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Dispelling a common myth, researchers from the Johns Hopkins Children’s Center say vaginal reconstruction should be a matter of preference for most teens or adult women born with a type of inter-sex condition marked by the presence of both female and male genitals. The findings of the research are being presented at the American Academy of Pediatrics Conference Oct. 26 through Oct. 30 in San Francisco.

Women with complete androgen insensitivity are born with relatively shallow vaginas that may or may not require surgical repair and with undescended testes that do require removal.

Vaginal surgery, if needed or wanted, should be done after puberty, when physical development is complete and a girl or a woman is mature enough to make a decision, researchers say.

“It is a common misconception in the general public — and quite often among doctors — that most girls born with this condition should have vaginal reconstruction in order to be sexually active,” says lead investigator Todd Purves, M.D. Ph.D., a urologist at Hopkins Children’s. “Our findings show that, on the contrary, most young women choose not to have the surgery, have vaginal depths that are within normal parameters and can lead active sexual lives.”

In their study of 29 women born with the syndrome, researchers found that 38 percent chose to have vaginal surgery. Comparing those who had surgery with those who did not, researchers found that both groups had similar rates of sexual activity: Eighty percent of those who chose not to have surgery were sexually active, compared to 70 percent of those who had surgery.

“As surgeons, we need to make sure that the parents of babies with this disorder understand that their daughter may not even need vaginal surgery, and if she does, it is a decision that should wait until after adolescence,” Purves says.

Gender identity in women born with this condition is almost always female.

Co-investigators in the study: Jennifer Miles-Thomas, M.D., Claude Midgeon, M.D., and John P. Gearhart, M.D., all of Hopkins.

About Johns Hopkins Children’s Center

Much of what we take for granted in medicine today—from the rigorous training of physicians and nurses to the emphasis on research and the rapid application of that research to patient care—emerged from innovations made more than a century ago at a brand new medical center in Baltimore, Johns Hopkins. Indeed, today the very name Johns Hopkins means medicine to a majority of Americans, according to a recent Gallup poll.

Hopkins now uses one overarching name—Johns Hopkins Medicine—to identify its whole medical enterprise. This $4 billion virtual organization unites the physicians and scientists of The Johns Hopkins University School of Medicine with the health professionals and facilities that make up the broad Johns Hopkins Health System.

About American Academy of Pediatrics

The American Academy of Pediatrics ("AAP") is an organization of pediatricians, physicians trained to deal with the medical care of infants, children, and adolescents. Its motto is: "Dedicated to the Health of All Children." Most American and Canadian pediatricians are members of this physician-focused organization.

History
In 1930, 60 physicians who specialized in child health founded the American Academy of Pediatrics (AAP). The name of the non-profit organization reflected the physician's commitment to children and the specialty of pediatrics. It also formally acknowledged the difference between adult and child health care. In 1948, the first issue of their journal Pediatrics was published.

In the last 75 years, the AAP has grown to a membership of 60,000 board-certified primary care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists. Through advocacy efforts, physician education, research, and the continual creation of pediatric care and practice policies, AAP members and staff work tirelessly to affect broad social and medical changes benefiting all children and the future of pediatrics.

A Board of Directors, consisting of district chairs elected by AAP members in 10 geographic districts, oversees the governance of the AAP. AAP chapters are organized groups of pediatricians and other health care professionals working to achieve AAP goals in their communities. There are 59 chapters in the US and 7 chapters in Canada.