Rangecroft L
Department of Paediatric Surgery, The Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK.
Arch Dis Child. 2003 Sep;88(9):799-801. doi: 10.1136/adc.88.9.799.
The surgical management of children born with ambiguous genitalia has always been difficult, subject to evolving attitudes and techniques, and at times controversial. Standard protocols have stressed the need for early diagnosis, gender assignment, and appropriate surgery in infancy.(1) In recent years some authors, backed by patient support groups, have claimed that such surgery is damaging or mutilating and, as it is essentially cosmetic, should not be performed until the fully informed consent of the patient could be obtained-that is, when the child becomes "Gillick competent".(2-)(4) There are, however, so many specific issues related to the different diagnostic groups that such a policy would seem to be too prescriptive.
对出生时生殖器模糊不清的儿童进行手术治疗一直都很困难，这受到不断变化的观念和技术的影响，有时还存在争议。标准方案强调了早期诊断、性别指定以及在婴儿期进行适当手术的必要性。（1）近年来，一些作者在患者支持团体的支持下声称，这种手术具有伤害性或致残性，而且由于其本质上是美容性的，在获得患者充分知情同意之前不应进行——也就是说，当孩子具备“吉利克能力”时。（2 - ）（4）然而，与不同诊断组相关的具体问题太多了，以至于这样一项政策似乎过于苛刻。
