Twenty-four anatomically intersexed patients with ambiguous external genitalia are described. All were studied in the Soviet Union. One patient was a true hermaphrodite, three had mixed gonadal dysgenesis, nine were male hermaphrodites with testes in various stages of dysgenesis, and 11 were females with congenital adrenal hyperplasia. In several cases, the appearance of the genitalia was markedly incongruent with the assigned sex, e.g., a woman with a 7-cm phallus and a boy with a 1.5-cm phallus. With two partial exceptions, gender identity corresponded to the sex assigned at birth. In same-aged patients with the same clinical features and almost identical appearance of the external genitalia, but assigned to different sexes, gender identity corresponded to neonatal sex assignment. These cases demonstrate that gender identity is not determined prenatally by biological influences. Gender identity is postnatally learned and determined by sex assignment in infancy and the resultant socialization experiences.
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Armstrong, C. (1955). Diversities of sex.Brit. Med. J. 1: 1173–1177.
Berg, I., Nixon, H., and MacMahon, R. (1963). Change of assignment of sex at puberty.Lancet 2: 1216.
Bresler, V., Verlinskaya, D., Goroshchenko, G., and Lieberman, L. (Lev-Ran, A.), Ponomarenko, A., and Potin, V. (1966). Cytological changes in the case of mixed gonadal dysgenesis with a leydigoma in the dysgenetic testicle.Tsitologiya 8: 304–309.
Brown, B., and Fryor, M. (1964). Plastic surgical correction of hypospadias with mistaken sex identity and transvestism resulting in normal marriage and parenthood.Surg. Gynecol. Obstet. 118: 45–46.
Burns, E., Segaloff, A., and Carrera, G. (1960). Reassignment of sex: Report of 3 cases.J. Urol. 84: 126–133.
Cappon, D. (1970). Intersexuality and transsexuality.Postgrad. Med. 48: 293–294.
Dewhurst, C., and Gordon, R. (1963). Change of sex.Lancet 2: 1213–1216.
Diamond, M. (1965). A critical evaluation of the ontogeny of human sexual behavior.Quart. Rev. Biol. 40: 147–175.
Ehrhardt, A. A., Epstein, R., and Money, J. (1968a). Fetal androgens and female gender identity in the early-treated adrenogenital syndrome.Johns Hopkins Med. J. 122: 160–167.
Ehrhardt, A. A., Evers, K., and Money, J. (1968b). Influence of androgen and some aspects of sexually dimorphic behavior in women with the late-treated adrenogenital syndrome.Johns Hopkins Med. J. 123: 115–122.
Gershman, H. (1967). The evolution of gender identity.Bull. N.Y. Acad. Med. 43: 1000–1018.
Ghabrial, F., and Girgis, S. M. (1962). Reorientation of sex.Internat. J. Fertil. 7: 249–258.
Goroshchenko, Y. L., Savitsky, G. A., Bresler, V. M., and Fedortseva, R. F. (1968). The karyotype and histological changes in gonadal anomalies in man. II. True hermaphroditism.Tsitologiya 10: 1162–1170.
Hampson, J. G. (1955). Hermaphroditic genital appearance, rearing and eroticism in hyper-adrenocorticism.Bull. Johns Hopkins Hosp. 96: 265–273.
Lieberman, L. L. (Lev-Ran, A.) (1966).Congenital Sexual Anomalies, Leningrad.
Money, J. (1955). Hermaphroditism, gender and precocity in hyperadrenocorticism: Psychologic findings.Bull. Johns Hopkins Hosp. 96: 253–264.
Money, J. (1963). Psychosexual development in man. InEncyclopedia of Mental Health Franklin Watts, New York; pp. 1678–1709.
Money, J. (1970). Matched pairs of hermaphrodites: Behavioral biology of sexual differentiation from chromosomes to gender identity.Eng. Sci. 33: 32–39.
Money, J. (1972). Determinants of human sexual identity and behavior. In Sager, C., and Kaplan, H. (eds.),Progress in Group and Family Therapy Brunner/Mazel, New York.
Money, J., Hampson, J. G., and Hampson, J. L. (1955a). Hermaphroditism: Recommendations concerning assignment of sex, change of sex, and psychologic management.Bull. Johns Hopkins Hosp. 97: 284–300.
Money, J., Hampson, J. G., and Hampson, J. L. (1955b). An examination of some basic sexual concepts: The evidence of human hermaphroditism.Bull. Johns Hopkins Hosp. 97: 301–319.
Norris, A., and Keettel, W. (1962). Change of sex role after adolescence: A case study.Am. J. Obstet. Gynecol. 84: 719–721.
Raskin, A., and Lieberman, L. (Lev-Ran, A.) (1963). The role of estrogens and androgens in libido in women.Trans. Bekhterev Psychoneurol. Inst. Leningrad 29: 359–367.
Rosenwald, A., Handlon, J., Rosenthal, I., Hyde, J., and Bronstein, I. (1958). Psychologic studies before and after clitoridectomy in female pseudohermaphroditism caused by congenital virilizing adrenal hyperplasia.Pediatrics 21: 832–839.
Teter, J., and Boczkowski, E. (1965). Errors in management and assignment of sex in patients with abnormal sexual differentiation.Am. J. Obstet. Gynecol. 93: 1084–1087.
Zuger, B. (1970). Gender role differentiation: A critical review of the evidence from hermaphroditism.Psychosom. Med. 32: 449–463.
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Lev-Ran, A. Gender role differentiation in hermaphrodites. Arch Sex Behav 3, 391–424 (1974). https://doi.org/10.1007/BF01541162
- Gender Role
- Role Differentiation
- Social Issue
- Gender Identity
- Congenital Adrenal Hyperplasia