What does DSD mean?
DSD, or disorders/differences of sex development, describes a group of conditions in which chromosomal, gonadal, hormonal, or genital development is atypical. Some children are identified at birth because the genital appearance is not typical, while others are investigated later because of severe hypospadias, undescended testes, delayed puberty, or discordant imaging and laboratory findings.
When is specialist evaluation needed?
Urgent specialist evaluation is important when a newborn has ambiguous genitalia, severe hypospadias with one or both testes not descended, a pelvic or abdominal gonad of uncertain type, or prenatal imaging that does not match the expected anatomy. Older children and adolescents may need evaluation when puberty does not progress as expected or when fertility and hormone questions arise.
How is the diagnosis clarified?
Evaluation may include a detailed physical examination, kidney and pelvic ultrasound, chromosome analysis, targeted genetic testing, hormone studies, and sometimes endoscopy or examination under anesthesia. The purpose is not to rush a label, but to understand anatomy, protect urinary function, identify any urgent endocrine risks, and guide families through the next steps carefully.
Treatment principles
Not every child with DSD needs surgery. Treatment depends on the exact diagnosis, urinary anatomy, gonadal position, endocrine status, and family goals. The first priorities are safety, kidney and bladder protection, and clear counseling. When procedures are considered, timing should be individualized and coordinated with the multidisciplinary team.
Why multidisciplinary follow-up matters
Children with DSD often benefit from coordinated care involving pediatric urology, pediatric endocrinology, genetics, psychology, and neonatology. Families need time, information, and continuity. Long-term follow-up may address urinary function, puberty, future fertility questions, and psychosocial support.
Dr. Kallas Chemaly's approach
Dr. Kallas Chemaly focuses on careful evaluation rather than rushed decisions. He helps families understand anatomy and treatment options, protects urinary function, coordinates referrals when endocrine or genetic testing is needed, and supports a staged plan centered on the child's long-term health and dignity.
References
- MedlinePlus Medical Encyclopedia: Ambiguous genitalia
- Children's Hospital Colorado: Ambiguous Genitalia (Atypical Genitalia)
Serving families across Beirut and Mount Lebanon
Dr. Kallas Chemaly sees children from Achrafieh, Gemmayzeh, Saifi, Sodeco, Verdun, Hamra, Clemenceau, Ras Beirut, Rabieh, Mtayleb, Brummana, Beit Mery, Bikfaya, Mansourieh, Kornet Chehwan, Antelias, Dbayeh, Jounieh, Kaslik, Hazmieh, Yarze, and across Keserwan, Metn, and Baabda.