sodium-ethylxanthate and Disorders-of-Sex-Development

For almost 2000 years, human beings have been discussing about gender. New scientific evidences give interesting new points of view, partially subverting the normal dichotomy described by the "two-gender" theory. In this article, we are going to critically review the history of the approach towards people born with a Sexual-Differentiation-Disorder, passing through the analysis of the Italian National Ethics Committee's opinion, describing the modern scientific evidences on the gender-identity development, furthermore ruling out the new approach borned from the femminist philosophies, and the new biogiuridical experiments borned in Australia and Germany. Would it be possible a world where a person could be more then a male or a female?

Topics: Attitude to Health; Child Rearing; Culture; Disorders of Sex Development; Female; Gender Identity; Genitalia; Genotype; Human Rights; Humans; Infant, Newborn; Male; Phenotype; Sex; Sex Characteristics; Sex Chromosome Disorders of Sex Development; Sexual Behavior

Topics: Animals; Ants; Disorders of Sex Development; Genes, Fungal; Germ Cells; Reproduction; Sex; Sex Characteristics; Sex Determination Processes; Sexual Behavior, Animal; Yeasts

In order to open new possibilities for bioethics, I argue that we need to rethink our concept of nature. The established cognitive framework determines in advance how new technologies will become visible. Indeed, in this dualistic approach of metaphysics, nature is posited as limitless, as material endowed with force which causes us to lose the sense of nature as arising out of itself, of having limits, an end. In contrast, drawing upon the example of the gender assignment and construction of intersexed infants, I want to suggest for bioethics an understanding of nature that arises not from our scientific explorations, but rather from attending to our situated perceptual encounters with the world which underlie such experimentation; these encounters are too easily overlooked, and yet they are crucial for opening up new ways of thinking.

Topics: Bioethics; Biotechnology; Disorders of Sex Development; Forecasting; Humans; Nature; Philosophy; Sex; Treatment Outcome

In humans, the choice between male or female development is genetically determined. Sex determination occurs as the undifferentiated and bipotential embryonic gonad becomes either testes or ovary. This process is influenced by the action of genes that have been discovered by genetics studies of sex-reversed patients, XY females, XX males, and XX true hermaphrodites. The development of the gonad is better known in males than in females. SRY, a gene located on the Y chromosome, triggers a complex genetic cascade leading to testicular development. Other genes such as DAX1, located on the X chromosome, antagonize the action of SRY and may influence ovarian development. Only a minority of sex-reversed patients can be explained genetically, suggesting that many genes influencing sex determination are yet to be discovered.

Topics: Disorders of Sex Development; Gonads; Humans; Male; Psychosexual Development; Sex; Sex Determination Processes; Sexual Behavior

Topics: Child; Child, Preschool; Choice Behavior; Cultural Diversity; Disorders of Sex Development; Ethics, Medical; Female; Genetic Diseases, Inborn; Humans; Male; Parental Consent; Sex; Social Values; Time Factors; Truth Disclosure; Uncertainty

Topics: Animals; Biological Evolution; Disorders of Sex Development; Female; Male; Models, Genetic; Ploidies; Sex; Sex Chromosomes; Sex Ratio

We have reviewed models dealing with the maintenance of male-sterility under different modes of inheritance. For females to remain among hermaphrodites requires cytoplasmic information determining male-sterility and nuclear information restoring male-fertility. Such a nuclear-cytoplasmic polymorphism can be maintained at equilibrium given certain assumptions. However this equilibrium result may be irrelevant because gynodioecious populations are usually not at equilibrium, and because founder effects may give rise to high frequencies of females, due possibly to the fact that populations are often very different from one another genetically. The genetic structure of such a species depends on the frequency of females. Females are obligate outbreeders and usually produce more seeds than hermaphrodites. These two traits are beneficial to a group where females are present, in terms of effective size and seed output, although they are not, themselves, causes of the occurrence of females. Nuclear-cytoplasmic gynodioecy may lead to dioecy.

