Hormonal sex reversal in a female.

The terms pseudo-hermaphroditism and hermaphroditism have been used in different senses by various authors and for this reason they were discarded by Wilkins (1950). He describes as 'intersexes' (hermaphrodites) those cases in which the sexual dimorphism is not due to a demonstrable endocrine abnormality, and as cases of 'sex reversal' those in which there is an endocrine abnormality. Hormonal sex reversal in the female due to congenital adrenal hyperplasia is not infrequent and is probably the commonest cause of heterosexual development (Wilkins, 1950). In most cases virilization does not start until after the external genitalia have practically completed their normal female differentiation and the anatomical abnormality is fairly uniform. Cases similar to that to be described, in which virilization appears to have started at an earlier stage of development, are most unusual and in fact only two are on record (Wilkins, quoting an unpublished case of Reilly, 1950; Schiller, 1940).