'They did not have a word': the parental quest to locate a 'true sex' for their intersex children

Given the paucity of research in this area, the primary aim of this study was to explore how parents of infants with unclear sex at birth made sense of 'intersex'. Qualitative methods were, used (semi-structured interviews, interpretative phenomenological analysis) with 10 parents to generate pertinent themes and provide ideas for further research. Our analysis highlights the fundamental shock engendered by the uncertain sex status of children, and documents parental struggles to negotiate a coherent sex identity for their children. Findings are discussed in light of the rigid two-sex system which pervades medicine and everyday life, and we argue that greater understanding of the complexity of sex and gender is required in order to facilitate better service provision and, ultimately, greater informed consent and parental participation regarding decisions about their children's status.

Simultaneous activity of male and female gonads in intersex hermit crabs

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Medicalizing gender: from intersex to DSD, from the laboratory to patient groups

The subject of this research, the medicalization of the gendered body, is a shifting object. It has changed its medical name from Intersex to DSD (Disorders -or Divergence- of Sex Development), since the beginning of this research project. Loosely speaking it addresses the gendered components of the body, and their subsequent consideration. Drawing closer, it addresses how modern medicine treats people who manifest variations of one of the gendered components of the body, inserting their bodies into pathological categories now called DSD. This shifting terrain of different modes of viewing the gendered body has grown to include many variations, no longer solely interested in the mythical hermaphrodite. The locus of this investigation is in the interaction between these patient groups and doctors in Italy.

Long-term estrogen exposure of whitefish Coregonus lavaretus induces intersex but not Lake Thun-typical gonad malformations

A high prevalence of gonad morphological variations has been observed in whitefish Coregonus lavaretus from Lake Thun (Switzerland). To clarify the role of endocrine disruption as a possible cause of the gonad alterations, whitefish were reared in a long-term laboratory experiment under exposure to 17 beta-estradiol (E2). Fish were fed from first-feeding until 3 yr of age at a daily rate of 0 (control), 0.5 or 50 microg E2 kg(-1) fish. E2 exposure resulted in a time- and concentration-dependent increase of prevalence and intensity of intersex gonads, i.e. gonads that macroscopically appeared as either testis or ovary but microscopically contained both male and female germ cells. Four types of intersex could be distinguished: Types 1 and 2 were composed of mainly male tissue, with Type 1 containing single oocytes and Type 2 displaying an ovary-like lamellar structure of the tissue. In Type 3, an increased percentage of the tissue was occupied by female germ cells, while in Type 4, the majority of the gonad tissue consisted of female germ cells. Chronic E2 exposure additionally resulted in a concentration-dependent shift of the sex ratio towards females, a reduced condition factor, retarded gonad growth together with delayed maturation of germ cells, and elevated levels of hepatic vitellogenin mRNA. However, Lake Thun-typical alterations of gonad morphology were not induced by chronic E2 exposure. The results provide evidence that estrogen-active compounds unlikely play a role in the etiology of gonad malformations in Lake Thun whitefish.

Intersex occurrence in rainbow trout (Oncorhynchus mykiss) male fry chronically exposed to ethynylestradiol.

This study aimed to investigate the male-to-female morphological and physiological transdifferentiation process in rainbow trout (Oncorhynchus mykiss) exposed to exogenous estrogens. The first objective was to elucidate whether trout develop intersex gonads under exposure to low levels of estrogen. To this end, the gonads of an all-male population of fry exposed chronically (from 60 to 136 days post fertilization--dpf) to several doses (from environmentally relevant 0.01 µg/L to supra-environmental levels: 0.1, 1 and 10 µg/L) of the potent synthetic estrogen ethynylestradiol (EE2) were examined histologically. The morphological evaluations were underpinned by the analysis of gonad steroid (testosterone, estradiol and 11-ketotestosterone) levels and of brain and gonad gene expression, including estrogen-responsive genes and genes involved in sex differentiation in (gonads: cyp19a1a, ER isoforms, vtg, dmrt1, sox9a2; sdY; cyp11b; brain: cyp19a1b, ER isoforms). Intersex gonads were observed from the first concentration used (0.01 µg EE2/L) and sexual inversion could be detected from 0.1 µg EE2/L. This was accompanied by a linear decrease in 11-KT levels, whereas no effect on E2 and T levels was observed. Q-PCR results from the gonads showed downregulation of testicular markers (dmrt1, sox9a2; sdY; cyp11b) with increasing EE2 exposure concentrations, and upregulation of the female vtg gene. No evidence was found for a direct involvement of aromatase in the sex conversion process. The results from this study provide evidence that gonads of male trout respond to estrogen exposure by intersex formation and, with increasing concentration, by morphological and physiological conversion to phenotypic ovaries. However, supra-environmental estrogen concentrations are needed to induce these changes.

