Gender: In the Genes or in the Jeans?

A Case Study on Sexual Differentiation

Part VI—“Social Implications”

by
William J. Hoese, California State University Fullerton
Judith Gibber, Columbia University
Bonnie Wood, University of Maine Presque Isle

Section A

Terry looked like a normal 14-year-old with typically developed breasts. But she was worried. All of her friends had been having their periods for a couple of years while she hadn’t started to menstruate at all. Her mother told her it was nothing to worry about. She reassured Terry that it was probably because she was a dancer and that often physically active girls started menstruating at a later age.

Terry’s boyfriend David not only adored her beautiful hair and figure, but he was someone Terry could confide in about anything. She told him she was concerned about not having started to menstruate.

"Hey, you’re lucky!" My sister is a fright when she gets her period."

"Yeah, I’ve seen her!" Terry laughed. "But seriously, I’m getting a little worried. All my girlfriends have already started."

"Did you talk to your Mom about it?"

"She says not to worry. But I’m not sure that she really knows anything."

"Well, you could go to a doctor and find out. There’s that Dr. Hunter who came to talk to us in sex-ed, remember? She seemed really nice, and she said we could visit her if we had questions. She works at Planned Parenthood over on the east side of town. It’s right near the dance school you go to on Thursdays, so you could stop there after your class."

At her Thursday appointment, Dr. Hunter looked at Terry’s body, took a blood sample, performed a pelvic exam, and asked Terry to come back the following week to discuss the results.

"Oh," she called after Terry as she was leaving. "Is it okay if I call your pediatrician? It’s always helpful to speak with a doctor who is familiar with your medical history." "Sure," Terry answered. "It’s Dr. Jacobs. He’s known me since I was a baby."

The following week, the nurse brought Terry’s folder to Dr. Hunter. Knowing that Terry was in the waiting room, she looked at the notes she had written there and wondered how to break the news to her patient.

Physical appearance: Normal female. Vagina is unusually short. XY chromosomes. Abdominal surgery as infant. Testes found in abdominal cavity and removed. No Mullerian duct development. No Wolffian duct development. Estrogen supplements prescribed to initiate puberty by Dr. Jacobs.

Question

Look at your flowchart and suggest a way to explain how Terry could have the outward appearance of a female, but still have the lab results described above.

Go to Part VI, Section B—“Social Implications” (Continued)

Originally published at http://www.sciencecases.org/gender/gender6a.asp