Surgery to correct birth defects in the genital area brings back the real gender for babies who have been deluded with the gender since birth.

24/04/2023 14:10

Case 1: N. T. D. (2 years old, Hanoi) has a very nice name from a young age as a white, pretty girl with normal physical development like her peers. However, the older the baby, the more she showed abnormalities in psychology, gender, and especially the private part, which was not completely similar to a girl, her family took her to see Assoc. Prof. Nguyen Viet Hoa, MD, PhD, Head of Pediatric and Neonatal Surgery Department Viet Duc University Hospital for advice. The child was found to have a hypospadias symptom as perineal form which causes the penis to be buried between the two sides of the scrotum, so it looks like a clitoris with two testicles that have not yet descended into the scrotum located in the inguinal canal. This is the reason why the child was deluded for the wrong gender. She had been indicated to do more sex determination tests: chromosomal gene tests, testicular differentiation genes and endocrine tests.

The test results confirmed that it was a boy. He was operated on by Assoc. Prof. Nguyen Viet Hoa, to descend the testicles on both sides to the scrotum when he was 1 year old and repair the urethra to bring the lower urinary opening from the perineal part to the top of the glans when he was 22 months old. After 10 days, he was catheterized and could stand to urinate like other normal boys. His mother is very emotional and happy to prepare the paperwork to renew the name and gender on his birth certificate. Assoc. Prof. Nguyen Viet Hoa, shared that had operated for many similar cases successfully, many children came to the clinic soon after birth, so they did not have to change their name or change their birth certificate. Early detection and timely intervention helped T.D. (now renamed Q. C.) with true gender, helping he live confidently and prepare psychologically to go to school with his peers.

 

Case 2: During the same period as N.T.D. There was one unfortunate case that was discovered and intervened late, Mr. N.T.A (28 years old resident in Ha Giang) until he got married and had difficulties in marital life to be treated for vaginal anomalies. Mr. T.A is the youngest child in a Nung family with 7 children with short stature (140cm). Coincidentally met Assoc. Prof. Nguyen Viet Hoa, during her business trip to Ha Giang, T.A. was examined and discovered that his hypospadias of severe form in the perineum makes patients difficult and less confident in daily life and activities.

 Believing in the doctors and determination to be cured the disease, T.A went to Viet Duc University Hospital for treatment. The patient’s chromosomal and endocrine tests showed that Mr. TA had a gender development disorder, a rare form, chromosomes 45 XO and 46 XY, the doctor determined that the patient was predisposed to male and had Assoc. Prof. Dr. Nguyen Viet Hoa, performed surgery to descend the testicles and correct the low urinary deviation. The surgery took place with a time of 4 hours, erecting the penis and creating a 1-way urethra, helping the patient not to undergo many other surgeries, the shaped urethra was 12cm long from the perineum to the top of the glans, after 10 days Mr.TA pees normally like other men. TA’s mother is old with grandchildren who is from the Nung ethnic group, honest and can’t talk much, just nods and says, “thank you doctor”. Mr. TA, who was in the same treatment room as the children, confided that because he did not know anything about his illness before, he was afraid because he was sick in the private part, so he was considered a boy when he was a child, but when he went to the toilet he sat down to pee. It wasn’t until he grew up, went out to work and got married that he found out and decided to go for medical treatment.

 Assoc. Prof. Dr. Nguyen Viet Hoa, informed that many cases of severe hypospadias with ectopic testes that have not yet descended into the scrotum will be mistaken for girls immediately after birth. Therefore, when parents see that their child has abnormalities in the genital areas, they need to seek a pediatrician expert for early examination and consultation and conduct gender-determination tests to avoid psychopathology which it is not necessary to grow up to be treated, causing psychological effects, inferiority complex with friends or being teased. Not only that, but there are also some cases where the new gender is redefined when they have passed adulthood, greatly affecting life, work and fertility. Assoc. Prof. Dr. Nguyen Viet Hoa, said that cases of early detection and treatment give good results in terms of the shape of the external genitals and psychophysiology of the child, early surgery such as ectopic testes before 1 year of age, hypospadias urinary before 2 years of age.