In The News – Hermaphroditism (Intersex) – Being Born Both Male and Female

Last week, 18-year-old South African athlete Caster Semenya won a gold medal in the 800 meters race at the 2009 World Championships in Athletics. Now she may be forced to return the medal if she fails a gender-verification test imposed by the International Association of Athletics Federations (IAAF). the IAAF are testing to see whether Semenya has a rare genetic disorder that means she has female genitalia but male chromosomes. This disorder is called hermaphroditism.


Caster Semenya.

Danger level: Low

What is it?

Our gender is determined, among other things, by our internal and external sex organs (Such as a penis or vagina on the outside, and a uterus on the inside). In some people, this distinction doesn’t fully exist – they may have both female and male sex organs.

Who gets it?

The numbers change from one study to another, but it is believed that between 0.1% and 0.2% of the population may be born with this condition.

What causes it?

We have 23 pairs of chromosomes in our DNA. These are molecules which hold our genetic material and tell our body how to develop and who we are going to become.

One of these pairs are the sex chromosomes. They are different between males and females. In males this pair is composed of an X chromosome and a Y chromosome. Females, on the other hand, have two X chromosomes.

When we develop in the uterus, our internal organs have the potential to become both male and female. Only at weeks 9-13 of pregnancy do we start developing into either males or females.

We usually develop into females by default unless we have the Y chromosome. This happens since there are certain genes on the Y chromosome which tell our body to develop testicles. Once testicles develop, they secrete a substance called testosterone (among other things), which helps us further develop into males, including a penis.

If we lack the Y chromosome, that gene is absent. In this case, instead of testicles, ovaries develop. Since there are no testicles to secrete testosterone, a female develops, including a uterus, fallopian tubes and vagina.


Some children are born differently, forming a group of disorders in which the above doesn’t necessarily happen:

  • Female pseudohermaphroditism – In this case the sex chromosomes are XX and the female has ovaries, but also external male sex organs (penis).
  • Male pseudohermaphroditism – They have XY as sex chromosomes, but their external organs are not fully developed or they are completely female on the outside.
  • True hermaphroditism – While the above were “pseudohermaphroditism”, meaning they are mostly male or mostly female, in this case there are both testicles and ovaries. These people can appear anywhere from females with a large clitoris to those with male external organs.

We won’t go into details as to why this can happen, since it’s beyond the scope of this article. The reasons generally include problems with the development of testicles, problems with the creation of testosterone and other problems.

How is it discovered?

As you may understand, the condition is visible to the eye in most cases. The diagnosis contains checking the baby’s DNA to understand whether they are females or males by genetics and so understand what they were “supposed” to be.

Other measures include an ultrasound and other imaging techniques which will show which organs exist on the inside.

How is it treated?

Treating the condition involves surgical restoration and psychological support of the whole family. The direction the surgery will take (male or female) isn’t always an easy choice and can affect the child later on in life, as can be seen in this video from the show “without prejudice” (please note that we do not endorse the idea of a $25,000 prize given for people’s misfortunes, and the video is only given here as an example):

The bottom line – How do I avoid it?

There is currently no known way to prevent the condition.