The Quigley scale is a descriptive, visual system of

phenotypic In genetics, the phenotype () is the set of observable characteristics or traits of an organism. The term covers the organism's morphology or physical form and structure, its developmental processes, its biochemical and physiological proper ...

grading that defines seven classes between "fully masculinized" and "fully feminized" genitalia. It was proposed by pediatric

endocrinologist Endocrinology (from ''endocrine'' + '' -ology'') is a branch of biology and medicine dealing with the endocrine system, its diseases, and its specific secretions known as hormones. It is also concerned with the integration of developmental events ...

Charmian A. Quigley et al. in 1995. It is similar in function to the

Prader scale The Prader scale or Prader staging, named after Andrea Prader, is a coarse rating system for the measurement of the degree of virilization of the Sex organ, genitalia of the human body and is similar to the Quigley scale. It primarily relates to v ...

and is used to describe genitalia in cases of

androgen insensitivity syndrome Androgen insensitivity syndrome (AIS) is a difference in sex development involving hormonal resistance due to androgen receptor dysfunction. It affects 1 in 20,000 to 64,000 XY ( karyotypically male) births. The condition results in the partial o ...

, including

complete androgen insensitivity syndrome Complete androgen insensitivity syndrome (CAIS) is an AIS condition that results in the complete inability of the cell to respond to androgens. As such, the insensitivity to androgens is only clinically significant when it occurs in individuals ...

partial androgen insensitivity syndrome Partial androgen insensitivity syndrome (PAIS) is a condition that results in the partial inability of the Eukaryote#Animal cell, cell to respond to androgens. It is an X linked recessive condition. The partial unresponsiveness of the cell to the ...

and

mild androgen insensitivity syndrome Mild androgen insensitivity syndrome (MAIS) is a condition that results in a mild impairment of the cell's ability to respond to androgens. The degree of impairment is sufficient to impair spermatogenesis and / or the development of secondary sexu ...

Schematic representation

Quigley scale for androgen insensitivity syndrome

Staging

The first six grades of the scale, grades 1 through 6, are differentiated by the degree of genital masculinization. Quigley describes the scale as one depicting "severity" or "defective masculinization". Grade 1 is indicated when the external genitalia is fully masculinized, and corresponds to

. Grades 6 and 7 are indicated when the external genitalia is fully feminized, corresponding to

. Grades 2 through 5 quantify four degrees of decreasingly masculinized genitalia that lie in the interim. Grades 2 through 5 of the Quigley scale quantify four degrees of increasingly feminized genitalia that correspond to partial androgen insensitivity syndrome. Grade 7 is indistinguishable from grade 6 until puberty, and is thereafter differentiated by the presence of

secondary Secondary may refer to: Science and nature * Secondary emission, of particles ** Secondary electrons, electrons generated as ionization products * The secondary winding, or the electrical or electronic circuit connected to the secondary winding i ...

terminal hair In humans, terminal hair is a variant of hair that is thick and long such as what grows on the scalp, as compared with vellus hair, colloquially known as peach fuzz, growing elsewhere.Marks, James G; Miller, Jeffery (2006)''Lookingbill and M ...

. Grade 6 is indicated when secondary terminal hair is present, whereas grade 7 is indicated when it is absent.

Controversy

While the scale has been defined as a grading system for feminized or undermasculinized genitalia, the concept that atypical genitals are necessarily abnormal is contested. An opinion paper by the Swiss National Advisory Centre for Biomedical Ethics advises that "not infrequently" variations from sex norms may not be pathological or require medical treatment. Similarly, an Australian Senate Committee report on involuntary sterilization determined that research "regarding 'adequate' or 'normal' genitals, particularly for women, raises some disturbing questions", including preferences influenced by doctors' specialism and gender. In a 2015 issue paper on ''Human rights and intersex people'', the Commissioner for Human Rights of the

Council of Europe The Council of Europe (CoE; french: Conseil de l'Europe, ) is an international organisation founded in the wake of World War II to uphold European Convention on Human Rights, human rights, democracy and the Law in Europe, rule of law in Europe. ...

recommended a review of medical classification that pathologise variations in sex characteristics.

Related concepts

Numerous clinical scales and measurement systems exist to define genitals as normal male or female, or "abnormal", including the

orchidometer An orchidometer (or orchiometer) is a medical instrument used to measure the volume of the testicles. The orchidometer was introduced in 1966 by Swiss pediatric endocrinologist Andrea Prader of the University of Zurich. It consists of a string of ...

and the satirical

Phall-O-Meter The Phall-O-meter is a satirical measure that critiques medical standards for normal male and female phalluses. The tool was developed by Kiira Triea (Denise Tree) based on a concept by Suzanne Kessler and is used to demonstrate concerns with the ...

References

{{Male congenital anomalies of genital organs , state=collapsed Male genital procedures Female genital procedures Intersex and medicine

Schematic representation

Staging

Controversy

Related concepts

See also

References