Topics: Animals; Biological Evolution; Disorders of Sex Development; Female; Heterozygote; Infertility, Male; Male; Models, Genetic; Sex

Topics: Adaptation, Physiological; Animals; Disorders of Sex Development; Female; Male; Mathematics; Models, Genetic; Selection, Genetic; Sex; Sex Chromosomes; Sex Determination Analysis; Sex Ratio

Theories on the evolution of sex determining mechanisms are reviewed for male and female heterogamety, environmental sex determination, and briefly, haplo-diploidy and hermaphroditism. Because of their discrete and well-defined nature, sex determining mechanisms lend themselves to three types of evolutionary questions: what variety occurs and might be expected but does not occur, how do changes occur from one mechanism to another, and why do certain changes occur? All three approaches were illustrated for these different sex determining mechanisms. A generality emerging from these studies is that, at the level of selection of the sex ratio, there are no intrinsic problems in evolving from one sex determining mechanism to another: straightforward transitions between different mechanisms exist under various conditions.

Topics: Animals; Biological Evolution; Diploidy; Disorders of Sex Development; Female; Fishes; Germ Cells; Haploidy; Male; Nematoda; Reptiles; Sex; Sex Determination Analysis; Sex Ratio

Opinions vary on the relative importance of biological and learning processes in the aetiology of sexual expression and deviance. The structure of personality, consistency of fantasy patterns, and the familial nature of homosexuality hint at a biological anlage. Research with the HY-antigen complex and X chromosome, and the elucidation of the interactions of intrauterine testosterone and its products with the foetal brain and neurotransmitters, have given us new models to understand the programming of sexuality. However, gonadotrophin feedback is not relevant as an indicator of brain feminization in primates and man. Finally, the interaction of masculinization and defeminization provides us with a model for understanding homosexual behaviour.

Topics: Animals; Brain; Disorders of Sex Development; Female; Fetus; Genitalia, Female; Genitalia, Male; H-Y Antigen; Homosexuality; Humans; Macaca mulatta; Male; Mice; Neurotransmitter Agents; Paraphilic Disorders; Rabbits; Rats; Sex; Sex Chromosomes; Sex Differentiation

Topics: Disorders of Sex Development; Female; Gender Identity; History of Medicine; History, 16th Century; History, 19th Century; History, 20th Century; History, 21st Century; History, Ancient; Homosexuality; Humans; Male; Politics; Sex; Social Discrimination; Transgender Persons; United States

Topics: Adrenal Hyperplasia, Congenital; Athletes; Disorders of Sex Development; Female; Genetic Testing; History, 20th Century; History, 21st Century; Humans; Hyperandrogenism; Intersex Persons; Male; Mutation; Polycystic Ovary Syndrome; Sex; Sex Characteristics; Sports; Testosterone

Non-invasive prenatal screening (NIPS) utilizes circulating cell-free DNA (cfDNA) to screen for fetal genetic abnormalities. NIPS is the first widely-available prenatal screen to assess genotypic sex. Most pediatricians have limited familiarity with NIPS technology and potential etiologies of discordant results. Increased familiarity may provide diagnostic insight and improve clinical care.. We reviewed all patients with discordant genotypic fetal sex assessed by cfDNA and neonatal phenotypic sex referred to our medical center.. Four infants with discordant cfDNA result and phenotypic sex were identified. Etiologies include vanishing twin syndrome, difference of sexual development, sex chromosome aneuploidy and maternal chimerism.. We present four cases illustrating potential etiologies of discordant cfDNA result and postnatal phenotypic sex. Unanticipated cfDNA results offer the perinatologist a unique opportunity for early diagnosis and targeted treatment of various conditions, many of which may not have otherwise been detected in the perinatal period.

Topics: Adult; Cell-Free Nucleic Acids; Disorders of Sex Development; Early Diagnosis; Female; Genetic Testing; Humans; Infant, Newborn; Liquid Biopsy; Male; Pregnancy; Prenatal Diagnosis; Sex; Sex Determination Analysis

Topics: Androgen-Insensitivity Syndrome; Animals; Chimera; Chromosomes, Human, X; Chromosomes, Human, Y; Disorders of Sex Development; Female; Genes, sry; Genotype; Gonadal Steroid Hormones; Gonads; Humans; Male; Mice; Mosaicism; Phenotype; Sex; Sex Characteristics; Sex Determination Analysis; Sex Determination Processes

Topics: Animals; Disorders of Sex Development; Female; Gonadal Steroid Hormones; Humans; Male; Sex; Sex Determination Processes

