NEW DELHI — “Is it a boy or a girl?” is often the first question asked after a baby is born. While it may seem harmless, doctors at AIIMS Delhi warn that hasty decisions about a newborn’s sex can have lifelong consequences for babies with differences of sex development (DSD) — medical conditions where sex organs, chromosomes, or hormones do not follow typical male or female patterns.
Specialists emphasize that DSD is a biological and medical condition, not an identity issue, and premature labeling can affect health, future care, and social well-being.
DSD: More Common Than People Realize
Dr. Vandana Jain, professor of paediatric endocrinology at AIIMS, notes that the institute sees around 150 new DSD cases annually, though under-reporting due to stigma likely underestimates the true numbers. Globally, DSD occurs in approximately 1 in 4,000 to 5,000 births.
“DSD may not always be visible at birth,” Dr. Jain explained. “Some children are diagnosed only during puberty when physical development is atypical or delayed.”
Certain DSD conditions, like congenital adrenal hyperplasia, can even become life-threatening if untreated, causing salt imbalances, shock, or death in newborns. However, early diagnosis and hormone therapy can enable most children to live healthy, normal lives.
The Risk of Premature Decisions
Doctors warn that social pressure and stigma often push families to make quick choices, which can lead to unnecessary medical interventions or missed follow-ups. “Sex development is complex — spanning genes, chromosomes, internal organs, external anatomy, and psychological growth,” Dr. Jain said. No single test can provide the full picture, reinforcing the need for patience.
At AIIMS, children with DSD are evaluated by a multidisciplinary team including pediatricians, endocrinologists, surgeons, geneticists, and mental-health professionals. Parents are counseled throughout, ensuring decisions are gradual and informed.
Supporting Families Beyond Medical Care
Mental health experts stress the emotional toll on families. Dr. Rajesh Sagar, professor of psychiatry at AIIMS, said, “Fear, guilt, and panic after birth can cause some parents to emotionally withdraw or discontinue care, worsening outcomes.”
Doctors also advocate flexibility in birth certificates and school documentation to avoid forcing families into early labeling. Their guidance is clear: when a baby’s sex is uncertain, patience protects the child more than societal expectations ever could.
