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The extraordinary case of the Guevedoces

Catherine and his cousin Carla, Guevedoces in the Dominican Republic

Catherine and his cousin Carla, Guevedoces in the Dominican Republic

The discovery of a small community in the Dominican Republic, where some males are born looking like girls and only grow penises at puberty, has led to the development of a blockbuster drug that has helped millions of people, writes Michael Mosley.

Johnny lives in a small town in the Dominican Republic where he, and others like him, are known as “Guevedoces”, which effectively translates as “penis at twelve”.

We came across Johnny when we were filming for a new BBC Two series Countdown to Life, which looks at how we develop in the womb and how those changes, normal and abnormal, impact us later in life.

Like the other Guevedoces, Johnny was brought up as a girl because he had no visible testes or penis and what appeared to be a vagina. It is only when he approached puberty that his penis grew and testicles descended.

Johnny, once known as Felicita, remembers going to school in a little red dress, though he says he was never happy doing girl things.

“I never liked to dress as a girl and when they bought me toys for girls I never bothered playing with them – when I saw a group of boys I would stop to play ball with them.”

When he became obviously male he was taunted at school, and responded with his fists.

“They used to say I was a devil, nasty things, bad words and I had no choice but to fight them because they were crossing the line.”

We also filmed with Carla, who at the seven is on the brink of changing into Carlos. His mother has seen the change coming for quite a while.

“When she turned five I noticed that whenever she saw one of her male friends she wanted to fight with him. Her muscles and chest began growing. You could see she was going to be a boy. I love her however she is. Girl or boy, it makes no difference.”

Child on swing



So why does it happen? Well, one of the first people to study this unusual condition was Dr Julianne Imperato-McGinley, from Cornell Medical College in New York. In the 1970s she made her way to this remote part of the Dominican Republic, drawn by extraordinary reports of girls turning into boys.

When she got there she found the rumours were true. She did lots of studies on the Guevedoces (including what must have been rather painful biopsies of their testicles) before finally unravelling the mystery of what was going on.

When you are conceived you normally have a pair of X chromosomes if you are to become a girl and a set of XY chromosomes if you are destined to be male.

For the first weeks of life in womb you are neither, though in both sexes nipples start to grow.

Then, around eight weeks after conception, the sex hormones kick in. If you’re genetically male the Y chromosome instructs your gonads to become testicles and sends testosterone to a structure called the tubercle, where it is converted into a more potent hormone called dihydro-testosterone This in turn transforms the tubercle into a penis. If you’re female and you don’t make dihydro-testosterone then your tubercle becomes a clitoris.

Foetus at 12 weeks

When Imperato-McGinley investigated the Guevedoces she discovered the reason they don’t have male genitalia when they are born is because they are deficient in an enzyme called 5-alpha-reductase, which normally converts testosterone into dihydro-testosterone.

This deficiency seems to be a genetic condition, quite common in this part of the Dominican Republic, but vanishingly rare elsewhere. So the boys, despite having an XY chromosome, appear female when they are born. At puberty, like other boys, they get a second surge of testosterone. This time the body does respond and they sprout muscles, testes and a penis.

Imperato-McGinley’s thorough medical investigations showed that in most cases their new, male equipment seems to work fine and that most Guevedoces live out their lives as men, though some go through an operation and remain female.

Another thing that Imperato-McGinley discovered, which would have profound implications for many men around the world, was that the Guevedoces tend to have small prostates.

This observation, made in 1974, was picked up by Roy Vagelos, head of research at the multinational pharmaceutical giant, Merck. He thought this was extremely interesting and set in progress research which led to the development of what has become a best-selling drug, finasteride, which blocks the action of 5-alpha-reductase, mimicking the lack of dihydro-testosterone seen in the Guevedoces.

My wife, who is a GP, routinely prescribes finasteride as it is an effective way to treat benign enlargement of the prostate, a real curse for many men as they get older. Finasteride is also used to treat male pattern baldness.

A final interesting observation that Imperato-McGinley made was that these boys, despite being brought up as girls, almost all showed strong heterosexual preferences. She concluded in her seminal paper that hormones in the womb matter more than rearing when it comes to your sexual orientation.

