Figure 8.

“Guevedoces” (literally, penis at 12) of Dominican Republic are biological males (46XY) with female-appearing external genitalia from birth until puberty; at puberty, they develop a penis, the testes descend, muscles and a male psychosexual orientation develop. Throughout life, the prostate remains small, because the congenital deficiency of 5α-reductase leaves affected individuals with markedly suppressed levels of dihydrotestosterone (DHT). DHT is the major androgenic stimulus for the prostate. Reprinted from Peterson RE et al.² with permission from Elsevier.