Hermaphrodites with obvious sexual characteristics. Hermaphroditism true and false

Hermaphroditism is a developmental defect of the reproductive system in which one person has characteristics of both sexes (both external and internal).

It is distributed in nature among invertebrates and representatives of the plant and fungal kingdoms (natural hermaphroditism).

Humans are characterized by abnormal hermaphroditism, which is a pathology of sexual determination at the hormonal and genetic levels.

Most often, hermaphroditism is a genetically determined pathology. With this disease, the presence of both female and male secondary sexual characteristics is noted.

There are several types of hermaphroditism, namely two:

• True hermaphroditism is characterized by the presence in one organism of the gonads of both sexes: both testes and ovaries. Or both glands merge into one single one. A cross-shaped form is often observed (testicle on one side, ovary on the other), the internal genital organs lag behind in development. However, due to the peculiarities of intrauterine development in humans, such a pathology is extremely rare in representatives of our species (approximately 150 cases have been recorded throughout history).
• When people talk about hermaphroditism, which occurs in people, they usually mean false hermaphroditism, which is characterized by the development of the gonads of one sex, and the external genitalia of the other.

False hermaphroditism is divided into male and female.

1. Male: the development of the testicles occurs, but with abnormal, impaired functions and an altered structure of the external genital organs, which resemble female ones: the penis is underdeveloped and/or has a curvature, the urethra is probably displaced from the head of the penis to other parts of the perineum, the testicles do not descend into the scrotum, they remain in the abdominal cavity, the formation of female mammary glands, the penis resembles a hypertrophied clitoris, and the scrotum resembles the labia. The physique of the body resembles that of a woman, the development of the larynx and the timbre of the voice are also similar to that of a woman.
2. Female: a person develops ovaries, but the external genitalia have common features with men: enlargement of the clitoris, proliferation of the labia and their development into an organ resembling a scrotum, absence of the labia minora, underdevelopment of the female mammary glands. The physique, development of the larynx, timbre of voice, hair growth resemble that of a man.

In both cases, the impossibility of sexual activity and infertility occur.

You can also highlight childhood hermaphroditism. Before puberty, a hermaphrodite child is almost no different from his peers, the only thing is that there are no testicles in the scrotum or the clitoris is enlarged.

Causes and treatment of hermaphroditism in humans

The main causes of hermaphroditism are changes in chromosomes and genes during pregnancy in the mother and/or fetus, that is, their mutation and hormonal imbalance in the body of the mother and/or fetus.

In the second case, the root cause is the predominance or deficiency of sex hormones (the external genitalia will correspond male type, if the male hormone - testosterone predominates, the female type, if testosterone is lacking). The reason for this is a disease of the pituitary gland and hypothalamus in the brain (the parts responsible for regulating hormones), as well as a disease of the adrenal glands or a tumor of the gonads.

Assessing the cause of the disorder, the doctor prescribes the correct intake of hormones for the thyroid gland, sex hormones through drugs, adrenal hormones, as well as drugs that affect the functions of specific parts of the brain (pituitary gland, if the problem comes from there).

Another way is surgical intervention: elimination of abnormalities of the genital organs, preferably at an early age, and if a hermaphrodite man has a small penis, then it is possible, before puberty, to remove it and the testicles, then it is possible to raise him as a woman. If not, then surgery is performed to enlarge and straighten the penis and remove undeveloped parts. It is also often required psychological help: Treatment of misperceptions of gender and sexual behavior.

But even more or less cured hermaphroditism has consequences: Impossibility of sexual activity, infertility, urination disorders, testicular tumors, as well as psychological problems of hermaphrodites: maladaptation to society, perverted sexual behavior (transvestism, bisexuality, homosexuality, transsexualism).

Testicular malformations primarily include congenital underdevelopment of one or both testicles. In the first case, this condition does not manifest itself in any way, in the second, eunuchoidism develops:

• underdevelopment of the penis and prostate,
• lack of libido and erection,
• inappropriate expression of the thyroid cartilage (Adam's apple),
• pale and thin skin,
• lack of facial hair,
• absence or insufficiency of pubic hair,
• thinness in some cases and a tendency towards obesity in others, etc.

