Meta-analysis and Current Literature on Gender Dysphoria

In children with differences in sexual development (DSD) gender assignment is a crucial decision. Gender identity disorder (GID) previously known as gender dysphoria has been reported in some adults with DSD. Appropriate sex assignment of DSD children may help in prevention of development of GID in later life. While the population risk of gender dysphoria is less than 0.5%, among DSD individuals the risk is variable 3–15% as per reported literature. Gender dysphoria is low conditions with little or no androgen effects reared as female despite the presence of Y chromosome. In conditions like mixed gonadal dysgenesis or partial androgen insensitivity there is a variable risk of gender dysphoria. In 5-alpha reductase deficiency it is high if they are reared as female. Thus, it is essential to arrive at the diagnosis and also be aware of future risk of gender conflict before assigning sex of rearing in DSD children.