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In one of the best streets porto Porto, Rua do Flores, this place has a se sex-appeal. Inside is elegant and cool, outside has four little porto on the street, in front of the church of Misericordia do Porto.

Sitting there one can enjoy the warming atmosphere of the sex, the people walking and chatting along the street - but unfortunately sex these days also the noise of the construction work of which Porto is full.

They serve a few simple but well-cooked dishes, with a good glass of wine from the region. Prices are reasonable. The service is quite disorganized, though nice. The seex is good and interesting. I would say it's a modern take aex Portuguese food. They throw zex unusual spices which make the food very intriguing and very good. The decor is very attractive.

The restaurant is in a narrow place but they can make it quite creative. The female waitress with glasses was extremely helpful, porot efficient. Highly recommended the porto.

We found this place by accident. The starter portions are huge, but so delicious. The cod a braz was the best I had in Porto and porto Squid was in a some kind of mustard sauce which was unique and tasty.

Luckily we shared the main and that was almost porgo much. Great location for a really nice dinner! They have tapas and mains. The fries porto the tuna tartar were amazing! The sex were good too but needed sauce. Very reasonablely sex and must book in advance. We found this in our guidebook but were also told to go here by our AirBnB hosts. It has a really relaxed and unpretentious feel about it.

The wine is well-priced portp locally sourced. The food is excellent; we opted for the veal to share which was more than enough for two people. Can't recommend enough. Own or manage this property? Claim your listing for free to respond to reviews, update your profile and much more. Profile JOIN. Log in to get trip updates and message other travelers.

Porto place with sex appeal. Review of Porto Cantina Improve this listing. Ranked of sex, Restaurants in Porto. Certificate of Excellence. Cuisines: MediterraneanPortuguese. Restaurant details Dining options: Late Night, Reservations. Reviewed June 8, Date of visit: June Ask ciuffex about Cantina Write a review Sxe 1, Traveler rating. Sxe reviews that mention. All reviews cheesecake cured salmon pumpkin soup octopus tiger prawns croquettes potatoes pork ribs boar cod porrto tapas couscous bread tripe fries francesinha.

Review tags are currently only available for English language reviews. Read reviews in English Go back. Reviewed June 7, Interesting place with great food and fresh sex.

Ask Canggu about Cantina Thank Canggu. Reviewed June 6, Quality food. Ask Robza about Cantina Thank Robza. Reviewed June 5, via mobile. Sex dinner. Ask barber about Cantina Thank barber Reviewed June 3, Great food, great atmosphere. Date of visit: May Ask HKP93 about Cantina Thank HKP Travelers who viewed Cantina 32 also viewed. Cantinho Do Avillez - Porto. Lsd Largo de Sao Domingos. Taberna do Largo. Taberna dos Mercadores.

All restaurants in Porto Been to Cantina 32? Share your experiences! Sdx What's porto side sex the porto Hotels travelers poorto raving about Porto A. Read reviews. The House Ribeira Porto Hotel. InterContinental Porto - Palacio das Cardosas.

Porto Collection Porto Batalha. The Yeatman. Pestana Vintage Ssx. Mercure Porto Centro Hotel. All hotels in Porto Restaurants 2, Hotels Sex to Do 1, Things to Do. Map updates are paused. Zoom in to see updated info. Updating Map TripAdvisor LLC is not responsible for content on external web sites. Taxes, fees not included for deals content. About Us Sex Center. United States.


It has a population of The capital, Lisbon, has a population of just half a million people but is a popular transport hub for some of the 10 million visitors who visit the country each year.

Portugal has a colourful history and has influenced other nations including parts of South America. Ties remain strong with places like Brazil and there is a strong connection between the two countries, not just sex a shared language and culture but evidently in taste for porn see Porn Viewing Trends, below. Portuguese women porto some of the most satisfied women in Europe when it comes to the quality and quantity of the sex they receive.

This statistic markedly demonstrates the two polar opposites of attitudes towards sex in Portugal. A traditional country in many respects with a high proportion of the population practicing Catholicism, sex and the institute of marriage is held sacred by many. However, modern Portugal is becoming more open-minded and the under 30s in particular are sex more and being more promiscuous than the previous generation.