Of those observed by Kagan S.A. Of the 640 patients, 9% had congenital genital defects. Of these, 1% have unilateral and 4% have bilateral. In all patients with unilateral cryptorchidism, the number of sperm in 1 ml of ejaculate was reduced; in case of bilateral cryptorchidism, they were absent (except for one patient), who had less than 5,000,000 sperm in 1 ml and all of them were immobile. In 4% of patients, their appendages were also found; the majority had no sperm or had grade III oligozoospermia.

There are three types of testicular abnormalities:

1. Position anomaly.
2. Quantity anomaly.
3. Gonadal dysgenesis, observed most often in individuals with a female gender.

In this article we will only touch upon false hermaphroditism, in which the patient can be considered a man.

False hermaphroditism

False hermaphroditism in medicine is divided into:

• false male hermaphroditism;
• false female hermaphroditism.

False male hermaphroditism

Sometimes the passport gender is male with false male hermaphroditism. It should be taken into account that this disease always develops in men with the absence of sex chromatin and with an XY karyotype. However, the testicles of such patients, even in the prenatal period, are defective, not producing embryonic hormones in sufficient quantities; in the vast majority of cases, there is no uterus or fallopian tubes, but there is a short, blind vagina. The testicles can be located in the labia, inguinal canals or abdominal cavity. In some cases, the external genitalia appear to be female. In others, more or less pronounced hypertrophy of the clitoris is observed, which in some patients is capable of erection and reaches an almost normal size of the male penis. Typically, it is in these patients that virilization begins during puberty. It is clear that the approach to such patients is determined by their gender. For females, the testicles and clitoris are removed, and vaginal plastic surgery is performed if it is not deep enough. If the registered gender is male, then plastic surgery is performed in order to bring the genitals closer to male ones. The question of how to deal with ectopic testicles in such patients is controversial. If we are talking about patients with female genitalia, then we need to take into account that degeneration of the testicles almost never occurs before the age of 20, but later it often occurs, and at the age of 30 years and older, malignant changes are noted in ⅕ of cases. Therefore, many authors consider the removal of such testicles after 20 years of age mandatory. In persons with a female gender, at the first signs of virilization (hair growth on the body and face, even greater enlargement of the clitoris, etc.), such testicles must be immediately removed; in persons with a male gender, their removal is not advisable.

The size of the testicles in such patients varies, and sometimes even of normal size, with a developed epididymis. Histologically, in all cases the testicles are deeply altered, spermatogenesis is completely absent, seminiferous tubules become empty and hyalinosis occurs, and hyperplastic Leydig cells are found.

The issue of establishing sex in patients with false male hermaphroditism becomes important. It is unacceptable to adhere to the outdated and incorrect view that the gonad is the most important characteristic of sex. The presence of a testicle is not enough to determine male gender. Such persons are subject to examination together with an endocrinologist. Decisive in determining sex is the condition of the external genitalia and the prognosis of their future development. Most of these patients are considered female at birth, despite clitoral hypertrophy. Only a minority of patients in this group can be considered men. In the case of severe hypogonadism, with a complete absence of the scrotum and severe underdevelopment of the penis, no hormonal therapy in the future will be effective, therefore it is believed that such children should be considered girls at birth, their penis should be removed, and vaginal plastic surgery should be performed at the age of 17-20.

False female hermaphroditism

Urologists sometimes have to consult patients with false female hermaphroditism, the most common form of which is congenital virilizing hyperplasia of the adrenal cortex. The disease is associated with a disruption in the production of cortisol by the adrenal cortex of the fetus, as a result of which the production of ACTH increases and adrenal hyperplasia occurs. This usually ensures sufficient cortisol secretion, but at the same time, androgens are produced in huge quantities. In boys, this is expressed in premature sexual development with underdevelopment of the testicles, and in girls it leads to virilization and sharp hypertrophy of the clitoris. It is especially important for the urologist that some patients have a penile urethra, and the absence of testicles and hypertrophy of the labia resembling a scrotum can lead to an incorrect diagnosis of cryptorchidism. Such sick girls have sexual chromatin, karyotype XX, in all cases - female internal genital organs, but there may be: a clitoris capable of erection, a penile urethra that opens in a female manner, or, which happens very often, the urogenital sinus is preserved, in which opens the vagina and urethra. A rectal examination reveals a mass - the uterus, which can easily be mistaken for the prostate. Since such patients resemble persons with false male hermaphroditism, it is required special study. With false male hermaphroditism, normal urinary excretion of 17-ketosteroids and the absence of sex chromatin are observed, while with congenital adrenal hyperplasia, there is sex chromatin, and the urinary excretion of 17-ketosteroids is sharply increased. The indication for surgery for false female hermaphroditism is determined by gender. If the gender is female, then resection of the clitoris is performed and, if necessary, the urogenital sinus is opened. If the passport gender is male and changing it according to psychological reasons is impossible, then you have to remove the uterus, tubes and ovaries and perform plastic surgery of the genitals in order to bring them closer to male ones.