Since the first sex reassignment operations were performed, individual sex has come to be, to some extent at least, a technological artifact. The existence of sperm sorting technology, and of prenatal determination of fetal sex via ultrasound along with the option of termination, means that we now have the power to choose the sex of our children. An influential contemporary line of thought about medical ethics suggests that we should use technology to serve the welfare of individuals and to remove limitations on the opportunities available to them. I argue that, if these are our goals, we may do well to move towards a "post sex" humanity. Until we have the technology to produce genuine hermaphrodites, the most efficient way to do this is to use sex selection technology to ensure that only girl children are born. There are significant restrictions on the opportunities available to men, around gestation, childbirth, and breast-feeding, which will be extremely difficult to overcome via social or technological mechanisms for the foreseeable future. Women also have longer life expectancies than men. Girl babies therefore have a significantly more "open" future than boy babies. Resisting the conclusion that we should ensure that all children are born the same sex will require insisting that sexual difference is natural to human beings and that we should not use technology to reshape humanity beyond certain natural limits. The real concern of my paper, then, is the moral significance of the idea of a normal human body in modern medicine.

Topics: Beneficence; Biomedical Enhancement; Choice Behavior; Disorders of Sex Development; Ethical Analysis; Ethical Theory; Female; Gender Identity; Human Body; Humans; Life Expectancy; Male; Moral Obligations; Parents; Parturition; Public Policy; Reproduction; Sex; Sex Characteristics; Sex Preselection; Sexuality

Topics: Biomedical Enhancement; Choice Behavior; Disorders of Sex Development; Ethical Analysis; Ethical Theory; Female; Feminism; Gender Identity; Humans; Male; Parents; Reproduction; Sex; Sex Characteristics; Sex Preselection; Sexuality; Social Justice

In poikilothermic vertebrates, sex determination is sometimes influenced by environmental factors such as temperature. However, little is known about the molecular mechanisms underlying environmental sex determination. The medaka (Oryzias latipes) is a teleost fish with an XX/XY sex determination system. Recently, it was reported that XX medaka can be sex-reversed into phenotypic males by high water temperature (HT; 32-34 degrees C) treatment during the sex differentiation period. Here we report that cortisol caused female-to-male sex reversal and that metyrapone (an inhibitor of cortisol synthesis) inhibited HT-induced masculinization of XX medaka. HT treatment caused elevation of whole-body levels of cortisol, while metyrapone suppressed the elevation by HT treatment during sexual differentiation. Moreover, cortisol and 33 degrees C treatments inhibited female-type proliferation of germ cells as well as expression of follicle-stimulating hormone receptor (fshr) mRNA in XX medaka during sexual differentiation. These results strongly suggest that HT induces masculinization of XX medaka by elevation of cortisol level, which, in turn, causes suppression of germ cell proliferation and of fshr mRNA expression.

Topics: Animals; Antimetabolites; Disorders of Sex Development; Female; Hot Temperature; Hydrocortisone; Male; Metyrapone; Oryzias; Sex; Sex Determination Processes; Sex Differentiation; Up-Regulation; X Chromosome

Several hypotheses have been proposed to explain the persistence of dioecy despite the reproductive advantages conferred to hermaphrodites, including greater efficiency at purging deleterious mutations in the former. Dioecy can benefit from both mutation purging and accelerated evolution by bringing together beneficial mutations in the same individual via recombination and shuffling of genotypes. In addition, mathematical treatment has shown that sexual selection is also capable of mitigating the cost of maintaining separate sexes by increasing the overall fitness of sexual populations, and genomic comparisons have shown that sexual selection can lead to accelerated evolution. Here, we examine the advantages of dioecy versus hermaphroditism by comparing the rate of evolution in sex-related genes and the rate of accumulation of deleterious mutations using a large number of orthologs (11,493) in the dioecious Caenorhabditis remanei and the hermaphroditic Caenorhabditis briggsae. We have used this data set to estimate the deleterious mutation rate per generation, U, in both species and find that although it is significantly higher in hermaphrodites, both species are at least 2 orders of magnitude lower than the value required to explain the persistence of sex by efficiency at purging deleterious mutations alone. We also find that genes expressed in sperm are evolving rapidly in both species; however, they show a greater increase in their rate of evolution relative to genes expressed in other tissues in C. remanei, suggesting stronger sexual selection pressure acting on these genes in dioecious species. Interestingly, the persistence of a signal of rapid evolution of sperm genes in C. briggsae suggests a recent evolutionary origin of hermaphrodism in this lineage. Our results provide empirical evidence of increased sexual selection pressure in dioecious animals, supporting the possibility that sexual selection may play an important role in the maintenance of sexual reproduction.