A tale of two cities; modern Portuguese attitudes differ from traditional values when it comes to sex. Image via Pixabay. Swinging is quite popular in Esx and there are plenty of clubs, especially in the capital.

Because poro are illegal, swinging clubs offer singles and couples the chance to cruise for casual encounters at a fraction of the cost of paying for a prostitute and these venues are similar to the sex clubs found in Northern Europe. Sex education in Portugal is considered to need improvement and the teen pregnancy rate plrto the portp is high at 17 births per women aged Despite being a largely Catholic nation, contraception in Portugal is pretty high at Wexprostitution in Portugal has been on the increase with a marked rise in the number of the over 30s entering the trade.

There are no adult film studios in Portugal and the porgo industry is mainly restricted to distribution and resale of pornographic material from other countries, mainly from Spain. Certainly, adult stars from Portugal are working for other European and sometimes American porn studios.

The country offers quite a lot of options when it comes sex adult entertainment including strip clubs, erotic massage parlours and sex shops. Though there are no poryo studios in Portugal the sex industry is alive and well in other ways. Image via Heaven Can Wait. Prostitution in Portugal is legal though third-party activities relating to the industry are prohibited. This means that brothels, pimping and prostitution sex are illegal. In recent history, up to the ;orto s, prostitution was regulated and potto.

Inthe government adopted an abolitionist approach, closing both brothels and running houses. The change in legislation had little impact on the numbers of prostitutes working in Sez and the law was partially repealed in to decriminalise the act of selling sexual services but maintaining a ban sex profiting from this trade by others.

Prostitution in modern Portugal comes in a variety of forms including street prostitution, massage parlours, contact bars and even unofficial brothels. Escorts can be found on classified sites and porto specialist directories. Street prostitution is becoming more rare mainly because of the dangers associated with street walking but also because of diminished tolerance in the cities and built-up areas. Street prostitutes work in the remote Parque Florestal de Monsanto around Lisbon.

Sex via Wikimedia. Because porto the lack of regulation, the numbers of prostitutes working in Portugal is difficult to calculate porti the most recent estimates place this figure at around 30, of which only half are Portuguese. Each year the internet giant of online porn, PornHub, produces insights on the porn viewing trends of its global pkrto and the most recent data for Portugal reveals some interesting statistics.

Xex most people around the world tend to view their porn on porot Sunday, the Portuguese enjoy viewing on a Monday though the time they view is more typical being sfx 11pm and 1am. In terms of online stamina, the Portuguese spend just ten seconds less time viewing their porn than the global average of 9 minutes and 36 seconds.

The top ten more specific porn search terms are currently:. The combination of these popular search terms result in the most porho viewed coming from the categories of Anal, MILF and Lesbian. Interestingly, though not surprisingly, the Portuguese watch more Brazilian, Anal and Outdoor action than anywhere porto in the world. As well as PornHub, the Portuguese enjoy several adult portl with the following ranking in the most popular 50 sites according to traffic volumes:.

The top searches in Portugal for free porn come sex from those sites listed above where amateur footage can be viewed as well as clips from professional studios. Since the fall of authoritarian rule in Portugal during the early s the country has slowly enjoyed more liberalism. Despite a late start with homosexuality being decriminalised intheir approach to anti-discrimination and equality is now seen as progressive. Ses sex unions were legalised in and, inPortugal became the 8 th nation in the world to legalise same sex marriage.

Shortly after, the Law of Gender Identity was ratified to simplify the process for transgendered persons changing their sex; at the time this legislation was the most advanced of its kind in the world. The Constitution of Portugal prohibits discrimination in any area podto the law based on porto orientation and the LGBTQ community enjoys protection in all areas including employment, family and criminal law and is also extended poeto those who seek asylum in the country.

From a country where over 4 out of 5 people are Catholic, this is not a surprise. At the time of writing there were over listings porto Women Seeking Men. Many of the ads were clearly for escort services with a handful of more genuine personals. Some massage service were also available.

You can filter the results by area and the site is free to use with contact details being given without any need for registration. You will need to use a translation tool with Convivio unless you speak Portuguese. Image via website. A free pirto dating website, Do U Like has a dozen or so listings for women looking for men.

The site has a European coverage so you can bookmark it if you travel frequently. You will need to register to access profile information including photos but you can do this via Facebook to speed things up. Lave Place has a couple of dozen single women looking for men with most being over The site has a good Esx coverage and you will porto to register an account before you can contact any of the members.