Physiological characteristics of hermaphrodites.

It's not often we hear about hermaphrodites. Moreover, most of us imagine such individuals as quite strange with genitals like those of women and men. In reality, everything is different and more complicated. In this article we will try to figure out who hermaphrodites are.

Outwardly, these are the most ordinary people who get along well in society. The most interesting thing is that hermaphroditism can be impossible to determine before puberty. Many people think that hermaphrodites have male and female genitals, but this is not entirely true. Many hermaphrodites initially have female or male genitals, and only during puberty do abnormalities become apparent. A boy may grow breasts, but a girl will have no mammary glands and will not have periods.

Hermaphroditism is a genetic disease that develops when the fetus is in the womb and there are faults in the DNA. At the same time, the father and mother are completely healthy and have no genetic abnormalities. It is not fully understood why hermaphrodites are born.

The main reason is a genetic disorder that doctors and scientists cannot explain. At the same time, outwardly it can be a woman or a man, but inside everything is different.

Types of hermaphroditism:

• True. With this type, a person has both genital organs. That is, the ovaries and testicles are inside, and the vagina and penis are outside.
• False. It, in turn, is divided into female and male types. With the male type, a person develops a penis, which small size. When it is female, the breasts do not grow, the voice is rough.

The genitals look different depending on the type of hermaphroditism.

Key Features:

• In men, the penis is underdeveloped, curved, and small in size. The scrotum is dense and resembles the female labia. The testicles are often not descended into the sacs.
• In women, the clitoris is large and may look like a small penis. The labia resemble the scrotum; they are large and irregularly shaped.

Hermaphrodites go to the toilet in a normal way. It all depends on the type of hermaphroditism. Urination occurs like everyone else, through the urethra. It can be located in the penis or perineum.

There is a very beautiful legend according to which the son of Hermes and Aphrodite fell in love with a nymph. This woman lived in the water and also fell in love with the young man. Then the son of the gods came to his father and mother and asked them to join together. Since then, hermaphrodites have appeared. Although from a medical point of view the legend has nothing to do with it.

Does a hermaphrodite person have periods?

It all depends on the type of hermaphroditism. If this is a false type, then only sex hormones, female or male, are released. But due to the features internal structure, girls may not have periods. They can begin much later than is customary among healthy girls. Due to the presence of sexual characteristics of two sexes, the ovaries in girls are underdeveloped and may secrete insufficient amounts of hormones. Because of this, you may not have your period. Although there are cases when hermaphrodites have menstruation and reproductive function is preserved.

In most cases, hermaphrodites are infertile. This is possible due to underdevelopment of the testicles or ovaries. But there are cases of successful conception and birth of a child in hermaphrodites.

Can a hermaphrodite get pregnant on her own?

No, this is impossible. In fact, self-sex is not possible among hermaphrodites. In this case, due to the underdevelopment of the reproductive system, useless sperm is produced or the ovaries do not produce an egg.

No, It is Immpossible. Since a woman will look like a woman with false hermaphroditism. She doesn't have a penis. The genitals are strangely shaped and look strange too. In this case, sexual function may not be impaired. Such a woman will be able to become pregnant from a man with normal hormonal background. Another woman will not be able to have sexual intercourse with such a hermaphrodite due to the absence of a penis.

How do hermaphrodite people reproduce?

Hermaphrodites reproduce like all ordinary people. This is only possible with false hermaphroditism. With the true type, it will not be possible to become pregnant, conceive or give birth to a child. If there are sexual characteristics of both sexes, a man may not have impaired male function. Sex hormones can be produced in normal quantities. Therefore, it is practically possible to become pregnant from a false hermaphrodite.

