1412 



HORMONAL REGULATION OF BEHAVIOR 



doxical appearance of their external geni- 

 talia. 



In our series of hermaphrodites there were 

 25 with a marked degree of contradiction 

 between their external genital appearance 

 and their assigned sex and rearing (Table 

 23.6) . Of the 16 older patients, all had lived 

 at least to teen-age (in one case as long as 

 47 years!) with ambiguous or contradictory 

 genital appearance. Of the 9 under 12 years 

 of age all had lived for at least 8 years of 

 their life surgically uncorrected. All but 2 

 of the 25 individuals had been able to come 

 to terms with his or her anomalous appear- 

 ance and had established a gender role 

 wholly consistent with assigned sex and 

 rearing. The exceptions, one a young adult, 

 the other a middle-aged man, had profound 

 psychologic problems, some of which were 

 clearly concerned with an ambivalent gen- 

 der identification. It is of interest that both 



of these patients had had a reassignment of 

 sex, the one by medical decision at the age 

 of 5 from female to male; the other, at the 

 age of 16, of his own initiative changed to 

 live as a male. 



Lest the foregoing be misunderstood, the 

 table documents the possibility of a per- 

 son's establishing a gender role consistent 

 with the sex of assignment and rearing de- 

 spite ambiguous looking or even contradic- 

 tory-looking genitals. The Table does not, 

 however, document the enormity of the 

 problem these people had to surmount in 

 coming to terms psychologically with their 

 paradoxical appearance. It has been our ex- 

 perience that more than anything else, the 

 visible anatomic genital or bodily contradic- 

 tions occasion the grestest psychologic dis- 

 tress. Although none of this group of pa- 

 tients had ever had a psychotic illness, 

 many displayed a moderate degree of psy- 



TABLE 23.G 

 External genital appearance and rearing contradictory: 25 cases 



Additional Data 



