Dr. Finlayson, pediatric endocrinologist at the multi-disciplinary Gender & Sex Development Program at Lurie Children’s Hospital, spoke to us about fertility preservation options in patients with DSD. She started by explaining that DSD represents a group of medical congenital conditions in which chromosomal, gonadal or anatomical sexual development is atypical. In the past, approach to DSD treatment typically involved early sex reassignment surgery, which is now discouraged after a 2006 consensus statement called attention to the problems with this approach, including the fact that these children are not psychosexually neutral. Dr. Finlayson then provided an eloquent and thorough discussion of how the fertility risks differ in the DSD compared to the cancer population, including risk of streak or dysgenetic gonads and progressive gonadal failure in Turner and Klinefelter syndrome patients, for example.