For generations, the first question echoing in a delivery room has been, "Is it a boy or a girl?" However, leading medical experts from the All India Institute of Medical Sciences (AIIMS) in New Delhi are now urging families and society to pause. They warn that answering this question too quickly for a small but significant group of newborns can set the stage for a lifetime of medical and psychological complications.
The Critical Difference: DSD is Biology, Not Identity
Doctors are highlighting a crucial distinction often lost in the rush to label a child. Differences of Sex Development (DSD) are a group of medical conditions where a baby is born with reproductive or sexual anatomy, chromosomes, or hormone patterns that don't fit the typical definitions of male or female. Specialists stress that DSD is fundamentally about biological development and must not be confused with issues of gender identity or transgender health.
Dr. Vandana Jain, Professor of Paediatric Endocrinology at AIIMS, reveals that the condition is more common than people think. The institute alone sees approximately 150 new DSD cases annually, with the real numbers likely higher due to stigma and under-reporting. Globally, the estimated incidence is about one in every 4,000 to 5,000 live births.
"Sex development unfolds across multiple layers - genes, chromosomes, internal organs, external anatomy and later psychological development," explains Dr. Jain. She emphasizes that no single test can provide the complete picture, necessitating a careful, staged evaluation.
Why Haste is Dangerous: From Life-Threatening Risks to Lifelong Harm
The drive for immediate categorization isn't just socially pressured; it can be medically dangerous. Some forms of DSD, like congenital adrenal hyperplasia (CAH), can cause severe salt imbalance, shock, and even death in newborns if not diagnosed and treated promptly. Thankfully, with early diagnosis and appropriate hormone therapy, many children with such conditions grow up to lead healthy lives.
Other risks include an increased chance of certain malignancies, making long-term medical follow-up essential. The consequences of hurried decisions under social pressure are severe. Doctors report that some children undergo irreversible medical or surgical interventions before their unique biology is fully understood. Conversely, others may miss out on vital continuous monitoring, leading to serious health complications later in life.
Mental health is a major concern. Dr. Rajesh Sagar, Professor of Psychiatry at AIIMS, notes that families often experience intense fear, guilt, and panic. Without proper counselling, some parents may emotionally withdraw from the child or discontinue essential care, worsening outcomes for everyone involved.
A Path of Patience: The Multidisciplinary Approach at AIIMS
To navigate this complex landscape, AIIMS employs a dedicated, multidisciplinary team. This group includes paediatricians, endocrinologists, surgeons, geneticists, and mental health professionals who evaluate each child comprehensively. Decisions are made gradually, with parents being counselled and supported at every single stage.
Doctors are also advocating for systemic changes, calling for flexibility in birth records and school documentation. This would prevent families from being forced into premature declarations that may not align with the child's best medical interest.
The core message from the medical community is clear and powerful. When a baby's sex characteristics are unclear, haste might satisfy societal curiosity, but it is patience, thorough evaluation, and informed care that truly protect the child's health, well-being, and future.
