Kaye, I understand and applaud your need to educate yourself. As the parent, the decision to have or not to have surgery is yours to make. It is also your decision to wait, and allow your daughter to make her choice. My daughter will have to have corrective surgery to disconnect the vagina from the urethra and to form a vaginal opening. This surgery has nothing to do with how she appears - it will be medically necessary. Right now she is 2 ½. Her ped urologist and I have tentatively decided that this surgery will take place when she is in the age range of 4 to 5 - but this is always subject to change. Just some of my thoughts on some of the issues you raised. 1. How often does someone else see you changing your daughter's diaper? In what situation does this occur, e.g. the mall? If you saw someone changing a diaper, would you really be able to see enough to determine the sex of the child? Or, would you guess based on clothing choice, or just ask the person doing the diaper change? When I have changed my daughter's diaper in public (restroom in a restaurant, mall, etc.), I get everything ready before starting, then it is a pretty quick off with the old, quick wipe, then on with the new. The way the changing tables are setup, no one could see, plus you need to move pretty quick to make sure there are no roll-offs. 2. How often is your daughter in public type babysitting situations, e.g. the church nursery, day care? In the "church nursery" situations that I am aware of, I will admit, I don't know how I would handle the need for someone else to change the diaper. I believe that how this is handled will vary greatly depending on how each girl appears and how the child care is setup. In my day care situation, the teachers who are assigned to the particular room are the ones who change the diapers. As a child with CAH, all of her day care providers are (should be) aware of her special medical needs, and know a fair amount about what is going on with her. I can say that NO ONE has ever noticed that my daughter does not have a vaginal opening - even some experienced moms (and at her age I think it is VERY obvious). This also includes her daycare providers who change many diapers every day. Very few have even noticed her Mongolian Spot that covers the upper area of her behind and really looks like it could be child abuse. 3. Some questions I might ask the ped endocrinologist and ped urologist (sorry if I'm showing my ignorance) might include. a. As a doctor/surgeon, why would you want to do surgery on young child? Wouldn't surgery be easier when the child is bigger? b. Typically, how would a child's appearance change with the growth and development process? Is there a possibility that the look will become closer to "normal"? c. Are there any medical reasons why surgery should be done, e.g. eliminate problems with urinary track infections? Or is this purely a cosmetic change? Sorry to have carried on so long. I hope I have been of some help.