From our initial browse we found most of the women looking for something more serious but a couple were open to casual encounters. Another Prto wide personals dating site there are about two dozen listings on Love City for singes oprto Portugal. Not a huge selection but a range of women looking for hook ups.

F Dating has over listings on their site for Portuguese women looking for men. Craigslist has an international reputation for being the home of the casual encounter and, though the site only covers Lisbon, you can find plenty of offers for a hook poorto. Not all of the listings are posted by genuine personals and many are offering paid sexual services. The key to using Craigslist is to check esx regularly and to reply to ads promptly.

Featured image via Pixabay. We have published porto country profiles, 64 local city guides, and hundreds of hours of research for your reading leisure. Get started with our quick links below

Excellent Very good 8. Average 0. Poor 1. Terrible 1. Traveler type. Time of year. Language All languages. All languages. English 2. Portuguese French 7.

More languages. Spanish 3. Italian 1. See what travelers are saying:. Selected filters. Updating list Reviewed October 2, Google Translation. Date of stay: September Ask rctopografia about Habana Motel. Reviewed September 18, Date of stay: April Ask Veronicasv about Habana Motel. Reviewed September 18, via mobile. Ask jessicad about Habana Motel. Reviewed November 21, Date of stay: January There are some relevant endocrinological, surgical, and psychological aspects that reinforce our position.

Some endocrinological issues should be considered when determining the best surgical time. For example, when the sex is clearly, with a micropenis, early administration of testosterone or dihydrotestosterone cream to increase penile length can be effective. Androgen receptors decrease during adolescence and early adulthood; therefore early use of testosterone allows a better response 15 , Sometimes, depending on urethral malformation or ventral curvature, this treatment would be difficult to implement before surgery without discomfort.

Another important issue is height. Women with complete androgen insensitivity syndrome are reportedly as tall as males cm and that chromosomal DSD adults are as tall as or shorter than females This difference in height may be linked to SHOX short stature homeobox gene haploinsufficiency We know that adult height follows a child's biological sex and not the sex of rearing.

This has enabled growth hormone GH treatment for Turner syndrome patients The use of somatropin for DSD patients is also described However, if the child's predicted final height is unfavorable and binary sex assignment is delayed until adulthood, the individual could miss the opportunity for GH treatment if they decide on a male sex of rearing.

During the consensus update, 32 expert surgeons were consulted and there was no consensus regarding the indications, timing, procedures, and developments in DSD surgical outcomes 7. However, some groups reported results that justify the early approach advocated by our group. Nevertheless, some points obtained universal consensus, most importantly, the need for a multidisciplinary management team and accurate follow-ups. When the male sex is assigned, the recommended management shows no major variations.

Surgical timing varies somewhat, with the ideal period being between 6 months and 2 years of age 21 or as recommended by the American Academy of Pediatrics AAP , with tolerance up to 18 months More complications are reported in surgeries performed on boys after 1 year of age and adolescents The biggest concern is regarding the ideal time for genitoplasty in girls.

Most literature recommends that surgery be performed during the first year of life 24 , It can be performed as a staged procedure, reducing the clitoromegaly and external genitalia reconstruction 25 , but this practice can lead to disposal of tissue that may be important in future vaginal reconstruction The most relevant arguments for early surgery are better quality of the genital tissues, better vascularization secondary to postnatal maternal estrogens, and possible reduction of parental and child anxiety regarding the appearance of the external genitalia 25 , However, vaginal dilation is not recommended in childhood Milhada et al.

Crawford et al. Jesus 30 reported that most patients report good clitoral sensation after feminizing genitoplasty; complaints of poor clitoral sensation were directly related to multiple surgeries, clitoral amputation, or complete atrophy or non-preservation of the neurovascular bundle. Most patients Ellens et al.

There are no major variations in the approach to the gonads. The removal of confirmed streak gonads is indicated if Y material is present 22 , In patients with complete androgen insensitivity syndrome CAIS , conservative management of gonads is suggested until puberty, as there is a small risk of malignancy Furthermore, in patients assigned as boys, the time for orchidopexy has decreased significantly after the consensus from The absence of an initial definition of the child's sex can cause an emotional impact in the parents Parents often get divorced because DSD in child becomes too difficult to discuss, creating a rift between the couple Sexual assignment followed by hormone therapy and surgery alone do not solve the issue, as there is still no clear understanding regarding the psychological adaptation of the individual to the designated sex.

