Find the gender of your child

Congenital defects such as hypospadias and cryptorchidism are common conditions that cause gender confusion right after birth. In many cases, children grow up with female-like genitals but are actually male or vice versa. Only when parents take their children to the hospital for examination and testing do they discover that their children are living in a gender-mismatch.

Many children live with the wrong gender

Taking care of her child in the hospital bed, Ms. LTH (38 years old, living in Dong Nai ) said that her child is now 12 years old but this is the 4th time he has had surgery. "When he was born, he was diagnosed with low urethral opening, so the doctors performed surgery on his urethral opening. The second time, he had a urethral fistula and had to have surgery again, the third time the fistula was patched. The fourth time, I accidentally took my child for a check-up and discovered that he had a narrowed urethra and residual urine in his bladder, so he had to have surgery," Ms. H. said.

According to Ms. H., the doctors were lucky to detect abnormalities in her child’s genitals and promptly intervened and treated her child. This also helped her child grow up to be the right gender and did not affect her child’s psychology too much.

Determining and finding the true gender for children is a humane thing to do.

As for the case of Mr. TCT's (36 years old) son, he was unlucky to have been living with the wrong gender for many years before discovering it. Mr. T. said that the child was born with male genitalia, so the family oriented the child to dress, communicate, and live like a boy. However, when he grew up, he felt that it was not suitable, so the family took him for a check-up and discovered that he did not have testicles but had ovaries, a uterus, and a vagina.

Dr. Pham Ngoc Thach, Deputy Director of Children's Hospital 2 (HCMC), said that the hospital has discovered many cases of children coming to examine, diagnose and intervene to help them live according to their true gender. This is also the only unit in the South that reissues gender identification certificates for children.

"Children's Hospital 2 is one of three facilities in Vietnam approved by the Ministry of Health as a place that can confirm gender and perform surgery to treat congenital gender defects in children. The rate of children with gender development disorders, when their external genitalia cannot be determined to be male or female, is about 1/5,000 children. In the past, the hospital has intervened to restore the true gender of 53 children with congenital disabilities, of which 34 cases were identified as male and 19 were female," Dr. Thach informed.

Golden time: 8 to 18 months

According to Dr. Thach, one of the causes of gender confusion is low urethral opening, cryptorchidism, mixed gonadal dysplasia, congenital adrenal hyperplasia... Of which, the two common groups of diseases are low urethral opening (with or without cryptorchidism) and congenital adrenal hyperplasia.

"If gender confusion is not treated promptly, when they grow up, children may have psychological problems due to inferiority complex with friends or being teased. In particular, some cases of finding their true gender after adulthood affect their lives. Therefore, if there is a little doubt about the child's gender, parents should take their child to the hospital for screening to have timely treatment. Because the best golden time to intervene in congenital malformations is 8 - 18 months" - Dr. Thach emphasized.

To determine the gender of a patient with gender ambiguity, diagnosis and surgical intervention are required if necessary. Diagnosis includes clinical examination and all necessary tests such as: sex chromosome testing, ultrasound, CT scan, assessment of the degree of male or female external genital malformation, biopsy of the gonads, psychological assessment of the child, etc.

Treatment for children requires the coordination of many specialties such as endocrinology, urology, and psychology to provide the best care for children. The medical council will base on clinical, paraclinical, laboratory results, or after surgical treatment of the defect to issue a certificate of true gender for the child.

However, not all cases are easy to identify and intervene, especially with intersex cases - children who have both male and female genitalia. For these children, they have to wait until they are older and choose their own true gender. The most important thing in the treatment process to restore the true gender is to ensure the maximum reproductive function of the child in the future.

"For children undergoing gender reassignment surgery, doctors will reconstruct the external genitalia to match, such as if the child has a low urethra, the urethra will be raised, if the penis is curved, it will be straightened... After surgery, the psychologist will consult with the child as well as the family so that the child can gradually orient towards the appropriate gender later on," said Dr. Thach.

Dr. Thach also pointed out that if parents have concerns about abnormalities in their child's genitals, they should take them to see a doctor. Some common identifying characteristics include: in female children, the clitoris is too exposed, the labia majora and labia minora are abnormal (too large, too small)...; in male children, the genitals are smaller than other children, the penis is located lower than the scrotum, the shape of the scrotum is similar to that of the labia majora of women, there are no testicles...

"Reassigning a child's gender must be based on many medical criteria (chromosomes, gonads, hormones, fertility, surgery...) as well as the psychology and awareness of the patient and parents. This is a humane act, ensuring that each person can live according to their own gender" - Dr. Thach shared.

Currently, although gender reassignment surgery has been recognized, it is still not allowed in Vietnam.

Explaining this further, Dr. Mai Ba Tien Dung, Head of the Department of Andrology - Binh Dan Hospital (HCMC), said that the hospital has established a gender clinic for the third gender community (LGBT) and has seen a great need for gender reassignment. However, if the transgender law is enacted, it will affect the quality of life, the Law on Marriage and Family, inheritance, military service... Therefore, the Ministry of Health only allows gender reassignment for patients with abnormalities in the genitals but on the chromosome system that matches the gender. For example, the external genitals are female but the patient's chromosomes are male. "Therefore, it is necessary to re-determine the needs and desires of both the family and the patient. When implementing, it must be through a gender assessment council" - Dr. Dung noted.

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