The Chop Experience with Cloacal Exstrophy and Gender Reassignment

  • Stephen A. Zderic
  • Douglas A. Canning
  • Michael C. Carr
  • Christine Kodman-Jones
  • Howard-McC. Snyder
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 511)


We have chosen to emphasize our experience with the management of patients with cloacal exstrophy, because this is the primary patient population in which gender reassignment has been utilized at this center over a 30 year span. These 11 reassigned patients comprise a cohort with similar medical and surgical issues, and their progress may be contrasted with 4 males who were not gender reassigned as well as 7 genetic females. By gender reassignment, we are specifically referring to the assignment of a female gender for a neonate with an absent phallus who has a normal XY karyotype and functional testes in the absence of any endocrine disorder. Other reasons for gender reassignment within this department have included aphalia, ablatio penis, and one case of classic exstrophy. In addition to these extremely rare cases, the division has accumulated a substantial experience in gender assignment in intersex cases with the most common diagnosis being congenital adrenal hyperplasia. It has always been the philosophy of this division to assign a gender consistent with the chromosomal and gonadal sex whenever possible.


Gender Identity Congenital Adrenal Hyperplasia Spina Bifida Hypothalamic Pituitary Adrenal Axis Androgen Insensitivity Syndrome 
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Copyright information

© Springer Science+Business Media New York 2002

Authors and Affiliations

  • Stephen A. Zderic
    • 1
  • Douglas A. Canning
    • 1
  • Michael C. Carr
    • 1
  • Christine Kodman-Jones
    • 1
  • Howard-McC. Snyder
    • 1
  1. 1.Division of UrologyThe Children’s Hospital of PhiladelphiaUSA

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