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So far we know of about 30 that must work together to build a normal testis or ovary. But our society is sexualised and children can be cruel to those even trivially different. But there are no universal answers. Adults are sometimes no more accepting; in some Asian and African countries families with DSD children may be ostracised and children neglected or killed. At the tragic end of the spectrum are mutations that disrupt more than sexual development. Not surprisingly, patients quail at labels like this that denote a disease and invite discrimination. What if they got it wrong and the child grew up hating who they were?

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