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Multi-stakeholder opinion statement on the care of individuals born with differences of sex development : common ground and opportunities for improvement

Martine Cools (UGent) , Earl Y. Cheng, Joanne Hall, Julie Alderson, Anne-Marie Amies Oelschlager, Adam H. Balen, Yee-Ming Chan, Mitchell E. Geffner, Claus H. Gravholt, Tülay Güran, et al.
(2025) HORMONE RESEARCH IN PAEDIATRICS. 98. p.226-242
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Abstract
Background: In the last 15 years, the care provided for individuals born with differences of sex development (DSD) has evolved, with a strong emphasis on interdisciplinary approaches. However, these developments have not convinced some stakeholders to embrace the current model of care. This care model has also paid insufficient attention to socio-cultural differences and global inequalities. Summary: This article is an opinion statement, resulting from in-depth discussions and reflection among clinicians, patients, and family support organizations based in the USA and Europe, where we seek areas of common ground and try to identify opportunities to further develop resources. The product of these conversations is summarized in 10 panels. The corresponding sections provide additional discussion on some of the panel items. Key Messages: Participants identified areas of agreement, gained a deeper understanding of the reasons behind disagreements on certain matters, and identified the necessary steps to foster future consensus. We offer preliminary recommendations for guiding clinical management and resource allocation. By promoting a broader consensus, we aim to enhance the quality of care and well-being for individuals of all ages who have a DSD.
Keywords
Differences of sex development, Disorders of sex development, Intersex, Peer support, Psychosocial care, Activism, Interdisciplinary team, DECISION-MAKING, DEVELOPMENT DSD, DISORDERS, MANAGEMENT, REGISTRY, STIGMA, UPDATE, PAPER

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MLA
Cools, Martine, et al. “Multi-Stakeholder Opinion Statement on the Care of Individuals Born with Differences of Sex Development : Common Ground and Opportunities for Improvement.” HORMONE RESEARCH IN PAEDIATRICS, vol. 98, 2025, pp. 226–42, doi:10.1159/000536296.
APA
Cools, M., Cheng, E. Y., Hall, J., Alderson, J., Amies Oelschlager, A.-M., Balen, A. H., … Subramaniam, R. (2025). Multi-stakeholder opinion statement on the care of individuals born with differences of sex development : common ground and opportunities for improvement. HORMONE RESEARCH IN PAEDIATRICS, 98, 226–242. https://doi.org/10.1159/000536296
Chicago author-date
Cools, Martine, Earl Y. Cheng, Joanne Hall, Julie Alderson, Anne-Marie Amies Oelschlager, Adam H. Balen, Yee-Ming Chan, et al. 2025. “Multi-Stakeholder Opinion Statement on the Care of Individuals Born with Differences of Sex Development : Common Ground and Opportunities for Improvement.” HORMONE RESEARCH IN PAEDIATRICS 98: 226–42. https://doi.org/10.1159/000536296.
Chicago author-date (all authors)
Cools, Martine, Earl Y. Cheng, Joanne Hall, Julie Alderson, Anne-Marie Amies Oelschlager, Adam H. Balen, Yee-Ming Chan, Mitchell E. Geffner, Claus H. Gravholt, Tülay Güran, Piet Hoebeke, Peter Lee, Ellie Magritte, Dina Matos, Ken McElreavey, Heino F.L. Meyer-Bahlburg, Richard C. Rink, Alexander Springer, Konrad M. Szymanski, Eric Vilain, Jo Williams, Katja P. Wolffenbuttel, David E. Sandberg, and Ramnath Subramaniam. 2025. “Multi-Stakeholder Opinion Statement on the Care of Individuals Born with Differences of Sex Development : Common Ground and Opportunities for Improvement.” HORMONE RESEARCH IN PAEDIATRICS 98: 226–242. doi:10.1159/000536296.
Vancouver
1.
Cools M, Cheng EY, Hall J, Alderson J, Amies Oelschlager A-M, Balen AH, et al. Multi-stakeholder opinion statement on the care of individuals born with differences of sex development : common ground and opportunities for improvement. HORMONE RESEARCH IN PAEDIATRICS. 2025;98:226–42.
IEEE
[1]
M. Cools et al., “Multi-stakeholder opinion statement on the care of individuals born with differences of sex development : common ground and opportunities for improvement,” HORMONE RESEARCH IN PAEDIATRICS, vol. 98, pp. 226–242, 2025.
@article{01JJF2MDT6K0P0YAMX5SCCBRPS,
  abstract     = {{Background: In the last 15 years, the care provided for individuals born with differences of sex development (DSD) has evolved, with a strong emphasis on interdisciplinary approaches. However, these developments have not convinced some stakeholders to embrace the current model of care. This care model has also paid insufficient attention to socio-cultural differences and global inequalities. Summary: This article is an opinion statement, resulting from in-depth discussions and reflection among clinicians, patients, and family support organizations based in the USA and Europe, where we seek areas of common ground and try to identify opportunities to further develop resources. The product of these conversations is summarized in 10 panels. The corresponding sections provide additional discussion on some of the panel items. Key Messages: Participants identified areas of agreement, gained a deeper understanding of the reasons behind disagreements on certain matters, and identified the necessary steps to foster future consensus. We offer preliminary recommendations for guiding clinical management and resource allocation. By promoting a broader consensus, we aim to enhance the quality of care and well-being for individuals of all ages who have a DSD.}},
  author       = {{Cools, Martine and Cheng, Earl Y. and Hall, Joanne and Alderson, Julie and Amies Oelschlager, Anne-Marie and Balen, Adam H. and Chan, Yee-Ming and Geffner, Mitchell E. and Gravholt, Claus H. and Güran, Tülay and Hoebeke, Piet and Lee, Peter and Magritte, Ellie and Matos, Dina and McElreavey, Ken and Meyer-Bahlburg, Heino F.L. and Rink, Richard C. and Springer, Alexander and Szymanski, Konrad M. and Vilain, Eric and Williams, Jo and Wolffenbuttel, Katja P. and Sandberg, David E. and Subramaniam, Ramnath}},
  issn         = {{1663-2818}},
  journal      = {{HORMONE RESEARCH IN PAEDIATRICS}},
  keywords     = {{Differences of sex development,Disorders of sex development,Intersex,Peer support,Psychosocial care,Activism,Interdisciplinary team,DECISION-MAKING,DEVELOPMENT DSD,DISORDERS,MANAGEMENT,REGISTRY,STIGMA,UPDATE,PAPER}},
  language     = {{eng}},
  pages        = {{226--242}},
  title        = {{Multi-stakeholder opinion statement on the care of individuals born with differences of sex development : common ground and opportunities for improvement}},
  url          = {{http://doi.org/10.1159/000536296}},
  volume       = {{98}},
  year         = {{2025}},
}
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