I would have these comments:

 Noelle's daughter is not just old enough.  She has a larger genitalia to operate on.  Also the surgery she is about to have will have a better chance of success as the eostrogen produced at her age is going to make any stretching necessary, a whole lot more effective. 

If it where my self, no matter what technology were available, I would leave my dughter to make her own decisions about her own body.  I would hardly see the point in operating for appearances sake, since I really feel that we only see the genitals several times daily when we are changing diapers.  Girls can be taught to be modest and discreet even from an early age and would just appear to be more lady like if anything, not what they 'appear' to be on the outside.  Beauty is skin deep---and on the inside not the outside.  

As for bonding, I have known worse congenital conditions to affect a child on the outside that could cause teasing---far worse than this.  Genitals appearing virilised on the outside for a short time during childhood (and childhood is only a fraction of our lives let's not forget here) is nothing compared to that of a port wine stain all over the face or even glasses that are so thick that the child get's teased OR downs syndrome.  Need I go on?  Why are we still feeling like we need to change our daughters outer appearance to accept her as a daughter in childhood?  She is every bit a woman on the inside with a uterus and ovaries and that is all we need to know.  So what that we have to keep people from seeing her genitals throughout childhood.  That is fleeting in comparison to her quality of sensation and sexual feeling later in life.  Some parents choose the surgery and I cringe at the thought of any baby girl being put through that.  Vaginal operations and gyneacological operations, and putting rods in to stretch vagina's are for adults and young ladies to be concerned with and coping with---not babies or children.  I would not care a jot if my duahgter had malformed genitalia.  She would still be a beautiful baby girl to me and grow to be a beautiful young woman.  Arn't we underestimating our daughters ability to cope in adulthood with gynealogical exams or self care when we make the decisions to "do these things to save them the trouble?"  How many of us had our parents fussing so much about our genitalia or doctors fussing and looking.  Do you realise how much damage this can do to a child in itself?  These girls should be left alone and not have anymore attention paid to their genitals until they are adult enough to deal with such.  It could be perceived by them as abuse in later life.   Celibrate in your daughter's sexuality from the inside where it truly is and just treat her as she is---a girl---and  for now wait until she is old enough to cope understand what has happened to her body so that you can explain to her what CAH is and what it means for her. 

To much we look to cut and correct something with the surgeons knife instead of waiting and getting counselling for ourselves and our children.  All through their childhood is fraught with being exposed to androgen's anyway, so if some surgeon 'was' able to do a lovely looking job, it may just be all undone by the age of 16 anyway.  Believe me, from being a baby---things can change and hormones escape at times due to growth or illness etc.  Why expose a child to two lots of surgery when you can wait for them to get through the trials and tribulations of childhood and all it throws at these kids and then evaluate what needs to be done and what doesn't?

JH