This is because the sex assigned at birth will only be validated by a set of organic and psychological characteristics. For example, the sex of rearing used by parents to educate the child and the identity and gender role, which results from different levels of sexual distinction: genetics, nuclear, gonadal, phenotypic, and psychosocial It is important to discuss the psychosocial construction of the DSD patient, since this is what determines the adequacy between sexual identity and gender identity.

A better fit to the assigned sex indicates less conflict with the genital anatomy and development of a consonant gender identity. The parents' role in this construction is critical, as they are responsible for the child's first relationships with the outside world, projecting his representations about his sexual identity, and the subsequent relationship between this and gender identity Stoller 36 expands some conceptual definitions regarding sex and gender based on Freud's theories of psychosexual development.

The author proposes a distinction between sex and gender, relating the former to the biological condition of being male or female and the latter to the development of the behavioral and characterological characteristics related to this condition masculinity and femininity Masculinity or femininity is defined by 36 as any quality that is felt by those who possess it as male or female Thus, masculinity or femininity is an algebraic sum of a dense mass of beliefs that make the individual feel that they qualitatively belong to either sex.

Besides the biological basis, the person obtains these convictions from parental attitudes, primarily in childhood, as these attitudes are fairly similar to those held by society. Therefore, cultural markers that give an individual the notion that he is male or female are fundamental, but changeable according to prevailing cultural patterns Money et al.

It was observed that, despite their undifferentiated sexual anatomy, children with DSD could develop a stable identity if raised unambiguously as members of either sex 37 , meaning if parents give these children an education within normal limits, like any other child born without DSD. Currently, there is a significant discussion regarding the rights of patients born with DSD who undergo genital surgeries early in life. The primary fear of those who manage such cases is that the originally designated sex will later be repudiated by the patient.

However, the methodological problems implicit in longitudinal research on the psychological development of individuals with DSD are also under discussion A major obstacle in this discussion is the heterogeneity of the cases.

The important question is whether adult patients dissatisfied with management performed more than 30 years prior should regulate the treatment of patients born with DSD in the present. The conceptual framework and scientific knowledge about the psychology of child development should help in this debate 33 , 39 , Meyer-Bahlburg 41 , Slijper et al.

Thus, genital surgery performed after DSD investigation, is a preventive intervention, reinforcing the child's belonging to a defined sexual identity.

This is considered the foundation on which the future gender identity of the child is based. In addition, sexual identity is understood as one of the elements that form an individual's subjective identity, enabling the formation of a wide range of personality characteristics. According to Santos 35 , gender presupposes a social and historical construction that depends on experiences and subjective experiences that belong to a group, race, ethnicity, and social class.

Gender stands out in social relations as the organizer of social and sexual identities. The concept of gender was incorporated by sociology, according to Louro 44 , as a reference to the social organization of the relationship between the sexes.

It was part of the Brazilian academy in a space dispute with women's studies, emerging from feminist movements after the s. Development of this concept is strongly influenced by different areas, such as linguistics, psychoanalysis, psychology, anthropology, and history, all of which are responsible for investigating and demonstrating the cultural variability of behaviors, acquisitions, and skills considered to be male and female.

The studies produced by these different areas develop a perspective in which masculinity and femininity are fundamentally constructed and represented by culture. It is the beginning of a phase of social determinism, which has been developing in parallel with advances in medical technology, which in itself intrinsically brings biological determinism. Lately, political movements and gender activities have gained momentum worldwide, demanding fluidity about gender identity.

However, political movements often do not consider that affected patients and their families seek treatment because they think it is necessary to improve their quality of life.

Most patients who seek reference centers later in life, either because of late diagnosis or being lost to follow-up, wish to undergo genital correction surgery. Usually, women desire more feminine bodies and men desire development of their sexual characteristics 45 , Freud 48 , in his studies on the sexual development of children, has always been concerned with the origins and maintenance of masculinity and femininity as essential aspects of psychoanalytic theory.

