Abstract:
Background: Disorders of sex development are anomalies in which the development of urogenital ridge is undif‑
ferentiated for the male and female child. Imaging plays a vital role in investigating the gross anatomy and associated
anomalies. Ultrasonography, such as genitography and magnetic resonance, is the primary modality for demonstrat‑
ing internal gonads and genitalia. Early multidisciplinary approach in the management of ambiguous genitalia includ‑
ing early surgical intervention is the predominant practice, with few current considerations on deferral of genital
reconstruction until adolescent age.
Case presentation: We report the rare case of a 24-year-old adult female from a majority ethnic group of the Volta
region, Ghana who was diagnosed and raised as male, now requiring surgical restoration to the female gender. The
surgical team decided to assign external genitalia to correspond with the already intact internal organs, thus con‑
structing the vulva. Consent was given by the client and her family members for management and surgical interven‑
tion. The surgery was scheduled and duly performed with a successful outcome. Understanding and consent was
sought from the patient for the purpose of using her images for teaching, scientific publication, and demonstrations.
Conclusion: The advantages of deferring surgical reconstruction with psychological counseling after early assessment need to be considered to prevent inappropriate gender assignment
