This article from the Journal of Pediatric Surgery provides clinical guidelines for the long-term obstetric and gynecologic care of individuals born with anorectal malformations (ARM). It emphasizes the necessity of specialized monitoring for unique anatomical challenges, such as Müllerian anomalies and the maintenance of neovaginas through dilation or surgery. Healthcare providers are encouraged to use shared decision-making when addressing sensitive topics like contraceptive placement, sexual health, and fertility preservation. The text also highlights the critical need for a structured transition from pediatric to adult medicine, utilizing patient-centered health summaries to ensure continuity of care. Finally, it outlines pregnancy considerations, noting that complex surgical histories often require multidisciplinary collaboration between obstetricians and surgical specialists to manage delivery risks.