I read with interest the article by Diamond and Sigmundson1 regarding the long-term follow-up of an intrinsically normal XY individual raised as a female who switched at puberty to living as a male. This article makes me reconsider long-held beliefs and also has received extensive coverage in the lay press. However, I cannot concur with one statement in the authors' conclusions. They state that "... any 46-chromosome, XY individual born normal and with a normal nervous system, in keeping with the psychosexual bias thus prenatally imposed, should be raised as a male."1 This statement is somewhat misleading as I am convinced that the authors would not include phenotypical females with complete androgen insensitivity syndrome (CAIS) (testicular feminization).