45, X/46, XY mosaicism and gender incongruence: ethical, medical, and psychological considerations

Limited guidance exists on managing gender incongruence in DSD, particularly regarding pubertal induction. In the UK, while sex assignment at birth is mandated, there is no specific guidance regarding the revision of sex assignment in childhood. A non-coercive environment is essential to support gender exploration whilst balancing medical, psychological, and ethical considerations in decision-making regarding pubertal induction.