Changing the Nomenclature of Intersex: The 2005 Dreger et al. Paper Explained
10/11/2026
"Changing the Nomenclature/Taxonomy for Intersex" is a 2005 article in the Journal of Pediatric Endocrinology and Metabolism, written by Alice Dreger and four co-authors. It argues for dropping terms such as hermaphroditism and pseudohermaphroditism and classifying these conditions by cause and karyotype. The "disorders of sex development" terminology followed in 2006 and is still debated.
What is the Dreger et al. 2005 paper?
The Dreger et al. paper is a scientific and clinical argument for replacing the older vocabulary used to classify intersex conditions. It is cited whenever writers trace how the field moved from "hermaphrodite" language to "DSD" and, later, back toward "intersex".
Full citation: Dreger AD, Chase C, Sousa A, Gruppuso PA, Frader J. Changing the Nomenclature/Taxonomy for Intersex: A Scientific and Clinical Rationale. J Pediatr Endocrinol Metab. 2005;18(8):729. The publisher's record is at doi.org/10.1515/jpem.2005.18.8.729. This site does not host the paper; readers should go to the publisher.
Who wrote it?
Five authors are credited in the publisher's metadata:
- A. D. Dreger
- C. Chase
- A. Sousa
- P. A. Gruppuso
- J. Frader
What did the paper propose?
The paper proposed that conditions grouped under "true hermaphroditism" and "male" or "female pseudohermaphroditism" be renamed according to their underlying cause and the person's karyotype, rather than by a term suggesting a mixture of two sexes.
| Older term | Direction proposed |
|---|---|
| True hermaphroditism | Name by cause and karyotype |
| Male pseudohermaphroditism | Name by cause and karyotype |
| Female pseudohermaphroditism | Name by cause and karyotype |
One familiar example is androgen insensitivity syndrome, which under this logic is named for its cause. Readers can start with what AIS is and the difference between complete and partial AIS.
Why is it still cited?
It is cited in accounts of how the term "disorders of sex development" (DSD) came about. That term appeared in the 2006 consensus statement summarized in Pediatrics 118(2):753–757 by Christopher Houk, Ieuan Hughes, S. Faisal Ahmed, Peter Lee and the conference writing committee, and in the full report by Hughes and colleagues in the Journal of Pediatric Urology, 2006;2(3):148–162. The 2006 statement is a separate, collective document that came a year after the paper.
How has the terminology aged?
The vocabulary keeps shifting. The 2006 consensus statement introduced "DSD" into clinical practice, and a 2017 article in Pediatrics argued for bringing "intersex" back.
| Year | Milestone |
|---|---|
| 2005 | Dreger et al. propose a cause-and-karyotype taxonomy |
| 2006 | Consensus statement adopts "disorders of sex development" |
| 2017 | A Pediatrics article, Bringing Back the Term "Intersex", questions DSD |
Everyday usage is covered in intersex terminology in everyday use, and an advocacy perspective appears in an intersex-led statement. Other conditions are listed under related conditions.
FAQ
What is the Dreger 2005 intersex nomenclature paper?
It is an article in the Journal of Pediatric Endocrinology and Metabolism that proposes replacing the taxonomy based on "hermaphroditism" with one based on cause and karyotype.
Who wrote "Changing the Nomenclature/Taxonomy for Intersex"?
A. D. Dreger, C. Chase, A. Sousa, P. A. Gruppuso and J. Frader, in 2005.
Did the paper lead to the term DSD?
The term "disorders of sex development" was adopted in the 2006 consensus statement, a collective document published a year after the paper.
Is "disorders of sex development" still the standard term?
It is used in medical settings and also questioned; a 2017 Pediatrics article proposed returning to "intersex".
Sources
- Dreger AD, Chase C, Sousa A, Gruppuso PA, Frader J. J Pediatr Endocrinol Metab. 2005;18(8).
- Summary of Consensus Statement on Intersex Disorders and Their Management. Pediatrics. 2006;118(2):753–757.
- Hughes IA et al. Consensus statement on management of intersex disorders. J Pediatr Urol. 2006;2(3):148–162.
- Bringing Back the Term "Intersex". Pediatrics. 2017;140(5):e20170505.
This page is informational and does not replace medical advice.