Archives of Sexual Behavior

, Volume 34, Issue 4, pp 423–438

Gender Identity Outcome in Female-Raised 46,XY Persons with Penile Agenesis, Cloacal Exstrophy of the Bladder, or Penile Ablation


DOI: 10.1007/s10508-005-4342-9

Cite this article as:
Meyer-Bahlburg, H.F.L. Arch Sex Behav (2005) 34: 423. doi:10.1007/s10508-005-4342-9


This review addresses the long-term gender outcome of gender assignment of persons with intersexuality and related conditions. The gender assignment to female of 46,XY newborns with severe genital abnormalities despite a presumably normal-male prenatal sex-hormone milieu is highly controversial because of variations in assumptions about the role of biological factors in gender identity formation. This article presents a literature review of gender outcome in three pertinent conditions (penile agenesis, cloacal exstrophy of the bladder, and penile ablation) in infancy or early childhood. The findings clearly indicate an increased risk of later patient-initiated gender re-assignment to male after female assignment in infancy or early childhood, but are nevertheless incompatible with the notion of a full determination of core gender identity by prenatal androgens.

Key Words

gender dysphoriagender identitypenile agenesiscloacal bladder exstrophypenile ablation

Copyright information

© Springer Science + Business Media, Inc. 2005

Authors and Affiliations

  1. 1.New York State Psychiatric InstituteNew York
  2. 2.Department of PsychiatryColumbia UniversityNew York
  3. 3.Department of Psychiatry, New York State Psychiatric InstituteColumbia UniversityNew York