This is still a controversial topic and one I explore later in the film when I meet Mati, who decided from the earliest age that though “he” looked like a boy, Mati was really a girl.

As for Johnny, since he developed male genitalia he has had a number of short term girlfriends, but he is still looking for love. “I’d like to get married and have children, a partner who will stand by me through good and bad,” he sighs wistfully.

Complete Article HERE!

I Can’t Get No Satisfaction

Name: Trey
Gender: Male
Age: 24
Location: Charleston, SC
I’m a good looking guy. At least that’s what people tell me. I’m educated, have a good job, have a great sense of humor, and I’m also bi. I thought that being attracted to both women and men would increase the likelihood of me finding the sexual satisfaction I so desperately want and need.

I’m not afraid of commitment, but I can’t seem to get beyond casual hook ups and affairs that last only a few months. The sex is a hit or miss kind of thing, but even when the sex is great, I always seem to hit a wall. I can’t seem to get to the next level.

The New Year is upon us and I don’t want to remain stuck in this holding pattern. What am I missing? Any advice for someone like me?

Thanks for the timely question, Trey. And Happy New Year to you.

i'd totally fuck youYou bring up two very important skill sets — satisfying sex and relationship building. Despite the myths perpetuated by the popular culture, the two are not necessarily interdependent. Sexual satisfaction is one thing, and it can be achieved through traditional relationship models or not. Successful primary relationships can and often do depend on the sexual satisfaction of the partners, but not always. And given the diversity of intimate interests people have, it’s no wonder some come away from the experience frustrated and disappointed. Think of it as a combination lock. All the tumblers need to align for the lock to open.

The secret, it seems to me, is to discover precisely what it is you are looking for and deciding precisely what it is you are willing to expend getting what you want.

And I hope that your bisexuality has lead you to embrace more relationship models than what is traditionally handed us as the be all and end all—heterosexual monogamy. There is so much more out there.foreplay

That being said, I do have some generic thoughts about sexual satisfaction that are applicable to whatever relationship model you choose. Great sex is dependent on mutuality, even in a casual hook up. Be sure your partner knows he or she is loved, appreciated, or in terms of the casual hook up, respected.

If the connection you have with another has legs, so to speak, you will soon discover that either you or your partner has a stronger libido than does the other. That’s pretty common. Deal with this immediately, like adults. Don’t wait for your relationship to go broken. It’s just too easy to walk away from something that is floundering instead of investing the effort it would take to right it. Does that sound familiar? I wouldn’t be surprised if it does. Accommodations and compromise are always necessary in seeking the common good. And by that I don’t mean sinking to the lowest common denominator.  People come to compromise and accommodation through effective communication. If you don’t know how to do that, your relationship, of whatever stripe, is doomed.

female body as art 2Passion is not a dirty word, nor is sexual expression a sin. If you or a partner has religious scruples about enjoying you own body or that of your partner you’re headed for trouble. And remember, boredom in the bedroom is a recipe for disaster.

You should be well versed in self-pleasuring. In fact, the more you know about your body and the mysteries of your sexual response cycle the smoother things will go in partnered sex. Nowadays there is absolutely no need for anyone to come to partnered sex uninformed about sex in general and his or her sexuality in particular.

Like I said, mutuality is the key. And since we all evolve sexually, partners need to grow right along with each other. Make your sex play an adventure. Never hesitate to check in with one another to see how the pleasure thing is going. What’s worked last time is not necessarily gonna work next time.

Spontaneity is always a real good thing. Both partners need to take responsibility for seeing that their intimacy needs are being met. Sometimes that will involve fucking like bunnies, other times it will mean vegging-out in front of the boob-tube with a fist full of Häagen-Dazs.

Again, communication is key! Openness and honesty about one’s most secret sexual fantasies and desires is essential. Can’t trust your partner with your secrets? That’s never a good sign. Take responsibility for your own sexuality. Ask for what you need, but don’t neglect caring for yourself.

Seek your partner’s pleasure before your own. This is particularly important for a man.

