As we all know, gynecology wards are dominated by women; regardless of age, all patients admitted are women.
However, a special "male" patient was recently admitted to the gynecology ward...
The patient's basic information is as follows:
26 years old, married, never been pregnant.
I was born at full term via vaginal delivery, and there were no obvious abnormalities at birth. Her sexual characteristics are female external genitalia.
At age 13, the patient's secondary sexual characteristics began to develop, and his height and weight were within the normal range for his age. His vital signs were also normal.
Postgraduate degree, with a stable job.
I started having sexual activity at age 23, without any particular discomfort.
Ah, isn't this just a normal woman? Everything about her seems so "womanly"...
She's clearly a girl, so why is she being called a "man"?
I couldn't help but examine myself closely. Could it be... that I'm actually a man too?
However, this patient is unique in that she has never had menstruation since childhood, and ultrasound showed no uterus or ovaries in her pelvic cavity.
Well, speaking of ultrasound results, does a "woman" without a uterus and ovaries not count as a woman? Can she only be called a tomboy?
However, from a medical perspective, the key basis for determining gender is not physical secondary sexual characteristics, not sex organs and gonads, not personality or sexual orientation, but... chromosomes.
As we know from biology textbooks, every normal person has 22 pairs of autosomes plus 1 pair of sex chromosomes.
In other words, the key to determining whether a person is male or female lies in whether their sex chromosomes are XY or XX.
Returning to the patient who appeared female, chromosome analysis revealed that the patient's sex chromosomes were XY, meaning they were male.
Married? And still able to have sex? Shocking, isn't it? This must be the legendary "hermaphrodite"! (Background music should play at this point: Mayday's "Hermaphrodite")
What exactly is this disease?
This condition is caused by a gene mutation on the X chromosome, resulting in individuals with XY chromosomes developing into individuals who appear female but are actually infertile.
The external genitalia of patients can typically present as those of an immature female (the vulva resembles that of an underage girl, with no obvious pigmentation and sparse or no pubic hair), without a uterus, and the testes usually remain in the abdominal cavity without spermatogenesis.
This type of disease is called "androgen insensitivity syndrome (AIS)," which is a type of male pseudohermaphroditism.
It was also known as "testicular feminization syndrome".
This term originates from the fact that patients' vulvar tissue lacks 5α-reductase, preventing testosterone from being converted into dihydrotestosterone, or lacks receptors to express androgens, leading to vulvar feminization...
Too Long, Didn't Read Summary
The chromosome is male.
It has a vagina but no uterus.
It has testicles.
Since you have sexual intercourse, it means that there is no problem with the structure of your vagina.
However, because there is no uterus to connect to, the vagina is a blind end, meaning that the end that was originally connected to the uterus does not have an opening.
Based on whether patients exhibit masculinization symptoms, androgen insensitivity syndrome is classified into complete androgen insensitivity syndrome and incomplete androgen insensitivity syndrome.
The above patients are all of the complete type.
To prevent cryptorchidism from developing into cancer, the undescended testicle is usually surgically removed, followed by androgen replacement therapy based on postoperative symptoms.
The main purpose of the above patients' hospitalization was to remove undescended testicles via laparoscopy.
In fact, we need to pay more attention to the psychological and social problems of these patients, such as their gender identity, sexual orientation, and social perceptions.
I naturally believe that "the most important thing in life is to be happy," but I also understand that this pressure is not so easy to bear.
However, it is still hoped that both the patient and public opinion can treat this matter more objectively.
So what do you think?
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