The document discusses intersexuality and sexual differentiation. It defines key terms like sex, gender, sexual identity and discusses normal sexual differentiation in humans. Intersex is defined as discordance between chromosomal, gonadal, genital or phenotypic sex. Common types of intersex include virilization of genetic females, incomplete masculinization of genetic males, and true hermaphroditism. The document outlines evaluation, diagnosis, sex assignment and management of intersex conditions at birth and in adolescence.
3. Human sexual differentiation Chromosomal sex Gonadal sex External genital sex Internal genital sex SEX ASSIGNMENT Gender identity and role Sex of rearing
5. Gonadal development SRY-gene (TDF) Short arm of Y chromosome Bipotential Gonad 2 X chromosomes Receptors For H -Y antigen OVARY TESTES Present Absent
8. Leydig cells Sertoli cells Testosterone Mullerian inhibiting factor Wollfian duct 5a-reductase Urogenital sinus Regrsession of Muuleian ducts Male external genitalia Male internal Genital organs DHT TESTIS Male development
9. Urogenital sinus Female external genitalia . Lower part of vagina OVARY Mullerian ducts Female internal genital Organs . Most of upper vagina . Cervix and uterus . Fallopian tubes Neutral Development Absence of androgen exposure Female development
19. Swyer ’s syndrome 46, XY No SRY OR its receptors STREAK GONADS - NO MIF (Uterus +) - NO SEX STEROIDS Female Internal Genitalia Female external Genitalia
21. Leydig-cell agenesis 46-XY/SRY TESTIS MIF ( partial/ complete absence Of leydig-cells) No or testosterone No or DHT ± Male Internal Genitalia Female or ambiguous external Genitalia
35. A PROTOCOL FOR INVESTIGATION OF A NEWBORN WITH AMBIGUOUS GENITALIA Karyotype all Palpable gonad YES NO CAH Sreen Positive - US / MRI -? Genitogram Negative . Biochemical profile . US / MRI /? genitogram . ? Gonadal biopsy