The appropriate medical organisations (American Academy of Pediatrics, the various endocrinology groups, and so on) have issued a statement that prenatal dexamethazone should only be given for congenital adrenal hyperplasia (CAH)in regulated, ethics-cleared (IRB) studies at large centers planning to do long-term (to adulthood) followup of the study patients.

Management of post-birth children with CAH has controversies, and the drug regimens are variable. To me, it would seem obvious that the major issues are dealing with the severe "salt-losing" kind of CAH, and preventing precocious puberty and the curtailed growth that results from very early puberty. Policing functional external genitalia is simply NOT medically appropriate for children and should NOT be the concern of anyone other than the adult with unusual but functional genitalia plus the capacity for true informed consent.

One question for New and Meyer-Bahlberg: CAH women have a significantly lower rate of fertility (in those heterosexual women with active partner and with adequate anatomy to allow PIV sex), and the more severe the CAH, the lower the rate. What happens if the prenatal therapy makes CAH women more "gender-normed", maternal, etc, but doesn't change the reduced fertility? The CAH women desiring children would simply face more frustration, and might envy gender-variant CAH women who are perfectly happy without children.

Short-term prenatal corticosteroids are commonly used to accelerate lung maturation in unstable situations where pre-term birth is likely. There's no question that outcomes are better in neonates with adequate lung development. There have been questions about reduced short-term memory in non-CAH recipients of short-term prenatal corticosteroids, but the advantages of good oxygenation (mature lungs), in terms of decreased brain hemorrhages and general brain development, far outweigh any possible subtle changes seen in retrospective studies.