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Related Experiment Videos

Early gender assignment in true hermaphroditism.

F I Luks1, F Hansbrough, D H Klotz

  • 1Department of Surgery, State University of New York, Brooklyn.

Journal of Pediatric Surgery
|December 1, 1988
PubMed
Summary
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True hermaphroditism, a rare intersex anomaly, requires careful gender assignment. Most infants with this condition should be raised as girls based on external genitalia appearance, guiding prompt infant gender assignment.

Area of Science:

  • Endocrinology
  • Genetics
  • Pediatric Surgery

Background:

  • True hermaphroditism is a rare intersex condition characterized by the presence of both male and female gonads.
  • Historically, individuals with true hermaphroditism were often raised as males, regardless of their physical characteristics.
  • Recent understanding suggests that gender assignment should prioritize external genitalia appearance for optimal outcomes.

Purpose of the Study:

  • To review cases of true hermaphroditism and establish guidelines for gender assignment.
  • To develop a classification system for external genitalia in true hermaphrodites to aid in early gender determination.
  • To determine the optimal gender assignment for infants with true hermaphroditism based on clinical presentation.

Main Methods:

Related Experiment Videos

  • Review of eight pediatric cases of true hermaphroditism managed between 1968 and 1987.
  • Analysis of karyotypes, gonadal distribution, and external genitalia characteristics.
  • Development of a six-class external genitalia classification system (Class I-VI) for gender assignment.

    • Main Results:

    • Karyotypes included 46XX (5), 46XY (1), 47XXY (1), and 46XX/mosaic (1).
    • Gonadal configurations varied: bilateral ovotestes (2), lateral testis and ovary (2), and unilateral ovotestis and ovary (4).
    • A classification system based on external genitalia appearance was proposed, with Classes I-IV recommended for female assignment and Class V for male assignment.

    Conclusions:

    • External genitalia appearance is a reliable indicator for prompt and definitive gender assignment in infants with true hermaphroditism.
    • The proposed classification system provides a simple screening tool for healthcare providers.
    • Most infants with true hermaphroditism, particularly those with less virilized genitalia (Classes I-IV), benefit from being raised as females.