"Mom, I still want to be a girl..." Linlin (pseudonym) said to her mother in the ward of the Endocrinology and Genetic Metabolism Department of Henan Children's Hospital. When Linlin was born, her external genitals were blurred, but overall, she looked more like a girl, so her pa

"Mom, I still want to be a girl..." Linlin (pseudonym) said to her mother in the ward of the Endocrinology and Genetic Metabolism Department of Henan Children's Hospital.

8-year-old child’s gender conversion

When Linlin was first born, her external genitals were blurred, but overall, she looked more like a girl , so her parents directly raised Linlin as a girl. In a blink of an eye, 8 years have passed. One day, Linlin suddenly found that her clitoris was slowly getting bigger. Linlin, who didn't understand what was going on, told her mother about this. mother also felt very strange, so she took Linlin to a local hospital for examination. The test results showed that Linlin's chromosome was 46XY, which means that Linlin was a boy. "Why did my daughter become a boy after raising so many years?" Linlin's family was puzzled and difficult to accept. In order to find a better solution, Linlin's parents brought their children to the clinic of Wei Haiyan, director of the Department of Endocrinology and Genetic Metabolic Sciences of Henan Children's Hospital. After improved the relevant examination, Wei Haiyan found that Linlin's B-ultrasound could be seen, but it was hidden in the abdominal cavity and not found. "This is the result of sexual development abnormality" , Wei Haiyan explained to Linlin's parents. The causes of sexual abnormalities in are simply that due to insufficient testosterone synthesis or dysfunction during the development process, the penis is short, hypourethral fissure, blind vagina, or the female fetus is exposed to excessive androgen during the development process, resulting in clitoral penis enlargement, labia majora fusion, etc., which leads to clinical manifestations that are difficult for male and female to distinguish between birth.

Multidisciplinary consultation to help

Henan Children's Hospital's Endocrinology Genetic Metabolic Department has established a specialized multidisciplinary consultation team for sexual development genetics. It is composed of medical imaging, urology, oncology surgery, children's health department, medical department , pediatrics research institute and other departments, involving pediatric gynecology, urology, ethics, psychology, ultrasound, imaging, genetics, pediatric oncology surgery and other disciplines. has been evaluated jointly by multiple disciplines, and has reasonably determined the gender, and has coordinated internal and surgical departments to develop the best intervention and follow-up plan for the children. After discussion, was diagnosed that the symptoms of Linlin were caused by sexual development abnormalities caused by abnormal NR5A1 gene. Combined with multiple perspectives such as physiological and psychological analysis, it was believed that Linlin was more suitable as a boy. Physiologically, Linlin's testicles hiding in the abdominal cavity can secrete testosterone, but they do not have uterus and ovary . Psychologically, the psychologist asked Linlin to draw a self-portrait. She had long hair since she was a child, but Linlin unconsciously drew a boy with a flat-haired hairstyle. other related sand table games and scale evaluations also show that Linlin's self-gender identity is actually more inclined to males.

is the key to early detection of

8 years old. At the age of 68, Linlin has formed a certain gender awareness. Many aspects such as family, school, and social cognition have made Linlin unable to accept the situation of becoming a boy. In the end, the parents decided to let Linlin continue to live as a girl, conduct regular sex hormones, psychology and other related assessments, and then decide whether to undergo surgery and drug treatment if they are older. Hospital has admitted a total of 15 children with sexual development abnormalities caused by NR5A1 gene abnormalities in the past three years. Sexual development abnormalities in men can be manifested as masculine features such as small penis, hypourethral fissure, cryptorchidism, and even symptoms such as female appearance, boy breast development, and periodic hematuria. The abnormal sexual development of women may occur in masculinal features such as clitoral hypertrophy, labia fusion, Adam's apple, as well as inguinal hernia in girls, primary amenorrhea and other symptoms. Wei Haiyan said: "Early detection is critical. If does not have a strong gender awareness in the early stages of infants or children, and if does not have a strong gender awareness, you can give androgen treatments such as to promptly improve penis shortness and other conditions."

Source: Henan Children's Hospital