Q:

One day a 9-year-old girl surprisingly announces to her mother, “Guess what, mommy, I’m not a girl; I’m a boy.” The mother and seeks medical attention. What is the most likely cause?

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One day a 9-year-old girl surprisingly announces to her mother, “Guess what, mommy, I’m not a girl; I’m a boy.” The mother is shocked but does act on the comment. During the next few years, the mother notices some tomboyish behavior and diffi-culty in social adjustment at school. When the girl is 12 years old, puberty starts with a striking virilization of the external genitalia. The mother is extremely concerned and seeks medical attention. What is the most likely cause?


  1. Male pseudo-intersexuality
  2. Female pseudo-intersexuality
  3. Congenital adrenal hyperplasia
  4. Testicular feminization
  5. Illegal use of anabolic steroids

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A. Reduced levels of androgens during fetal development of an XY male fetus cause a femi-nization of the male external genitalia such that the baby can be phenotypically mistaken for female. Parents raise the XY male baby as a girl until puberty or other medical problems bring the child to medical attention.

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