May 2023 Update
Overview
This page is based on research with an emphasis on DES Sons published between 1973 and 2023. DES Sons are persons born male who were born to mothers who were treated with the drug diethylstilbestrol (DES) to prevent miscarriage.
It is estimated that between 200,000 and 1.5 million males born in the U.S. between 1947 and 1971 were DES-exposed. DES Sons were also born in Canada, Europe and Australia, but reliable statistics are unavailable.
DES Sons have often been referred to as “the forgotten piece of the jigsaw.” There were as many DES Sons as DES Daughters born in the U.S. during the prime period of late 1940s to early 1970s, but far less research and advocacy on behalf of DES Sons has occurred over the years. Nearly 90% of the primary research on the human health effects of DES has been limited to DES Daughters and most of the public health research, education and advocacy has centered around concerns of DES Daughters only.
Primary documented health effects in DES Sons
The most common cited effects of prenatal DES exposure in persons born male include:
* Cryptorchidism–Extremely small testes and/or undescended testes
* Epididymal cysts–Benign cysts (fluid-filled sacs) that feel like small lumps
* Hypospadias–Opening of the penis is in the wrong place, often corrected with surgery
* Microphallus–Increased risk for a smaller than average penis
* Testicular Variocoeles–Irregularly swollen or varicose vein on the testicle
* Infertility–Potential for increased risk of infertility in DES Sons as they age
* Testicular Cancer Risk–To date, testicular cancer has not been directly attributed to DES exposure, but this is an area of ongoing concern
* Hypogonadism (Testosterone deficiency, in primary or secondary form–low LH and FSH levels included)
* Cardiovascular Disease
* Diabetes
* Osteoporosis
* Hypertension
* Psychological and psychiatric effects
* Sexuality and gender identity effects
My Ongoing Research with DES Sons
My own research for nearly the past 30 years has focused on assessing the range of health, medical, and psychosexual and psychiatric issues raised by members of the DES Sons International Network (N=1000), and is discussed in more detail in this separate page: Academic Research Into Prenatal Hormonal Influences on Gender and Sexual Development
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Journal References 1959-2023
2019-2023
- Risk Factors for Testicular Cancer: Environment, Genes and Infections–Is it All? (2023), by Sertac Yazici, et. al, published in the journal Medicina (full-text)
- Endocrine Disruption and Male Reproductive Health (2022), by Philippa D. Darbre, published in the textbook Endocrine Disruption and Human Health, Second Edition (abstract)
- Contribution of Prenatal Endocrine-disrupting Chemical Exposure to Genital Anomalies in Males: The Pooled Results from Current Evidence (2022), by Yuhao Wu, et. al, published in the journal Chemosphere (abstract plus)
- Prenatal Diethylstilbestrol Exposure and Risk of Depression in Women and Men (2020), by Linda Titus, et. al, published in the journal Epidemiology (full-text)
- Prenatal Diethylstilbestrol Exposure and Cancer Risk in Males (2020), by William C. Strohsnitter, et. al, published in the journal Cancer Epidemiology, Biomarkers, & Prevention (full-text)
- Effects on Human Males of in utero Exposure to Exogenous Sex Hormones (2020), by W B Gill, published in the textbook Toxicity of Hormones in Perinatal Life (Takao Mori & Hiroshi Nagasawa, eds. (abstract only)
- Hypogonadism and Cryptorchidism (2020), by Wiwat Rodprasert, et. al, published in the journal Frontiers in Endocrinology (full-text)
- Effect of Environmental and Pharmaceutical Exposures on Fetal Testis Development and Function: A Systematic Review of Human Experimental Data (2019), by Karen R. Kilcoyne & Rod T. Mitchell, published in the journal Human Reproduction Update (full-text)
- Prenatal Diethylstilbestrol Exposure: A Harbinger for Future Testicular Cancer Incidence? (2019), by William C. Strohsnitter, published in the journal JNCI Cancer Spectrum (full-text)