If you are too busy to celebrate your sexuality with your partner, you are indeed too fuckin’ busy. Prioritize your life with your partner at its center.

nipple rubThere’s a fundamental difference between making love and fucking. Both have their place in a healthy sex life. And there ought also be room for solitary sex too. Everyone in entitled to privacy and private time, especially in a relationship.  If your job, or career, or whatever else interests you is more important than your relationship don’t expect that relationship to last.

Be creative in your sexual expression; toys, fantasies, role-playing, they’re all good. Don’t be afraid to experiment. Attend to making your sex play spaces fit the mood — romantic to down and dirty. One size does not fit all, if you catch my drift.

Stay in shape (and there’s not just one shape), get plenty of exercise, and keep yourself interesting and attractive to your partner. Pay attention to your personal hygiene. No one wants to bump someone with a smelly body or bad breath.

Make sure your partner is fully aroused before full-on fucking. And remember sex is way more than the old in an out. Finally, have a sense of humor about the whole damn thing; it will help take the edge off.

Good luck

A Rose By Any Other Name

We’re all back from spring break. The Dr Dick Review Crew is all rested and relaxed. Sadly, I can’t say the same thing about me. oh well, no rest for the wicked.


I enjoy your podcast, the frankness and open vocabulary is exactly what I like. No need in beating around the bush, just get to the point. Wish more people would live by that philosophy.

Ok. I am a 45 YO, gay male, very experienced sexually, some say whore… LOL! I enjoy a lot of fetishes; the unusual has always been very attractive to me. The more bizarre the more I will probably like it.

Until I was about 40 I was a DOM top. I started experimenting with the group party world and enjoyed it greatly. Became an experienced fisting top with some formal training, I guess you could call it an apprentice who graduated, or so I thought. Then a few of the FF bottoms suggested I was missing something. Because I didn’t have any experience as a FF bottom I couldn’t realize the true feelings and emotions involved with fisting. I was encouraged to experience fisting as a bottom.

This was a HUGE ordeal for me. The mental change alone was like, wow. The first time I crawled into a sling and had my whole ass on display, legs spread like a woman at her gynecologist…man was I uncomfortable. This was 5 years ago. Now I can hop into a sling and take a fist-fuck fairly easy. I now understand the advice given to me: I finally understand what fisting is all about.

Now my issues.

I have changed. My whole personality has been altered. Changing from a Dominate Top to fisting bottom has created issues with my head and overall sexuality. These changes are now affecting my sex life. I guess I need some help figuring things out.


Thank you, Jimmy, for your message and your kind words about my podcasts.

We really get boxed in with all our self-identification we do, huh? I mean I know why we categorize ourselves and others as gay or straight, top or bottom, sub or Dom. It helps us understand ourselves and communicate in a kind of shorthand with others. But there is a downside to this, as you sling

I believe that human sexual response is a whole lot more fluid than we give it credit for. But this fluidity is often stifled when we overly compartmentalize ourselves or others. Not to mention the fallacy of the binary system — being one thing or the other.  It just ain’t so and you are the perfect case in point.

I’m always talking about how the best tops are those who, on occasion, bottom. The best submissives are those who, on occasion, dominate. Besides the wider range of experience this provides us, we also grow in emotional maturity encompassing both our yin and yang.

Also the words we use to describe ourselves have, over time, become heavily laden with unintended cultural connotations. Top/bottom, sub/Dom are classic examples of this. That’s why I believe that we ought, from time to time, reinvent the language we use to talk about ourselves. In this case, I prefer terms like: giver/receiver over top/bottom. A change in vocabulary can certainly cut through a lot of the cultural nonsense and it can open the door to a more fluid sexual expression; as I believe it ought to be.nekkidbookclub

I hasten to add that at lot of hard-core pervs disagree with me on this. And that’s perfectly fine with me. It’s just that, if our language detracts from our experience, or hems us in, rather than facilitates it, and frees us up, something’s out of whack.

You will pardon the shameless self-promotion, but I’d like to call your attention to my latest book, The Gospel of Kink. It’s a communication and relationship building workshop in workbook form. It centers on the skills us kinksters need to communicate with others, and initiate, build, and maintain the relationships that will serve us well. Learn how to ask for what you want and get what you ask for from the people best situated to fulfill your desires. The book covers a lot of the territory that you raise in your question.

Stay in touch and let me know how this sits with you.