Topics: Animals; Caenorhabditis; Chromosomes; Disorders of Sex Development; Evolution, Molecular; Female; Genes, Helminth; Helminth Proteins; Male; Mutation; Selection, Genetic; Sex; Sex Characteristics; Sexual Behavior, Animal; Spermatozoa; Synteny

Which conditions favour the evolution of hermaphroditism or separate sexes? One classical hypothesis states that an organism's mode of locomotion (if any) when searching for a mate should influence breeding system evolution. We used published phylogenies to reconstruct evolutionary changes in adult mate-search efficiency and breeding systems among multicellular organisms. Employing maximum-likelihood analyses, we found that changes in adult mate-search efficiency are significantly correlated with changes in breeding system, and this result is robust to uncertainties in the phylogenies. These data provide the first statistical support, across a broad range of taxa, for the hypothesis that breeding systems and mate-search efficiency did not evolve independently. We discuss our results in context with other causal factors, such as inbreeding avoidance and sexual specialization, likely to affect breeding system evolution.

Topics: Animals; Biological Evolution; Computer Simulation; Disorders of Sex Development; Invertebrates; Models, Biological; Phylogeny; Plants; Reproduction; Sex; Sex Characteristics; Vertebrates

To report a rare case of true hermaphroditism presenting in adolescence as bilateral gynecomastia in a phenotypic male.. Case report.. Academic medical center.. A 19-year-old phenotypic male who presented with pronounced bilateral gynecomastia and was ultimately diagnosed with true hermaphroditism.. Endoscopic removal of the internal female genital tract (hemiuterus and ovary), reduction mammoplasty, repair of penile chordee, and left testicular prosthesis placement.. Diagnosis and treatment of true hermaphroditism.. Bilateral mammoplasties, repair of a penile chordee, placement of a left testicular prosthesis, and excision of the left hemiuterus and ovary resulted in return to testicular function in this true hermaphrodite.. Although rare, true hermaphroditism should be suspected in male patients presenting with bilateral breast enlargement in adolescence.

Topics: Adult; Disorders of Sex Development; Female; Gynecomastia; Humans; Hypospadias; Hysterectomy; Karyotyping; Male; Mammaplasty; Ovariectomy; Penis; Phenotype; Prostheses and Implants; Sex; Testis; Uterus

We formulate two single-locus Mendelian models, one for androdioecy and the other one for gynodioecy, each with 3 parameters: t the male (female) fertility rate of males (females) to hermaphrodites, s the fraction of the progeny derived from selfing; and g the fitness of inbreeders. Each model is expressed as a transformation of a 3 dimensional zygotic algebra, which we interpret as a rational map of the projective plane. We then study the dynamics for the evolution of each reproductive system; and compare our results with similar published models. In this process, we introduce a general concept of fitness and list some of its properties, obtaining a relative measure of population growth, computable as an eigenvalue of a mixed mating transformation for a population in equilibrium. Our results concur with previous models of the evolution of androdioecy and gynodioecy regarding the threshold values above which the sexual polymophism is stable, although the previous models assume constant the fraction of ovules from hermaphrodites that are self pollinated, while we assume constant the fraction of the progeny derived from selfing. A stable androdioecy requires more stringent conditions than a stable gynodioecy if the amount of pollen used for selfing is negligible in comparison with the total amount of pollen produced by hermaphrodites. Otherwise, both models are identical. We show explicitly that the genotype fitnesses depend linearly on their frequencies. Simulations show that any population not at equilibrium always converges to the equilibrium point of higher fitness. However, at intermediate steps, the fitness function occasionally decreases.

