General Medical Information

Cultural Aspects of Sexual Differentiation Disorders

Sarah E. Herbert

In western European culture, only two genders—male and female—have been recognized. There has been an implicit assumption that an individual had to have normal-looking and sexually functional genitals to be considered a member of that gender. These concepts have been particularly salient for males in western European culture. When male infants sustained traumatic injuries to their genitals or were born with a micropenis or ambiguous genitalia, such that they would never look “normal” and would not be able to perform urinary or genital functions in a typical way, recommendations were made to reassign them as girls. Girls born with an enlarged clitoris or otherwise masculinized genitals often in the past had early genital surgery to repair what had been considered defective genitals.

In cultures more patriarchal than our own, where significant advantages accrue to being male, parents or adolescents may still choose assignment to the male gender for boys who have ambiguous genitals or who may never function sexually in typical ways. In some more primitive cultures, intersex individuals have been given a label, possibly indicating a third sex or intersex identity. For example, in the Dominican Republic, the label guevodoces (“balls at 12”) or machihembra (“macho missy”) was given to boys who masculinized at puberty but initially were reared as females. Among the Sambia of Papua, New Guinea, a boy with the same disorder was called “turnim-man”.