Thursday July 16, 2020

1200-1400 EDT

Joint Symposium 2: Differences of Sexual Differentiation/Transgender

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 Co-chairs: David Chitayat,Head, The Prenatal Diagnosis and Medical Genetics Program, Department of Obstetrics and Gynecology, Mt. Sinai Hospital, Pediatrics, The Hospital for Sick Children, Toronto, ON
Stephen Hill, Department of Laboratory Medicine, McMaster University Medical Centre, Hamilton ON
1200 Welcome
1205 Pink, Blue, and the Uncertainties in-between: Novel Approaches to Differences of Sex Development
Speaker: Eric Vilain, MD, Ph.D., Director of the Center for Genetic Medecine Research, Children’s National Health System, Chair, Department of Genomics & Precision Medicine, George Washington University, Washington, DC
Objectives: At the end of the session participants will be able to:
1. Decipher the biological mechanisms of sexual development.
2. Analyze the role of genetics in diagnosing differences of sex development.
3. Describe the current controversies in the management of differences of sex development.
Overview: A defining moment of our lives begins when we embark on a male or female path in the womb; disruption of typical male or female development results in Differences of Sex Development (DSD), which collectively occur frequently- in about 1% of the human population. The quality of life of people affected by DSD and their families is often threatened by uncertainty about what caused the condition, doubt over choices in care, and the chronic stress associated with anticipated or experienced stigma, and lifelong clinical care. To inform emerging clinical practice guidelines for the assessment and management of DSD, we present data that uncovers the genetic causes of DSD and examines connections between the genetics, patient and family psychological adaptation, and both medical and surgical decisions. The session will be of value to: Geneticists, Pediatricians, Trainees, Medical Students, Residents, and Basic Scientists.
1300 Legal and Ethical Developments Concerning Intersex Children
Speaker: Bernard M. Dickens, Professor Emeritus of Health Law and Policy, Faculty of Law and Joint Centre for Bioethics, University of Toronto, Toronto ON
Objectives: At the end of the session participants will be able to:
1. Assess whether intervention is required to confirm the child according to a binary (male or female) gender
2. Distinguish between intersex and transgender status
3. Counsel parents on intervention options for intersex children and the implication of options
Overview: The talk opens by addressing children born with ambiguous genitalia whose birth registration is to be completed under a binary (male or female) classification system. It contrasts sex defined by biology with gender defined by social identification, tracing depathologization of “gender dysphoria” and “gender-identity-disorder” by recognizing intersex status and transsexual inclination as non-pathological “gender incongruence”. Legal developments are placed in an international setting, identifying the growing range of jurisdictions that, guided by human rights principles, have expanded binary gender identification by recognizing a third category of gender status. This is accommodated in language, for instance, by adding to the “he/she” difference acceptance of the singular “they”. Conservative resistance is typified in retention, for instance, of “bathroom laws” compelling individuals’ resort in public places to use bathrooms according to their binary birth registration, not their chosen gender identity. The advantages and disadvantages of medical intervention in intersex status to conform to binary gender norms are outlined, particularly hysterectomy for masculinity and emasculation for femininity. The option of non-intervention is addressed in the contexts of human rights and of children’s rights to an “open future” of individuals’ autonomous choice of their own gender identity. The session is designed to be of value to: Geneticists, Trainees, Pediatricians, Gynecologists, Medical Students and Residents.1305
1400  Gender 101: A Beginner's Guide to Being a "Gender Bandit" 
Speaker:  Eliot Newton, Founder, Genderbandit Consulting, Ottawa ON 
Objectives:  At the end of the session participants will be able to:
1. Identify and explain the nuances between sex, gender identity, and gender expression, as well as appropriate applications of each
2. Describe the importance of cultural humility in the treatment of queer and trans persons
3. Make connections between trans lived experience and their own identity 
Overview:  Join Eliot Newton, our resident "gender bandit", in an introduction to the basic tenets of gender theory and how it relates to biology and identity. With humour, grace, and audience interaction, Eliot will use their own story as a starting point for your understanding into the world of queer and trans experience. Leave your assumptions at the door and bring your "stupid" questions as we learn together about trans identities and journeys... and maybe even a little about ourselves. 
1500  Updates on Congenital Adrenal Hyperplasia 
Speaker:  Mabel Yau, Assistant Professor, Pediatrics, Mount Sinai Kravis Children’s Hospital, New York, NY 
Objectives:  At the end of the session participants will be able to:
1. Explain the pathophysiology and diagnostic criteria for congenital adrenal hyperplasia
2. Discuss the challenges associate with genetic testing for CAH owing to 21-hydroxylase deficiency
3. Review current adjunct therapies and those being developed for CAH 
Overview:  CAH describes a group of genetic disorders of defective steroidogenesis owing to different enzymatic defects with the most common enzyme deficiency being 21-hydroxylase deficiency.Depending on the enzymatic activity and genetic mutations, 21-hydroxylase deficiency CAH is classified as either classical (salt wasting or simple virilizing) or non-classical. In classical 21-hydroxylase deficiency CAH, there is an accumulation of 17-hydroxyprogesterone which is shunted into the intact androgen pathway. This leads to prenatally virilized external genitalia in females at as early as 9 weeks of gestation. Inadequately treated patients may develop progressive penile or clitoral enlargement, premature adrenarche, precocious puberty, rapid linear growth accompanied by premature epiphysis maturation leading to compromised final adult height and impaired fertility. The goal of therapy in CAH is to both correct the deficiency in cortisol secretion and to suppress ACTH overproduction. Virilization of the genitalia in a female fetus affected with CAH owing to 21-OHD and 11B-OHD can be treated prenatally with dexamethasone administered to the mother before the 9th week of gestation. Adjunct therapies are currently used and being developed to address complications of chronic hyperandrogenism and glucocorticoid excess. The session will be of value to Geneticists, Genetic Counselors, and General Practitioners. 
   
   
Save the Dates!

 

CCMG/CSCC Virtual Sessions: Indigenous Health: Time for Action - June 25, 2020

CCMG/CSCC Virtual Sessions: Differences of Sexual Differentiation/Transgender - July 16, 2020

General Examination (3 hours)  - September 15, 2020

Specialty Written Examination - September 16, 2020

OSLEs (written only) - September 17, 2020

45th Annual Scientific Meeting in St. John’s, NL - June 12-16, 2021 - Delta St John's Hotel and Conference Centre