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Review of "Disorders of Sex Development:"

By Amy Wisniewski, Steven Chernausek and Bradley Kropp
Johns Hopkins University Press, 2012
Review by Elin Weiss on Dec 11th 2012
Disorders of Sex Development:

Disorders of Sex Development: A Guide for Parents and Physicians by Amy Wisniewski, Steven Chernausek and Bradley Kropp is a handbook that covers brief information about disorders of sex development (DSDs) while describing several DSDs in order to help physicians and parents to better understand the nature and cause of these different DSDs.

The guide is made up of nine short chapters that discuss topics and titles such as: Long-term Health of People with DSD and How Will My Newborn Baby Be Evaluated? The handbook provides explanations to questions regarding treatment, the cause of DSDs, as well as a breakdown of complicated biological processes that are suitable for the lay person.

The authors are (as are many other authors who study DSDs) conscious of the use of the term disorder of sex development as it can be interpreted to connote sickness. Therefore, the authors suggest that the term differences in sex development might be preferable.

The guide explains that there are several different types of DSDs, and discusses the root of the most common types. The authors reassure parents by stating that a DSD is not caused by something that the parents have done during the pregnancy. Instead DSDs are believed to usually result from a mix of hormonal and biological causes. Usually individuals with DSDs live healthy and happy lives but some types of DSDs need to be medicated; such as deficiencies in for example cortisol or when the child has high blood pressure. 

In regards to gender and identity, the authors state that the child's gender role might be atypical in that girls might like hunting and sports and boys might like fashion design. Such behaviors are described as atypical but are not unhealthy or incorrect. In this chapter I would personally have appreciated a discussion on gender role stereotypes. The chapter could have included a critical discussion on gender and gender roles that drew information from feminism and men's studies to ensure parents and physicians that it is not unusual to disagree with the gender role expectations and stereotypes that accompany one's identity as either male or female. Moreover, I do not believe that the term atypical is appropriate to use in regards to gender roles and behavior. Instead the term non-stereotypical gender behavior/gender roles would be more suitable.

In regards to gender identity the authors state that:

 "One of the most important goals in developing a treatment plan for newborns with DSD is to have a child develop a gender identity that matches their upbringing" (p. 50).

The authors do not, however, fully explain what a treatment plan can look like. This statement also seems to imply that the child should accept the parent's and doctor's decision in regards to their gender, instead of the family leaving the child to decide over their own identity.

The guide is written in an explanatory way and uses plenty of summaries and pictures in order to make a very complicated subject a little bit easier to understand. Although the topic might eventually need additional explanation, the authors have succeeded in making the handbook fairly easy to understand. There is no way of getting around the difficult biological language that characterizes DSDs but the authors have made it easier to understand the basic reasons to why DSDs occurs.

On the down side, the guide does not focus much on what the parents can expect in regards to their children's behavior, identity and feelings concerning identity, or even what not to expect. It does cover some commonalities in regards to sexual orientation, such as the fact that girls with some types of DSDs more often identify as lesbian than girls who do not have DSDs. However, a stronger emphasis on gender stereotypes would probably have been suitable.

A great book to read together with the guide would be Elizabeth Reis's Bodies in Doubt: An American History of Intersex, which deals with gender stereotypes and the belief in compulsory heterosexuality in intersex individuals. 

The guide is, as the title states, aimed at parents and physicians. This does not mean, however, that it cannot be read by other individuals in order to gain more knowledge of DSDs and to foster understanding. The guide can be used by parents and physicians but also by health care personnel and for educational purposes. Thereby it can be used by, and presented to, a wide audience.


© 2012 Elin Weiss


Elin Weiss has a Bachelor's Degree in Psychology and a Master's Degree in Women's Studies from University College Dublin, Ireland. Elin writes for Feminists For Choice (www.feministsforchoice.com).