'Practical Approach to Intersex' article

[Dana Gold]

I transferred (copied/pasted) the below post fron 'In the News" because it was actually more appropriate in this section....and also for thinking it might get "buried" in the news section:
=======================================
I came across a recent (2/24/05) news article entitled "Practical Approach to Intersex" on the Red Nova webpage. I "hooked up" with SUNA (source entity) and found the complete technical/diagnostic (and illustrated) article below, which goes into /surgical/anatomic/physiological detail; (Referential sources of Milton Diamond and ISNA are mentioned); please be forewarned: graphic photos of genitalia and surgery):


http://www.suna.org/cgi-bin/WebObjects/SUNAMain.woa/1/wa/viewSection?wosid=OQ8J1kghAUcN2Q67uR94WV6g77E&tName=article021124&s_id=1073743836&ss_id=536873417


Dana :pizza:

PS: Betsy or Peter: if you could please delete the same post under 'In the News" to avoid confusion and redundancy.......thank you :biggrin:

PSS: An article “The Molecular Basis for Intersexuality” for any molecular biologists here (Sophie?):

http://www.duj.com/Article/Aaronson.html

homepage:

http://www.duj.com/index.html

:pizza:

[Betsy]

I don't hve time to do a full read right now but, my quick read revealed horrible research.

Even abstracts should be properly footnoted and this one was missing a crucial item. When the author talks about controversy, she mentions media and popular culture picking it up, stating that even 60 minutes has covered the issue. That is incorrect to the best of my knowledge. 60 minutes in Australia did a story with Tony Briffa, but it's never been done by 60 Minutes in the US and since she is not making her countries of sources of clear and even in the same sentence mentions another US News outlet (Newsweek), it is simply bad research.

Betsy

[Dana Gold]

I didn't have time to read the whole thing either (down to the "controversy" paragraphs)...because me, science nerd, initially focused on the med/surg info (w/o reading it thoroughly either)....anyway:

I did notice this passage, after reading down, from author's "controversy" section:

Some would argue that the patients themselves should decide when they reach an age of appropriate understanding. However, this ignores the reality of societal pressures that segregate expectations, social structures, and peer pressure along gender lines.

....and then this in the opening statement:

The Internet is a fantastic tool for distributing information. However, often it is unfiltered information, which may be emotionally biased.

Me thinks there's a bit of ( cool-emotioned, clinical and unfiltered) bias of the author involved in the " segregate expectations etc" statement....including, as Betsy pointed out reference to magazines and TV shows, which are not at all reliable clinical research references in determining conclusions or "factors" of said research.

Medical researh papers/articles or orations of any kind should not have personal bias interjected into clinical case studies or presentation of any medical conditions....or have notations of what the author thinks is the determining factor in the "correct choice"...based on segregation of the "patient" from the clinical decision making process....such things belong in Newsweek and associated "social commentary" news......( and "other rags")..not in pure research...especially when such biased "teaching research" is presented to future med students and nurses.

And I still haven't read the whole thing.... :redface: ...well, that's my "bias"

And, TGIF!..it's been a busy and tiring (but productive )week :sleepy: .....("job security" :idea2: ....)

Dana :pizza:

[prince....ss?]

Hello Dana,

I’m new here but I have been reading your posts. Yes I am very impressed with your knowledge and information base. I tried to read the article but it was like trying to do calculus before learning to count on your fingers and toes. Terms like “Mullerian ducts” I’m clueless. Do you have a good simple 101 link for things like this? I also have some medical terms that were written on my medical chart that I can’t find in any medical dictionary or source books. I also have a short list medicine that my mom was on while she carried me. Would you be willing to look at this for me and give me a quick run down?
:wavey: I love these stupid things.

[Sophie338]

Hi Dana :)

“The Molecular Basis for Intersexuality” for any molecular biologists here (Sophie?):

It is an interesting article, covering MSRs in areas other than the Y chromosome. But there is still this hangover with SRY in particular.

However this is interesting

How is it possible, for example, that some XX males seem to be totally lacking in SRY, yet the majority of XY females seem to be amply endowed with this gene? To explain these puzzles McElreavy36 proposed that the SRY gene product acts not as an activator but primarily as a repressor of another hitherto unidentified gene ìZî the role of which is to inhibit testis formation. This, and other models are currently being explored to explain the remaining clinical and experimental puzzles. Although tantalizingly near, we are still a little way from finally understanding the molecular complexities of testicular development.