Analysis of sexually dimorphic growth in captive reared cobia (Rachycentron canadum) and the occurrence of intersex individuals

The growth of three cohorts of captive reared cobia, grown in a combination of flow-though and recirculating aquaculture systems, was progressively measured to determine the existence and extent of sexually dimorphic growth in cobia. Approximately 100 fish from each cohort were individually identified and regularly weighed until the average weight of the fish was approximately 5 kg. The sex of individuals was determined through gonadal observations at the conclusion of each trial and the gender fitted retrospectively to the growth data set. Intersex gonads were observed in the first two cohorts of cobia, with 16.9% incidence in cohort 1 and 6.8% in cohort 2. Cobia is considered a gonochoristic species. This was the first reported observation of intersex gonads in cobia and the first reported occurrence of intersex gonads from a gonochoristic fish species from Australian waters. Only one fish out of the 182 examined in the third cohort was identified as intersex. There was no sexually dimorphic growth in cobia when there was a relatively high incidence of the intersex anomaly, as seen in the first two cohorts of fish. In the relative absence of the intersex condition, female cobia was significantly larger than males from 2 kg onwards. The weight of female cobia was almost 30% more than that of males at 17 months of age when average weight of the cohort was 4.6 kg. It is likely that the first two cobia cohorts were exposed to endocrine disruption in some form, and the possible sources are discussed. Statement of relevance This study demonstrated that female cobia grow significantly faster than male fish and that investigations into monosex culture could lead to significant productivity gains for cobia aquaculture. It also demonstrated that cohorts containing intersex fish did not exhibit sexually dimorphic growth. It is likely that the reproductive anomaly is the result of disruption to the endocrine system.

A NOVEL NON-LETHAL LAPAROSCOPIC APPROACH TO DETECT INTERSEX (TESTICULAR OOCYTES) IN LARGEMOUTH BASS (MICROPTERUS SALMOIDES) AND SMALLMOUTH BASS (MICROPTERUS DOLOMIEU)

The appearance of testicular oocytes (TO) in wild fish populations has received considerable attention in the scientific literature and public media. Current methods to quantify TO are lethal; instead, a non-lethal alternative was examined. Laparoscopic insertion into the genital pore allowed internal visualization of the gonad and detection of TO by collecting five testis biopsies in smallmouth bass Micropterus dolomieu and largemouth bass Micropterus salmoides. Overall, biopsies quantified similar levels of TO detection and severity to conventional transverse sectioning with less than 10% mortality. Suitability of surgical anesthetics, tricaine methanesulfonate and electronarcosis were examined in laboratory and field applications. Electronarcosis had the added benefit of rapid sex identification and immediate release of female fish with minimal trauma, representing significant benefits when sampling small or compromised populations. Laparoscopy may be useful for monitoring the prevalence and severity of TO in these fish species when lethal sampling is not a desired outcome.

Signal trait sexual dimorphism and mutual sexual selection in Drosophila serrata

The evolution of sexual dimorphism may occur when natural and sexual selection result in different optimum trait values for males and females. Perhaps the most prominent examples of sexual dimorphism occur in sexually selected traits, for which males usually display exaggerated trait levels, while females may show reduced expression of the trait. In some species, females also exhibit secondary sexual traits that may either be a consequence of a correlated response to sexual selection on males or direct sexual selection for female secondary sexual traits. In this experiment, we simultaneously measure the intersex genetic correlations and the relative strength of sexual selection on males and females for a set of cuticular hydrocarbons in Drosophila serrata. There was significant directional sexual selection on both male and female cuticular hydrocarbons: the strength of sexual selection did not differ among the sexes but males and females preferred different cuticular hydrocarbons. In contrast with many previous studies of sexual dimorphism, intersex genetic correlations were low. The evolution of sexual dimorphism in D. serrata appears to have been achieved by sex-limited expression of traits controlled by genes on the X chromosome and is likely to be in its final stages.

