Legal Aspects of DSD: Indian and International Scenario

The terms intersex or hermaphroditism have currently been replaced with more inclusive terminology, difference of sex development (DSD). In the past, the medical and surgical outcomes in relation to functionality were the main focus when describing outcomes of those with DSD. Of late gender-related issues and the psychological and social problems associated with DSD have taken the center stage. Both the medical and the social problems start soon after the birth and get extended during the adulthood. In addition to identification of life-threatening conditions, medical and surgical management may be promptly required in some. The timing of medical or surgical intervention has always been a matter of debate. As soon as the baby with DSD is born assignment of sex of rearing becomes a major social emergency. Gender confirming treatments have been a matter of great debate recently. Several states and countries have even gone ahead with their own regulations in DSD management. While the right of the DSD individual to decide treatment as an adult is being upheld legal and ethical guidelines have often cut a balance in not denying the essential lifesaving treatment. While the decision to defer treatment is being called for, one should also consider the need for safe upbringing of the school going child. Medical and legal issues should be addressed side by side without compromising ethics.