Testicular tissue in TH was defined by the presence of seminiferous tubules with spermatogonia, and ovarian tissue was defined by the presence of numerous primordial and/or maturing follicles within the ovarian stroma.MGD was diagnosed in all patients who have varying degrees of structural and functional abnormalities of the gonads, which included cases showing differentiated testis with a contralateral streak gonad, bilateral streak testes, a streak testis with a streak gonad, a streak testis with a differentiated prepubertal testis, and bilateral dysgenetic testes.Some authors reserve the term mixed gonadal dysgenesis (MGD) for individuals who present a 45, X/46, XY karyotype with a testis on one side and a streak on the other side (1); other authors apply the term to all patients who have varying degrees of asymmetrical gonadal dysgenesis with testicular differentiation on either side, bilateral streak testis, or bilateral dysgenetic testis (2, 3); in contrast, true hermaphroditism (TH) is the rarest form of intersexuality in humans, and the term is applied to an individual who has both well-developed ovarian and testicular tissues.A differential diagnosis between the two conditions has important clinical implications for gender assignment; furthermore, early gonadectomy in MGD patients is needed to prevent the development of malignant germ cell tumors.
Furthermore, being born with genetic, psychological, or hormonal abnormalities is no more license for sexual sin than being born with violent tendencies is license for violence.
Chromosomal analysis had been performed in all 10 cases on peripheral lymphocytes using conventional techniques.
To check testicular function, a human chorionic gonadotropin (h CG) stimulation test, giving 1000 U/d for 3 days and measuring testosterone before and after stimulation, was performed in six patients (Cases 1–3, 6, 8, and 9).
Ten cases of TH (n = 4) and MGD (n = 6) at the age of ≤3 years were found in the surgical pathology files from January 1991 to December 2001 in the Department of Pathology at the Asan Medical Center in Seoul, Korea.
The pathology reports and clinical records, including age, reared sex, cytogenetic results, hormonal profiles, and operative findings, were reviewed for all 10 patients.