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Correspondence
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Volume 350:2204-2206 May 20, 2004 Number 21
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Sex Determination, Differentiation, and Identity

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To the Editor: We applaud Reiner and Gearhart (Jan. 22 issue)1 for highlighting the difficulties of sex assignment but would like to emphasize how their study confirms the complexity of the development of sexual identity,2 not its biologic determination.

First, the data are subject to alternative explanations. Sexual identity is internal, and thus to assess it from parents' reports is problematic. Parents may have misinterpreted behavior as reflective of sexual identity. Prenatal androgens facilitate male-typical play, but masculine play is consistent with female identity.3,4 Second, the decision by 6 of 14 subjects to reassign themselves to the male sex may . . . [Full Text of this Article]



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