Not a disorder, but a different order
It is not often that a work of fiction challenges the way that I would think about a patient. However this remarkable book does just that. Shortlisted for the Orange Prize for Fiction 2011, Kathleen Winter’s debut novel Annabel is a moving portrayal of a child who was born with both male and female sexual organs, growing up in rural Canada. The story may begin in 1968 but the issues that are sensitively and astutely raised by the author are wholly relevant to the medical student of 2011.
From birth, our gender forms an integral part of our identity. “Is the baby a boy or a girl?” is often the first question asked of new parents. What happens, however, when the baby has ambiguous genitalia? How do the parents feel about this? And, should a gender re-assignment operation be carried out as soon as possible in the neonatal period? In