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Why not just create a new article? Three reasons: (1) today the medical care system for atypical sex is so in flux that it would be difficult to accurately capture the current variety of practices without that representation potentially becoming quickly out of date; (2) the ethical critiques I put forth in 1998 are still worth reviewing, even though some practices have changed; (3) the 1998 article when taken in conjunction with this 2011 epilogue may provide the reader with a sense that medical practice can change for the better through the efforts of patient advocates (including clinicians) who are attuned to evidence and ethics.