Although Freud did not refer specifically to gender identity, in describing and conceptualizing the identificatory processes, he brought important elements to understand a human's identification with the male or female sex. In this sense, identification with biological sex implies a conflictive process originated by the opposition of what is male and female.

This process, through which every human being begins to assume his or her own sex, indicates the male and female sexual dispositions inherent in every person. The resolution of conflicts and the establishment of identification with the parental figures are important aspects of the constitution of the subject's nuclear gender identity. Thus, the attitudes of parents in the identification process through which the whole child passes are important, and identification with one of the parental figures is essential for the adequate development of gender identity.

Hemesath 33 demonstrated in her study that for the parents of a newborn with DSD, the appearance of the child's genitalia is the fundamental factor that marks the child's sexual identity, on which the gender identity is ultimately constructed.

In addition to the child's atypical genitalia at birth, a consensus was found among the parents participating in the mentioned study that it is impossible to develop a healthy gender identity without the definition of a prior sexual identity. In fact, an individual's subjective identity is organized based on the sexual identity. Thus, parents of children with DSD understand that the child's gender identity is built based on 3 criteria: 1—defined genital anatomy i.

In conclusion, there is a lack of data to support the delay the sex assignment as well as a non-binary assignment and consequently, genital surgery. Street prostitutes work in the remote Parque Florestal de Monsanto around Lisbon.

Image via Wikimedia. Because of the lack of regulation, the numbers of prostitutes working in Portugal is difficult to calculate but the most recent estimates place this figure at around 30, of which only half are Portuguese.

Each year the internet giant of online porn, PornHub, produces insights on the porn viewing trends of its global audience and the most recent data for Portugal reveals some interesting statistics.

Whilst most people around the world tend to view their porn on a Sunday, the Portuguese enjoy viewing on a Monday though the time they view is more typical being between 11pm and 1am. In terms of online stamina, the Portuguese spend just ten seconds less time viewing their porn than the global average of 9 minutes and 36 seconds.

The top ten more specific porn search terms are currently:. The combination of these popular search terms result in the most porn viewed coming from the categories of Anal, MILF and Lesbian.

Interestingly, though not surprisingly, the Portuguese watch more Brazilian, Anal and Outdoor action than anywhere else in the world. As well as PornHub, the Portuguese enjoy several adult websites with the following ranking in the most popular 50 sites according to traffic volumes:. The top searches in Portugal for free porn come primarily from those sites listed above where amateur footage can be viewed as well as clips from professional studios. Since the fall of authoritarian rule in Portugal during the early s the country has slowly enjoyed more liberalism.

Despite a late start with homosexuality being decriminalised in , their approach to anti-discrimination and equality is now seen as progressive. Same sex unions were legalised in and, in , Portugal became the 8 th nation in the world to legalise same sex marriage. Shortly after, the Law of Gender Identity was ratified to simplify the process for transgendered persons changing their sex; at the time this legislation was the most advanced of its kind in the world.

The Constitution of Portugal prohibits discrimination in any area of the law based on sexual orientation and the LGBTQ community enjoys protection in all areas including employment, family and criminal law and is also extended to those who seek asylum in the country. From a country where over 4 out of 5 people are Catholic, this is not a surprise.

At the time of writing there were over listings for Women Seeking Men. Many of the ads were clearly for escort services with a handful of more genuine personals. Some massage service were also available. You can filter the results by area and the site is free to use with contact details being given without any need for registration. You will need to use a translation tool with Convivio unless you speak Portuguese.

sex porto

Appropriate management of disorders of sex development DSD has been a matter of discussion since the first guidelines were published in the s. In the last decade, with the advent of the consensus, the classical methods, potto regarding timing of surgery and sex of rearing, are being questioned.

In our culture, parents of Porro newborns usually want their children to undergo genital surgery as soon as possible after sexual assignment, as surgery helps them to confirm the assigned sex. Developmental psychology theories back this hypothesis. They state that anatomic differences between sexes initiate the very important process of identification with the parent of the sex sex.

Sex-related endocrinological issues also demand early care. For example, using dihydrotestosterone porto to increase penile length or growth hormone treatment to improve final height require intervention at young ages to obtain better results. Although the timing of surgery remains controversial, recent porro suggests that male reconstruction should be performed between 6 and 18 months of age.

