Gender dysphoria and XX congenital adrenal hyperplasia: how frequent is it? Is male-sex rearing a good idea?

This review examines gender dysphoria frequency in 46,XX CAH patients, finding 9% prevalence among female-raised individuals and higher rates in male-raised patients. The analysis challenges assumptions about optimal gender assignment in severely virilized cases, noting that male-raising involves infertility and multiple surgeries without clear evidence of reduced gender dysphoria risk.