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Babies With Micro Penis Disorder Happier When Raised Male Genetically and
physically male babies born with a condition called "micropenis" are more likely
to achieve psychological and sexual well-being in adulthood if raised male,
according to a new study by researchers at Johns Hopkins and three other
centers. Their report in this month's Hormone Research is the first
comprehensive, long-term study examining psychological and sexual outcomes for
both men and women. People born with a micropenis and raised as girls said they
identified solidly with their female gender, but only 20 percent of the women
said they were satisfied with their genitalia. In contrast, 50 percent of men,
some of whom had attained normal penis length with the help of testosterone
replacement, said they were satisfied with their genitalia. Like the women, men
said they identified with their male gender.
"Raising the baby either male or female presents parents with challenges,"
says Johns Hopkins Children's Center psychologist Amy Wisniewski, Ph.D., lead
author of the study. "But we were pleased with the successful outcome of some of
the males. All men who were compliant with their testosterone replacement
attained a final penile length within the normal range."
The research team collected birth and adult genitalia measurements from 13
men and 5 women, all born with a micropenis. The researchers surveyed the
individuals, all adults between 21 and 54 years of age at the time of the study,
for self-assessments of gender identity, sexual function and satisfaction with
their genitalia. The researchers also asked the participants questions regarding
sexual orientation, marriage and satisfaction with their sex of rearing.
Of the 12 men who responded, 10 reported a male heterosexual orientation, six
were married, and 11 said they were satisfied with their sex of rearing. Among
the women, three (of four responding) reported a female heterosexual
orientation, none was married, and all were satisfied with the sex of their
rearing, although men were more often satisfied with the appearance of their
genitalia.
While the researchers do not necessarily recommend that parents raise a baby
with a micropenis as male, their study suggests that a child raised female would
require extensive feminizing treatments to achieve satisfactory cosmetic and
functional outcome for her genitalia.
"Patients reared male considered themselves to be masculine and those raised
female considered themselves to be feminine," Wisniewski says. "Our
recommendation that babies be raised male is based not on problems with gender
identity but on the difficulties associated with the surgical construction of a
vagina and subsequent hormone treatment."
Micropenis occurs when the penis elongates properly during the first
trimester of a genetically male embryo's development but fails to grow normally
during the second and third trimesters. Micropenises are typically 1.9 cm (0.75
inches) or less at birth when stretched. Micropenis may also be accompanied by
small testes and lower testosterone production, which often leads to enlarged
breasts and sparse body hair as the child grows older.
Because the micropenis birth defect can, in some cases, result in inadequate
male sexual function later in life, some parents have chosen to raise their
child female with the hope that genital reconstruction is more likely to result
in a strong sexual identity, positive body image and pleasurable sex life. |
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