Male or Female? What about disorders of sex development

After the first trimester of pregnancy future parents are commonly asked if their child will be male or female. Such a question creates many expectations and implies the true determination of the baby's identity. Indeed, since the earliest stages of pregnancy knowing the gender of unborn babies creates expectations in their families, which grow with the approach of childbirth. Babies born with atypical genitalia, which consequently makes impossible to address whether they are really the same as they had been imagined, create considerable difficulties in their parents, who see their believes undermined. The evaluation of infants' genitalia, taken for granted when referring to genitalia phenotypically in the standard and often not reported for brevity in the first clinical examination after birth, becomes fundamental in case of atypia. In order to be able to take best care of such children, it is necessary to know how the hypothalamus-pituitary-gonad axis and the consequent genital development work and to understand, whenever possible, what the problem was to be able to build the best plan to support families and patients.