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The management of intersex conditions and anomalies of the development of the female genitalia can only be properly achieved with appropriate input from a number of health professionals. Furthermore, the needs of the individual may change over time and so both the patient and her family must be provided with a seamless transition between the various stages of care — from the diagnosis, which may be in early infancy or in the teenage years, through childhood, adolescence and then to adulthood. Therefore, although intersex conditions are rare, it is imperative that they are managed in centres by a multidisciplinary team that includes paediatric surgeons, urologists (often paediatric and adult), plastic surgeons, endocrinologists, specialist nurses, psychologists and also the gynaecologist. The role of the gynaecologist is to help to coordinate the transition from childhood through adolescence and then womanhood and to help with issues relating to sexual function and sexual identity, endocrinology and fertility. It is during the difficult time of adolescence that the patient usually first realises that there are serious problems and it is often the specialist gynaecologist who helps her to understand the diagnosis and requirements for management. The support of a skilled nurse and clinical psychologist is invaluable at this time.
The Department of Health in the UK is currently reviewing the national provision of services for the management of intersex. Parathentically, those units that have the skills to manage intersex conditions also have the appropriate facilities to treat complex developmental anomalies of the Müllerian tract (for example cervical and vaginal agenesis).
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