to face society.
Born as IS, is there something wrong with that?
Cosplay is one of the most important things in Xiao Qian's life. In 2008, the teenage Xiaoqian was first exposed to comic exhibitions, and the colorful world had full attraction. Xiaoqian joined the society, did stage performances, rehearsed during the day and had dinner at night, and the days were hard but made people feel very happy. Xiaoqian and his partner also won the championship of stage drama performances in a certain division.
When he knew that he was sick, Xiao Qian's heart was a mess, and he didn't know who to talk to. Jacko is the best partner in his community and the most trusted friend, and he wants to tell Jacko.
On the phone, Xiaoqian kept crying, and Jacko asked softly, "What's wrong?"
The two made an appointment to meet and talk again, and Xiaoqian cried and finished talking about his physical condition.
"Big deal, if you can't be a brother, you will marry you" "There are quite a lot of women haojie in history", Jie Ge joked and told Xiaoqian to rest well.
His reaction made Xiao Qianchang breathe a sigh of relief, and the pressure drifted from the confined space into the air, becoming thin.
Jacko is the only one outside of his family who can reveal his secrets.
But two days later, more than a dozen members of the community sent a message to Xiaoqian asking if it was true or not, "I heard that you are intersex, is it true, I can't believe it" "You're okay, it's okay" "You're amazing."
Xiao Qian realized that Jacko had told someone else about it. At that time, there were rumors about ta in the popular QQ anonymous message box - "He is a demon" and "he is really disgusting".
"It's over, I'm ruined," Xiao Qian thought.
It's not as simple as losing friends. After an activity, Xiaoqian, who came home alone, was beaten by several boys in the alley, one of whom was once Xiaoqian's good brother, and he once lent money to the boy to help the other party chase the girl he liked.
While beating, the boys scolded Xiaoqian for being a "dead demon" and "pretending to be a girl to rub someone else's oil". Ta's posterior alveolar teeth were shattered, his nose was bleeding a lot, and his face was swollen.
A few days later, a black garbage bag appeared on the doorknob of Xiao Qian's house, and inside was a dead rat. Friends of the society told Xiaoqian that the boy who borrowed money to help had shown off to others.
Xiao Qian's identity became a joke in the community, and he had to change his name, keep his hair long, and pretend to be another person.
There was a girl who confessed to Xiaoqian that she liked the coolness of Xiaoqian.com.
"I'll feel bad if I hide from the other party," Xiaoqian confessed to his situation.
"You're a monster," the other person typed a few words.
Ta tried to send a message to the girl science popularization, the QQ dialog box popped up a red exclamation point, "You are not his/her friend."
Keep the secret first, Xiao Qian thought.
In the company, Xiaoqian dressed up as a girl, shared snacks, ate, chatted with colleagues, and everything was friendly.
But when he woke up from a nap, he found that his colleagues around him were talking about whether he was male or female, saying that this person was very strange. When it was time to eat, he called his colleague to eat, but the colleague ignored it. Ta recalled and speculated that he had said a dream during his lunch break and used a male voice.
In the end, unable to survive everyone's eyes, Xiaoqian did not explain and chose to leave.
At that time, Xiaoqian did not know much about DSD, but felt that he was "abnormal" and "defective".
"It was my fault that everyone alienated me." At that time, he used to hide in the bedroom and cry.
But it's not ta's fault.
Including Xiaoqian, to this day, many patients will hate themselves when they learn that they are sick, and they will also encounter disgust from others.
To remove the stigma, the medical community began to work.
As early as 2006, the Chicago Consensus abolished the old name of "gender dysplasia" with a certain insult, and introduced the concept of "gender development abnormalities", which include a wider range than "gender dysmorphic abnormalities".
In addition to stigma, new titles and concepts also provide a more open space for patients to choose their gender.
Lu Yiqing said, "For most DSD patients, gender selection is actually open", but the diagnosis of the old name such as "female/male pseudosexual deformity" and "true gender deformity" will give patients the hint that "gender has been framed", so that patients and their families have preconceived judgments, thinking that they only have one way to choose, and stifling the patient's right to choose from the beginning of diagnosis.
For example, Lu Yiqing, even in the old "male pseudo-hermaphroditic malformation", there are patients with severe androgen insensitivity, serious lack of maleization, after full assessment and communication, patients have every opportunity to choose to be women.
Therefore, the new chromosome-based classification will respect the patient's willingness to choose the sex from the beginning and give more open space for sex selection.
Who decides my gender
The medical community tries to face the choice of gender in patients with a more open mind, but some patients' families are not aware of this.
In 2020, 18-year-old Ke Orange began taking estrogen drugs, hoping to change gender and become a girl.
Ke Orange participated in the Asian Robotics Championship and won the all-around challenge event. In the same year, she (note: based on psychological sex rather than biological sex, the same below) participated in THE NOIP (National Youth Informatics League) and won the first prize.
