Choice of gender in 5α-reductase deficiency: A moving target

Christopher P. Houk, D. Damiani, Peter Lee

Research output: Contribution to journalArticlepeer-review

26 Scopus citations


Steroid 5α-reductase deficiency is a rare, male-limited autosomal recessive disorder caused by mutation in the SRD5A2 gene resulting in a deficiency of dihydrotestosterone (DHT) during fetal development. Here we report an affected 46,XY adolescent who was born with incompletely virilized genitalia and was raised in the female gender. At 12 years of age, the patient requested feminizing genital surgery. Surgery was withheld and psychiatric counseling was instituted. At 14 years of age, the patient's gender identity and role appeared to be in transition from a female to an increasingly male gender. This case demonstrates that in patients with disorders such as 5α-reductase deficiency, in which significant prenatal androgen exposures are combined with postnatal virilization, adult gender identity and gender role may be a dynamic process that is not complete until well after adolescence.

Original languageEnglish (US)
Pages (from-to)339-345
Number of pages7
JournalJournal of Pediatric Endocrinology and Metabolism
Issue number4
StatePublished - Apr 2005

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


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