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Hopkins research shows nature, not nurture, determines gender

Two Johns Hopkins Children's Center studies confirm that prenatal exposure to normal male hormones alone dictates male gender identity in normal XY male babies, even if they are born without a penis. The results seriously question the current practice of sex-reassigning some of these infants as females, performing castrations or other surgery to align them cosmetically and hormonally with a female role.

In what are believed to be the first studies of their kind, Hopkins researchers followed the development of 27 genetically male children -- with normal XY male chromosomes. All were born with cloacal exstrophy, a rare, major defect characterized by lack of a penis, but presence of normal testicles, indicating exposure to normal male hormone patterns before birth. Twenty-five of the children were reassigned by physicians at birth, castrated and raised as females. Presenting the findings at the Lawson Wilkins Pediatric Endocrine Society Meeting in Boston today, William G. Reiner, M.D., a child and adolescent psychiatrist and urologist at the Hopkins Children's Center, reported that the majority of these children, between the ages of 5 and 16, have subsequently "reassigned" themselves back to males. All 27 showed strong male behaviors, activities and attitudes.

"These studies suggest that male gender identity is directly related to normal male patterns of male hormone exposure in utero," says Reiner. "These children demonstrate that normal male gender identity can develop not only in the absence of the penis, but even after the removal of testicles or castration at birth, and unequivocal rearing as female. Rather than the environment forming these children's gender identity, their identity and gender role seem to have developed despite a total environment telling them they were female."

In the first study, Reiner and Director of Pediatric Urology at the Hopkins Children's Center John Gearhart, M.D., followed 14 children whose tes
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Contact: Wendy Mullins
wmullins@jhmi.edu
410-223-1741
Johns Hopkins Medical Institutions
12-May-2000


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