For several decades now, prenatal dexamethasone has been used off-label by some physicians treating pregnant women at risk for carrying a female fetus with 21-hydroxylase deficiency, the most common form of congenital adrenal hyperplasia.

The primary goal of this treatment is preventing development of ambiguous genitalia in the fetus. Administration of dexamethasone for this purpose has long been controversial, both in the endocrine and the bioethics communities. Concerns have included the wisdom of using a class C steroid known and intended to alter fetal development for treatment of a non-life-threatening condition, and the ethics of using such a treatment when at least seven of eight fetuses treated will bear the risks, yet derive no benefit by virtue of not being 46,XX congenital adrenal hyperplasia (CAH)-affected.

Experimental status of prenatal dexamethasone for CAH re-affirmed

An intersexed friend of mine shared this with me and seems to have the opinion that this sort of thing is always wrong. I don't have her experiences or personal biases to see this in the same perspective, but given my limited background in developmental biology, I would feel uncomfortable administering anything like this to a fetus.

I feel somewhat divided on the issue and was hoping to hear some other perspective on it.

Edit: sorry, did not see the subforums. My apologies if I put this in the wrong place.

I think we may be messing around with evolution. What if humans are trying to evolve into sexless human beings? What's wrong with that? or perhaps humans could evolve into self procreation beings. Or maybe the human race is trying to die out. I think we should not be interfering unless something is life threatening or disfiguring. I think it would be cool to be born with a vagina and a penis. Maybe a bit kinky, but cool. And, I think I would be a little more than upset if I found out I could have been born like that but someone decided to "fix" it for me in utero.

Humans aren't trying to evolve into anything.
And I think the parthenogenetic boat (or some similar reproductive option) has sailed where humans are concerned.

How do you know humans aren't trying to evolve into anything? Do you plan to stick around for the next 10,000 years and wait for the test results? When you find out, write us all a letter and let us know what you found out

Grace wrote:How do you know humans aren't trying to evolve into anything? Do you plan to stick around for the next 10,000 years and wait for the test results? When you find out, write us all a letter and let us know what you found out

Your use of the terms "trying to evolve" implies that it is a deliberate process under at least some conscious influence and that is just not the case. Plus 10K years is far too short a span of time for the degree of change via evolution you propose.

In addition you seem to think that even if we could influence a desired evolutionary direction/outcome for humans that what we would choose would be beneficial.

It would serve you better to learn about evolution and what it is before making ignorant statements.

It would serve you better to learn how to think outside the universe and what that means before making arrogant statements.

Grace wrote:It would serve you better to learn how to think outside the universe and what that means before making arrogant statements.

It would help if you learned how to think.

Grace wrote:It would serve you better to learn how to think outside the universe and what that means before making arrogant statements.

How does one think outside the universe?

Back on topic, I suppose your friend is reacting to cases where "normalising" genital surgery is used not for health but for social/aesthetic reasons (make an individual "appear" feminine/masculine). This can also have negative consequences for later sexual functioning. I would tentatively agree that such surgery is better avoided in children. But I suppose influencing fetal development would avoid the condition, not just reverse its visible effects, so I don't think this is quite equivalent. In short, I don't think that "this sort of thing is always wrong" in principle; I think in such cases the questions of consent and self-determination, restoring physical functionality and reducing (potential?) psychological harm are complicated to the extent that right and wrong are not always obvious. From a quick reading though, it does seem that at least for now this treatment is a bit of a hit-and-miss and data on its long-term effects are extremely patchy, so I'd be reluctant to use it.

Unless I read something horribly wrong, I thought the article I posted was about treating fetuses with dexamethasone, not surgery.

Tollens wrote:Unless I read something horribly wrong, I thought the article I posted was about treating fetuses with dexamethasone, not surgery.

Well, yes. I was comparing the two because surgery is a usual way of treatment for intersex individuals, and quite a wrought issue (so I assumed attitudes to this can easily carry over to other ways of attempting to deal with the condition). But most of my comment specifically deals with treating fetuses with dexamethasone.

Sorry, long night. Stupid finals.

epepke, I've been praised for my creative thinking ability. So, if you THINK I'm going to be shamed and humiliated by you, you've got another THINK coming.

Yes, but what is thinking outside the universe? How does one do that?

Fallible wrote:Yes, but what is thinking outside the universe? How does one do that?

I asked first.

What is thinking outside the universe?

Third in wins. Neener neener.

Grace wrote:I think we may be messing around with evolution. What if humans are trying to evolve into sexless human beings? What's wrong with that? or perhaps humans could evolve into self procreation beings. Or maybe the human race is trying to die out.

That is... so not how this works, Grace, creative thinking outside of the universe or no.

Grace wrote:I think we should not be interfering unless something is life threatening or disfiguring.

While I personally agree, I must ask: How is having two sets of genitalia, or some kind of mixed version of genitalia not "disfiguring" in the commonly used sense?

Grace wrote:I think it would be cool to be born with a vagina and a penis. Maybe a bit kinky, but cool. And, I think I would be a little more than upset if I found out I could have been born like that but someone decided to "fix" it for me in utero.

True enough. Then again, while I don't know anybody of that kind, I do know some transsexuals, and they would have been more than happy to get "fixed" in utero rather than undergoing surgery and hormonal treatments for years to reach their desired sex. Just saying.

Grace wrote:I think we may be messing around with evolution. What if humans are trying to evolve into sexless human beings? What's wrong with that? or perhaps humans could evolve into self procreation beings. Or maybe the human race is trying to die out. I think we should not be interfering unless something is life threatening or disfiguring. I think it would be cool to be born with a vagina and a penis. Maybe a bit kinky, but cool. And, I think I would be a little more than upset if I found out I could have been born like that but someone decided to "fix" it for me in utero.

Evolution doesn't "try" to do anything.

Grace wrote:How do you know humans aren't trying to evolve into anything? Do you plan to stick around for the next 10,000 years and wait for the test results? When you find out, write us all a letter and let us know what you found out

Evolution doesn't "try" to do anything.

katja z wrote:How does one think outside the universe?

The same way you apply Laplace transforms outside of the universe I guess.