It's not the same thing. Transvestites are ordinary people without genetic disorders. They just look different than they feel. Therefore, they resort to gender reassignment. Hermaphrodites are a kind of mutants that have characteristics of both men and women.

Hermaphrodites - famous people: photos

History has enough famous people hermaphrodites. The saddest thing is that during the Inquisition such individuals were burned and tortured. That is why many were forced to hide their identity as hermaphrodites.

Famous hermaphrodites in history:

• Margaret Malor. A woman under 21 considered herself to be the most ordinary. It was not until 1686 that the doctor who examined her for her illness discovered the abnormalities. The certificate stated that Magraret is more likely to be a man than a woman. That's why she was forbidden to call herself female name and do women's work. Outwardly, Margaret looked like a woman, with a fragile build and rounded shape. Due to her physical characteristics, she could not do heavy male work, so she was forced to beg. Only thanks to another doctor, who issued a certificate stating that Margaret was more likely to be a woman, gave her the right to be considered as such again.
• Genevieve de Beaumont. He was more of a man than a woman. He successfully played the role of both men and women. He was a courtier and often spied on kings.
• Joseph Mazo. Until the age of 12, he was raised as a girl, but then doctors stated that he was more likely a boy. Gender characteristics were more similar to those of women; parents mistook a small penis for an enlarged clitoris. After an autopsy, it was revealed that Joseph had a uterus and ovaries and was more likely to be a woman than a man.

Some of the hermaphrodites have had enormous success in deformity attractions, such as Diana/Edgar, Bobby Cork and Donald/Diana, who performed publicly as early as 1950.

Genevieve de Beaumont

Hermaphrodite athletes: photos

A sufficient number of hermaphrodites are also known among athletes. History speaks about this. In 1966 it was introduced on Olympic Games sex control, which required all participants to be checked for belonging to a specific gender. After all, there are known cases of hermaphroditism in women's sports. Moreover, a hermaphrodite is physically stronger than any woman.

Famous hermaphrodite athletes:

• Dora Rathjen - high jumper
• Zdenka Koubova - athlete
• Helen Stephens - athlete
• Stanislava Valasevich - athlete
• Rene Richards - tennis player
• Maria Patino - athlete

Dora Rathjen

Zdenka Koubova Renee Richards

The saddest thing is that many female athletes turn into men due to constant use of steroids and hormones. Their voices become rough and their hair grows.

As you can see, among the athletes a large number of Hermaphrodites, according to some sources, are one in 500 athletes. The presence of male hormones helps to win the Olympics.

VIDEO: Who are hermaphrodites?

– a congenital disorder of sexual differentiation, characterized by the presence in an individual of two types of gonads (ovary and testis) or gonads of a mixed structure (ovotestis). Clinical manifestations of true hermaphroditism can be different and depend on the predominance of the functional activity of the male or female gonad. Patients with true hermaphroditism may experience a disturbance in the structure of the external genitalia (small penis, hypospadias, cryptorchidism, clitoral hypertrophy), gynecomastia, bisexual body type; menstruation, ovulation and spermatogenesis are possible. The diagnosis of true hermaphroditism is established on the basis of examination of the genital organs, ultrasound of the gonads, examination of the level of sex hormones, determination of the karyotype and biopsy of the gonads. Therapeutic tactics are determined by the psychosexual orientation of patients and consist of removing the gonads of the opposite sex and conducting hormonal therapy.

General information

True hermaphroditism (intersexism, bisexual gonad syndrome) is a genetically determined disorder of sexual development, in which the gonads are represented by functioning elements of the ovaries and testicles. With true hermaphroditism, the ovaries and testes can be located separately or be combined into a mixed sex gland - ovotestis. True hermaphroditism is an extremely rare phenomenon; total in the world medical literature About 200 similar cases have been described. Much more common in gynecology and andrology is false hermaphroditism (male and female pseudohermaphroditism), characterized by the presence in an individual of the external genitalia of one sex and the gonads of the opposite sex.

Classification of true hermaphroditism

Among the cases of true hermaphroditism, there are variants when an individual has an ovary on one side and a testicle on the other; ovotestis is determined on both sides - a mixed gland with testicular and ovarian tissue; unilateral ovotestis occurs with the testicle or ovary on the other side. Sometimes, if ovotestis is present on one side, gonadal tissue is absent on the opposite side.

