Cloacal exstrophy

Study finds that boys raised as girls still considered themselves male

By SETH HETTENA

Associated Press Writer

Saturday, May 13, 2000

Baltimore -- A study of male children who were born without penises and raised as girls found that most of them considered themselves boys when they got older -- suggesting that gender identity is determined in the womb.

The results call into question the practice of surgically "reassigning" the sex of such infants, researchers at the Johns Hopkins Hospital said Friday.

Researchers tracked the development of 27 children who had been born without penises, a rare defect known as a cloacal exstrophy. The infants were otherwise male with normal testicles, male genes and hormones.

Twenty-five of the children were sex-reassigned -- doctors castrated them at birth and their parents raised them as girls.

But over the years, all of the children, now ages 5 to 16, exhibited the rough-and-tumble play of boys. Fourteen declared themselves to be boys, in one case as early as age 5, said William G. Reiner, a child and adolescent psychiatrist and urologist at the Hopkins Children's Center.

"These studies indicate that with time and age, children may well know what their gender is, regardless of any and all information and child-rearing to the contrary," he said. "They seem to be quite capable of telling us who they are."

The two children who were not reassigned and were raised as boys fit in well with their normal male peers and were better adjusted psychologically than the reassigned children, Reiner said.

The findings were presented Friday at the Lawson Wilkins Pediatric Endocrine Society Meeting in Boston.

The results contradicted a Canadian study published in 1998 that suggested gender identity develops after birth. In that study, researchers found that a boy who was raised as a girl after his penis was mutilated during circumcision continued to live as a woman.

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