No Sex development surgeries in children till age of consent: Panel set up to reform medical norms
New Delhi: The All India Institute of Medical Sciences (AIIMS) and the Indian Association of Paediatric Surgeons have established a 23-member committee to draft guidelines for medically necessary surgeries in children with Disorders of Sex Development (DSD) that cannot be delayed until the child reaches the age of consent.
This initiative, announced in an AIIMS press release on Friday, aims to address the complex needs of children with DSD, emphasizing individual evaluation based on medical necessity. “The committee reiterated the right to health of a child, as a child has to be upheld and cannot be neglected,” the statement said.
Chaired by Dr Sandeep Agarwala, head of paediatric surgery at AIIMS, the committee concluded that DSD encompasses a wide range of conditions requiring tailored approaches. These conditions, which can present at birth, puberty, or adulthood, involve individuals having characteristics of both sexes due to chromosomal, gonadal, or genital differences.
According to the committee, while irreversible procedures are typically postponed until children can make informed decisions, there are instances where early surgery is necessary to prevent serious health risks. Conditions such as dehydration, electrolyte disturbances, urinary tract infections, abnormal genital bleeding, difficulty in urination, abnormal puberty, psychological distress, or the potential for cancerous changes in the gonads may necessitate surgery before the legal age of consent, reports the Hindustan Times.
The causes of DSD include genetic mutations, developmental issues during fetal growth, hormone deficiencies, and exposure to certain substances during pregnancy, such as testosterone blockers. Treatment options may involve hormone replacement therapy or reconstructive surgery. However, healthcare providers generally prefer to delay irreversible procedures unless medically necessary, as highlighted by the Cleveland Clinic.
According to The Daily, on May 11, the committee, comprising paediatric surgeons, endocrinologists, and clinical psychologists from across India, convened at AIIMS. They underscored the importance of a multidisciplinary approach and shared decision-making among stakeholders in managing DSD conditions. The committee emphasized that while some cases allow for delayed surgery, those posing significant health risks and potential damage require immediate intervention.
The AIIMS statement stressed the need for a careful and collaborative approach to DSD management, balancing the urgency of medical needs with children's rights to participate in decisions about their bodies. The committee's guidelines will serve as a crucial framework for clinicians in determining the appropriate timing and necessity of surgical interventions in children with DSD.
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