Intersex patients in military service

The term "intersex" describes a variety of medical conditions in which sex determination is atypical. One of its most severe forms is an inadequate response to androgens due to mutations in the androgen receptor gene, which may manifest as a complete androgen insensitivity syndrome (CAIS). In this form of intersex condition, genetically male individuals do not form masculine genitalia, but have a female phenotype. Officially, Israel Defense Forces policy does not prohibit intersex patients' draft. However, it is uncommon to encounter intersex patients in the military setting. In this report, we describe a case of a combat Israeli Defense Forces female soldier, whose CAIS diagnosis was not reported to the military health authorities before her recruitment, but was revealed only during active service. Medical and other professional issues were discreetly handled, permitting her to successfully fulfill her 2 years of duty service. Although CAIS is a rare entity, it should be appropriately addressed in medical, psychological, social, and command aspects in the unique military setting. Our recommendation is to allow intersex patients military service, but not in combat units.