problendoПроблемы ЭндокринологииProblems of Endocrinology0375-96602308-1430Endocrinology Research Centre10.14341/probl12514problendo-12514Research ArticleДетская эндокринологияPediatric EndocrinologyНарушения половой дифференцировки: состояние проблемы через 15 лет после чикагского консенсусаDisorders of sex differentiation: state of the problem 15 years after the Chicago consensushttps://orcid.org/0000-0001-7201-0978ШиряевНиколай ДанииловичShiryaevNikolay D.

д.м.н., профессор

MD, PhD, Professor

nikshir@yandex.ruhttps://orcid.org/0000-0002-3957-1615КаганцовИлья МарковичKagantsovIlya M.

д.м.н.

MD, PhD

ilkagan@rambler.ruhttps://orcid.org/0000-0001-9145-8671СизоновВладимир ВалентиновичSizonovVladimir V.

д.м.н.

MD, PhD

vsizonov@mail.ruСеверный Государственный медицинский университетРоссияNorthern State Medical UniversityRussian FederationСыктывкарский государственный университет им. Питирима Сорокина; Республиканская детская клиническая больницаРоссияPitirim Sorokin Syktyvkar State University; Republican Children’s Clinical HospitalRussian FederationОбластная детская клиническая больница; Ростовский государственный медицинский университетРоссияRostov Regional Pediatric Hospital; RostSMU of Minzdrav of RussiaRussian Federation2020160920206637080Copyright © Ширяев Н.Д., Каганцов И.М., Сизонов В.В., 20202020Ширяев Н.Д., Каганцов И.М., Сизонов В.В.Shiryaev N.D., Kagantsov I.M., Sizonov V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.probl-endojournals.ru/jour/article/view/12514

Хорошо известно, что в 2005 г. была проведена Международная консенсусная конференция по вопросам интерсексуальных нарушений в Чикаго, на которой были изменены номенклатура и классификация, а также предложены, среди других, следующие рекомендации: (1) всем детям должна быть присвоена половая принадлежность, и это должно быть сделано как можно быстрее с учетом времени, необходимого для обследования; (2) все младенцы с врожденной гиперплазией надпочечников и 46,ХХ кариотипом, включая имеющих выраженную вирилизацию, должны воспитываться женщинами; (3) оперативное лечение должно осуществляться рано, и в случаях феминизирующей генитопластики редукцию клитора следует проводить одновременно с реконструкцией урогенитального синуса (разделением влагалища и уретры). Анализ современной литературы показывает, что ни одно из перечисленных предложений, сформулированных 15 лет назад на Чикагской встрече, не выдержало проверки временем. Новые номенклатура и классификация постоянно пересматриваются. В настоящее время многие группы больных хотят отмены термина «нарушения полового развития». Рекомендации, касавшиеся назначения пола и соответствующего раннего хирургического лечения, полностью проигнорированы в некоторых странах. Всему этому во многом способствовала конфронтационная деятельность ряда поддерживающих групп.

It is well known that the nomenclature and classification were changed in 2005 at the international consensus conference on intersex disorders, held in Chicago, where, among others, the following recommendations were proposed: (1) all children should be assigned a gender identity, and this should be done as quickly as possible, taking into account the time required for the examination. (2) all infants with congenital adrenal hyperplasia and 46,XX karyotype, including those with pronounced masculinization, must be raised as women. (3) Surgical treatment should be performed early and in cases of feminizing genitoplasty, clitoral reduction should be performed simultaneously with reconstruction of the urogenital sinus (separation of the vagina and urethra). An analysis of contemporary literature shows that all these theories, proposed 15 years ago at the Chicago meeting, failed to stand the test of time. New nomenclature and classification are constantly being revised. Currently, many groups of patients want to abolish the term «sexual maturity disorders.» Recommendations regarding gender reassignment and appropriate early surgical treatment have been completely ignored in some countries. All this was largely facilitated by the confrontational activities of a number of support groups.

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The authors declare that there are no conflicts of interest present.