Gender identity and gender transposition: longitudinal outcome study of 32 male hermaphrodites assigned as girls.

The longitudinal case histories of 32 female-assigned male hermaphrodites aged 18 or older were indexed and abstracted for evidence of variables related to gender transposition, i.e., bisexualism, lesbianism, or sex reassignment to live as male. The prevalence of transposition was biased because of the referral of cases selected for reassignment. Childhood stigmatization, either subtle or blatant, because of the birth defect of the sex organs correlated with gender transposition (p less than .001) and was related to the age of feminizing surgery (p less than .05), which often coincided with the age of gonadectomy. Variables not significantly correlated with gender transposition were: neonatal ambivalence regarding the sex of announcement; feminizing or masculinizing puberty; presence or absence of mullerian organs; and gross family pathology. Physicians encountered no moral problem with sex reassignment as the chromosomal and gonadal sex were male.