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Hi Kristyn, I hear what you are saying regarding the 'all girl' thing in regards to classical CAH kids. For those baby girls who received Dex during pregnancy I can see that it is more possible for them to be 'all girl' - for a while at least.
In my (small) experience of recent years having now met quite a number of females across ALL age ranges of CAH there are some but not very many who don't have some major issues regarding physical observable appearance. Whether it is short stature, obesity, hirsutism, muscular build, deep voice etc. there are characteristics which are quite prevalent.
As babies and young children most CAH girls probably look ok (apart from the obvious genital issues) and may play with all the 'right' toys etc. One problem seems to be however, that even when a treated CAH teen/adult may look quite 'good/normal' they can be/often are tempted to test the boundaries of compliance with medications and end up with permanent/longterm problems, such as hirsutism. So for example, once hair follicles are established they are very difficult to eradicate and life long shaving may be necessary (if unable to have IPL or other depilatory treatment). This is not something that the average girl/woman has to contend with.
The cumulative effect of a lifetime of less than ideal treatment does cause problems in CAH females.
Of course we hope that better treatment and more understanding of this condition resulting in better compliance from an early age, will improve the outcomes for the next generation but we must not delude ourselves that the outcomes will be perfect for everyone.
