Link: Managing disorder of sexual development surgically: A single center experience

http://www.indianjurol.com/article.asp?issn=0970-1591;year=2012;volume=28;issue=3;spage=286;epage=291;aulast=Kumar

Linked is a 2012 article that sheds light on the surgeries given to intersex children recently.  It also helps with clarifying some terms. However, we can see from the article that medical advancements has make it easier to achieve satisfactory both cosmetically and functionally in disorder of sexual development (DSD) surgeries. The process is not as harmful now as Fausto-Sterling described in the 90's. If in the end we finally find a way to "correct" intersex children to conform to genital binary, would we opt for the children to go through these surgeries if the best time to conduct these surgeries, as the article suggested, is before 2 years old, when the children are not aware of what gender and DSD means? If we choose yes, what does our choice mean?

A quote from the article makes clear its antagonism against the utopian policy supported by intersex activists. While the optimal gender policy assumes socialization as the formative force in gender identity development, it does not recommend early genital surgery if the social sexual identity is acquired later in life than at 2 years of age. Is the article misrepresenting the constructionist view of gender identity?

"For the past 50 years practice has been informed by the so-called optimal gender policy, which proposed that in ambiguous genitalia, gender assignment should be that which allows optimal psychosexual and psychosocial functioning later in life. ^[8] This approach assumes the socialization is the decisive factor in gender identity development. In practice to support the assigned gender, early feminizing or masculinizing surgery of external genitalia was recommended, as socially acquired sexual identity is established by the age of 2 years. ^[The optimal gender policy has been challenged; in particular, the underlying assumption that gender identity is socially constructed. Parents are now routinely advised that children have the right to full details about their diagnosis and the medical and surgical management of this. Evidence suggests that parents have significant fears about the impact of ambiguous genitalia ad disclosure of diagnosis on their child's development. They are often uncertain about what to say and fear child will blame them or develop psychological difficulties.