Topics: Algorithms; Alleles; Animals; Biological Evolution; Diploidy; Disorders of Sex Development; Female; Genes, Dominant; Genes, Recessive; Genetic Variation; Genetics, Population; Inbreeding; Male; Models, Genetic; Plants; Population Density; Population Dynamics; Reproduction; Selection, Genetic; Sex; Sex Determination Processes

Topics: Adaptation, Psychological; Child; Child Advocacy; Child Welfare; Disorders of Sex Development; Emergencies; Ethics, Clinical; Female; General Surgery; Humans; Infant, Newborn; Male; Parental Consent; Sex; Social Adjustment; United States

The genetic cost of sexual reproduction has been attributed to two causes in mathematical formulations: male function or genome dilution. We develop and analyse a genetic model that shows that both costs occur, depending upon the conditions. The model differs from previous formulations in that the level of output and fertilization success of male gametes produced by hermaphrodites that are asexual in their female function (henceforth "parthenogenetic hermaphrodites") are treated as variables, rather than constants fixed at 0 or 1, as has previously been the case. By expressing the cost of sex in terms of per capita egg loss of sexual individuals and parthenogenetic hermaphrodites, we partition the cost into components due to male function and genome dilution. Which component dominates the cost of sex depends upon the relative male gamete output of the parthenogenetic hermaphrodites. The cost of sex is observed to increase, or remain unchanged in some marginal cases, with increases in (i) frequency of parthenogenetic hermaphrodites, (ii) fertilization success of male gametes produced by parthenogenetic hermaphrodites and (iii) potential eggs lost by diverting resources to male gamete production. In certain situations, parthenogenetic hermaphrodites with an intermediate level of male gamete output have the greatest fitness advantage over sexual individuals. If heritable variation for levels of male gamete output exists among parthenogenetic hermaphrodites, this raises the possibility of the evolution of optimal levels of male gamete production by parthenogenetic hermaphrodites through natural selection, in situations of recurring invasion of asexual populations by propagules from sexual populations, a scenario that is increasingly being appreciated as potentially fairly likely to occur in nature.

Topics: Animals; Biological Evolution; Disorders of Sex Development; Female; Genotype; Male; Models, Genetic; Ovum; Sex; Spermatozoa

In this paper we present a mathematical model of mutation and selection that allows for the coexistence of multiple alleles at a locus with very small selective differences between alleles. The model also allows for the determination of fitness by multiple loci. Models of this sort are biologically plausible. However, some previous attempts to construct similar models have assumed that all mutations produce a decrease in fitness, and this has led to a tendency for the average fitness of population members to decline when population numbers are finite. In our model we incorporate some of the ideas of R. A. FISHER, so that both deleterious and beneficial mutations are possible. As a result, average fitness tends to approach a stationary distribution. We have used computer simulation methods to apply the Fisherian mutation model to the problem of the evolution of sex and recombination. The results suggest that sex and recombination can provide very large benefits in terms of average fitness. The results also suggest that obligately sexual species will win ecological competitions with species that produce a substantial fraction of their offspring asexually, so long as the number of sites under selection within the genomes of the competing species is not too small and the population sizes are not too large. Our model focuses on fertility selection in an hermaphroditic plant. However, the results are likely to generalize to a wide variety of other situations as well.

Topics: Biological Evolution; Computer Simulation; Disorders of Sex Development; Ecology; Fertility; Genes; Genes, Plant; Models, Genetic; Mutation; Plant Physiological Phenomena; Plants; Population Density; Population Dynamics; Recombination, Genetic; Selection, Genetic; Sex

While aesthetic facial surgery performed for reasons of undesired facial masculinity or femininity has had some attention in the literature, there is a lack of information on gender-confirming facial surgery as part of an overall surgical sex reassignment program. In this paper we try to capture some of the sex differences, respectively, of skeleton, musculature and other subcutaneous soft tissues, integument and frame of the face. From this, we come to a description of some general differences of facial appearance between the sexes. In restructuring the skeletal architecture and facial proportions to match the desired gender, these factors should be taken into account.

