• Question: is it true that a person can be a male and a female and why?

    Asked by to Anna, Elaine, Fiona, Kevin, Darren on 23 Jun 2014. This question was also asked by .
    • Photo: Kevin O'Dell

      Kevin O'Dell answered on 23 Jun 2014:


      It’s true that there are people that are part male and part female. The easiest way to think about how this could happen is think about how we end up being male or female.

      You’ll know that genetically-speaking females are XX and males are XY and there is a male determining gene on the Y-chromosome. There is no female determining gene.

      So all embryos start life developing as a female, then a few weeks after conception EITHER it continues female development OR because of the action of the male determining gene the embryo is converted into a male. (Some researchers think that because all male embryos sort of start life as a female, and are converted to males, explains why males have nipples).

      The step to becoming a male is complex but think of it in four stages:

      1, The ovary is converted into testis
      2, The testis make testosterone (the male hormone)
      3, Testosterone travels round the body
      4, Each cell in the body is converted to be male

      To make this work every cell (in a male or female) has to have a testosterone receptor so that cell can work out whether testosterone is there or not.

      So how could you be part male and part female?

      We all have a gene that codes for the testosterone receptor. Nearly all of us will have two functional copies of the gene (+/+). Let’s suppose at conception (at the one cell stage) one of two testosterone receptor genes is mutant (+/-). That is no problem because the other copy of the gene works OK and makes the receptor. Then let us suppose at the 8-cell stage there is a mistake in DNA replication and the functioning copy of the gene mutates. Then you have cells that make no receptor (-/-) and cells that do make the receptor (+/-). In other words the embryo is a mixture of cells that recognise testosterone (+/-) and cells that do not (-/-).

      In an XY embryo the resulting person will make testosterone which will be recognised by (+/-) cells which become male, but testosterone will not berecognised by (-/-) cells which will stay female.

      I hope that makes sense? There are other ways this could happen to.

      Remember that most of the events I’ve described here is very rare and therefore very unlikely, but as there are 7.5 billion people on the planet, rare genetic events will happen!

    • Photo: Elaine Cloutman-Green

      Elaine Cloutman-Green answered on 23 Jun 2014:


      We have clinics at the hospital especially for children who are born as both male and female (Hermaphrodites). They need a lot of support as having both sexual characteristics often comes as part of other conditions that are very complex.

      Although these aren’t my patients I’m aware that they get support to help them to decide whether they want to live as a man or a woman and when they are older to see if they want to have surgery to make them just male or just female.

      I have a friend who was born a hermaphrodite and she grew up as a boy but decided to have surgery and live as a woman when she went through puberty. She had a lot of counselling and it was difficult for her parents I think because they had brought her up as a boy.

      As Kevin said it is a very rare condition, which is why there are just a few specialist centres that provide this kind of support.

    • Photo: Anna Bramwell-Dicks

      Anna Bramwell-Dicks answered on 24 Jun 2014:


      As well as Hermaphrodites which Kevin and Elaine have discussed, there are also people that have something called gender dysmorphia.

      Science has shown us that small areas of the brain develop as male or female and for some people this does not match up with their physical gender. This means that someone with male genitalia may have a female brain and identify themselves as being female, and someone with female genitalia may identify as being male.

      We believe these brain differences are actually programmed before birth, so someone can feel like a boy even if they are physically a girl. Most people will find that their physical gender matches their feelings, but not all. These people, where the sex organs that have developed do not match their brain have gender dysmorphia.

      Some of these people choose to change their sex so that their brains and bodies align which involves taking hormones and some people will also have surgery. Others may just choose to keep their bodies the same, but live as the opposite sex by wearing different clothes and changing their names. If someone with gender dysmorphia has an intense need to live according to their opposite gender role (i.e. someone born male wants to live as a female) then it is referred to as transsexualism, or transgender.

      I know a few people that are transgender, both male-to-female and female-to-male, who have chosen to live in their opposite gender role. It is definitely a very difficult transition to make. But, it must be impossibly difficult to spend your life living in a brain that doesn’t align with your physical body.

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