Discussion surrounding issues of gender assignment are beyond the scope of this book. In general, the sex of rearing should be determined only after diagnostic evaluation by a specialist team. In the past, gender assignment had been approached as though individuals are psychosexually neutral at birth and as though healthy psychosexual development is related to the appearance of the external genitals. However, these beliefs have been challenged. It is now believed that prenatal and early exposure of the brain to androgens, if present, influences gender-specific behavioral patterns and sexual identity in addition to the external appearance of the genitalia or their future function. Considering the significance of the decision for the affected patient's emotional, physical, and reproductive health, a highly specialized multidisciplinary team of pediatricians, urologists, endocrinologists, geneticists, psychiatrists, and others is needed, and each case must be approached individually. Specialized treatment centers should provide long-term care to optimize prognosis. The Consortium on Disorders of Sex Development maintains a website with clinical guidelines and information for families (www.dsdguidelines.org), as do many other support groups such as the Intersex Society of North America (www.isna.org), the Congenital Adrenal Hyperplasia Support and Education (CARES) Foundation (www.caresfoundation.org), and others.