Adult female outcomes of feminising surgery for ambiguous genitalia.

For the last half a century, feminising genital surgery has been routine practice for children with ambiguous genitalia assigned to a female sex of rearing. Due to various factors including the stigma and secrecy associated with intersex and the practical difficulties of paediatricians following-up adult patients, there has been little available outcome data on this policy. Recently however adult peer support groups have expressed dissatisfaction with the results of surgery. In addition there is increasing data to confirm a high rate of repeat vaginoplasty as well as a detrimental effect on adult sexual function. The lack of outcome data supporting this policy of genital surgery for all means it is time to radically evaluate our clinical practice. The option of psychological and peer support as an alternative to routine genital surgery must become a realistic proposition.