The process of development of the fetus in the mother’s womb contains a whole network of chemical and organic reactions that make the evolution of the baby possible. But this development, which works like a perfect machine, is sometimes altered, causing all kinds of organic abnormalities.

This is the case of güevedoces, a curious phenomenon quite common in the Dominican Republic in which some girls, upon entering puberty, undergo a kind of natural sex change.

Who are the Güevedoces?

Güevedoces is an appellation given to a series of people originating from the Dominican Republic born with an imperceptible chromosomal alteration at the time of birth that causes the following phenomenon: babies born with the appearance of ambiguous genitalia, and who are usually assigned the female sex, who experience a process of masculinization upon reaching puberty.

These people actually possess male chromosomes (XY). However, during fetal development they grow by developing a genital ambiguity . At birth, they tend to be assigned to the female sex and when puberty arrives, at approximately 12 years of age, there is an increase in the penis and a decrease in the testicles.

Furthermore, if there is something that makes this phenomenon even more fascinating, it is that it occurs in an almost insignificant way all over the world, but nevertheless, in the province of Barahona, in the Dominican Republic, it appears in approximately 1 out of every 50 births in which the sex of the baby is determined to be female. Due to this enormous number of cases, if the incidence of this condition in the world population is taken into account, children born with these characteristics are called güevedoces.

A type of pseudo-intersexuality

This genital disorder, considered a type of male pseudointersexuality , was first described in the Dominican Republic in the 1970s by the American doctor and endocrinologist Julianne Imperato-McGinley. As a result of studies and research of people with these characteristics, it was determined that the güevedoces suffered from a deficit of the enzyme 5-alpha reductase.

Deficiency of this enzyme causes a physical disorder known as hereditary male pseudo-intersexuality. Adequate levels of this enzyme are essential for the conversion of testosterone into dihitestosterone . If this does not occur due to a lack of 5-alpha reductase, the masculinisation of the external genitalia cannot take place during foetal development.

In the specific case of güevedoces, the increase in testosterone levels during puberty generates a response in the body, causing the growth of the penis and the descent of the testicles.

How do they develop physically?

Usually, during the development of the first weeks of gestation the fetus does not possess any specifications regarding sexual organs , only the development of the nipples in both sexes occurs. Then, at approximately eight weeks of gestation, the sex hormones intervene again.

Birth and childhood

If the baby is genetically determined as male, the Y chromosome ensures that the gonads are transformed into testes by sending testosterone to the tuber, where it is converted into the hormone dihytestosterone. This hormone, as we have already mentioned, makes it possible to masculinize the sexual organs and convert the tuber into the penis.

In the case of having chromosomes corresponding to the female sex, the synthesis of dihydrosterone does not take place and the tuber then becomes a clitoris.

However, in people known as güevedoces, in whom this type of pseudointersex appears, the symptoms are limited to the appearance of the external genitals, which appear phenotypically as female . Sometimes before puberty, there is a small penis that may appear as a clitoris, a forked scrotum, and an open urogenital sinus in the perineum.

The testicles are usually located hidden in the inguinal canal or in the labio-scrotal folds, while the internal structures derived from the Wolf duct (epididymis, vas deferens and seminal vesicles) develop without any kind of abnormality.

Puberty

With the passage of time and the onset of puberty, as with all young people, the person experiences a large exposure to endogenous testosterone . That is, testosterone produced by our own body. This produces a masculinization of both the physical features of the person and the genitals in the case of güevedoces.

This masculinisation, in addition to the usual appearance of a deep voice, an increase in muscle mass, in people with a hereditary male pseudo-intersexuality of this type also causes the growth of the penis and the descent and increase in size of the testicles. In addition, no similar type of breast development to that of the female occurs.

In contrast, in most cases the typically male facial hair is barely visible and the size of the prostate is significantly smaller than average.

As a result of the case study, it has been determined that güevedoces experience erections normally, and can have sexual relations with complete penetration, but without the ability to inseminate due to the arrangement of the urethra.

The results of the Imperato-McGinley study

After years of study of the Güevedoces, Dr. Imperato-McGinley discovered that in most cases people express identification with their male sex and with a heterosexual orientation , despite having been raised as children, and decide to conserve the male genital changes.

However, at other times the person feels part of the female gender, so it is common for some of them to undergo a sex change operation that gives them female genitalia.

As a result, the doctor and her team concluded that when it comes to adopting a sexual and gender identity, the influence of hormones is stronger than the conditioning factors of education .

Regardless of one case or another, most of the time the appearance of male genitals has an impact on the person, who may experience a series of crises in his identity, as this causes a change in the person’s gender role.

Finally, despite the fact that this phenomenon is relatively common in this area of the Dominican Republic, the Güevedoces are often repudiated in society, being victims of a part of the population that does not accept them. This entails a risk of marginalization and social isolation.