In general, gonadal tumors are unlikely in the absence of a Y chromosome or Y genes which may be present on the X chromosome. When there is a Y chromosome or Y genes are surmised to be present, the gonads are at elevated risk, and should be carefully monitored.
Because the risk is slight before early adulthood, gonadectomy should not be imposed on infants. It should be delayed until the patient can weigh the options and choose for her/himself. Functioning gonads, even partially functioning gonads, are a big advantage over hormone replacement therapy. The patient must be allowed to weigh the risks, talk with other patients about their experiences, and choose what is best for her/himself. Note, though, that it is critical to remove partially functioning testes before puberty from an intersexual who identifies as female and wishes her body not to virilize.
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