- Systematic Review and Meta-Analysis of Testicular Germ-Cell Tumors Following in utero Exposure to Diethylstilbestrol (2019), by Marianne Hom, et. al, published in the journal Cancer Spectrum (full-text)
- Effect of Environmental and Pharmaceutical Exposures on Fetal Testis Development and Function: A Systematic Review of Human Experimental Data (2019), by Karen R. Kilcoyne & Rod T. Mitchell, published in the journal Human Reproduction Update (full-text)
2010-2018 - The Present and Future of Human Sexuality: Impact of Faulty Perinatal Hormonal Imprinting (2017), by Gyorgy Csaba, published in the journal Sexual Medicine Reviews (full-text)
- Risk Factors for Cryptorchidism (2017), by Jason K. Gurney, et. al, published in the journal Natural Reviews Urology (full-text)
- Male Reproductive Disorders and Fertility Trends: Influences of Environment and Genetic Susceptibility (2015), by Niels E. Skakkabaek, et. al, published in the journal Physiological Reviews (full-text)
- Cryptorchidism and Endocrine Disrupting Chemicals (2013), by Helena E. Virtanen & Annika Adamsson, published in the journal Molecular and Cellular Endocrinology (full-text)
- Medical Conditions Among Adult Offspring Prenatally Exposed to Diethylstilbestrol (2013), by Rebecca Troisi, et. al, published in the journal Epidemiology (full-text)
- Cryptorchidism and Endocrine Disrupting Chemicals (2013), by Helena E. Virtanen & Annika Adamsson, published in the journal Molecular and Cellular Endocrinology (full-text)
2005-2009 - Clinical Implications of the Organizational and Activational Effects of Hormones (2009), by Milton Diamond, published in the journal Hormones and Behavior (full-text)
- Urogenital Abnormalities in Men Exposed to Diethylstilbestrol in utero: A Cohort Study (2009), by Julie R. Palmer, et. al, published in the journal Environmental Health (full-text)
- Testicular Dysgenesis Syndrome: Foetal Origin of Adult Reproductive Problems (2009), by Christine Wohlfahrt-Veje et. al, published in the journal Clinical Endocrinology
- Long-term Effects of Environmental Endocrine Disruptors on Reproductive Physiology and Behavior (2009), by Heather B. Patisaul and Heather B. Adewale, published in the journal Frontiers in Behavioral Neuroscience (full-text)
- Steroidogenesis in the Fetal Testis and its Susceptibility to Disruption by Exogenous Compounds (2009), by Hayley M. Scott, et. al, published in the journal Endocrine Reviews (full-text)
- Are Estrogens Carcinogenic during Development of the Testes? (2009), by John A. McLachlan, et. al, published in the Journal of Pathology, Microbiology and Immunology (APMIS), abstract only
- The Retreat from Precaution: Regulating Diethylstilbestrol (DES), Endocrine Disruptors, and Environmental Health (2008), by Nancy Langston, published in the journal Environmental History (abstract only)
- Estrogen Imprinting: When your Epigenetic Memories Come Back to Haunt You (2008), by Gail S. Prins, published in the journal Endocrinology (full-text)
- Testicular Dysgenesis Syndrome and the Estrogen Hypothesis: A Quantitative Meta-Analysis (2008), by Olwenn V. Martin, et. al, published in the journal Environmental Health Perspectives
- Prenatal Exposure to Diethylstilbestrol (DES) (2008) by Retha R. Newbold, published in the journal Fertility and Sterility (full-text)
- Epidemiology and Pathogenesis of Cryptorchidism (2008), by H.E., Virtanen & J. Toppari, published in the journal Human Reproduction Update (full-text)
- Sexual Differentiation of the Brain and Behavior (2007), by Dick F. Swaab, published in the journal Best Practice & Research Clinical Endocrinology & Metabolism (abstract only)
- Human Exposure to Endocrine-Disrupting Chemicals and Prenatal Risk Factors for Cryptorchidism and Hypospadias: A Nested Case-Control Study (2007), by Mariana F. Fernandez, et. al, published in the journal Environmental Health Perspectives (full-text)