Topics: Cephalometry; Dentition; Dermatologic Surgical Procedures; Disorders of Sex Development; Esthetics; Eye; Eyebrows; Face; Facial Bones; Facial Muscles; Female; Forehead; Hair; Humans; Male; Mandible; Neck; Nose; Orbit; Sex; Sex Characteristics; Skin; Skull; Surgery, Plastic; Zygoma

Topics: Biological Evolution; Disorders of Sex Development; Female; Homosexuality, Female; Homosexuality, Male; Humans; Male; Sex; Twin Studies as Topic

Topics: Anatomy; Disorders of Sex Development; Gynecology; History, 19th Century; Humans; Sex; United Kingdom

In this paper an analysis is made of a model of selection for asexual reproduction in hermaphrodite (or monoecious) populations in which variation occurs in relative female and male fertilities. It is shown that the advantage of an asexual mutant (the cost of sex) increases with increasing degree of differentiation in functional sex. This effect is very marked at low levels of selfing, but weak with a high selfing rate. In general, the advantage of an asexual mutant in a hermaphrodite population depends on the relative resource allocation to male and female gametes, and increases with increasing bias to femaleness. Thus the cost of sex in gynodioecious populations is (with a low level of selfing) as high as in a dioecious population. This applies, however, to a nuclear genetic determination of gynodioecy, which is presumably rare. In a more realistic model assuming nuclear-cytoplasmic determination of gynodioecy the cost of sex is considerably lower.

Topics: Animals; Diploidy; Disorders of Sex Development; Female; Fertility; Male; Models, Genetic; Reproduction; Sex

A study group has been constituted at the Hôpital des Enfants-Malades in order to analyse the relational approach with adolescent girls with various disorders and malformations of the genital tract followed since childhood. This group has been using a methodology which has already been applied to psychological aspects of other somatic diseases. Endocrinologists, gynecologists and psychoanalysts have weekly discussions about clinical cases. Their discussions are tape-recorded. The transcriptions are analysed by the whole group in order to evaluate the objective and subjective data concerning patients, families and doctors. We intend to discuss problems which appear to be the most important in relation to these disorders. Whatever the somatic problem is, these girls' future is also determined by their psychic reality and also that of their families and doctors. This psychic reality integrates and modifies the objective data as well as their environment.

Topics: Adrenal Hyperplasia, Congenital; Castration; Disorders of Sex Development; Family; Female; Genital Diseases, Female; Genitalia, Female; Humans; Ovarian Neoplasms; Physician-Patient Relations; Psychology, Adolescent; Sex

Thirty years ago the term gender was borrowed from philology for use in sexological psychology in a paper on hermaphroditism (Money, 1955). As originally defined, gender role consists of both introspective and the extraspective manifestations of the concept. In general usage, the introspective manifestations soon became separately known as gender identity. The acronym, G-I/R, being singular, restores the unity of the concept. Without this unity, gender role has become a socially transmitted acquisition, divorced from the biology of sex and the brain. Sex and gender have been partitioned between body and mind, respectively. The desexualization of gender is in accord with the Zeitgeist of contemporary sexual politics together with victimology and an expanding criminalization of sex. The funding of sexological research is being diverted to victimology, which is, de facto, a branch of law enforcement. Victimologists--and sexological professionals among them--are vulnerable to a backlash of being themselves criminalized. This happens as a result of false accusations of various types of malpractice, including sexual abuse of clients, especially children. Under Hitler, there was an historical parallel when the destruction of sexology was effected by the application of the theory of social eugenics and racial purity with sexologists had endorsed. They were among the first of Hitler's victims.

Topics: Adult; Child; Criminology; Critical Period, Psychological; Disorders of Sex Development; Female; Gender Identity; Humans; Identification, Psychological; Male; Sex

A person's sexual status is conventionally defined on the criterion of the external sex organs, and this criterion is presumed to be concordant with the other criteria of sex. When the sex organs are deformed, as in hermaphroditism, or mutilated, their sex role is to some extent affected, whereas all the other manifestations of the person's masculinity or femininity may be intact. Gender, not sex, is the umbrella term which refers to the totality of masculinity/femininity, genital sex included. Gender role and gender identity are two sides of the same coin, gender-identity/role (G-I/R). G-I/R may differentiate to be discordant with one or more of the basic sex variables which are now listed in the definition of sex in Dorland's Medical Dictionary. G-I/R is the product not of either nature or nurture acting alone, but of both in interaction at crucial periods of developmental differentiation. The new paradigm is nature/crucial-period/nurture, not nature/nurture. Social scientists and sexologists are among those who, for the most part, have not made the paradigm shift.

