Jump to ContentJump to Main Navigation
Show Summary Details
More options …

Journal of Pediatric Endocrinology and Metabolism

Editor-in-Chief: Kiess, Wieland

Ed. by Bereket, Abdullah / Darendeliler, Feyza / Dattani, Mehul / Gustafsson, Jan / Luo, Fei Hong / Mericq, Veronica / Toppari, Jorma

IMPACT FACTOR 2018: 1.239

CiteScore 2018: 1.22

SCImago Journal Rank (SJR) 2018: 0.507
Source Normalized Impact per Paper (SNIP) 2018: 0.562

See all formats and pricing
More options …
Volume 23, Issue 8


Genital Surgery for Disorders of Sex Development: Implementing a Shared Decision-Making Approach

Katrina Karkazis / Anne Tamar-Mattis / Alexander A. Kon
  • Department of Pediatrics and the Program in Bioethics at the University of California Davis, Sacramento, CA, USA
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2010-09-17 | DOI: https://doi.org/10.1515/jpem.2010.129


Ongoing controversy surrounds early genital surgery for children with disorders of sex development, making decisions about these procedures extraordinarily complex. Professional organizations have encouraged healthcare providers to adopt shared decision-making due to its broad potential to improve the decision-making process, perhaps most so when data are lacking, when there is no clear “best-choice” treatment, when decisions involve more than one choice, where each choice has both advantages and disadvantages, and where the ranking of options depends heavily on the decision-maker's values. We present a 6-step model for shared decision-making in decisions about genital surgery for disorders of sex development: 1) Set the stage and develop an appropriate team; 2) Establish preferences for information and roles in decision-making; 3) Perceive and address emotions; 4) Define concerns and values; 5) Identify options and present evidence; and 6) Share responsibility for making a decision. As long as controversy persists regarding surgery for DSD, an SDM process can facilitate the increased sharing of relevant information essential for making important health care decisions.

KEY WORDS: (MeSH): decision-making; sex differentiation disorders; Hermaphroditism; urogenital surgical procedures

About the article

Corresponding author: Katrina Karkazis, PhD, MPH,

Published Online: 2010-09-17

Published in Print: 2010-08-01

Citation Information: Journal of Pediatric Endocrinology and Metabolism, Volume 23, Issue 8, Pages 789–805, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem.2010.129.

Export Citation

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

Erica M. Weidler, Arlene Baratz, Miriam Muscarella, S. Janett Hernandez, and Kathleen van Leeuwen
Seminars in Pediatric Surgery, 2019, Page 150844
Dilraj Kalsi, Joel Ward, Regent Lee, Kenneth Fulford, and Ashok Handa
Journal of Evaluation in Clinical Practice, 2019
Rebecca M. Harris and Yee-Ming Chan
Current Opinion in Endocrinology & Diabetes and Obesity, 2019, Volume 26, Number 1, Page 49
Melissa Gardner and David E. Sandberg
Frontiers in Pediatrics, 2018, Volume 6
Stefan Timmermans, Ashelee Yang, Melissa Gardner, Catherine E. Keegan, Beverly M. Yashar, Patricia Y. Fechner, Margarett Shnorhavorian, Eric Vilain, Laura A. Siminoff, and David E. Sandberg
Journal of Health and Social Behavior, 2018, Page 002214651880246
Arwen H. Pieterse, Hanna Bomhof-Roordink, and Anne M. Stiggelbout
Patient Education and Counseling, 2018, Volume 101, Number 8, Page 1307
Emilie K. Johnson, Ilina Rosoklija, Angela Shurba, Anthony D'Oro, Elisa J. Gordon, Diane Chen, Courtney Finlayson, and Jane L. Holl
Journal of Pediatric Urology, 2017
Elizabeth McCauley
American Journal of Medical Genetics Part C: Seminars in Medical Genetics, 2017, Volume 175, Number 2, Page 293
Michael Pfeil
Journal of Child Health Care, 2011, Volume 15, Number 4, Page 380
Kathleen Graziano and Mary E. Fallat
Advances in Pediatrics, 2016, Volume 63, Number 1, Page 473
S. Faisal Ahmed, John C. Achermann, Wiebke Arlt, Adam Balen, Gerry Conway, Zoe Edwards, Sue Elford, Ieuan A. Hughes, Louise Izatt, Nils Krone, Harriet Miles, Stuart O'Toole, Les Perry, Caroline Sanders, Margaret Simmonds, Andrew Watt, and Debbie Willis
Clinical Endocrinology, 2016, Volume 84, Number 5, Page 771
L. Sann
Revue de médecine périnatale, 2015, Volume 7, Number 3, Page 179
Franco D'Alberton, Maria Teresa Assante, Maura Foresti, Antonio Balsamo, Silvano Bertelloni, Eleonora Dati, Laura Nardi, Maria Letizia Bacchi, and Laura Mazzanti
The Journal of Sexual Medicine, 2015, Volume 12, Number 6, Page 1440
Armando J. Lorenzo, João L. Pippi Salle, Bozana Zlateska, Martin A. Koyle, Darius J. Bägli, and Luis H.P. Braga
The Journal of Urology, 2014, Volume 191, Number 5, Page 1558
Kyla L. Boyse, Melissa Gardner, Donna J. Marvicsin, and David E. Sandberg
Journal of Pediatric Nursing, 2014, Volume 29, Number 5, Page 436
Anne Tamar-Mattis, Arlene Baratz, Katharine Baratz Dalke, and Katrina Karkazis
Psychology & Sexuality, 2014, Volume 5, Number 1, Page 44
S.F. Ahmed, M. Gardner, and D.E. Sandberg
Psychology & Sexuality, 2014, Volume 5, Number 1, Page 5
Lih-Mei Liao and Margaret Simmonds
Psychology & Sexuality, 2014, Volume 5, Number 1, Page 83
Jürg C. Streuli, Effy Vayena, Yvonne Cavicchia‐Balmer, and Johannes Huber
The Journal of Sexual Medicine, 2013, Volume 10, Number 8, Page 1953
Jürg C. Streuli, Birgit Köhler, Knut Werner-Rosen, and Christine Mitchell
Advances in Urology, 2012, Volume 2012, Page 1
Caroline Sanders, Bernie Carter, and Lynne Goodacre
Journal of Clinical Nursing, 2012, Volume 21, Number 21-22, Page 3315
Halley P Crissman, Lauren Warner, Melissa Gardner, Meagan Carr, Aileen Schast, Alexandra L Quittner, Barry Kogan, and David E Sandberg
International Journal of Pediatric Endocrinology, 2011, Volume 2011, Number 1, Page 10
S. Faisal Ahmed, John C. Achermann, Wiebke Arlt, Adam H. Balen, Gerry Conway, Zoe L. Edwards, Sue Elford, Ieuan A. Hughes, Louise Izatt, Nils Krone, Harriet L. Miles, Stuart O’Toole, Les Perry, Caroline Sanders, Margaret Simmonds, A. Michael Wallace, Andrew Watt, and Debbie Willis
Clinical Endocrinology, 2011, Volume 75, Number 1, Page 12
K. Karkazis and W. C. Rossi
Pediatrics in Review, 2010, Volume 31, Number 11, Page e82

Comments (0)

Please log in or register to comment.
Log in