A recent advance in gynecology has been a better understanding of the problems of sexual development. True hermaphroditism is a condition in which one person possesses gonads containing microscopic elements resembling those of both the male and the female gonads. This condition is relatively rare. Twenty such cases with the diagnosis proved microscopically were collected by Young.1 Most "hermaphrodites" are pseudohermaphrodites, that is, persons having either male or female gonads in association with various malformations of the external genitalia.
The exact cause of such malformations is not entirely clear. According to Broster and Vines,2 also quoted by Hamblen,3 they are due to adrenal cortical hyperplasia or neoplasia during the fetal period. Adrenal cortical hyperplasia or neoplasia later in life also causes masculinization of the female, but with only moderate changes in the external genitalia (enlarged clitoris), hirsutism and male voice. Schiller4 expressed the belief that