Variations in Sex Characteristics.

Variations in sex characteristics (VSCs) include conditions where there is atypical chromosomal, gonadal, or anatomic sex. VSCs may be identified when evaluating an infant with atypical genital appearance at birth, a child with a hernia or precocious puberty, an adolescent with delayed puberty or amenorrhea, or an adult with infertility. Care for the patient with a VSC requires a thoughtful approach to history-taking, physical examination, imaging, and hormonal and genetic testing. Consultation with an experienced multidisciplinary team is recommended. Psychological and peer support is essential, with particular care taken to support a patient's gender identity development and autonomy.