The Reason Why

I didn't get a quick definitive answer during my first visit to the Richmond doctor. Dr. Grise called surgery and a specialist in urology at the University of Kentucky Chandler Medical Center. Dr. Grise told me, "When you feel like it, come in and let's talk about it. But I'm going to have to send you to somebody else." I tried to ignore it.

Thinking I was both sexes was one reason I'd rebelled and quit going to church. How can a person survive being both sexes when there's just male and female and that's how God created them? How could that person ever have a life?

When I didn't come back, Dr. Grise thought he'd lost his patient. More that a year passed between my first visit to the Dr. and the first trip to Lexington, Kentucky to see Dr. J. William McRoberts.

I drank some and bills piled up. There was a feeling of disarray. I wanted a home, a life. The confusion was more painful than the fear of exposure. Finally, the will to do something won out.

I was still really in mystery, and was looking forward to seeing Dr. McRoberts. First they took a long history of my life. There were several exams by different doctors until McRoberts arrived. But this time, there was no lying on the back, legs spread and feet in stirrups. It was very embarrassing for me, and I think that's true with anyone, but I found hope. Dr. McRoberts diagnosed my problem right away. Tests followed, but they were only to make sure nothing had been missed. The cause of my lifelong confusion was a birth defect.

Linda Hammond was born male. He had male sex organs. But his development had been incomplete, and at birth he'd been confused with a female. The male hormones produced by male glands had given him normal male desires.

Dr. McRoberts explained the medical term was male pseudo (or false) hermaphrodite. The term has caused much confusion. It simply means that Linda was male, always male, but that his untreated appearance could be confused with someone who had the characteristics of both sexes.

Confusing sexual characteristics occur in perhaps one in every 1,000 births, Dr. McRoberts said. Some of the causes can be explained. For instance, a malfunctioning adrenal gland can cause a female to develop genitalia that look like those of a male. Other causes are not as well understood, and with the exception of the reproductive system, the patient is otherwise normal.

Most of the time, these problems are detected at birth. The problem is corrected, the baby goes home either a boy or a girl. Sometimes the birth defect is discovered later. As a surgeon specializing in urology, Dr. McRoberts had seen babies with confusing sex characteristics hundreds of times before, but rarely in anyone over the age of 8. Only once before had he seen it in a teenager. At 26, I was the oldest patient with such a problem whom Dr. McRoberts had ever seen.

The Confusion and the Courage

The confusion began before my birth. A developing embryo has the potential to be either male or female. Each embryo has wolffien ducts - a tube with the potential to form the male reproductive system - and mullerian ducts that can develop into the female reproductive system. The sex chromosome - contributed by the father - causes secretion of the hormones that determine whether the wolffian male duct or the mullerian ducts will predominate. An embryo becomes male because of the secretion of a hormone (testosterone) that develops the wolffian ducts and inhibits the mullerian. All the hormones and all of the events must be just right.

For me, the final stage was incomplete. I had all the normal male equipment, but my testicles remained inside my body and produced male hormones. My penis was covered by the folds of skin that normally join together to form the scrotal sac. The urethral opening to my bladder was malformed. But enough was right so the condition could be surgically corrected to give normal male sexual function.

But for those first few weeks after my visit to Dr. McRoberts, I didn't worry about the four operations to come. I was relieved that my confusion was over. I knew Id always been male.