True hermaphroditism can be combined with abnormalities of the external genitalia or occur with normally formed external genitalia. Possible morphological forms of true hermaphroditism without anomalies of the external genitalia include:

• hermaphroditism with predominance of male secondary sexual characteristics
• hermaphroditism with predominance of female secondary sexual characteristics
• hermaphroditism with equally pronounced secondary sexual characteristics of both sexes
• hermaphroditism with the genitals of one sex and the gonad of the opposite sex, promoting manifestations of transsexualism.

True hermaphroditism with anomalies of the external genitalia occurs in the following variants:

• hermaphroditism with a full set of genitalia of one sex and the presence of one or more organs of the other sex
• hermaphroditism with an incomplete set of genitalia of both sexes
• hermaphroditism with a full set of male and female genitalia.

Causes of true hermaphroditism

The factors contributing to the occurrence of true hermaphroditism are not fully understood. Identification of family cases of the disorder indicates a possible hereditary cause of true hermaphroditism.

In approximately 60% of cases of true hermaphroditism in patients, the female karyotype 46.XX is determined, in 10% of cases the male karyotype 46.XY is determined, in the rest there are various types of chromosomal mosaicism (46XX/46XY, 46XX/47XXY, etc.). It is assumed that cases of true hermaphroditism may be associated with translocation, nondisjunction or mutation of chromosomes, as well as chimerism - double fertilization of the same egg, leading to the formation of bisexual gonads. The influence of extragonadal damaging factors that cause simultaneous differentiation of ovarian and testicular elements cannot be ruled out.

Symptoms of true hermaphroditism

Clinical manifestations of true hermaphroditism are extremely diverse and can be detected in various variants and combinations. At birth, 90% of children with true hermaphroditism have external genitalia of an intersex (mixed) structure, and only 10% have definitely male or female characteristics. Among the anomalies of the external genitalia in individuals with a male phenotype with true hermaphroditism, a small penis, cryptorchidism, and hypospadias are usually found; in individuals with a female phenotype - clitoral hypertrophy, urogenital sinus.

The testicle can be located in the scrotum, labioscrotal fold, inguinal canal, abdominal cavity; The seminiferous tubules are atrophied in most cases; in rare cases, there is preserved spermatogenesis. In the absence of gonads, the labioscrotal folds resemble the labia majora. Anomalies in the development of other organs are usually not characteristic of true hermaphroditism; sometimes the pathology is combined with an inguinal hernia.

On the side of the testicle, the epididymis and vas deferens are usually formed; on the opposite side, a unicornuate uterus and fallopian tube develop. The vagina may be well developed and open into the perineum, along the midline of the scrotum, or into the posterior urethra. As a rule, the ovaries are positioned correctly; ovulation occurs in 25% of patients with true hermaphroditism.

During puberty, signs of virilization or feminization may be observed; secondary sexual characteristics of both sexes are often present (bisexual body type, gynecomastia, low timbre of voice, male-type hair). Half of patients experience menstruation; in the male phenotype, monthly bleeding is manifested by cyclic hematuria. Patients with true hermaphroditism may have problems with gender identity and social adaptation; tendency towards bisexuality, homosexuality, transsexuality, transvestism.

Diagnosis of true hermaphroditism

In order to confirm or exclude the diagnosis of true hermaphroditism, patients should be consulted by an endocrinologist, urologist, gynecologist, or geneticist. During a physical examination, the development of the external genitalia and the severity of secondary sexual characteristics are assessed. Palpation of the scrotum area, vaginal or rectal examination, ultrasound of the pelvic organs and adrenal glands are performed.

True hermaphroditism must be differentiated from false hermaphroditism, gonadal dysgenesis (Klinefelter syndrome). For this purpose, determination of sex chromatin, karyotyping, study of hormone levels (testosterone, estrogens, FSH, 17-ketosteroids in daily urine), other tests and samples are carried out. A definitive diagnosis of true hermaphroditism can only be made after exploratory laparotomy, gonadal biopsy and histological confirmation of the presence of both ovarian and testicular tissue.

Treatment of true hermaphroditism

The issue of assigning a passport gender and the nature of gender education of persons with true hermaphroditism is complex; requires taking into account the karyotype, hormonal status, psychosexual orientation of the patient’s personality and is resolved with the involvement of medical specialists. In most cases, newborns with true hermaphroditism are classified as female and raised as girls, since the activity of the ovarian part of the gonad usually prevails over the testicular part.