They will probably find that the protein that SRY inhibits is something akin to a number of apoptosis regulating peptides or numerous proteins made up of only a small number of peptides, rather than some single protein. The point they are making is that virilisation happens in a large number of discreet steps. And they are implying that the differentiation of gonadal tissue is no longer the primary step on a molecular level.

I suspect they will not find a clean cut "This is the protein that SRY stops" rather There are a number of peptides/proteins that may be involved in apoptosis/differentiation in pre sex deterministic cell differentiation. So they probably will not find a "Feminising protein" just a looser collection of smaller proteins, or as I say single peptide chains that would in the absense of SRY be defaulting to female differentiation.

Basically there is a layer of cell differentiation that is going on prior to sex determination, It could be compared to running a computer, the final result being an operating system running, Either windows or linux. But prior to that other things need to happen before we get to booting an OS, like the bios finding where the disks are and so on. a whole lot of complex steps to get the basics going first.

In a way trying to find "A Gene" and "A product of a gene" that is the primary genesis of sex determination is looking for holy grails. You really have to get down to the nitty gritty of cell differentiation and apoptosis, dealing with caspases and so on. And given that, they will find a universal cure for cancer before they find some definative "sex gene"

This is probably why I tend to find myself doing stuff that relates more to oncology than the genetics of intersex. Once you get beyond the chromosomes and MSRs (Man genes) on the chromosomes you start looking at things like caspases and many small peptides.

The fact that they are themselves stating this is very promising.

As for the term "intersexuality" it seems evident to me that, they still do not have much of a clue about us as human beings.

You have probably read similar commentary to theirs in my articles, only I admit that I tend to dwell at the pre sex deterministic level, which can be confusing to the reader.

Shalom

Sophie.

[Sophie338]

Hi Again Dana :)

I did notice this passage, after reading down, from author's "controversy" section:

Some would argue that the patients themselves should decide when they reach an age of appropriate understanding. However, this ignores the reality of societal pressures that segregate expectations, social structures, and peer pressure along gender lines.



Oh the moment some "Cool and detatched" medical professionals talk like that with phrases like "I hear what you are saying... but" I find it a lot easier to dismatle their science to be honest. As soon as you do, it is often easy to expose the more social agenda they are working by.



....and then this in the opening statement:

The Internet is a fantastic tool for distributing information. However, often it is unfiltered information, which may be emotionally biased.


Oh I remember something like this, when a few years ago they were backhandedly hammering Cheryl Chase at ISNA. It took the form of the AAP doing a "Study" about the "Accuracy of intersexual medicine" of "internet websites". And in the abstract I seem to remember thinly veiled snipes at Chase and ISNA.

I wonder if anyone remembers that study? I could do with a copy of the abstract.

This sentance is something I remembered.

Support groups often do not have the complete picture, demanding surgery be banned but not considering society as such the information is emotionally biased and not reliable

I suppose they seem to think that being carved up as a child is something we should not be emotional about. :doh:

Shalom

Sophie.

[Betsy]

I m pretty sure I have a copy of it somewhere on our server still waiting for me to find the wherewithall to catalogue all that stuff. I'l try looking for it over the next couple of days.

Or...if you are in a hurry, PM me for a suggestion in grabbing it.

I know that ISNA published the abstract of it when it first came out.

[Sophie338]

Hi Betsy :)

I m pretty sure I have a copy of it somewhere on our server still waiting for me to find the wherewithall to catalogue all that stuff. I'l try looking for it over the next couple of days.

Or...if you are in a hurry, PM me for a suggestion in grabbing it.

I know that ISNA published the abstract of it when it first came out.

thats well cool thanks :)

There is no immediate hurry, it would be handy to have because I am planning to write some articles about the way the AAP has carried on from time to time.

Big hug :grouphug0

Sophie

[Dana Gold]

quote by prince...ss:

Would you be willing to look at this for me and give me a quick run down?

Sure, in fact, here's some stuff to "get you started"

http://www.rxlist.com/

the above has med. dictionary in left side menu

http://www.nlm.nih.gov/medlineplus/mplusdictionary.html

the above has drug info on its menu

http://www.healthyplace.com/communities/gender/intersexuals/intersexuality_faq.htm

http://www.healthyplace.com/communities/gender/intersexuals/article_jh_page4.htm

Both links above are somewhat old, and the author/originator of the webpage has passed away ( I think ).

