Gender identity and gender transposition: longitudinal outcome study of 24 male hermaphrodites assigned as boys.

The longitudinal case histories of 24 male-assigned male hermaphrodites aged 18 or older were indexed and abstracted for the presence or absence of variables related to gender transposition, namely, bisexualism, homosexuality, or sex reassignment to live as a female. The sample was biased in favor of cases (N = 20) not showing signs of gender transposition. In these cases, there was no gender transposition even if the following variables were in evidence; neonatal ambivalence in announcing the sex; cosmetic inadequacy of masculine genital appearance; sitting posture for urination; and feminizing (N = 9) instead of virilizing (N = 11) puberty. Despite the small size of the minority subsample (N = 4), it showed a trend toward an association between gender transposition and sitting to urinate, and being stigmatized in childhood. This trend is consistent with the association between stigmatization and gender transposition found in a counterpart study of male hermaphrodites announced and reared as girls. Freedom from gender transposition did not prevent suicidal depression, drug or alcohol addiction, marital failure, or death from testicular cancer.