This is dependent on the age at which the problem is recognized.
Once the child is accustomed to a particular gender then it is difficult for it to change. Psychological factors are the most important in the management of these patients.
Whatever age the condition is discovered it is essential to define the genital configuration by examination under anaesthesia and laparoscopy and/or laparotomy.
Abdominal testes should be removed because of the risk of development of testicular cancer.
If a female gender is adopted then oestrogen therapy will be required at the age of puberty. Cosmetic surgery on the external genitalia may be required, and later the young 'adult woman' may require the construction of a functional vagina.
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