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In rare cases, immediate surgeries are required out of medical necessity.For example, a child may not have a free-flowing urinary opening.Some intersex traits aren’t discovered until a person hits puberty or has difficulty conceiving, while others are obvious at birth.Sometimes the differences are relatively subtle—a girl may have an enlarged clitoris or a boy’s urethra opening may be on the underside of his penis, rather than the tip.Rosie has a more serious form of the condition called salt-wasting CAH, which can be life-threatening.After birth, Rosie’s blood sugar and weight plummeted, and she spent 19 days in the NICU.Still, intersex children are more likely than other children to feel that their sex assignment doesn’t match their gender identity.

For instance, a woman may take male hormones to treat severe endometriosis before knowing she’s pregnant, or produce them through an ovarian tumour.There’s research on how people with certain conditions identify on the gender spectrum, which can help guide decision-making.For example, 95 percent of genetic females with CAH who were raised as girls identify as female.“Before you start feminizing or masculinizing their genitals, wait and see how your child adjusts, get a better grip on what their gender identity is and let them decide what to do with their own body.Surgery is a huge risk because you don’t know what any child’s gender identity is going to be, intersex or not.” On their third day at the London Health Sciences Centre in Ontario, while Rosie was still in the NICU, Eric and Stephani Lohman had their first DSD team meeting.

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