Interdisciplinary care in disorders/differences of sex development (DSD): The psychosocial component of the DSD—Translational research network / How common are these conditions?

That’s hard to say, because to provide a number for sure, we would have to have a consensus on what counts as different-enough-from-average to count as a DSD. There is, in fact, no consensus on how small a penis must be or how large a clitoris must be before it counts as a DSD.

We do know that some particular disorders of sex development are fairly rare, occurring perhaps only once in ten or twenty thousand live births. For example, the development of ovotestes is a relatively rare phenomenon. But some DSD are substantially more common. For example, hypospadias (in which the urinary opening of the penis is not in the typical location) is estimated to occur as often as once in every 150 live male births.

Estimates from specialists working in major medical centers suggest that about one in every 2,000 births at a hospital involves a child whose genitals are atypical enough to make the child’s sex unclear. But, as noted above, if we count all types of sex anomalies, DSD must be considered much more numerous than 1 in 2,000. One review estimates that about one in a hundred persons has some kind of sex anomaly.

So, what we can say with some confidence, is that DSD are more common than the average person would probably guess. If you are in a moderate-sized town or in the kind of superstore that has several hundred customers at a time, there are probably people around you with DSD. If you are in a college football stadium watching a game, there are probably people around you with DSD. And if you are in a large school, there are children around you who were born with DSD. DSD affects our families, neighbors, coworkers, and friends.