Intersex

Hermoprodites Earthworm Psedohermophrodite

male psedohermoprodite female psedohermophrodite

Sex of an individual to the individual and commuity judged by

secondary sex character &external genitalia
breasts

voice and
facial hair

Secaondary sexual characters

Community interests
Marriage Partake in women athletics

Normal sex of an individual

Chromosomal sex Gonadal sex Hormonal sex

External anatomical sex

Internal anatomical sex Sex rearing Gender role(social role)

Definition
Imperfect sexual differentiation Relative term Rudiments persists

Physiologic consideration

Every human fetus is destined to be a female

Feminity is neuter atate and musculanity is superimposed character

Chromosome sex drive

X-Y Interchange

classification
Deletion syndrome of Y lines 46XY 46xy true hemophrodite

46xx true hermophrodite

46xx

46XY
Gonadal dysgenesis(swyer syndrome) Empty pelvis: agonadia Enzyme dificiency

Affecting both adrenals and testes P-450 3 -HSD 17 -hydroxylase 2. Affecting testes 17 - hydroxylase 17 HSD 5 -reductase
1.

Androgen insensitivity syndrome Defect in AMH

46xx
46xx reversal male Congenital adrenal hyperplasia 1. 21-hydroxilase dficiency 2. 11 hydroxilase dificiency 3. 3 -01-dehydrogenase dificiency Aromatase deficiency

Maternal androgens

drugs,tumors Non sex chromosome defect (autosomal)

Errors in sex chromosome Division and Distribution

45xo,45yo,47xxx,47xxy

 Duplication Deletion Translocation

X-Y interchange

Isochromosome
Mosacism Chimerism -binovular twins Dispermy singleton preg

Sex chromosome pattern

12th day Lyonisation of X chromosome Trophoblasts Epithelial cells Leucocytes

Ovotestis
Chromosomal direction is confused

mosaicism chimerism

Streak gonads
Y-chromosome is defective Y- chromosome is absent

Turner syndrome
45xo Non-disjunction Absent of Y-chromosome

Other streak gonads

Physical malformations of tuner on XXp/XYp Protect against the streak gonad-XXq/Xyq Noonan syndrome - # pulmonary valve

Enuchoid build
46xx/45xo masaic

Triple X syndrome

Superfemale -misnomer

Klinefelter syndrome

YY syndrome

Autosomal intersex

Androgen insensitivity syndrome

Gonadal intersex

True hermaphroditism

Male hermaphroditism

Female hermaphroditism

Hormonal intersex
Leuteoma of pregnancy Androgen tumor Congenital adrenal hyperplasia

Mullerian duct normal Ambigious genitalia

Psychological sex

Mind trapped in wrong body Transvestism Transsexuality

Sex rearing

Investigation
Chromatin study 17-ketosteroids 17-OH progesterone

Adrenal stimulation test

FSH & LH level Ultrasonography Intravenous urography Laparoscopy

Treatment
Sex of rearing Easier to castrate and convert female Abnormal gonads should be removed

Supportive hormone therapy

Counselling for sexuality

Medical
Estrogen Progesterone Testosterone

Dexamethasone

 Testicular feminisation syndrome Male hermophroditism True hermophroditism

Turner syndrome
Hirsuitism