Advertisement

Archives of Sexual Behavior

, 38:873 | Cite as

Apparent Male Gender Identity in a Patient with Complete Androgen Insensitivity Syndrome

  • Bindu Kulshreshtha
  • Pascal Philibert
  • Marumudi Eunice
  • Sudhir K. Khandelwal
  • Manju Mehta
  • Françoise Audran
  • Françoise Paris
  • Charles Sultan
  • Ariachery C. Ammini
Letter to the Editor

Clinicians universally agree on female sex of rearing in patients with complete androgen insensitivity syndrome (CAIS). These patients have a female phenotype though they have an XY karyotype and testis. Long-term studies have shown an overall patient satisfaction with the assigned female sex, female gender identity, and heterosexual preferences in patients with CAIS (Hines, Ahmed, & Hughes, 2003; Mazur, 2005; Wisniewski et al., 2000). We report here a case of CAIS (reared as a female until age 11 years) who presented with a desire to live as a male at age 11 years.

This 11 year, 3 month old girl was the youngest of five siblings (one brother and three sisters). She had undergone surgery for bilateral inguinal swellings one year prior at a local hospital. Testicular tissue was found on exploration. The wound was closed without any surgical manipulation and the patient was referred to the endocrine department of this hospital. The child was accompanied by father and brother at the first...

Keywords

Androgen Receptor Testicular Tissue Androgen Insensitivity Syndrome Male Pattern Complete Androgen Insensitivity Syndrome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Arnold, A. P. (2004). Sex chromosomes and brain gender. Nature Reviews: Neuroscience, 5, 701–708.CrossRefPubMedGoogle Scholar
  2. Bouvattier, C., Carel, J. C., Lecointre, C., David, A., Sultan, C., Bertrand, A. M., et al. (2002). Postnatal changes of T, LH, and FSH in 46, XY infants with mutations in the AR gene. Journal of Clinical Endocrinology and Metabolism, 87, 29–32.CrossRefPubMedGoogle Scholar
  3. Carruth, L. L., Reisert, I., & Arnold, A. P. (2002). Sex chromosome genes directly affect brain sexual differentiation. Nature Neuroscience, 5, 933–934.CrossRefPubMedGoogle Scholar
  4. De Bellis, A., Quigley, C. A., Cariello, N. F., El-Awady, M. K., Sar, M., Lane, M. V., et al. (1992). Single base mutations in the human androgen receptor gene causing complete androgen insensitivity: Rapid detection by a modified denaturing gradient gel electrophoresis technique. Molecular Endocrinology, 6, 1909–1920.CrossRefPubMedGoogle Scholar
  5. Elsayed, S. M., Al-Maghraby, M., Hafeiz, H. B., & Taha, S. A. (1988). Psychological aspects of intersex in Saudi patients. Acta Psychiatrica Scandinavica, 77, 297–300.CrossRefPubMedGoogle Scholar
  6. Hines, M., Ahmed, S. F., & Hughes, I. A. (2003). Psychological outcomes and gender-related development in complete androgen insensitivity syndrome. Archives of Sexual Behavior, 32, 93–101.CrossRefPubMedGoogle Scholar
  7. Jakubiczka, S., Werder, E. A., & Wieacker, P. (1992). Point mutation in the steroid-binding domain of the androgen receptor gene in a family with complete androgen insensitivity syndrome (CAIS). Human Genetics, 90, 311–312.CrossRefPubMedGoogle Scholar
  8. Machover, K. (1951). Drawing of the human figure: A method of personality investigation. In G. L. Anderson (Ed.), An introduction to projective techniques (pp. 341–369). New York: Prentice Hall.Google Scholar
  9. Mazur, T. (2005). Gender dysphoria and gender change in androgen insensitivity or micropenis. Archives of Sexual Behavior, 34, 411–421.CrossRefPubMedGoogle Scholar
  10. Murray, H. A. (1943). Thematic apperception test. Cambridge, MA: Harvard University Press.Google Scholar
  11. Taha, S. A. (1994). Male pseudohermaphroditism: Factors determining the gender of rearing in Saudi Arabia. Urology, 43, 370–374.CrossRefPubMedGoogle Scholar
  12. Taha, S. A., & Maqbool, G. M. (1995). The pattern of intersex disorders and gender assignment in the Eastern province of Saudi Arabia. Saudi Medical Journal, 16, 17–22.Google Scholar
  13. Thin, T. H., Wang, L., Kim, E., Collins, L. L., Basavappa, R., & Chang, C. (2003). Isolation and characterization of androgen receptor mutant, AR (M749L), with hypersensitivity to 17-beta estradiol treatment. Journal of Biological Chemistry, 278, 7699–7708.CrossRefPubMedGoogle Scholar
  14. Wisniewski, A. B., Migeon, C. J., Meyer-Bahlburg, H. F. L., Gearhart, J. P., Berkovitz, G. D., Brown, T. R., et al. (2000). Complete androgen insensitivity syndrome: Long-term medical, surgical, and psychosexual outcome. Journal of Clinical Endocrinology and Metabolism, 85, 2664–2669.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Bindu Kulshreshtha
    • 1
  • Pascal Philibert
    • 2
  • Marumudi Eunice
    • 1
  • Sudhir K. Khandelwal
    • 3
  • Manju Mehta
    • 3
  • Françoise Audran
    • 2
  • Françoise Paris
    • 2
  • Charles Sultan
    • 2
  • Ariachery C. Ammini
    • 1
  1. 1.Department of Endocrinology and MetabolismAll India Institute of Medical SciencesNew DelhiIndia
  2. 2.Pediatric Endocrine Unit and the Hormones Laboratory of the University Hospital of MontpellierMontpellier CedexFrance
  3. 3.Department of PsychiatryAll India Institute of Medical SciencesNew DelhiIndia

Personalised recommendations