This book represents the proceedings from a conference that took place in Dallas in the spring of 1999 which was entitled "Pediatric Gender Assignment - A Critical Reappraisal". Some participants rightfully argued that the conference really focused on the issue of pediatric gender assignment, and that reassignment was not applied in most cases. Their comments were reflected in the title of this monograph. This multidisciplinary meeting was sponsored by a conference grant from the National Institutes of Health, and a broad inquiry into this complex topic took place from many points of view. Basic scientists offered insight into mechanisms of sexual differentiation of the gonads, physical phenotype and imprinting of the central nervous system. Endocrinologists reviewed their experience in diagnosis and management, surgeons described traditional as well as innovative approaches, and there was strong representation from the ethical and behavioral sciences. In putting together such a panel, it was essential that we identify a cast of speakers who could address their viewpoints with strong convictions, and yet not let their passions render the meeting counter productive. We were not disappointed. While many differing points of view were firmly expressed by the panelists and audience, all viewpoints were accorded the respect they deserved. The concept behind the meeting and this book really originated in 1997 shortly after Diamond and Sigmundson published their long term follow up study of the John/Joan case.

1. SRY and the Genetics of Sex Determination; B.K. Jordan, E. Vilain. 2. Normal and Abnormal Testicular Development; F. Hadziselimovic, D. Huff. 3. Mullerian Inhibiting Substance: An Update; D.T. MacLaughlin, P.K. Donahoe. 4. Micropenis: An Animal Model and its Human Correlates; D.A. Husmann. 5. Hypothalamic Imprinting by Gonadal Steroid Hormones; R.A. Gorski. 6. Sexual Differentiation of the Human Hypothalamus; D.F. Swaab, et al. 7. The Endocrinologist's Approach to the Intersex Patient; P.C. White. 8. 5alpha-reductase;2 Deficiency and Complete Androgen Insensitivity: Lessons from Nature; J. Imperato-McGinley. 9. The CHOP Experience with Cloacal Exstrophy and Gender Reassignment; S.A. Zderic, et al. 10. A Framework for the Ethically Justified Clinical Management of Intersex Conditions; L.B. McCullough. 11. Gender Identity and Sex Assignment: A Reappraisal for the 21st Century; W.G. Reiner. 12. Gender Assignment and Reassignment in Intersexuality: Controversies, Data and Guidelines for Research; H.F.L. Meyer-Bahlburg. 13. Prenatal Diagnosis and Treatment of Intersex States; N.E. Rintoul, et al. 14. Anatomical Studies of the Fetal Genitalia: Surgical Reconstructive Implications; L.S. Baskin. 15. Feminizing Genitoplasty; T.W. Hensle, J. Bingham. 16. The Management of Cloacal Exstrophy; M. Mitchell, J. Chadwick Plaire. 17. Total Phallic Construction, Option to Gender Reassignment; G.H. Jordan. 18. Penile Reconstruction with a Free Sensate Osteocutaneous Fibula Flap in the Surgical Management of the Intersex Patient; J.W. McRoberts, R.C. Sadove. 19. Tissue Engineering Approaches for Genital Reconstruction; A. Atala.