A full exploration of the subject of ambiguous genitalia and intersex states is beyond the scope of the CIRCLIST website. All such birth defects should be regarded as contra-indications to neonatal circumcision. Genital surgery of any nature (not just circumcision) must be deferred until a complete, specialist assessment of the intersex condition has been carried out.

Particularly in cases where there is a marked discrepancy between physical genitalia and chromosomal gender, psychometric investigation as well as genetic and physical examinations will be required. As far as possible the genitalia should be left as they are found at least until such time as the child has settled into their freely chosen gender role. Only once the individual is able to express an informed, experiential opinion regarding their sexuality should any gender assignment surgery be contemplated.

A word here about bilateral cryptorchidism, which is something of a special case. It can be an indicator of an intersex condition, but it is not necessarily an indicator of an intersex condition. If the parents so choose, such a boy can be circumcised as soon as the absence of any abnormality other than cryptorchidism has been established. There is no absolute need to wait until the orchidopexy surgery is performed, although that is an option.

The incidence of intersex conditions is reported by the Intersex Society of North America (ISNA) as being approximately 1 in 2000 live births. Readers with personal experience of this subject are advised to contact either ISNA, the United Kingdom Intersex Association or their own national support group.

The following external links will open in a new window. CIRCLIST is not responsible for the proper functioning or content of other websites.

  Androgen Insensitivity Syndrome (AIS) Support Group Australia Inc.
  Intersex Awareness New Zealand
  Intersex.ch  (German language/Swiss dialect)
  Intersex Society of North America
  United Kingdom Intersex Association

CIRCLIST acknowledges the following sources, used in the preparation of this web page:

	The Online Learning facilities of Chulalongkorn University Faculty of Medicine, Bangkok.
	Ellaithi, M., et al., BMC Pediatrics 2006 6:11 reporting fieldwork conducted in the Sudan.
	Nistal, M., et al., Usefulness of gonadal biopsy in the diagnosis of sexual developmental disorders. Actas Urol España. 2007; 31(9):1056-1075.
	The website of the United Kingdom Intersex Association.
	The website of the University of California (UCAL), Santa Barbara.

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