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DSDs are medical conditions involving the way the reproductive system develops from infancy (and before birth) through young adulthood.
There are several types of DSDs and their effect on the external and internal reproductive organs varies greatly.
One of the more uncommon DSDs is 5-alpha-reductase deficiency (5ARD).
It is caused by a shortage early in life of an enzyme that activates testosterone.
In complete androgen insensitivity syndrome (CAIS) the result is a totally feminine appearance, including typical female breast development.
Open-minded parenting, appropriate and conservative medical intervention, and age-appropriate child involvement in the treatment plan contribute greatly to successful outcomes for the entire range of DSDs.
In the milder form, called partial androgen insensitivity syndrome (PAIS), the genitals can vary from mostly female to almost completely male.
Some people with PAIS think of themselves as women or girls, others regard themselves as men or boys, and some consider themselves nonbinary.
If 5ARD is diagnosed at a young age, the child is often raised as a boy (a 1996 Brazilian study suggested that the majority of adults with this condition consider themselves men but this has been questioned in some more recent research).
In addition to CAH, CAIS, PAIS, and 5ARD there are several rarer types of DSDs, and in some cases, it is not possible to make a clear diagnosis of the underlying condition.