Although gender can usually be readily assigned through the external genitalia, it is important to recall that gender can be defined in several ways, both objective and subjective. The objective criteria include genetic/chromosomal gender, internal morphological gender (the uterus and prostate and their respective appendages), external morphological gender (penis, vagina, testes), hormonal gender (androgens and estrogens), and phenotypic gender based on secondary sexual features such as body shape, hair geography and breast development.
While even these seemingly objective criteria can be problematic, even more difficulty can arise for the parents, patient and physician when subjective criteria are used to identify gender. These can include arbitrarily assigned gender, usually by a physician; the gender of rearing; and, most complex, the gender of self-identity.
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