Practice patterns in feminizing genitoplasty for disorders of sexual development: a national survey of pediatric surgical specialists

Abstract Objectives Disorders of sex development (DSD) require a multidisciplinary approach to diagnosis and treatment. Feminizing genitoplasty (FG) is one of the main surgical interventions performed in DSD, although its timing and necessity remain controversial. This study aims to evaluate the perspectives of pediatric surgeons and pediatric urologists in Türkiye on FG. Methods A structured online survey was administered to pediatric surgeons and pediatric urologists in Türkiye. The survey comprised demographic information, surgical experience, preferred surgical techniques, and follow-up practices. The responses were analyzed descriptively. Results A total of 264 physicians’ responses were collected. The majority of participants (57 %, n=151), possessing varying levels of experience and case numbers, reported performing FG procedures. While 73.7 % of this group conduct fewer than five FG surgeries annually, only 1.3 % perform more than 15. Preferences regarding surgical timing and techniques varied among physicians. Follow-up protocols differed considerably, with 49.3 % of respondents indicating the absence of long-term postoperative follow-up. The primary priorities in FG included the cosmetic appearance of the external genitalia (91.8 %), achieving a normal-sized clitoris and vagina (90.6 %), and ensuring functionality (94.1 %). Conclusions There is no consensus among pediatric surgeons and pediatric urologists in Türkiye on the timing and necessity of FG. The lack of standardized follow-up protocols and multidisciplinary decision-making mechanisms remains a significant issue. Further research with larger cohorts and long-term outcome assessments is necessary to establish clearer guidelines.