- Testicular Dysgenesis Syndrome: Possible Role of Endocrine Disruptors (2006), by Katrine Bay, et. al, published in the journal Best Practice & Research Clinical Endocrinology & Metabolism (full-text)
- Male Reproductive Disorders in Humans and Prenatal Indicators of Estrogen Exposure: A Review of the Published Epidemiological Studies (2006), by Lone Storgaard, Jens Peter Bonde, & Jorn Olsen, published in the journal Reproductive Toxicology (abstract only)
- Hypospadias: A Transgenerational Effect of Diethylstilbestrol? (2006), by M.M. Brouwers, et. al, published in the journal Human Reproduction (full-text)
- Estrogen Effects on Fetal and Neonatal Testicular Development (2006), by Geraldine Delbes, et. al, published in the journal Reproduction (full-text)
- Reproductive Outcomes in Men with Prenatal Exposure to Diethylstilbestrol (2005), by Kimberly M. Perez, et. al, published in the journal Fertility and Sterility (full-text)
- Are EDCs Blurring Issues of Gender? (2005), by Ernie Hood, published in the journal Environmental Health Perspectives (fulltext)
- Prenatal Diethylstilbestrol Exposure in Males and Gender-Related Disorders (2005), by Scott Kerlin, DES Sons International Network presented at the annual BC Canada Psychology Research Consortium
- The Riddle of Gender: Science, Activism, and Transgender Rights (2005), by Deborah Rudacille (textbook), see chapter “The Fear of a Pink Planet”
- In utero Exposure to Environmental Estrogens and Male Reproductive Health: A Systematic Review of Biological and Epidemiologic Evidence (2005), by Alex C. Vidaeff & Lowell E. Sever, published in the journal Reproductive Toxicology (full-text)
1990-2004 - The DES Sons Online Discussion Network (2003), by Scott Kerlin & Dana Beyer, published in the journal Transgender Tapestry, No. 100
- A Psycho-Endocrinological Overview of Transsexualism (2003), by Aude Michel, et. al, published in the European Journal of Endocrinology (abstract only)
- Psychosexual Characteristics of Men and Women Exposed Prenatally to Diethylstilbestrol (2003), by Linda Titus-Ernstoff, et. al, published in the journal Epidemiology (abstract only)
- Environmental Endocrine Disrupters and Disorders of Sexual Differentiation (2002), by Jorma Toppari, published in the journal Seminars in Reproductive Medicine (abstract only)
- American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the Evaluation and Treatment of Hypogonadism in Adult Male Patients–2002 Update (2002), by Steven M. Petak, et. al, published in the journal Endocrine Practice (abstract only)
- Environmental Influences on Male Reproduction (2002), by R. Weber, et. al, published in the journal BJU International (full-text)
- Environmental Xenoestrogens, Anti-androgens, and Disorders of Male Sexual Differentiation (2001), by Charles Sultan, et. al, published in the journal Molecular and Cellular Endocrinology (full-text)
- Cancer Risk in Men Exposed in utero to Diethylstilbestrol (2001), by William C. Strohsnitter, et. al, published in the Journal of the National Cancer Institute (full-text)
- Testicular Dysgenesis Syndrome: An Increasingly Common Developmental Disorder with Environmental Aspects: Opinion (2001), by NE Skakkebaek, et. al, published in the journal Human Reproduction (full-text)
- The Effects on Men of Prenatal Exposure to Diethylstilbestrol (1997), in L. I Lipschultz, Infertility in the Male, pp. 268-80
- Male Reproductive Health and Environmental Xenoestrogens (1996), by J Toppari, et. al, published in the journal Environmental Health Perspectives (abstract only)
- Fertility in Men Exposed Prenatally to Diethylstilbestrol (1995), by AJ Wilcox, published in the New England Journal of Medicine (full-text)
- Diethylstilbestrol Revisited: A Review of the Long-term Health Effects (1995), by Ruthann Giusti, et. al, published in the journal Annals of Internal Medicine (abstract only)
- Psychopathology and Social Functioning in Men Prenatally Exposed to Diethylstilbestrol (DES) (1993), by Richard C. Pillard, et. al, published in the journal Psychosomatic Medicine (abstract only)
