However, sometimes sexual differentiation can be violated, and at birth it can be difficult to determine the child's belonging to the sex. Hermaphrodite, the structure of reproductive organs - what can be with a child?
Basic terms
For the description of an individual with signs of both a female and a male, the term "hermaphrodite" is used. In some species of animals, this is the norm. In a person such a pathology refers to violations of sexual differentiation.
Hermaphroditism
The word "hermaphrodite" comes from the name of God, the son of Hermes and Aphrodite, in ancient Greek mythology combined in one body with a female nymph. In medicine, this term is used to refer to certain types of intersexual states:
True hermaphroditism
Characterized by the development of the fetus at the same time male and female reproductive organs. This individual has both male and female gonads, and in some cases - combined sex gland (ovotestis), which has tissue elements of the ovaries and testes. True hermaphroditism is very rare. In the world medical literature only about 400 such cases are described. These patients showed significant variability in the structure of internal and external genital organs. Most neonatal hermaphrodites, however, had more pronounced signs of the male sex.
Pseudohermaphroditism
It is characterized by the presence of mixed external genital organs, while the sex glands are formed correctly by male or female type.
Pseudohermabauditism
Pseudohermaphroditism is a group of pathological conditions in which an individual has external signs of both sexes, and the sex glands are formed according to a male or female type. These people have either testicles or ovaries, and not both. Pseudohermaphroditism is a fairly rare disease, but it occurs much more often than true hermaphroditism. There are two main types of pseudohermaphroditism: male and female. With female hermaphroditism, the enlarged labia and clitoris resemble a scrotum and a penis.
Causes
The sexual duality of male pseudohermaphrodites can be due to several reasons, for example, the violation of the formation of testes in the period of embryonic development (gonadal dysgenesis), the insensitivity of the body tissues to testosterone, the deficiency of enzymes that ensure the reaction of tissues to testosterone.
Female pseudohermaphroditism
Female pseudohermaphrodites have a female chromosome set (46, XX), but their external genital organs are formed partially or completely in the male type. They can have a hypertrophic clitoris resembling a penis. The vaginal opening is often closed. Male-like appearance is usually caused by excessive production of male hormones by the adrenal glands during embryonic development.
Enzyme insufficiency
The cause of this unusual disease may be a violation of the production of enzymes by the adrenal glands, most often 21-hydroxylase. This enzyme is necessary for the production of two major hormones of the adrenal glands, cortisol and aldosterone. With the deficiency of 21-hydroxylase, these hormones are produced in insufficient quantities. On hormonal imbalance, the body reacts by increasing the production of adrenocorticotropic hormone, which in turn stimulates the function of the adrenal glands.
Male sex hormones
With an increase in the level of adrenocorticotropic hormone, the adrenal glands are activated, producing, among others, male sex hormones, androgens. Under their influence in the female body, male symptoms appear. Children with such abnormalities throughout life need substitution therapy with analogues of cortisol and aldosterone. However, it is impossible to fill the missing enzyme. If the child has sexual duality, it is necessary to decide whether he will be male or female. It is necessary to take into account the interests of the child. Sexual duality happens, it is obvious already at birth. Therefore, it is extremely important to take emergency measures. The undisciplined treatment of a hermaphrodite child can lead to serious problems for both himself and his parents. Appropriate treatment is usually appointed immediately after the appearance of the baby in the light.
A boy or a girl?
All mothers and fathers want to know what gender their newborn is. When there are doubts about this, a quick response should not be given. However, it is difficult for medical professionals not to answer the main question of parents - they are forced to say whether this is a boy or a girl.
Delay with the decision
The difficulty also lies in the fact that the decision on gender, taken immediately after birth, is subsequently very difficult to change. From the very beginning, parents and relatives treat boys and girls differently. This difference manifests itself immediately - for example, newborn boys are dressed in blue clothes, and girls - in pink. Moreover, the child's awareness of his sex is formed about a year and a half ago. Therefore, in some cases it is better to postpone sex announcement than to take a hasty and incorrect decision.
Psychological consequences
Doctors and patients should think about the future and take into account that the critical attitude of a person to his appearance - and especially to sex - can lead to serious psychological consequences.
Childhood
Children-hermaphrodites can realize that they are different from others when they start communicating with their peers in school. They can also notice parents' concerns about their sexual ambivalence.
The pubertal period
The pubertal period is an important stage of development for every person. Problems at this age associated with gender identity or appearance are generally known and can be very traumatic. At hermaphrodites, the pubertal period can go even harder. Some of them may delay puberty. Others may be disturbed by noticeable changes in the body, for example, hair growth on the face and an increase in the clitoris of a girl, the development of the mammary glands in a young man.
Sex determination
Before deciding on the choice of sex of hermaphrodite, the doctor should discuss in detail with the parents what is best for the child. The correct tactic of action with respect to the hermaphrodite child implies abstention from hasty statements about his sex.
The Council
For each patient a consultation is being held with the participation of pediatricians, as well as specialized specialists. Based on genetic studies and ultrasound results, the most acceptable sex for a child is determined. Ultrasound examination allows visualizing internal organs, such as the uterus or the testicles that have not reached the normal position. Parents often experience different emotions: shaking, helplessness, irritation or fear. This complex situation requires thorough discussion and interviews with parents.
Decision-making
Doctors sometimes need more than one day to decide which sex is most appropriate for the child. At the same time, given the concerns of parents, this should take as little time as possible. Before a final conclusion is reached, a birth certificate can not be issued. Before the final withdrawal, all interested persons (including friends and relatives) with respect to the child should refrain from using words denoting sex, for example "he" or "she".
Participation of parents
The final decision regarding the sex of the child is taken in conjunction with the parents. This takes into account the chromosome set, heredity, enzyme activity, as well as features of the anatomy and physiology of the organism. It can be difficult to convey this information to the consciousness of relatives. However, the task of specialists related to solving this problem is to present key points as clearly as possible, while simultaneously showing empathy and sympathy. The final decision should be the choice of sex, with which the child can safely live his whole life. Most experts recommend that a child be brought up as a girl. This is because the hermaphrodites of the female sex with the help of plastic surgery are easier to adjust the external signs of the male sex. As a rule, in the future, they successfully fit into the society as a woman. Quite another is a feminized boy, whose appearance is difficult to change enough to give him male characteristics. Therefore, it is preferable to raise such a child as a girl. In the future, he will look like an ordinary girl, and later as a woman (but she can not have children). According to the law, the female gender will be indicated on the birth certificate of the child. If such a decision is made, all testicular tissue is removed. Firstly, because testicles can be produced in the testicles, which can lead to the appearance of some masculine signs (for example, growth of hair on the face). Secondly, in the testicular tissue at a later age can be observed tumor changes. If the decision is made to raise a child-hermaphrodite as a boy and he has a very small penis (micropeniasis), it is necessary to begin treatment as early as possible. Thus, it can be achieved that, as he grows up, he will have a close-to-normal masculine appearance.
Looking forward
When making any decision, it is necessary to think about the future, assuming which way of life the child will lead in the future and how he adapts in society.