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In July 19 issue of The Lancet, there is a rebuttal from Dr. Juan Tovar, a pediatric surgeon from Hospital Universitario La Paz, Madrid, who is skeptical of the conclusions drawn from Catherine Minto, Sarah Creighton, and colleagues' study, which was published in the April 12 edition of the same publication, regarding the adverse impact of clitoral surgeries on adult intersex women's sexual function.
Among other things, Tovar says that avoiding surgery until the patient is able to decide for herself or himself "may be a good policy for some patients, but for most patients with adrenal hyperplasia (Prader grades 3 or 4) the idea of leaving the genitalia as they are found at birth until adulthood is unrealistic." He further states: "I believe it is unlikely that such individuals would develop normal sexual attitudes and function later in life if they are left with ambiguous genitalia... [It] would be naive to think that normal and harmonic sexual development is only possible by clitoral preservation."
To this, Minto and colleagues respond: "The idea that leaving ambiguous genitals unaltered would be an unbearable burden that leads to socially unacceptable sexual attitudes and behaviour in adulthood remains an assumption in the absence of clear evidence."
Further, Minto et al. allege that Tovar's use of the word "excessive" to describe the team's relatively moderate argument (i.e. "more research is needed before definitive conclusions can be reached," but "good practice and informed consent demand that potential risks to sexual function be discussed before surgery") as the sign of Tovar's "an unexamined commitment to a practice that has escaped scientific and ethical interrogation for almost half a century."
Posted by Emi on Jul 17, 2003