Exploration of ethical issues in the multiple disciplinary team model for children with 46, XY disorders of sex development
10.12026/j.issn.1001-8565.2026.06.03
- VernacularTitle:46，XY性发育异常患儿多学科诊疗模式下的伦理问题探讨
- Author:
Lili PAN
1
;
Zhe SU
1
;
Wei SU
1
;
Ying ZU
2
;
Chenxi LI
2
;
Huiping SU
1
;
Jingyu YOU
1
;
Kexin JIN
1
;
Rongfei ZHENG
1
Author Information
1. Department of Endocrinology， Shenzhen Children’s Hospital， Shenzhen 518026， China
2. Department of Medical Ethics， Shenzhen Children’s Hospital， Shenzhen 518026， China
- Publication Type:Journal Article
- Keywords:
46, XY disorders of sex development;
multiple disciplinary team;
medical ethics
- From:
Chinese Medical Ethics
2026;39(6):718-723
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo explore the ethical issues and coping strategies in the diagnosis and treatment of 46, XY disorders of sex development （46, XY DSD） under a multidisciplinary team （MDT） model， and to deepen the understanding of relevant ethical issues while accumulating experience. MethodsA retrospective collection was conducted on the data of children with 46, XY disorders of sex development under a single-center MDT model from January 2017 to December 2024， and the ethical issues involved in the diagnosis and treatment process were analyzed. ResultsA total of 24 MDT discussion documents involving 20 children were collected， including 17 with female social gender and 3 with male social gender. The age ranged from 0.5 to 15.8 years， with children under 8 years accounting for 75%. The ethical issues primarily involved how to ensure adequate informed consent， whether surgery was necessary and its timing， and whether gender selection is reasonable and its timing. Among the 10 children raised as females who completed the gender role psychological scale assessment， 5 demonstrated masculine tendencies， all of whom had pathogenic genetic variants. Furthermore， only 1 patient changed the social gender to male. ConclusionThe diagnosis and treatment of 46, XY DSD is relatively complex， requiring multidisciplinary collaboration. This process involves numerous ethical issues and necessitates adhering to medical ethical principles. Ensuring adequate informed consent is crucial， especially for younger children. The surgery and its timing selection must adhere to the principles of beneficence， non-maleficence， and leaving room for the future. Gender selection constitutes a focus and challenge in diagnosis and treatment. Psychological scales and genetic etiologies are conducive to judgments regarding gender selection， yet multiple factors in the real world may interfere with the gender selection.
