Hermaphroditism And Gender Ambiguity

True hermaphroditism is rare, but the term is commonly used to describe an abnormality called pseudohermaphroditism; those born pseudohermaphroditic may have the appearance of both sets of genitalia.

Hermaphroditism is actually descriptive of an exceedingly rare condition in which the subject has both testicular and ovarian internal organs with the apparent combination of normal sexual organs on the outside, but almost never occurs. Pseudohermaphroditism is, on the other hand, relatively common, and usually involves extreme enlargement of the clitoris, such that it resembles penile tissue, or an apparent rift in the scrotum resembling labial tissue. Such organs are called ambiguous genitalia, though the true sex of the subject can be determined by observation of the most functional organ or chromosomally. Those with pseudohermaphroditism are frequently identified as "intersex".

Cases of more considerably ambiguous genitals are often corrected surgically at birth, though this process has been brought into a more analytical light in recent years. Such 'corrective' surgery may at birth force upon a patient the role of a gender which is physically or psychologically unsuitable, and may cause more aesthetic damage to the genitals than already exists. Careful consideration should be given to any decisions regarding such procedures, and it may be best to put off such things until a later date, when the gender with which the child identifies is clearer.

Psuedohermaphroditism is not a medical concern, but one should be on the lookout for psychological and emotional trauma surrounding the gender identification of the affected individual, especially during and after adolescence. It is sometimes difficult for sexually distinct individuals to identify fully with their gender, and it is much more difficult for those faced with gender ambiguity to do the same. Even if a gender is 'chosen' for the child at birth, and even if it was likely the best choice, it is common that some identification trouble will appear later in life.


Moreover, surgery to reduce the size of a congenitally enlarged clitoris may do permanent damage to the sexual capacity of the child later in life, and may entirely compromise sexual function. Studies indicate, in fact, that despite apparently better and newer techniques, the results are roughly the same--more than one third of all patients who receive 'corrective' clitoral surgery at birth are entirely unable to achieve orgasm, and most of the remaining sustain significantly deteriorated sexual function. Virtually every study conducted has shown better sexual function as a result of non-intrusion than that which is achieved as a result of corrective surgery.

Counseling may be a better option, some experts suggest, as raising a child to be male or female arbitrarily may have persistent negative effects upon the psychology of the child, and those who undergo surgery seem to have had similar if not exacerbated problems late in life to those whose natural genitals remain intact. All signs point to the belief that minimal intervention is generally the best possible route, for the physical and emotional wellbeing of the child later in life. If nothing else, waiting until the child is grown to pursue options for cosmetic surgery can help to ease the pain of gender ambiguity, especially if more marginal genital ambiguity exists.

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