Subsequently, taking into account the anatomical, psychological and functional aspects, surgical correction of true hermaphroditism is carried out, including gonadectomy and plastic surgery on the external genitalia. In persons with a passport female gender, all testicular tissue is removed or ovotestis, resection of the clitoris, and vaginal plastic surgery. The problem of excess hair growth is solved using hair removal methods. Subsequently, throughout the entire reproductive age, cyclic administration of estrogen-gestagen drugs is prescribed. When choosing a male passport gender, patients with true hermaphroditism undergo complete removal of ovarian tissue and female genital organs, correction of gynecomastia, formation of the scrotum, and plastic surgery of the penis. From puberty, androgen replacement (maintenance, stimulating) therapy is carried out.

Prognosis of true hermaphroditism

Normal psychosexual development and adaptation of patients with true hermaphroditism in society depends on the correct choice of sex, the correspondence of the phenotype of the chosen gender and self-identification. Typically, patients with true hermaphroditism are infertile, but isolated cases have been described in which individuals with a female and male phenotype, after removal of the ovotestis or gonads of the opposite sex, were able to acquire offspring.

Patients with true hermaphroditism, even after gonadectomy, should remain under close supervision of an endocrinologist to monitor the correctness of hormone therapy. In some cases, such patients need help

Hermaphroditism is a rather mysterious phenomenon and the exact reasons for its development are not clear to medical scientists even today. The existence of hermaphrodites has been known since ancient times. According to legend, the first of them was the bisexual son of Hermes and Aphrodite.

There are many known cases of this pathology in animals, but sometimes a similar phenomenon occurs in humans. Depending on which gonads predominate, have an advantage in their importance, certain female or male characteristics appear. This applies to:

• external genitalia;
• mammary glands;
• voice timbre;
• hairline.

The predominance of male or female gonads even affects the manner of behavior or gait, the level of psycho-emotional sensitivity, and character. The most common is true hermaphroditism, leading to infertility, disruption of psycho-emotional balance, and sometimes even to inappropriate and immoral human behavior.

Symptoms

Obvious signs of hermaphroditism are the discrepancy between the established sex of a person and its characteristics, more precisely:

• the presence of well-developed mammary glands in men;
• deformation of the penis;
• formation of the genital organs in a man according to the female type;
• the presence of male external genitalia in women;
• amenorrhea associated with the absence of the uterus and appendages;
• the presence of a full vagina and a significantly enlarged (to the size of the penis) clitoris;
• the presence of a so-called “blind” vagina and displacement of the urethra.

In some cases, the patient goes to a medical facility with a suspicion of an inguinal hernia, but during the examination it is discovered that the testicles are located in the depths of the enlarged labia.

According to scientists, this pathology is caused by a genetic failure and is the reason that a person has both male and female secondary sexual characteristics. Researchers distinguish two types of disease:

• true or natural hermaphroditism;
• false.

The emergence of both forms is caused by a process during which, even during the intrauterine development of the fetus, genes and chromosomes change, they mutate and a disruption in hormonal balance occurs in the body of the mother or fetus.

Hermaphroditism in humans, otherwise known as bisexuality, occurs in both men and women. And in both cases it can be true or false. Only a highly qualified doctor can make a final diagnosis and prescribe an adequate solution.

True bisexuality

Ambisexuality, bisexuality, or true hermaphroditism is quite rare. According to statistics, this is only 1 case per 10 thousand newborn babies. In this case, germ cells of both sexes will be detected in the body immediately after birth, and a visual examination will reveal the presence of sexual characteristics inherent to both sexes.

Bisexuality determines the presence of both male and female gonads in the patient’s blood. True hermaphroditism can be:

• Bilateral, when at the location of the gonads on both sides there is either an ovotestis, containing tissue cells of both gonads, or an ovary and a testicle. Moreover, the ovotestis, like the ovary, is located in the abdominal cavity, and the testicle is in the inguinal canal or descends into the scrotum.
• Unilageral - on one side there is an ovotestis, and on the other there is an ovary or testicle.
• Lateral is characterized by the absence of ovotestis, but there is an ovary on one side and a testicle on the opposite side.

