Gender Assignment and Genital Reconstruction

In most children the hemiphalli are rudimentary and far apart. Thus, all genetic females and most genetic males are reared as girls [32,35,36]. Male type C variants may have united hemiphalli and may be suitable for a male sex of rearing [22]. Genetic males assigned the female gender of rearing will need early orchidec-tomy to prevent further testosterone imprinting and vaginal reconstruction in later life using scrotal skin or bowel segments [26,31,35,42]. Genetic females also need genital reconstruction as the Mullerian structures are duplex, often far apart, and sometimes poorly developed. The vaginae may open in the back wall of the bladder or may be blind. The hemivaginae are too far apart to be surgically united and generally the lesser of the two is excised [31]. If both hemivaginae are inadequate, a vagina may be reconstructed from bowel segment, bladder remnant, or even a dilated ureter [26,31,35,42]. Whatever the sex of rearing, the result often leaves much to be desired (see psychosexual issues). Hormonal replacement therapy is needed for genetic males reared as girls [32].

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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