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In August a new standard of care was published in Pediatrics! With Accord Alliance in place, ISNA can close its doors with the comfort and knowledge that its work will continue to have an impact. The CS states that psychosocial support is integral to care, that ongoing open communication with patients and families is essential and that it helps with well-being; that genital exams and medical photography should be limited; and that care should be more focussed on addressing stigma not solely gender assignment and genital appearance. In , ISNA sponsored and convened a national group of health care and advocacy professionals to establish a nonprofit organization charged with making sure the new ideas about appropriate care are known and implemented across the country. Although it is far from perfect, some of the ground-breaking changes advocated in the Consensus Statement CS include: It also states that the functional outcome of genital surgeries should be emphasized, not just cosmetic appearance. This organization, Accord Alliance , opened its doors in March, , and will continue to lead national efforts to improve DSD-related health care and outcomes. There are no mechanisms are in place to foster implementation nor to evaluate to what extent these changes improve health care experiences and outcomes for persons and families affected by DSDs. From these scrappy, brave, and confrontational beginnings, ISNA evolved into an important resource for clinicians, parents, and affected individuals who require basic information about disorders of sex development DSDs and for how to improve the health care and overall well-being of people with DSDs. We believe the most fruitful way to move beyond the current dynamic is to support a new organization with a mission to promote integrated, comprehensive approaches to care that enhance the overall health and well-being of persons with DSDs and their families. Archives of our historical documents and accomplishments will be preserved at the Kinsey Institute at Indiana University all steps for maintaining confidentiality and privacy will be ensured through Kinsey. The Consensus Statement on Management of Intersex Disorders is an important inroad to resolving this crisis, and it incorporates many of the concepts and changes long advocated by ISNA. Accord Alliance believes that improving the way health care is made available and delivered is essential to ensure that people receive the services and support they need to lead healthy, happy lives. For ISNA and many of our collaborators, this has been extraordinarily frustrating and has hindered our ability to champion and move forward in this important work.

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