Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
Seek emergency care for a baby or person with possible adrenal hormone problems who has:
Repeated vomiting or severe diarrhoea
Poor feeding with unusual sleepiness or weakness
Signs of dehydration, such as very few wet nappies or little urine
Fainting, confusion, collapse or difficulty waking
A known adrenal condition and inability to keep emergency medicine down
Clinicians can check hormones and body salts without assuming there is an emergency.
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
Sudden severe lower abdominal or groin pain also needs urgent assessment.
In some people, this may mean gonadal tissue has twisted and lost its blood supply.
Arrange prompt medical assessment if a newborn’s genital appearance differs from expected patterns, even if the baby seems well.
3
Does any of this apply?
Book an appointment
Seek routine medical advice if puberty is not progressing as expected, periods have not started, groin swelling develops, or there are fertility or hormone concerns.
Support is also available if medical visits, body concerns, disclosure or identity uncertainty are causing distress.
Every sign above is quoted from the sofidex article on Differences of sex development. If you are not sure, err upward — it is always reasonable to be checked.