- Are Estrogens Involved in Falling Sperm Counts and Disorders of the Male Reproductive Tract? (1993), by R M Sharpe & N E. Sklakkebaek, published in the journal The Lancet (abstract only)
- Effects of Prenatal Exposure to Diethylstilbestrol (DES) on Hemispheric Laterality and Spatial Ability in Human Males (1992), by June M. Reinisch & Stephanie A. Sanders, published in the journal Hormones and Behavior (abstract only)
1959-1990 - A Case-Control Study of Testicular Cancer Using Connecticut Tumour Registry Data (1988), by Susan T. Gershman & Paul D. Stolley, published in the International Journal of Epidemiology (abstract only)
- Effects of in utero Exposure to DES on Male Progeny (1985), by Ann M. Niculescu, published in the Journal of Obstetric, Gynecologic & Neonatal Nursing (abstract/partial-text)
- Males Exposed in utero to Diethylstilbestrol (1984), by Frank J. Leary, et. al, published in the Journal of the American Medical Association (JAMA) (abstract only)
- In utero Exposure to Diethylstilbestrol: Adverse Effects on the Reproductive Tract and Reproductive Performance of Male and Female Offspring (1982), by RJ Stillman, published in the American Journal of Obstetrics and Gynecology (abstract only)
- Possible Relationship Between in utero Diethylstilbestrol Exposure and Male Fertility (1981), by M A Stenchever, et. al, published in the American Journal of Obstetrics and Gynecology (abstract only)
- Genital Abnormalities and Abnormal Semen Analysis in Male Patients Exposed to Diethylstilbestrol in utero (1981), by E. Douglas Whitehead & Elliot Leiter, published in the Journal of Urology (abstract only)
- Prenatal ‘Female Hormone’ Administration and Pschosexual Development in Human Males (1980), by Patricia Kester, et al, published in the journal Psychoneuroendocrinology (abstract only)
- Association of Diethylstilbestrol Exposure in utero with Cryptorchidism, Testicular Hypoplasia and Semen Abnormalities (1979), by W B Gill, et. al, published in The Journal of Urology (abstract only)
- Transplacental Exposure to Diethylstilbestrol in Men (1979), by Robert W. Andonian & Robert Kessler, published in the journal Urology (abstract only)
- Effect of Prenatal Estrogen Exposure on Male Genitalia (1978), by James L. Mills & Alfred M. Bongiovanni, published in the journal Pediatrics (abstract only)
- Behavioral Effects of Estrogen Treatment in Human Males (1978), by Heino FL Meyer-Bahlburg (1978), published in the journal Pediatrics (abstract only)
- Pathological Semen and Anatomical Abnormalities of the Genital Tract in Human Male Subjects Exposed to Diethylstilbestrol in utero (1977), by W R Gill, et. al, published in The Journal of Urology (abstract only)
- Male Genitourinary Abnormalities and Maternal Diethylstilbestrol (1977), by M D Cosgrove, B Benton, & B E Henderson, published in the Journal of Urology (abstract only)
- Follow-up Study of Male and Female Offspring of DES-Exposed Mothers (1977), by M Bibbo, et. al, published in the journal Obstetrics & Gynecology (abstract only)
- Structural and Functional Abnormalities in the Sex Organs of Male Offspring of Mothers Treated with Diethylstilbestrol (DES), by WB Gill, GF Schumacher, & M Bibbo (1976), published in The Journal of Reproductive Medicine (abstract only)
- Urogenital Tract Abnormalities in Sons of Women Treated with Diethylstilbestrol (1976), by B E Henderson, et. al, published in the journal Pediatrics (abstract only)
- Letter: Prenatal Diethylstilbestrol Exposure and Male Hypogonadism (1976), by D Hoefnagel, published in the journal Lancet (no abstract available)
- Prenatal Exposure to Female Hormones: Effect on Psychosexual Development in Boys (1973), by Irvin D. Yalom, et. al, published in the Archives of General Psychiatry (abstract only)
- Male Pseudohermaphrodism–Report of a Case, with Observations on Pathogenesis (1959), by Norman M. Kaplan, published in the New England Journal of Medicine (abstract only)
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