Shell utilization pattern of the hermit crab Clibanarius vittatus (Crustacea, Anomura) in an estuary at São Vicente, State of São Paulo, Brazil

We evaluated the gastropod shell utilization pattern of the hermit crab Clibanarius vittatus (Bosc, 1802) at Pescadores Beach in São Vicente, State of São Paulo, Brazil. Specimens were collected monthly from May 2001 through April 2003, in the intertidal zone at low tide. The crabs were weighed and their carapace shield length measured. All gastropod shells were identified and had their shell biometric parameters (total length and aperture length) measured (mm) and weighed (g). A total of 2,344 hermit crabs (644 males, 1,594 females, 45 ovigerous females and 61 individuals in intersex), using 13 species of gastropod shells, were collected. Stramonita haemastoma (Linnaeus, 1767), Cymatium parthenopeum (Von Salis, 1793) and Achatina fulica (Bowdich, 1822) comprised over 98% of all the shells. Male and intersex crabs were significantly larger than the females. This size difference strongly influenced the shell utilization pattern, principally in A. fulica, which has the largest shell size, that was only used by males and intersexual individuals of C. vittatus. Cymatium parthenopeum was the only shell species that showed a high determinant coefficient in all the biometric correlations evaluated. The high abundance of S. haemastoma shells and a strong correlation between crab size and shell aperture length established by a significant determination coefficient, indicated that C. vittatus uses this species as the principal resource for shell occupation at Pescadores Beach.

Am I my brain or my genitals? A nature-culture controversy in the hermaphrodite debate from the mid-1960s to the late 1990s.

The groundbreaking and prophetic rhetoric of neuroscience has recently highlighted the fetal brain as the most promising organ for understanding why transsexuals feel "trapped in the wrong body", and for predicting whether children born with "ambiguous" genitalia will grow up to feel like a man or a woman.This article proposes a recent history of the cerebralization of intersexuality and of transsexuality as atypical neurodevelopmental conditions. It examines the ways in which the organizational theory of brain sex differentiation developed in the late 1950s in behavioral neuroendocrinology has gained increased prominence in and through controversies over best practice issues in the case management of intersex newborns, and the etiology of transsexuality.It focuses on the American context and on the leading warrior in this battle: Milton Diamond, now a most prominent figure in professional debates about the clinical management of intersexuality, and the intersex person's best friend. Persons with an intersexed or transsexual condition consider, not their gonads, but their brains, their core sense of self, as the primary determinant of sex. (Diamond and Beh 2005, 6-7, note 1)

Hérnia inguinal na infância

A persistência do conduto peritoniovaginal (CPV) pode se manifestar como hérnia inguinal indireta, hidrocele comunicante, cisto do cordão ou pela combinação de duas ou até três destas formas. A hérnia é muito comum na infância, seu número vem crescendo com a sobrevida cada vez maior de prematuros de baixo peso, e deve ser operada sem demora devido ao risco de encarceramento. Já o cisto e a hidrocele só serão operados após uma certa espera pela sua cura espontânea. São resumidos o quadro clínico e o diagnóstico de cada uma das três formas de apresentação. A irredutibilidade, seja o simples encarceramento ou o estrangulamento, é analisada, lembrando aspectos característicos da criança, como por exemplo o risco que corre o testículo. A técnica operatória na criança é centralizada na ligadura do conduto peritoniovaginal. A conduta a tomar em situações especiais, como o encontro de uma Síndrome de Testículos Feminizantes é descrita, assim como as variantes técnicas a serem empregadas nos casos mais difíceis. Os casos em que a operação não pode ser limitada à simples ligadura do saco são lembrados. A conduta terapêutica na hérnia irredutível é descrita. O problema de explorar ou não a região inguinal oposta, dada a freqüência com que a persistência do CPV é bilateral, é analisado, mostrando os parâmetros que podem nortear a conduta em cada caso, inclusive o uso da videolaparoscopia. Finalmente, são revistas as complicações peculiares à cirurgia da hérnia na criança, lembrando que a recidiva é muito menos freqüente que no adulto.

