Lakshmi Aishwarya, James Amritha, Annasamy Rameshkumar, Krishnan Rajkumar
Department of Oral Pathology and Microbiology, SRM Dental College, Chennai, Tamil Nadu, India.
J Oral Maxillofac Pathol. 2023 Oct-Dec;27(4):674-678. doi: 10.4103/jomfp.jomfp_342_23. Epub 2023 Dec 20.
Sex determination in forensic medicine is considered one of the first and foremost steps in personal identification. The need for identifying the exact sex of the individual arises when deciding whether a person can exercise certain civil rights reserved for one particular sex, for competing in sex-specific athletic and sports events, legitimacy, divorce, paternity disputes and also to some criminal offenses. Nuclear sexing by Barr body examination can be done using buccal smears to establish the sex of the individual when routine methods fail to disclose the exact gender of the individual.
To determine and compare the Barr bodies present in exfoliated buccal epithelial cells in males, females and transgender populations using light and fluorescence microscopy.
A total of 90 patients were recruited for the study. Group I consisted of 30 female patients. Group II consisted of 30 male patients and group III consisted of 30 transgender patients. The buccal mucosa was then scraped using a wooden spatula and the cells obtained were fixed in 95% ethanol. Two smears per individual were made and stained. One smear was stained with papanicolaou (PAP) stain and the other with Acridine orange and viewed under light microscopy and fluorescent microscopy, respectively.
When PAP stained slides were examined, the percentage of Barr-bodies in females ranged from 3% to 5% and in males it was 0% and in transgenders, it ranged from 0% to 5%. In Acridine orange stained smears, the percentage of Barr bodies in females ranged from 1% to 3% and in males it was 0% and in transgenders, it was 0%. Kruskal-Wallis test to study the relation of Barr body percentage in females, males and transgender subjects demonstrated significant differences between the groups ( < 0.001). Wilcoxon signed rank test was done for pairwise comparison, which showed that the distribution of percentage of positive cells in females are statistically significant from males and transgenders ( < 0. 001).
Nuclear sexing using Barr bodies offers a simple yet effective method for determining the sex of transgender patients which could help them in understanding their gender identity better and diagnose any underlying chromosomal aberration.
法医学中的性别鉴定被认为是个人身份识别中首要的步骤之一。在决定一个人是否能够行使某些特定性别的公民权利、参加特定性别的体育赛事、确定合法性、离婚、亲子关系纠纷以及某些刑事犯罪时，就需要确定个人的确切性别。当常规方法无法确定个人的准确性别时，可以通过巴氏小体检查进行核性别鉴定，使用口腔涂片来确定个人的性别。
使用光学显微镜和荧光显微镜来确定并比较男性、女性和跨性别群体脱落口腔上皮细胞中巴氏小体的情况。
共招募90名患者进行研究。第一组由30名女性患者组成。第二组由30名男性患者组成，第三组由30名跨性别患者组成。然后用木制刮勺刮取口腔黏膜，所获得的细胞用95%乙醇固定。为每个个体制作两张涂片并进行染色。一张涂片用巴氏（PAP）染色，另一张用吖啶橙染色，分别在光学显微镜和荧光显微镜下观察。
检查巴氏染色的玻片时，女性中巴氏小体的百分比范围为3%至5%，男性为0%，跨性别者为0%至5%。在吖啶橙染色的涂片中，女性中巴氏小体的百分比范围为1%至3%，男性为0%，跨性别者为0%。采用Kruskal-Wallis检验研究女性、男性和跨性别者中巴氏小体百分比的关系，结果显示各组之间存在显著差异（<0.001）。采用Wilcoxon符号秩检验进行两两比较，结果显示女性阳性细胞百分比的分布与男性和跨性别者相比具有统计学意义（<0.001）。
使用巴氏小体进行核性别鉴定为确定跨性别患者的性别提供了一种简单而有效的方法，这有助于他们更好地理解自己的性别认同，并诊断任何潜在的染色体异常。