Topics: Animals; Disorders of Sex Development; Environment; Female; Gender Identity; Genitalia; Humans; Identification, Psychological; Macaca mulatta; Male; Politics; Sex; Sex Differentiation; Sexual Dysfunctions, Psychological; Terminology as Topic

Lacking an empirically based theory of erotosexual development and health in childhood, pediatrics too easily falls back on reductionistic hypotheses of the nature versus nurture type. A new, three-term paradigm, namely, nature/critical-period/nurture, is needed to explain, for example, the phenomenology of hermaphroditism, and the differentiation of gender-identity/role (G-I/R) in individual cases. In 30 young women with a history of the early-treated, 46,XX congenital virilizing adrenal hyperplasia (CVAH) syndrome, 37% (N = 11) had a history of bisexual imagery or practice, as compared with 7% in the control patients (chi 2 = 17.7; p less than .001); and 5 of these 11 rated themselves as exclusively or predominantly lesbian. In Kinsey's sample, 15% of females reported homoerotic imagery by age 20, and 2 out of 3 of them also had homoerotic partner contact. The CVAH finding may be a function of prenatal and/or neonatal brain androgenization, but other variables, such as the history of juvenile erotosexual rehearsal play, cannot be ruled out. Among adolescents with a history of hermaphroditism, sex-reassignment applications are honored predominantly if they are made by 46,XY hermaphrodites assigned neonatally as girls and with nonfeminizing hormonal puberty, as medical and folk traditions both favor approval of such applicants more than others. Parthenogenic whiptail lizards that alternately simulate the male and female mating behavior of related diecious species provide an animal model that demonstrates the existence of both male and female sexual schemas in the same brain. In human beings, the irreducible sex differences are that males impregnate, and females menstruate, gestate, and lactate. Otherwise, sexual dimorphism that is programmed into the brain under the influence of prenatal hormones appears to be not sex-irreducible, but sex-shared and threshold-dimorphic. A complete theory of the differentiation of all the constituents of masculinity or femininity of G-I/R needs to be both multivariate and sequential in type. It must be applicable to all of the syndromes of hermaphroditism, and to the genesis of all the G-I/R phenomena, including transvestism and transsexualism, as well as to the genesis of a heterosexual G-I/R.

Topics: Adrenal Hyperplasia, Congenital; Animals; Brain; Disorders of Sex Development; Female; Gender Identity; Gonadal Steroid Hormones; Gonads; Homosexuality; Humans; Imagination; Lizards; Pediatrics; Play and Playthings; Sex; Sex Differentiation; Sexual Behavior; Virilism

Topics: Animals; Biological Evolution; Disorders of Sex Development; Environment; Female; Genetics, Population; Male; Plants; Reproduction; Sex; Sex Ratio

Topics: Animals; Biological Evolution; Disorders of Sex Development; Extrachromosomal Inheritance; Female; Genes; Male; Meiosis; Models, Genetic; Plants; Selection, Genetic; Sex; Sex Determination Analysis; Sex Ratio

Topics: Animals; Disorders of Sex Development; Female; Fertilization; Gene Frequency; Genes, Recessive; Inbreeding; Male; Meiosis; Models, Genetic; Mutation; Reproduction; Reproduction, Asexual; Sex

Topics: Animals; Caenorhabditis; Disorders of Sex Development; Female; Fertilization; Genes, Recessive; Gonads; Male; Models, Biological; Mutation; Phenotype; Sex; Sex Determination Analysis; Spermatogenesis; Temperature; X Chromosome

Topics: Disorders of Sex Development; Female; Humans; Male; Sex; Sexual Behavior; Sexual Dysfunction, Physiological

Topics: Disorders of Sex Development; Female; Humans; Jurisprudence; Male; Sex; United Kingdom

Topics: Adolescent; Adrenal Hyperplasia, Congenital; Adrenocortical Hyperfunction; Adult; Child; Child, Preschool; Disorders of Sex Development; Female; Humans; Male; Role; Sex; Sex Characteristics; Sex Determination Analysis; Socialization; Turner Syndrome; USSR

Topics: Disorders of Sex Development; Female; Genitalia; Humans; Infant, Newborn; Male; Parent-Child Relations; Prognosis; Psychology; Sex; Social Adjustment

Topics: Child Behavior; Disorders of Sex Development; Follow-Up Studies; Humans; Identification, Psychological; Infant; Male; Mental Health; Penis; Psychology; Role; Sex

