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Cloacal Exstrophy <ul><li>Rare, complex defect of the   entire pelvis and its contents </li></ul><ul><li>Occurs during emb...
Cloacal Exstrophy Treatment  of Genetic Males <ul><li>Orchiectomy and construction   of vulvae </li></ul><ul><li>Testes no...
Cloacal Exstrophy Reiner, William G. and Gearhart, John P.  Discordant Sexual Identity in Some Genetic Males with Cloacal ...
Cloacal Exstrophy Reiner, William G. and Gearhart, John P.  Discordant Sexual Identity in Some Genetic Males with Cloacal ...
Development of Male Sexual Identity in Cloacal Exstrophy <ul><li>Prenatal androgens appear to be a major biologic factor <...
DES Research– a Test of the Prenatal Hormonal Hypothesis! <ul><li>DES is a synthetic estrogen formerly prescribed to pregn...
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7 Cloacal Exstrophy Des

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What can we learn about the development of sexual identity from genetic males who were castrated at birth, hormonally feminized and socialized as females? What happens to the sexuality of fetuses exposed to a synthetic hormone like DES?

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Transcript of "7 Cloacal Exstrophy Des"

  1. 1. Cloacal Exstrophy <ul><li>Rare, complex defect of the entire pelvis and its contents </li></ul><ul><li>Occurs during embryogenesis </li></ul><ul><li>Associated with severe phallic inadequacy or phallic absence in genetic males </li></ul><ul><li>For about 25 years, neonatal assignment to female sex has been advocated for affected males </li></ul>
  2. 2. Cloacal Exstrophy Treatment of Genetic Males <ul><li>Orchiectomy and construction of vulvae </li></ul><ul><li>Testes normal </li></ul><ul><li>Phallic atresia occurs despite the presence of normal prenatal androgen levels </li></ul><ul><li>At birth, female-sex assignment socially, legally, and surgically </li></ul><ul><li>Neonatal orchiectomy induces a hypogonadal endocrine disorder that precludes postnatal and pubertal androgen surges </li></ul><ul><li>Unique opportunity to assess prenatal androgen influences on sexual development in genetic males with female-sex assignment and feminized genitalia in a uniform population of patients </li></ul>Reiner, William G. and Gearhart, John P. Discordant Sexual Identity in Some Genetic Males with Cloacal Exstrophy Assigned to Female Sex at Birth. THE NEW ENGLAND JOURNAL OF MEDICINE, 350:333-341 (2004)
  3. 3. Cloacal Exstrophy Reiner, William G. and Gearhart, John P. Discordant Sexual Identity in Some Genetic Males with Cloacal Exstrophy Assigned to Female Sex at Birth. THE NEW ENGLAND JOURNAL OF MEDICINE, 350:333-341 (2004)
  4. 4. Cloacal Exstrophy Reiner, William G. and Gearhart, John P. Discordant Sexual Identity in Some Genetic Males with Cloacal Exstrophy Assigned to Female Sex at Birth. THE NEW ENGLAND JOURNAL OF MEDICINE, 350:333-341 (2004)
  5. 5. Development of Male Sexual Identity in Cloacal Exstrophy <ul><li>Prenatal androgens appear to be a major biologic factor </li></ul><ul><li>Results suggest that children who are born genetically and hormonally male may identify themselves as males despite being raised as females and undergoing feminizing genitoplasty at birth </li></ul><ul><li>Reiner, William G. and Gearhart, John P. Discordant Sexual Identity in Some Genetic Males with Cloacal Exstrophy Assigned to Female Sex at Birth. THE NEW ENGLAND JOURNAL OF MEDICINE, 350:333-341 (2004) </li></ul>
  6. 6. DES Research– a Test of the Prenatal Hormonal Hypothesis! <ul><li>DES is a synthetic estrogen formerly prescribed to pregnant women who were at risk for having miscarriages </li></ul><ul><li>Research on DES indicates that exposure to excess estrogens is modestly associated with greater homosexuality in fantasy and behavior in some women </li></ul><ul><li>Ehrhardt, A. A., Meyer-Bahlburg, H. F. L., Rosen, L. R., Feldman, J. F., Veridiano, N. P., Zimmerman, I., & McEwen, B. S. Sexual Orientation After Prenatal Exposure To Exogenous Estrogen. ARCHIVES OF SEXUAL BEHAVIOR, 14: 57-77 (1985) </li></ul><ul><li>Meyer-Bahlburg, H. F. L., Ehrhardt, A. A., Rosen, L. R., Gruen, R. S., Veridiano, N. P., Vann, F. H., & Neuwalder, H. F. Prenatal Estrogens And The Development Of Homosexual Orientation. DEVELOPMENTAL PSYCHOLOGY, 31: 12-21 (1995) </li></ul>

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