At the births of thousands of babies each year in the United States, the obstetrician can’t pronounce, It’s a girl! Some have a vagina and female external organs but lack such internal organs as ovaries and fallopian tubes; instead, they have certain male internal organs, like seminal vesicles, as well as testes hidden up in the body.

Most of these walking mosaics of sex manage to survive this adversity: indeed, their stories are moving testimony to humans’ ability to cope with the injustice that can be dealt out by nature.

Only in the case of chromosome 23, the sex chromosome, do the two representatives differ, and even then only in men, whose twenty-third chromosomes are of unequal sizes: a larger X chromosome paired with a smaller Y chromosome. However, the Y chromosome contains genes specifying the development of testes.

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It is very rare indeed that you find among humans true hermaphrodites--individuals possessing both male and female gonads.

However, there are some unfortunate individuals called pseudohermaphrodites, whose sex presents an ambiguous appearance. Like Barbara, some appear to be born as girls but develop as boys at puberty.

Barbara grew up as an apparently normal girl enjoying a happy childhood.

As her teenage years approached, she looked forward to experiencing the same sexual development she saw in older girls.

How could the mechanisms that determine something so fundamental go so wrong?

Ultimately, of course, our gender is laid down by our genes, which are bundled together in each cell in 23 pairs of microscopic packages called chromosomes.Thus the natural tendency of our primordial gonad is to develop as an ovary if nothing intervenes; something special--a Y chromosome--is required to change it into a testis.It’s tempting to restate this simple fact in emotionally loaded terms.It establishes two radically contrasting possibilities and determines how we view ourselves and how other people view us.In almost all cultures it also establishes a division between contrasting economic and social roles.To find one’s gender ambiguous or shifting is as cruel a blow as could befall one’s ego.