If the above links do not answer your questions, post your query to me here and I'll do my best to find the respective information.

PS: There's no real way to simplify (in absolute layman's terms) the various medical conditions of sexual differentiation and also of pharmacology......even basic arithmetic has its complexities.

Dana :pizza:

[Dana Gold]

Yes, I do believe that social agendas do, in a lot of cases, get mixed into research and/or clinical presentations.....these researchers and academians are , after all, human.....and human nature/biases will accompany and affect not only the basic premise of the research.....but its direction.

I suspect they will not find a clean cut "This is the protein that SRY stops" rather There are a number of peptides/proteins that may be involved in apoptosis/differentiation in pre sex deterministic cell differentiation. So they probably will not find a "Feminising protein" just a looser collection of smaller proteins, or as I say single peptide chains that would in the absense of SRY be defaulting to female differentiation.



Yes, I absolutely agree that the cascade of genetic and biochemical events that determine sexual differentiation cannot be regulated by just one "holy grail" factor. A feminising protein does not make sense to me if the universally accepted default mode of the mammalian fetus is female to begin with. I once read (in a British publication) that the Y chromosome is actually a variant evolutionary gene of a distant X-like ancestor.......if that is true then "Eve came before Adam"...to use a metaphor.

only I admit that I tend to dwell at the pre sex deterministic level, which can be confusing to the reader.

Quick reference and maybe a bit on a tangent....an article I perused in Discover magazine (last year issue sometime) went into the human ovum being much more complex in bio-chemical make-up than previously thought.....even before spermatoza initiate the reproductive cascade.

Anyway, back to work here at the Univ.......take care!

Dana :wavey:


PS: Apoptosis (as well as angiogenesis) is a fascinating process and yes, we can learn a lot from oncology and related research.

[Betsy]

Sophie, here's the abstract from the article:

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11479853&dopt=Abstract

If the link doesn't work, google "Lelli, intersex"

ISNA has a summary on their site as well.

I thought I had it, but if I do, can't locate it.

Ironically, it was the proceeds of the presentation done at the AAP meeting in 2000--the same time at which the AAP stated in their policy that the best policy for boys born with micropenis should be surgically assigned a female.

Betsy

[prince....ss?]

Thank you so much for the links I’ll get started on them tonight. The one thing on my medical chart that I can’t find a definition for is “Glams.” With a hand drawn description of my condition it is located just above the urethra. Is this just a miss- spelling or an actual body part?

I know you were doing some research about possible medicine interaction on pregnant mothers. I will dig through my records I remember there was a short list if medicine my mother was on. She also had a miscarriage just before me.

Also I have a cousin I would swear has an IS condition and another cousin that is unable to have children. We were all the last child born to our respective families. Have there been any studies along those lines?

Thanks again

[Dana Gold]

glans:

The head of the penis.

She also had a miscarriage just before me.

My mother did before with me also....I suspect but cannot prove that she perhaps was taking diethylstilbestrol (DES), a synthetic estrogen to prevent another miscarriage....(DES has been/is purported to result in possible reproductive organ anomalies in male fetuses... estrogenic effects as well)

Progestins, (reproductive organ anomalies and androgenic effects in female fetuses) were also administered in the hopes of preventing miscarriages.
Both regimens were not only useless treatment modes, but potentially harmful as well.

If you want to know the possible drug effects of any drug, refer to the Warning/Precautions menu item for any of the listings in the RxList website I provided earlier....it will inform the you of the Pregnancy Category and respective adverse fetal effects.

Dana :pizza:

[Betsy]

glans:
The head of the penis.


And uh, the "head" of the clitoris, commonly known as the visible part.

Betsy

[Dana Gold]

Thanks for the "heads up" :rolleye11 , Betsy...correction, that is :wink_smil

:biggrin:

[prince....ss?]

That's strange that it would be the head of anything in the location the drawing indicated. Just above the urethra two side by side round notty structures sitting at the base of what looks like a phallas? Golly Gee, I was a messed up little kid. thanks

[Betsy]

It's not unheard of it to be "split" . It's pretty rare but it does occur. I think they call it bifurcated or something like that.

Most penises and clitoris are like two headed creatures joined in middle afterall.

Betsy