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We recommend that a discussion regarding the risks and benefits of operative vaginal delivery for the management of second stage arrest take place in the third trimester and that appropriate reporting of these discussions takes place by means of a comprehensive written informed consent document. We found that the majority of both endocrinologists and urologists agreed that informed consent documents should acknowledge that there is an ongoing debate as to whether or not surgery is in the best interest of the child, and that in the future, the child may have conflict with their assigned sex and therefore request further surgery to reverse current surgery. Many physicians can point to the informed consent document and show that it was provided and signed; yet, verifying a document was signed and ensuring that a patient understood the material are two vastly different acts. |
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