The patient is 21 years old, born female but has a male genetic code (46.XY). Patients come for examination because they have never had menstruation and their external genitals are abnormal.
From a young age, the patient was raised as a girl, and when she reached maturity, she developed the sternum and mu won normally, but did not have periods. When examined, the doctor discovered that the external genitals had a small penis shape, a low urethra and no touches to the testicles in the scrotum.
Test results showed that the patient had a set of chrome cards XY - genetic gender is male, testosterone concentration is within the male physiological limit. The MRI scan determined that there were two testicles in the fallopian tube, without the uterus and ovaries. The patient was diagnosed with genital development disorder 46,XY - a rare genetic disorder with inconsistent gene, hormone and body type.
According to Dr. Nguyen Van Phuc, Department of Andrology - 108 Central Military Hospital, human gender is the synthesis of chromeostasis, hormones and genitals. In normal people, the SRY gene on chrome Y triggers testicular formation. As testicles develop, testosterone helps the body form male characteristics, while the hormone AMH prevents the growth of the uterus and ovaries.
If one of these stages is disrupted such as underdeveloped testicles or the body does not respond to testosterone the sex body may deviate from the genetic gender.
The patient underwent surgery to lower the testicles to the scrotum and perform a labor force to check the ability to fertilize. The results showed that testicular tissue was fibrotic, the Establishment tube was small, and there were no stem cells, meaning a complete loss of fertility. However, the doctor said that the surgery is still very meaningful: reducing the risk of hidden testicular cancer, clearly defining male gender, favorable for hormonal monitoring and long-term health. After surgery, the patient was advised to identify the male gender, and was also given psychological support to understand himself and integrate into society.
In addition, the patient will undergo additional urology surgery to correct the deformity of the small urethra - removing the urethra to a natural position at the tip of the penis. This surgery not only helps patients urinate normally but also ensures aesthetics and restores physiological function.
Doctors recommend that sexual dysfunction is a rare congenital disease but can be detected early through the following signs: unclear external genitals, no touching testicles in the scrotum, or a girl does not have menstrual bleeding when she is middle-aged. The diagnosis needs to be done at specialized facilities in Andrology - Endocrinology - Genetics to accurately determine the biological gender.
Dr. Phuc emphasized that treatment of gender-developed disorders is not simply a "fy physical repair", but a process of combining medicine, psychology and society. The goal is not to change gender, but to help patients live true to their true biological gender, have a good quality of life and be accepted by society.
