To the Editor,

I read with interest the article entitled “Sexual ambiguity — a social predicament: case report” by Hassan et al. [1] in your esteemed journal. I would like to present several comments:

1. (1)

   The paper presents a case with sex ambiguity and its diagnosis and management. I agree with the authors that Disorders of Sex Development (DSD) are really challenging, particularly when they present beyond childhood. They are actually not uncommon in Saudi Arabia and neighboring countries where consanguinity is prevalent [2].

2. (2)

   The paper did not include the endocrine tests or the opinion of an endocrinologist to come up with the diagnosis of androgen insensitivity, be it partial or complete.

3. (3)

   The authors failed to include a reasonably rich literature from Islamic countries particularly Saudi Arabia, which addressed many aspects of the problem from both medical and cultural points of view [3–10]. I feel that it is worth referring to the Saudi experience particularly to the Islamic guidelines on DSD, which were distilled from the work of official Islamic scholars and published in a medical journal for guidance [3]. This is particularly important for a distinguished journal produced in Saudi Arabia.