Consensus in Guidelines for Evaluation of DSD by the Texas Children's Hospital Multidisciplinary Gender Medicine Team

Table 1 DSD examples and sex assignment considerations.

Condition	Sex assignment	Evidence	Grade
CAH	Usually female	Berenbaum and Bailey [92]	Strong recommendation with very low quality Evidence for female sex assignment.
CAIS	Female	Wisniewski et al. [93]	Strong recommendation with very low quality evidence for female sex assignment.
PAIS	Depends on the phenotype	Köhler et al. [94]	Consensus statement to base sex assignment on the phenotype.
Gonadal dysgenesis	Usually female	Sarafoglou and Ostrer [95]	Consensus statement for female sex assignment in most instances.
Hypospadias	Usually male	Boisen et al. [96]	Weak recommendation with low quality evidence for male sex assignment.
Hypopituitarism/ Hypogonadotropic hypogonadism	Male	Grumbach [14]	Consensus statement for male sex assignment, and to evaluate babies within the first 6 months and treat with testosterone.
Ovotesticular syndrome	Depends on the continent	Hadjiathanasiou et al. [97]	Strong recommendation with very low quality evidence. assign gender on an individual basis.
5-Reductase deficiency	Depends on the continent	Imperato-McGinley et al. [21]	Strong recommendation with very low quality evidence. assign gender on an individual basis with appropriate consideration of the patient's degree of masculinization.

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