She said on Zhihu that she detected a chromosomal abnormality, which is XXY. But the parents were convinced that Ke Orange was a boy and took the medicine and mobile phone.
At the end of November 2020, parents will be sent to an orthopaedic institution.
There, Ke Orange sent a distress signal with his watch. After Ke Orange lost contact, the "Ke Orange Rescue Team" was spontaneously formed. The volunteers rushed to the correctional institution with the police and were told that Ke Orange had indeed come, had been sent by his parents, and had been picked up by them.
In January 2022, the volunteers who were involved in the rescue at that time commented under a video on Station B, and the volunteers contacted Ke Orange, she is fine now, but does not want to be paid too much attention.
Many years ago, Shi Huirong, an obstetrician and gynecologist at Zhengda First Affiliated Hospital, received such a patient - he grew up as a boy, but he came to menstruation during adolescence.
After the doctor's examination, it was found that the patient's chromosome was 46XX, the reproductive system development belonged to the female, but the external genitalia developed with masculinization, and after treatment, they could marry and have children normally. Therefore, Shi Huirong suggested that patients choose the female gender. But neither the other party nor the parents can accept it, and they are determined to retain the male gender.
Doctors and patients and parents fully communicate, if you continue to choose to retain the male sex, do not do surgical treatment, the future will not be able to marry normally; if you do gender reassignment surgery, not only the risk of surgery is larger, the economic burden is heavy, and there is no reproductive function. Patients and families accepted the doctor's advice after reflection.
There are many factors that affect the choice of gender distribution, and both Shi Huirong and Lu Yiqing believe that the fundamental principle is to maximize the interests of patients and respect the patients' own wishes as much as possible.
In Shanghai Children's Hospital, the ideal gender distribution process is like this: after the child is admitted, the MDT team composed of different departments such as urology, endocrinology, imaging, and psychology will conduct a complete assessment of the child, make a diagnosis, and then fully communicate with the child and family and reach a preliminary consensus, issue a follow-up treatment plan including gender selection, and report it to the hospital ethics committee for review.
After fully understanding and discussing the child's physical, psychological and social conditions (usually 2-3 months), the ethics committee will make a review decision and recommendations.
If approved by the ethics committee, the surgeon will ask a professional lawyer to witness as a third party before the operation, confirm the gender selection with the parents and the child (if necessary), inform before the choice and before the operation, and ensure that the lawyer does not conceal, deceive, or coerce the behavior, and the patient's family fully understands and accepts the treatment plan. If the child and parents have doubts, hesitations or even disagreements, the doctor cannot perform gender assignment surgery.
In Lu Yiqing's office, a 12-year-old child strongly demanded, "Continue to be a girl."
Lu Yiqing asked, "Have you always felt that you are a girl?"
"Yes", the child is very determined.
Lu Yiqing said, "Child, we have found that you have not only the girl's tissue in your body, but also the boy's organs, do you want to reconsider whether you want to be a boy or a girl?"
The child still insists on being a girl. Judging from the psychological assessment, it is true that the female tendency is more obvious at present.
If the child's wishes, it is true that surgery can be performed, but from past experience, the child's male tendency will become more and more obvious in the future, which means that if you insist on choosing a woman, the difficulty of treatment will increase, and the patient may have to make greater efforts to approach the normal population physically and psychologically. Many physicians use this as an excuse to reject their child's willingness to choose a woman.
"But in the long run, children already have a strong gender perception, forced changes, will fall into greater psychological anxiety, and may even have suicidal tendencies." And what we can do is to respect the patient's choice and minimize the risk as much as possible."
Ultimately, the team of doctors respected the child's ideas. While having rights, 12-year-old girls must take responsibility for their choices through legal notarization.
In the face of the choice of gender distribution, some parents are more hasty and radical and want to "quickly settle down"; some parents prefer sons to daughters and hope that their children will be boys; and some parents are afraid that their children will be too stressed after learning of the disease, and want to hide their children as much as possible.
From time to time, parents will ask Lu Yiqing, "Children don't understand these things when they are young, let's not tell our children, can we settle down?"
Lu Yiqing shook his head, he did not agree to conceal.
"Concealment is impossible, in the future dating, love, marriage and other aspects of the child, may find their own abnormalities, they will also go to check, if the parents did not inform at the time to make a decision, the child will know when he grows up, and may also blame his parents when he returns." 」
According to the Civil Code, minors over the age of 8 are "persons with limited capacity for civil conduct" and have the right to know.
"The sooner your child gets involved, the better they can plan their treatment plan." What parents should consider is to choose the appropriate period and way to inform their children, rather than blindly concealing it."
In November 2021, Asakusa's parents took her to a city hospital for further examination. Previously, she had also been examined for menstrual problems.
In the examination room, the doctor instructed the father to come and get the test results himself, and not to bring the child. 16-year-old Asakusa vaguely felt that there would be a problem of gender selection, and she wanted to go, "I'm a patient, why can't I listen?"
