Multiple gender or ambiguous genitalia is a rare condition inwhere the appearance of the genital organs of a newborn is not clear, whether it is female or male. Multiple sex is not a disease, but a developmental disorder of sexual organs that affects the sexual development of children.
Multiple sexes are not always immediately recognizable from prenatal care or immediately after the baby is born. To determine the sex of a baby with multiple sexes, doctors need further postpartum examinations.
Why Can Multiple Genders Occur?
This condition can be recognized through many terms, such as ambiguous genitalia, hermaphrodite, or intersex. In general, a baby is said to have multiple sexes if:
- Have ovaries and testes with external genitals that are not clear, whether male or female.
- Have ovaries and the shape of the external genitalia that resembles a penis.
- Have external female genitalia (including the vulva) and testes that do not descend into the scrotum (so the testicles do not contain testes).
Multiple sexes can occur if during pregnancy there is something that does not work normally to interfere with the development of the sex organs of the fetus, for example:
- Lack or insufficient male hormones in male fetuses.
- Excess male hormones in female fetuses.
- Mutations in certain genes.
- Chromosomal and genetic disorders, such as androgen insensitivity syndrome.
- Pregnant women take certain drugs.
- The presence of a tumor that affects the mother's hormones while pregnant.
Multiple Gender Signs
If the baby is genetically female, the signs of multiple sex that can be seen are:
- The clitoris is large enough to look like a small penis.
- The labia or the outer and inner vaginal lips may fuse together and look like the scrotum.
- Sometimes it feels like a lump of tissue within the labia fused together, making it look like a scrotum with a testicle.
- The urethral opening (where urine comes out or the urinary opening) can be along, above, or below the surface of the clitoris.
- Babies are often considered male, but the testicles do not descend.
If the baby is genetically male, multiple sexes can be seen from the following signs:
- The size of the penis is small (less than 2 or 3 cm) to look like an enlarged clitoris and with the urethral opening closer to the scrotum.
- The urethral opening can be along, above, or below the penis. It can also be located in the perineum (the area between the anus and the scrotum or vulva) to make the baby look like a girl.
- There may be a small scrotum that separates and looks like the labia.
- The testes do not descend and the scrotum is empty to look like labia, with or without a small penis.
Dual Sex Treatment
Multiple sex can affect psychological and social well-being. Not only for parents, but also for children when they grow up. Therefore, this condition needs to be handled very carefully and pay attention to various factors. However, this case is complex and rarely occurs, so it is necessary to form a special team of doctors to handle it.
Usually the team of doctors consists of several specialists, namely pediatricians, pediatric urologists, newborn care specialists, pediatric general surgeons, endocrine and glandular system specialists, geneticists, and psychologists.
Surgery is an option in dealing with multiple sex cases. This procedure may be followed by hormone therapy when they are teenagers. The point is to help them go through puberty. No less important, counseling needs to be done to maintain the psychological and emotional health of parents and children themselves.
Multiple sex treatment is carried out not only for the sake of the child's social welfare and psychological condition, but also for his or her physical health. Why? Because multiple sexes can cause infertility, impaired sexual function, increase the risk of cancer, and feel uncomfortable about gender identity.
Multiple sexes can indeed be treated with surgery. However, this should not be decided arbitrarily and without careful consideration, because this concerns the needs of children's lives from childhood to old age.