The mechanism that normally governs the differentiation of the two sexes is not fully understood. It is accepted, however, that the sex of the individual is determined at the time of fertilization.1 The union of maternal and paternal cells is considered the determining factor in the development from the embryonic bisexual "anglage" into either ovaries or testicles under the guide of the endocrine system. If such normal development—for reasons entirely unknown to us—is disturbed during any time of the embryonic life, one encounters as the product of such faulty development the anatomic picture of the intersex.
It is not intended here to enter into a review of the voluminous literature, which since von Neugebauer's2 fundamental work in 1908 has increased steadily, but to refer briefly to a few communications pertinent to this study. A convenient review of the newer literature may be found in the recent publication by
RUBOVITS WH, SAPHIR W. INTERSEXUALITY. JAMA. 1938;110(22):1823–1826. doi:10.1001/jama.1938.02790220025009
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