Differences in Sexual Development (DSD) Clinic
At the Disorders of Sexual Development (DSD) Clinic, you’ll find specialized care for children whose reproductive systems develop differently. Our team includes specialists in pediatric endocrinology, urology, genetics, gynecology and social work. They work together to gather information and guide your family through each step of your care journey.
We recognize DSD conditions are sensitive in nature and our team is committed to supporting you and your family in making the best choices for your child.
We provide comprehensive evaluations, care plans made just for your child and long-term support for their medical, psycho-social and emotional needs.
What are DSDs?
Differences in Sexual Development (DSD), also called sexual differentiation disorders, are rare conditions that affect how a child’s body and reproductive systems develop. These differences are often identified at birth or during puberty and may impact physical development, hormone levels or fertility. Most people with DSD lead healthy, fulfilling lives with the right treatment and care.
What to Expect at Your Appointment
At your first visit, you’ll meet a team of specialists who understand the medical and emotional aspects of differences in sex development. We’ll take time to get to know you and your child, review their medical history, answer your questions and perform any needed exams or tests. You’ll leave with a clear care plan and a confident path forward in your child’s diagnostic journey.
Meet Your Care Team
Your child will be cared for by an experienced team of providers who work together to support their needs. The team includes specialists in endocrinology, urology, gynecology, genetics, counseling and social work.
You’ll also have a nurse coordinator to help navigate follow-up appointments, arrange testing, manage medication orders, work with insurance for prior authorizations and answer questions to make sure you always know what to expect.
What Causes Differences in Sexual Development?
There are several reasons a child may be born with sexual development differences. Causes can include genetic changes, issues with organ development during pregnancy, hormone imbalances or exposure to certain medications or hormones before birth. Sometimes, the exact cause is unknown.
Types of Differences in Sexual Development
There are many different types of DSDs, each affecting how a child’s reproductive organs, hormones or chromosomes develop. Some are identified at birth, while others may not appear until puberty.
Types of DSDs include:
- Hormone-related DSDs: These affect how the body makes or uses sex hormones, like testosterone or estrogen. They can change how a child’s genitals develop, how puberty happens and sometimes fertility. Examples include Congenital Adrenal Hyperplasia (CAH), Androgen Insensitivity Syndrome (AIS) and 5-Alpha Reductase Deficiency.
- Chromosome-related DSDs: These happen when there are changes in the number or structure of sex chromosomes (X and Y). They can affect reproductive organ development and hormone levels. Examples include Turner Syndrome (45,X) and Klinefelter Syndrome (47,XXY).
- Anatomical or structural DSDs: These involve differences in how reproductive organs form or look, either inside or outside the body. Some types are caused by changes in certain genes, such as WT1-related syndromes, which can affect the development of the kidneys and sex organs.
Some DSDs are well understood, while others are rare or unclassified. No matter the diagnosis, our team is here to guide you through testing, treatment options, long-term care and support tailored to your child’s needs.
DSD Symptoms
Individuals with differences of sexual development can experience a wide range of symptoms, which may include:
- Electrolyte imbalances
- Genitals that appear different than expected for a boy or girl, such as an underdeveloped penis or an enlarged clitoris
- Hormonal imbalances or adrenal gland issues
- Hypospadias (when the opening of the urethra isn’t at the tip of the penis)
- Missing or absent genitals at birth (such as aphallia or vaginal agenesis)
- Starting menstruation unusually early or late
Every child is unique. Some symptoms are noticed at birth, while others appear later, especially during puberty. Our team is here to help you understand what’s happening and what steps to take next.
DSD Treatments We Provide
Treatment for differences in sexual development depends on the type and severity of symptoms. Some children may need:
- Genetic testing to help confirm a diagnosis and guide care decisions.
- Hormone therapy to support puberty and prevent additional health issues.
- Surgical procedures to change the appearance or improve the function of the genitalia. Surgery is only recommended if there is a clear medical reason and many children don't need surgery at all.
In milder cases, no treatment may be needed at all.
