To the Editor.—We read with interest the discussion by Kaplan et al, "Inguinal Hernias in Females and the Testicular Feminization Syndrome" (Amer J Dis Child117:243-251 [Feb] 1969). Two aspects of this problem require, in our opinion, additional comment.
First, the existence of the two following clinically and genetically distinct forms of testicular feminization seems established1: (1) a "complete" form, in which pubescent individuals have well-developed breasts, scanty or absent pubic hair, and normal clitoris, and (2) an "incomplete" form, in which pubescent individuals have poorly developed breasts, abundant pubic hair, and an enlarged clitoris. The distinction is important because only in the "complete" form are affected individuals adequately feminized. The same form of testicular feminization is found in the various affected members of a given family, confirming the existence of genetically distinct forms.1 Second, the contention by Dr. Brennan (p 249) that interpreting buccal smears for