This piece was sent to us by the ISNA News on March 24.

The Journal of Gynecology and Neonatal Nursing has published an editorial (Haller 1998) which cites with apparent approval the new model of treatment guidelines for intersex births offered by (Diamond and Sigmundson 1997) and by ISNA, including ISNA's web site URL. The most important features of the model are an avoidance of non-consensual genital surgery on infants and children, and honesty with parents and patient. The JOGGN editor encourages readers to "pull the report by Diamond and Sigmundson from the library; and then download the ISNA's recommendations for treatment of intersex infants, along with a complete bibliography on intersexuality, from the Internet (http://www.isna.org)."

The editorial accompanies a review article which presents without criticism the traditional medical model of management of intersex births; indeed the author encourages nurses to help parents invent falsehoods to conceal the child's actual condition. ("[S]tating that the infant is critically ill and in the neonatal intensive-care unit ... will usually dissuade further questioning.")

However, in what seems to be a paragraph that was inserted as an afterthought, ISNA's "Recommendations for Treatment" are cited as a source of controversy.

It's interesting to note that the editorial cites the review article's presentation of what continues to be standard treatment (secrecy and surgery) as "more information and different views" no more or less authoritative than (Diamond and Sigmundson 1997) or ISNA.

REFERENCES

Diamond, Milton, and H. Keith Sigmundson. 1997. Management of Intersexuality: Guidelines for dealing with persons with ambiguous genitalia. Archives of Pediatrics and Adolescent Medicine 151:1046-1050.

Haller, Karen B. 1998. When John Became Joan (Editorial). Journal of Obstetric, Gynecologic, and Neonatal Nursing 27 (1):11.

Parker, Leslie A. 1998. Ambiguous Genitalia: Etiology, Treatment, and Nursing Implications. Journal of Obstetric, Gynecologic, and Neonatal Nursing 27 (1):15-22.

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