Mermithid (nematoa: mermithidae) infections of black flies (Diptera: Simuliidae) : seasonal variation and developmental characteristics /

Mermithid nematodes (Nematoda: Mermithidae) parasitize larval, pupal and adult black flies (Diptera: Simuliidae), oftentimes resulting in partial or complete host feminization. This study was designed to characterize parasite-host seasonal variation and to estabUsh the developmental life stage at which feminization is initiated. Data indicate that the total adult population of black flies collected from Algonquin Provincial Park throughout the spring of 2004 was comprised of 31.8% female, 67.8% male and 0.4% intersex individuals. Of the total population, 0.6% was infected by mermithid nematodes (69.0% female, 3.5% male and 27.6% intersex). Seasonal infection trends established over a 12-month period revealed that black flies with different life histories host the same mermithid subfamilies, while black flies with similar life histories host mermithids from different subfamilies. If a simuliid species simultaneously hosts two mermithid species, these parasites are from different subfamilies. Molecular mermithid identification revealed two mermithid subfamilies, Me.somermithinae and Gastromermithinae, present in the simuliid hosts. Mermithid colour variation was not found to be a reliable species indicator. The developmental stage at which feminization is initiated was determined by examining gonad morphology and meiotic chromosomal condition. Results indicate that mermithid-infected black flies exhibit feminization prior to larval histoblast formation. Larvae can be morphologically male (testes present) or female (ovaries present), with morphological males exhibiting either male (achiasmate) or female (chiasmate) meiotic chromosomes; morphological females were only genetically female. Additionally, mermithid infection inhibits simuliid gonad development.

Intersexualidad y derecho: análisis del concepto género en las sentencias de asignación de sexo (Análisis de las sentencias: T-477 de 1.995, SU-337 de 1.999, T-551 de 1.999, T-692 de 1.999, T-1390 de 2.000, T-1025 de 2.002, T-1021 de 2.003 y T-912 de 2.008)

Esta monografía estudia 8 casos de menores de edad intersexuales que han sido fallados por la Corte Constitucional. A partir de las discertaciones jurídicas hechas por los magistrados se pueden encontrar interesantes elementos para el estudio del concepto género y la postura que frente al mismo ha tomado la Corte en su jurisprudencia.

Estratégia reprodutiva do peixe hermafrodita mussum, Synbranchus marmoratus Osteichthyes, Synbranchidae em um açude do Rio Grande do Norte, Brasil

Reproductive strategy of the hermaphrodite fish the marbled swamp eel, Synbranchus marmoratus (Bloch, 1795) (Osteichthyes: Synbranchidae) was investigated in the Marechal Dutra reservoir, Acari, Rio Grande do Norte, using fish samples captured monthly during the period of July 2010 to July 2011. The limnological parameters and rainfall were verified. The captured fish specimens were numbered, weighed, measured, dissected and their gonads and liver were removed, weighed and identified as to sex and developmental stages of gonads. The length-weight relationship was determined for grouped sex. The size of first gonadal maturation, gonadosomatic index (GSI), condition factor (K) and hepatosomatic index (HSI) were calculated. The development stages of the gonads were investigated using macroscopic and histological techniques, besides the fecundity and reproductive period. The macroscopic characteristics and the histological development of gonads confirmed the four different sexual types in the sampled population: primary males, females, intersex and secondary males. The secondary males were bigger and heavier than all the other types. This species showed a negative allometric growth with a higher increase in length than weight. The size at which 50% of the females began the process of gonadal maturation was 43.5 cm of total length, and for secondary males it was 58.5 cm. Condition factor showed two peaks in February and in April 2011. IGS indicated a reproductive period from July to September 2010 and was negatively correlated with the condition factor and rainfall. IGS showed a negative correlation when compared with the condition factor and the rainy season. HSI was highest in February ad lowest in December. The reproductive period of this species occurs between the end of the rainy season and the beginning of the dry season. S. marmoratus presents a seasonal reproductive strategy which optimizes its reproductive success under the semiarid climatic conditions