It is my understanding (maybe wrong) that there are only a very limited number of medical facilities in the nation that perform sex reassignments on adults and only after a long and careful evaluation, lasting over a year.  If this is indeed true then one of the biggest problems with the surgeries on intersexed infants and children (aside from consent, which is a major issue in my mind) is that every Tom, Dick, and Harry surgeon at Community General Hospital feels comfortable and proceeds with the often mutilating surgeries even though they may only perform a small number in their career and they do not care about the long term outcome as many patients are "lost to follow-up."  Although formal long-term studies have not been completed on outcomes - I know from personal experience, as well as reading postings on the boards that while the surgeons are saying "a good cosmetic result" happened, there are many cases, where in actuality, the long-term outcome is far different.

Bottom line - Why isn't sex reassignment on infants and children restricted to being performed at only a few major medical centers, undertaken only in the most SEVERE cases, not rushed into, and only after intensive counseling for the family and careful and honest evaluation of the child's situation?  Just as in adult reassignment a team is needed consisting of highly specialized physicians from all disciplines who must agree on the appropriate course of action, along with the parents who need to explore every angle, and be given all the facts as they are known.  If this were the case, the patients could be followed long term, and failures, as well as successes, could be studied and documented, and adjustments to treatment made as necessary.  Gender is a complex issue and has never been defined to my satisfaction.  I realize this is not an end-all solution to a very complex matter, but perhaps it would be a starting point.