Topics: Disorders of Sex Development; Environment; Female; Gonadal Steroid Hormones; Gonads; Homosexuality; Humans; Karyotyping; Male; Sex; Sex Characteristics; Sex Chromosomes; Sexual Behavior; Transsexualism; Turner Syndrome

Topics: Adolescent; Adult; Disorders of Sex Development; Female; Humans; MMPI; Role; Schizoid Personality Disorder; Sex

Topics: Animals; Cell Differentiation; Denervation; Disorders of Sex Development; Female; Gonads; Male; Oligochaeta; Ovum; Sex; Testis; Transplantation, Homologous

Topics: Adolescent; Adult; Animals; Child; Child, Preschool; Disorders of Sex Development; Female; Genetic Code; Genetics; Genetics, Medical; Haplorhini; Humans; Infant; Infant, Newborn; Male; Psychosexual Development; Self Concept; Sex; Sex Characteristics; Sexual Behavior

Topics: Adult; Behavior Therapy; Child; Contraception; Curriculum; Disorders of Sex Development; Erotica; Female; Humans; Male; Physician-Patient Relations; Psychosexual Development; Psychotherapy; Sex; Sex Education; Sexual Behavior; Sexual Dysfunction, Physiological

Topics: Adolescent; Adult; Child; Child, Preschool; Disorders of Sex Development; Female; Genetics; Genetics, Medical; Humans; Identification, Psychological; Infant; Infant, Newborn; Male; Psychosexual Development; Self Concept; Sex; Sex Chromosome Aberrations; Sexual Behavior

Topics: Abortion, Induced; Disorders of Sex Development; Family Planning Services; Female; Humans; Male; Morbidity; Pregnancy; Psychology; Sex; Sex Characteristics; Sex Chromosomes; Sex Education; Sex Factors; Sex Offenses

Topics: Adult; Anxiety, Castration; Conflict, Psychological; Disorders of Sex Development; Female; Homosexuality; Humans; Identification, Psychological; Male; Neurotic Disorders; Psychosexual Development; Schizophrenia; Sex; Transsexualism; Transvestism; Unconscious, Psychology

Topics: Adrenal Hyperplasia, Congenital; Black or African American; Child; Cortisone; Disorders of Sex Development; Environment; Female; Humans; Identification, Psychological; Mutism; Projective Techniques; Psychosexual Development; Sex; Sex Education; Speech Disorders

Topics: Adrenal Hyperplasia, Congenital; Adult; Attitude; Child Rearing; Disorders of Sex Development; Female; Humans; Identification, Psychological; Male; Mother-Child Relations; Self Concept; Sex

Topics: Adult; Child Rearing; Disorders of Sex Development; Dreams; Fantasy; Female; Humans; Identification, Psychological; Klinefelter Syndrome; Male; Sex; Sex Chromosomes; Testis

Topics: Biological Evolution; Clitoris; Coitus; Culture; Disorders of Sex Development; Female; Genitalia, Female; Humans; Male; Menstruation; Psychoanalytic Theory; Sex; Sexual Behavior; Sexual Dysfunction, Physiological; Sexual Dysfunctions, Psychological; Vagina; Women

Topics: Disorders of Sex Development; Humans; Sex; Surgical Procedures, Operative

Topics: Disorders of Sex Development; Humans; Sex

Topics: 46, XX Disorders of Sex Development; Disorders of Sex Development; Female; Humans; Sex

Topics: Disorders of Sex Development; Genetics; Heredity; Humans; Sex; Zoology

Topics: Disorders of Sex Development; Humans; Sex

Topics: Disorders of Sex Development; Humans; Sex

Topics: Animals; Disorders of Sex Development; Drosophila melanogaster; Sex

Topics: Adrenal Glands; Disorders of Sex Development; Gonads; Humans; Sex

Topics: Disorders of Sex Development; Humans; Sex

Topics: Animals; Daphnia; Disorders of Sex Development; Sex; Temperature

Topics: Disorders of Sex Development; Plants; Polyploidy; Sex; Triploidy

Topics: Disorders of Sex Development; Genitalia; Humans; Sex; Sex Determination Analysis

Topics: Disorders of Sex Development; Female; Humans; Hymenoptera; Sex

Topics: Animals; Disorders of Sex Development; Drosophila; Sex

Topics: Disorders of Sex Development; Humans; Sex