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Pseudo-Hermaphroditism: A Multi-Faceted Pathosis

Muhammad Tahir M Bhinder, Amin Saleh Halum and Sandy Lee

Pseudo-hermaphroditism is a rare condition which has much mystique to it. It is generally due to a deficiency of the enzyme 5α-reductase, responsible for the secretion and conversion of testosterone to dihydrotestosterone, which, in turn, defines the external genitalia during embryonic development. As a result of this, individuals present with ambiguous external genitalia, and do not have a defined idea of what their true identity is. One such example is present in Las Salinas, in the south of the Dominican Republic, where there is a growing minority of pseudo-hermaphrodites (1 in every 50 births), known as "guevedoces" which literally translates into "penis at 12". These individuals undergo a spontaneous change from female to male at puberty, which means that they are often brought up as females, but then become males at puberty. However, the issue not only lies in the physical changes that these individuals go through, rather it is a multi-faceted one that has deeply embedded psychological and psycho-social implications as well.