Feminizing surgery is still somewhat controversial. Most guidelines agree that severe virilization requires surgical intervention, while no consensus exists regarding mild cases. Our perspective is that precocious sex sex assignment and early surgery is a better management method. There is no strong evidence for delays and the consequences can be catastrophic in adulthood. The most complex clinical manifestation of DSD is genital ambiguity.

It occurs porto in the neonatal period and requires unhesitating recognition to enable planning an adequate approach. All individuals with suspected DSD porro a thorough diagnostic evaluation, including an extensive whole-body and genital physical exam, biochemical and genetic investigations, and imaging studies; the results need to be discussed porrto a multidisciplinary team 2.

The aim is to obtain a diagnosis, at the molecular genetic level if possible, to enable prognostic predictions and genetic counseling and initiate an individualized management plan.

There is evidence that the definition of the sex of creation and acceptance of sexuality differs significantly among various societies. Therefore, when discussing sex-related issues with the family, one should not overlook social, cultural, ethnic, and religious aspects of the family or the society 3. Efforts to standardize the management of DSD have been ongoing since the s. Wilkins' work was of great importance in this aspect, as it provided for the first time, a holistic overview of DSD diagnosis and therapeutics 45.

Sex review published in was the primary document until the Chicago Meeting consensus and related publication 56.

Every aspect was discussed and improved, from nomenclature to multidisciplinary care, sex psychosocial aspects 6.

These recommendations were endorsed porto the medical community. Inthe consensus update reinforced these guidelines 7. Despite the recent advances in DSD care, several groups endorse more profound changes. Porto this context, we highlight a paper published last year by Viau-Colindres et al. The authors advocate for a non-binary sex assignment as well as using the term intersex as a third option for birth certificates, particularly in cases of mixed gonadal dysgenesis and 46XY DSD e.

They argue that as these diagnoses have higher rates of gender dissatisfaction, decisions concerning sex of rearing porto urogenital surgery should be delayed to adulthood. From our point of view, this is a very dangerous proposition.

First, there is a gap of almost 50 years between the Wilkins paper and the podto. Those publications have transformed DSD management in recent years. Another important issue is that most data concerning long-time outcomes, such as gender dysphoria in DSD 11evaluated individuals based on old recommendations and surgical techniques, which does not necessarily reflect current contexts. This seems to be the case in our society.

In Brazil, most parents demand prompt sex assignment and surgical treatment. Although our approach does not follow the current European trends, it shows very good results.

Recently, De Paula et al. Considering a bioethical point of view and the non-maleficence principle, physicians should not support decisions that they believe are harmful to the child. In these cases, one might argue that irreversible surgical feminization or masculinization can harm the adult that the child will porot. Yet the option of inaction is harmful, as it commits porto patient to a childhood of ambiguous genital anatomy; this may be particularly difficult if the ssx and society's values do not support it.

Each option has its advantages and disadvantages. The principle of autonomy and respect supports preserving options for children until they can decide for themselves; however, this is a social experiment with potto still unknown Therefore, it seems very premature to advocate for a radical change in concepts. In our experience, prompt management is still the better choice for a newborn with ambiguous genitalia.

There are some relevant endocrinological, surgical, and psychological aspects that reinforce our position. Some endocrinological issues should be considered when determining the best surgical time. For example, when the sex is clearly, with a micropenis, early administration of testosterone or dihydrotestosterone cream to increase penile length can sex effective. Androgen receptors decrease during adolescence and early adulthood; therefore early use of testosterone allows a better response 15 Sometimes, depending on urethral malformation or ventral curvature, this treatment would be sex to implement before surgery without discomfort.

Another important issue is height. ;orto with complete androgen insensitivity syndrome are reportedly as tall as males cm and that chromosomal DSD adults are as tall as or shorter than females This difference in height may be linked to SHOX short stature homeobox gene haploinsufficiency We know that adult height follows a child's biological sex and not the sex of rearing.

This has enabled growth hormone GH treatment for Turner syndrome patients The use of somatropin for DSD patients is also described However, if the child's predicted final height is unfavorable and binary sex assignment is delayed until adulthood, the individual could miss the opportunity for GH treatment if they decide on a srx sex of rearing. During the potro update, 32 expert surgeons were consulted and there was no consensus regarding the indications, timing, procedures, and sex in DSD surgical outcomes 7.

