All Subjects Without Taboos

Hermaphrodite: the different anomalies

The three categories of sexual development abnormalities are:

Hermaphroditism true

True hermaphroditism refers to a very rare case of intersexuality: it represents about 5% of sexual ambiguities. The person has variable sex chromosomes (XX, XY), but is most often born with sexual ambiguity and the simultaneous presence of testicular and ovarian tissues, leading to the development of male (real erectile penis and prostate) and female (vagina) structures. and uterus).

This pathology remains poorly understood at present, however, different forms of true hermaphroditism exist, it depends on the importance of the action of the Y chromosome, responsible for masculinization.

Female pseudo-hermaphrodite

The female pseudo-hermaphrodite has ovaries and a female karyotype (46, XX) with ambiguous external genitalia. This represents about 60% of sexual ambiguities. It is due to early exposure to androgens (male hormones that can be secreted by the adrenal glands). Congenital adrenal hyperplasia is a genetic disorder that can cause these disorders. Other causes include the presence of an adrenal tumor in pregnant women, or exposure to inappropriate hormone therapy.

The external genitals are virilized in a variable way. The clitoris can have the shape of a penis with hypospadias, that is to say that the urinary orifice is on the underside of the penis, instead of being located at its end. Scholarships do not contain testicles. There is sometimes a vaginal obstruction. The internal genitals (vagina, uterus, ovaries and fallopian tubes) are normal. A future pregnancy is possible.

The masculine pseudo-hermaphrodite

The male pseudo-hermaphrodite has a male karyotype (46, XY), as well as testicles that are not necessarily in the purses. However, the genital tract and external genitalia are ambiguous. This represents about 35% of sexual ambiguities.
It is due to a deficiency of di-hydrotestosterone (DHT, male hormone derived from testosterone and regulating the male differentiation of the external genitalia).

It may be due to a testosterone deficiency. In this case, the androgen-dependent Wolff and Müller channels for their differentiation are also affected. The external genitalia will rather have a feminine aspect.

If the amount of testosterone is normal (only the dihydrotestosterone is disturbed), the external genitalia can evolve towards a male differentiation at puberty, under the effect of the pubertal production of testosterone. The subject can then be fertile.

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