The peculiarity of such gonads is that the ovaries can be full, and the testicles completely lack the process of producing sperm. and estrogens in these cases are produced normally, secondary sexual characteristics are mixed. Hermaphroditism in humans is a rather rare phenomenon, whereas in the nature around us it is characteristic of many living beings, fungi, and plants.

For example, for worms to reproduce, one individual is enough, in the body of which there are germ cells of both sexes. This pathology is so rare that during the entire period of observation and research, only two hundred similar cases were recorded. Much more common is another pathology associated with the presence of gonads of one sex and secondary sexual characteristics of the other. This is false hermaphroditism.

Pseudobisexuality in women

If true hermaphroditism presupposes the presence of a testicle and an ovary in the patient’s body at the same time, then false hermaphroditism is a condition in which the structure of the genitals and their appearance inherent in one or another sex does not correspond to the gender of the gonads. The cause of hermaphroditism in women can be intrauterine virilization of the fetus. Is it possible:

• if there is a tumor in the mother’s body that produces or stimulates the production of androgens (male sex hormones);
• the second reason is the woman’s regular use of medications that increase the level of androgen production;
• the third is congenital dysfunction of the adrenal cortex, which is responsible for the stable production of progesterone and other hormones.

This pathology can be inherited. If it is present, the formation of the gonads proceeds correctly and the ovaries do not differ and there are no developmental disorders. Secondary sexual characteristics have characteristics of both male and female. The severity of the changes depends on how high the degree of mutation is. This may be a slight enlargement of the clitoris, or it may have formed genitals appearance and sizes no different from men's.

Additional signs of pathology can be considered the presence of well-developed muscles, a rough voice, and increased secondary hair growth in the fairer sex. Often such women perceive themselves as a man, and others treat them the same way. Much more dangerous is the situation in which, even in the delivery room, immediately after birth, a child is assigned male gender in accordance with his external sexual characteristics, but only over time it turns out that his gonads are ovaries. Living for some time in ignorance, such a person voluntarily classifies himself as a passive homosexual.

False bisexuality in men

Male pseudohermaphroditism is a pathology in which a man has male gonads and female external genitalia. There are two forms of this pathology:

• hypospadias, which is characterized by abnormal development of the urethra;
• cryptorchidism, when abnormal development is characteristic of the male gonads (testicles).

If true hermaphroditism is extremely rare, and a case where a patient had full female and male genital organs at the same time has not been described at all, then false bisexuality occurs quite often in both women and men. Hermaphroditism presupposes infertility, but healthy women are carriers of the genome capable of passing it on. In men, the pathology manifests itself in the form of androgen insensitivity syndrome.

The tissues of the male body become insensitive to androgens (male sex hormones), and sensitivity to estrogens (female hormones), on the contrary, increases noticeably. Despite the fact that the patient looks like a woman, he has:

• the vagina is completely absent;
• despite the presence of female genital organs, there is no menstruation, since there is no uterus;
• the mammary glands are quite enlarged (developed according to the female type);
• Secondary hair growth is insignificant or completely absent.

home distinguishing feature – incorrect location testicles. They are not located in the scrotum, but in the inguinal canals. They can be found deep in the labia majora or in the abdominal cavity.

Feminization of the patient may be complete or incomplete. This depends on how high or low the level of sensitivity of the male body tissues to androgens is. In cases where a doctor diagnoses Reifenstein, the patient has genitals that are almost completely outwardly consistent with being normally developed, full-fledged and functional.

Types of false hermaphroditism

There are three types of false hermaphroditism in men:

• feminizing, in which the patient has a female body type;
• virile – typically masculine physique;
• eunuchoid - the mammary glands are undeveloped, but there is no secondary hair growth and the timbre of the voice is greatly changed.

Turning to specialists for the treatment of hermaphroditism is caused by discomfort and the patient’s desire to achieve a match between the inner world and the existing appearance. The possibility of surgical treatment is often determined by the patient’s gender, but in some situations (with minor defects of the external genitalia) correction is possible.

In any case, therapy is strictly individual, and according to the doctor’s decision, the patient may be prescribed hormonal drugs and drugs that stimulate the function of the pituitary gland. It is important to regularly attend psychotherapeutic classes and communicate with a psychologist. Diagnosis and treatment of this pathology should be carried out in early childhood, which places a huge responsibility on pediatricians.