True hermaphroditism. A review of 41 cases with observations on testicular histology and function

Thirty-six children and five adults with true hermaphroditism have been reviewed. Twenty-five were raised as males and 16 as females. Those assigned as males had all ovarian tissue excised, leaving either a single testis or the testicular portion of one or both ovotestes. Post-operative testicular function was studied in 15 males. Basal testosterone levels were low in all four post-pubertal patients. Eleven children had plasma testosterone measured before and after stimulation with HCG. Response was poor in eight and normal in only three. Although social factors in South Africa usually result in true hermaphrodites being raised as males, the functional outcome of this decision is often disappointing.