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M. M. MELICOW, G. F. CAHILL, THE ROLE OF THE ADRENAL CORTEX IN SOMATOSEXUAL DISTURBANCES IN INFANTS AND CHILDREN: A CLINICO-PATHOLOGIC ANALYSIS, The Journal of Clinical Endocrinology & Metabolism, Volume 10, Issue 1, 1 January 1950, Pages 24–53, https://doi.org/10.1210/jcem-10-1-24
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Abstract
SIGNIFICANT deviations from the relatively normal somatosexual pattern are rare in spite of the pronounced complexity in the processes of differentiation of the embryo. When deviations occur, they usually cause consternation to the parents, perplexity to the physician, and tragedy to the victim. Aberrations from the normal somatosexual make-up may be present at birth, or develop during infancy, childhood or puberty. An erroneous conclusion as to the true sex often leads to irreversible psychosomatic fixation and trauma to the patient, the degree depending on the age when the true sex is finally discovered. Some heteroclites grow up as notorious medical “cases” others become circus curiosities; and still others carry their abnormality locked like a skeleton in their own somatosexual closet, fearful of exposure, embittered in their lot, antisocial and suicidal in their outlook.
The basic sex of an individual is apparently predetermined by the genes but definitive differentiation is not accomplished until about the sixth week of intrauterine life. Further elaboration and development, particularly of the secondary sexual apparatus, is postponed until puberty and is then undex the control of the individual's own endocrine system. True hermaphrodism is probably genotypical in origin and should be distinguished from psewdohermaphrodism which usually results from endocrine hyperfunction or dysfunction, maternal and/or fetal. The true hermaphrodite possesses adequate gonadal tissue or gonads of both sexes (ovario-testis, or ovary and testis); the pseudohermaphrodite is basically of one sex, but outwardly the sexual pattern resembles that of the opposite sex.
