Prader scale explained

The Prader scale or Prader staging, named after Andrea Prader, is a coarse rating system for the measurement of the degree of virilization of the genitalia of the human body[1] [2] and is similar to the Quigley scale. It primarily relates to virilization of the female genitalia in cases of congenital adrenal hyperplasia (CAH) and identifies five distinct stages, but in recent times has been used to describe the range of differentiation of genitalia, with normal infant presentation being shown on either end of the scale, female on the left (0) and male on the right (6).[3]

Staging

Controversy

While the scale has been defined as a grading system for "abnormal" genitalia, the concept that atypical genitals are necessarily abnormal is contested. An opinion paper by the Swiss National Advisory Centre for Biomedical Ethics advises that "not infrequently" variations from sex norms may not be pathological or require medical treatment.[8] Similarly, an Australian Senate Committee report on involuntary sterilization determined that research "regarding 'adequate' or 'normal' genitals, particularly for women, raises some disturbing questions", including preferences influenced by doctors' specialism and gender.[9]

Related concepts

Numerous clinical scales and measurement systems exist to define genitals as normal male or female, or "abnormal", including the orchidometer, Quigley scale and the satirical Phall-O-Meter.

See also

External links

Notes and References

  1. White PC, Speiser PW . Congenital adrenal hyperplasia due to 21-hydroxylase deficiency . Endocr. Rev. . 21 . 3 . 245–91 . June 2000 . 10857554 . Speiser . 10.1210/edrv.21.3.0398 . free .
  2. . Prader. Andreas. 1954. Der genitalbefund beim pseudohermaphroditismus femininus der kengenitalen adrenogenitalen syndroms. Helvetica Paediatrica Acta. 9. 231–248.
  3. Jorge . Juan Carlos . Echeverri . Carolina . Medina . Yailis . Acevedo . Pedro . Male Gender Identity in an XX Individual with Congenital Adrenal Hyperplasia . The Journal of Sexual Medicine . January 2008 . 5 . 1 . 122–131 . 10.1111/j.1743-6109.2007.00558.x . 17655659 .
  4. Book: Harris, Wayne. Examination Paediatrics : a Guide to Paediatric Training. 2006. Churchill Livingstone Elsevier. Sydney. 978-0729537728. 132–134. 3rd.
  5. Diamond . Milton . Watson . Linda Ann . Androgen insensitivity syndrome and Klinefelter's syndrome: sex and gender considerations . Child and Adolescent Psychiatric Clinics of North America . July 2004 . 13 . 3 . 623–640 . 10.1016/j.chc.2004.02.015 . 15183377 .
  6. Ogilvy-Stuart. AL. Brain, CE. Early assessment of ambiguous genitalia. Archives of Disease in Childhood. May 2004. 89. 5. 401–7. 10.1136/adc.2002.011312. 15102623. 1719899.
  7. Book: 10.1007/978-3-642-22964-0_11 . The Neonate with Ambiguous Genitalia . Disorders of Sex Development . 2012 . Hutson . John M. . 103–114 . 978-3-642-22963-3 .
  8. Book: Swiss National Advisory Commission on Biomedical Ethics NEK-CNE . On the management of differences of sex development. Ethical issues relating to "intersexuality".Opinion No. 20/2012 . Berne . November 2012 . dead . https://web.archive.org/web/20150423213245/http://www.nek-cne.ch/fileadmin/nek-cne-dateien/Themen/Stellungnahmen/en/NEK_Intersexualitaet_En.pdf . 2015-04-23.
  9. Book: Involuntary Or Coerced Sterilisation of People with Disabilities in Australia . 2013 . Senate Community Affairs References Committee . 978-1-74229-897-9 .