Gender Dysphoria and the Pediatric Surgeon: A Plea for Clarity and Caution

Pediatric surgeons have long cared for children with disorders of sexual differentiation (DSD), in which a child's external genitalia are ambiguous or discordant with the genotype. Normal biological sexual development occurs along binary male–female pathways [1]. Gender has historically been equated with external genitalia, but many now view gender as a “social construct” independent of biological sex. Incongruence between sex and gender that is associated with significant distress is termed gender dysphoria.