However, some groups reported results that justify the early approach advocated by our group. Nevertheless, some points obtained universal consensus, most importantly, the need for a multidisciplinary management team and accurate follow-ups.

When the male sex is assigned, the recommended management shows no major variations. Surgical sex varies somewhat, with the ideal period being between 6 months and 2 years of age 21 or as recommended by the Ssx Academy of Pediatrics AAPwith tolerance up to 18 months More complications are reported in surgeries performed on boys after 1 year of age and adolescents The biggest concern is regarding the ideal time for genitoplasty in girls.

Most literature recommends that surgery be performed during the first year of life 24 It can be performed as a staged procedure, reducing the clitoromegaly and external genitalia reconstruction 25but this practice can lead to disposal of tissue that may be important in future vaginal reconstruction The most relevant arguments for early surgery are better quality of the genital tissues, better vascularization secondary to oprto maternal estrogens, and possible reduction of parental and child anxiety regarding the appearance of the external genitalia 25 However, vaginal dilation is not recommended in childhood Milhada et al.

Crawford et al. Jesus 30 porto that most patients report good clitoral sensation after feminizing genitoplasty; complaints of poor clitoral sensation were directly related to multiple surgeries, clitoral amputation, or complete portl or non-preservation of the neurovascular bundle. Most patients Ellens et al. There are no major variations in the approach to the gonads. The removal of confirmed streak gonads is indicated if Y material is present 22 In patients with complete androgen insensitivity syndrome CAISconservative management of gonads is suggested until puberty, as there is a small risk of malignancy Furthermore, in patients assigned as boys, the time for orchidopexy has decreased significantly porgo the consensus from The absence of an initial definition of the child's sex can cause an emotional impact in the parents Parents often get divorced because DSD in child becomes too difficult to discuss, creating a rift between the couple Sexual assignment followed by hormone therapy and surgery alone do not solve the issue, as there is still no clear understanding regarding the psychological adaptation of the individual to the designated sex.

This is because the sex assigned at birth will only be validated by a set of organic and psychological characteristics. For example, the sex of rearing used by parents to educate the child and the identity and port role, which results from different levels of sexual distinction: genetics, nuclear, gonadal, phenotypic, and psychosocial It is important to discuss the psychosocial construction of the DSD patient, since this is what determines the adequacy between sexual identity and gender identity.

A better fit porto the assigned sex indicates less conflict with the genital anatomy and development of a consonant gender identity. The parents' role in this construction is critical, as they are responsible for sed child's first relationships with the outside world, projecting his representations about his sexual identity, and the subsequent relationship between this and gender identity Stoller 36 expands some conceptual definitions regarding sex and gender based on Freud's theories of psychosexual development.

The author proposes a distinction between sex and gender, relating the former to the biological condition of being male or female and the latter to the development of the behavioral and characterological characteristics related to this condition masculinity and femininity Masculinity or femininity is defined by 36 as any quality that is felt by those who possess it as male sdx female Thus, masculinity or femininity is an algebraic sum of a dense mass of beliefs that make the individual feel that they qualitatively belong to either sex.

Besides the biological basis, the person obtains these convictions from parental attitudes, primarily in childhood, as these attitudes are fairly similar to those held by society. Therefore, cultural markers that give an individual the notion that he is male or female are fundamental, but changeable according to prevailing cultural patterns Money et al.

It was observed that, despite their undifferentiated sexual anatomy, children with DSD could develop a stable identity if raised unambiguously as members of either sex 37meaning if parents give these children an education within normal limits, like any other child born without DSD.

Currently, there sex a significant discussion regarding the rights of patients born with Porto who undergo genital surgeries early in life. The primary fear of those who manage such cases porto that the originally designated sex will later be repudiated by the patient. However, the methodological problems implicit in longitudinal research on the psychological development of individuals with DSD are also under discussion A major obstacle in this discussion is the heterogeneity of the cases.

The important question is whether adult patients dissatisfied with management performed more than 30 years prior should regulate the treatment of patients born with DSD in the present. The conceptual framework and scientific knowledge about the psychology of child development should help in this debate 3339 Meyer-Bahlburg 41Slijper et al. Thus, genital surgery performed after DSD investigation, is a preventive intervention, reinforcing the child's belonging to a defined sexual identity.

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