I guess it's the philosophical roots of the French educational system. You can't just have an autistic approach to it and say, I'm just going to ignore it completely. In older individuals the accepted gender may be reinforced by the appropriate surgical procedures and by hormonal therapy. In this case, the classification categories are structured around the karyotype features of the chromosomes in the nucleus of the cell, including number, size and shape: The FCG model should therefore also determine traits in which both chromosomal and gonadal sex have a role to play. He basically tells the story of this girl who clearly has a large clitoris. Despite the fact that the consensus statement explicitly mentions the importance of psychosexual outcomes and support, the focus on promissory genetics has led to a focus on biomedical intervention rather than on psychosocial support Liao et al. This disorder, also called adrenogenital syndrome AGS , results from a genetically caused deficiency of cortisol, a steroid hormone produced by the adrenal cortex. So we said maybe we should have a fresh approach to this. Sometimes we wouldn't know who to include and who not to include. And the question being, how can we translate this genetic knowledge into clinical practice? The majority of health care professionals were very happy with it. There has been considerable controversy over whether surgeons should immediately make a decision about an infant's sex and quickly correct ambiguous genitalia. The issue of sexual classification, however, is complicated by factors such as chromosomal complement, external genitalia, gender identification and surgical alteration.