"You may not be able to accept it, but the doctor has his reason for saying this", Asakusa still could not go.
After my father returned from the hospital, he briefly told her about her physical condition and told her that taking medication after surgery could also be used as a girl. Asakusa is also willing to continue to be a girl. Two generations didn't say much and reached a tacit understanding of gender selection.
In January 2022, Asakusa was hospitalized in preparation for surgery
In the past six years, my parents have basically not mentioned surgery to Xiaoqian, and the most they can do is to ask him whether he wants to marry a man or a woman?
In 2014, the day the diagnosis was obtained, doctors recommended that Xiaoqian have surgery, which will reduce endocrine disorders and reduce the risk of cancer. But Xiaoqian was a little hesitant to do the operation, but chose to "see as a girl" first.
After that, he consulted a lot of information on the Internet and began to think that "the third gender is also a choice." Now, he has decided not to have surgery for the time being.
Xiaoqian does not want to change his body in order to cater to the eyes of others, and his attitude towards gender surgery is: under the premise of ensuring health, whether it is a third gender or a man or a woman, as long as he feels happy and comfortable.
Can patients who have not yet decided on gender allocation remain in a state of ambiguity of biological sex for a long time?
Similar patients have consulted Shi Huirong.
Shi Huirong's suggestion is that from the perspective of the patient's physical health and mental health, it is best to choose a certain reproductive system.
"The two sets of reproductive organs that patients have are unlikely to be fully developed, and if female patients have male gonads in their bodies, there is a risk of future gonadal cancer." In the existing social environment, we will also face the problem of marriage and childbirth, and it may be easier to integrate into society and the family by selecting and retaining a reproductive system that is better developed and closer to the psychological and social sex of the patient."
In addition to physical health considerations, Lu Yiqing added, this also involves social culture, public perception, and even religious beliefs, which are currently controversial around the world. Societies have different levels of acceptance of such situations, but we may be able to learn from abroad, introduce a third gender, and care for such people in all aspects of social life.
"If it's only men and women, it forces them to make choices as soon as possible, but a lot of times there is no good step. A civilized society should allow the existence of such groups, and our society should be more tolerant and more caring for such special groups."
Groping for acceptance
After the operation involving gender change, Shi Huirong will provide the patient with proof of changing the gender of the IDENTITY card.
Xiaoqian did not have surgery, learned that in the early stage of the illness, ta tried to change the gender of the IDENTIT CARD, and after running between the police station, the hospital, and the neighborhood committee many times, he failed. Now, he accepts his third gender, and the ID card does not have a corresponding gender, so he abandons the change of gender.
After the diagnosis, Xiaoqian never went to the bathhouse again, never even went to the place to swim, and refused to look in the mirror.
Ye Zi is Xiao Qian's good friend, she studies psychology and slowly guides Xiao Qian to appreciate her body. The leaves praised Xiaoqian's eyes are very large, the legs are thin and long, the shoulders are wide, and it is particularly good to look at men's clothes, and the slender legs are also good to wear skirts.
This gives Xiaoqian some confidence in himself, and he stays longer and longer in front of the mirror, taking selfies and social platforms.
For his own body, Xiaoqian is slowly accepting, and he is no longer the child who cowers in the corner and cries.
Xiaoqian is no longer walking on the road like before, afraid that others will discover his identity.
Nowadays, when someone comes to ask, he will calmly tell the other person that I am IS. But he did not want his future partner to bear the pressure of such criticism, and did not consider getting married and having children for the time being.
"If in the future, DSD is also considered a normal disease like a cold and fever, maybe at that time, no one will feel inferior because of being a patient", Xiaoqian hopes to have this day.
Asakusa feels that she is a girl and wants to be a girl, and at first she feels physically uncomfortable.
Anxiety still bubbles up from time to time, but Asakusa tries to accept herself.
Some time ago, Asakusa completed the removal of incompletely developed reproductive organs in her body, and she hoped that she could become like a "normal girl".
"What do you think is normal?"
She was stunned, "How is a normal girl?" I don't know."
This article was reviewed by Lin Ming, attending physician of the Department of Pediatric Endocrinology, Wuhan Union Medical College Hospital
(In order to protect personal privacy, except for Lu Yiqing and Shi Huirong, other names in the text are pseudonyms)
Author: Shi Jie Su Wei Chu
Producer: Li Chen
Source: Courtesy of respondents
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2. Chinese expert diagnosis and treatment consensus on gender development abnormalities[J].Chinese Journal of Pediatric Surgery,2019(04):289-297.
3. Liu Hui,Tong Xiaomei. Clinical evaluation and management of neonates with sexual development abnormalities[J].Chinese Journal of Contemporary Pediatrics,2016,18(12):1313-1318.
4. Hughes I A, Houk C, Ahmed S F, et al. Consensus statement on management of intersex disorders[J]. Journal of pediatric urology, 2006, 2(3): 148-162.
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