Good luck

Touchy Little Bugger

Name: Lilla
Gender: Female
Age: 27
Location: Evansville, IN
My BF and I have been together for a three years. We have a great sex life together…or we did. Recently he asked me if I would be interested in some anal play — me inserting something in his butt. I thought ok; lets give it a try. After some fumbling around the first time, (I was very self-conscious) I really got into it. It was very empowering. I never imagined how different it is inserting a dildo into someone as opposed to being inserted into, if ya know what I mean.
We were both having such a good time and I could see that he was totally turned on by the play.
After one of these very fun sessions I made an off-handed comment that all the butt play was going to make him gay. This innocent remark had an immediate and devastating effect on him. It was as if I had slapped him in the face. He stormed out of the room and sulked all the rest of the day. I told him I was just a joking. But he didn’t believe me and now there’s no butt play at all. In fact, there’s not much sex between us anymore.
I really screwed up, I know. I had no idea he would react this way. Is there anything I can do to redeem myself? I feel absolutely dreadful.

Wow, touchy little bugger, isn’t he? What we have here is some unresolved masculinity issues on the part of your novice butt-pirate BF. Too bad he’s cutting his nose off to spite his face instead of dealing with his issues in an up front way.

And just to put your mind to rest, Lilla, this implosion was bound to happen sooner or later. I know you feel bad about triggering it, but it’s not really your fault.

In his defense, we can chalk up your BF’s regrettable response to you poking (no pun intended) fun as the result of a lifetime of homophobic conditioning. One can only guess at the virulent anti-gay messages he’s received throughout his lifetime there in one of the reddest of red states. I think we can all agree that Evansville, Indiana is no San Francisco, California.ShameHands

All us men, including all us gay men, have some vestiges of homophobia inside us. And some have a whole lot. It’s regrettable, but that don’t make it any less true. This fear we all carry around inside of us can turn us inside out. It can get in the way of us accepting and loving ourselves for who we are, if we are indeed gay. And this fear can lead us to all kinds of destructive antisocial behavior against others if we are straight.

I’d be willing to guess your BF is the kind of guy that tells fag jokes and laughs loudest when he hears the same. I’d be willing to guess your BF is the kind of guy that raises an eyebrow (and possibly even a fist) when he encounters an effeminate man. I’d be willing to guess your BF is the kind of guy that over-compensates for even the slightest perceived feminine tendency within himself. I’d be willing to guess your BF is the kind of guy that has a very structured and uniform notion of what a woman’s place in society should be.

stubbornI added this last one, because I’m convinced that the root of all homophobia is actually a fear and hatred of women. In the worldview of most men, masculinity is privileged, making it superior femininity. To these men, it’s an affront to their world order to see any another man behave in a less than masculine way, even if that behavior is in the privacy of his own bedroom. This strict sex-role stereotyping has them in a strangle hold, choking all the joy and pleasure from their lives.

One can only imagine the massive internal conflict your BF must have struggled with before he asked you to bugger him. Imagine his chagrin when the only person in the whole wild world he’s ever opened up to about this mortifying desire of his; turned around and make a joke about it…and a fag joke on top of it.

I know, I know, you didn’t mean it to be a fag joke, but it was one nonetheless; at least in his mind. Your harmless little comment went to the heart of his insecurities. He had been found out, as it were, and the tables turned on him. And all he was left with was his shame. How enormously sad!

Can I tell you a story? Early in my therapeutic career I had a couple come to see me for marriage counseling. They were a pretty conservative heterosexual couple with two preteen children. They were both prim and proper and neither one had so much as a hair out of place. Can you say: buttoned down?homophobia2

When I got around to asking them to tell me what was wrong, the wife broke into sobs. She couldn’t talk. I thought to myself, “this is gonna be juicy.” The husband hung his head in shame and began to spill the beans. After 10 years of marriage he finally got up the courage to ask the little woman for some oral sex. Apparently she was mortified at the suggestion. Good girls don’t do that! It took another two years of supplication before she finally relented and gave him his one and only blowjob.

I was spellbound as he recounted the fateful night that he finally got his wish. His wife, on the other hand, was completely beside herself, holding her face in her hands. With a little prompting from me, the husband continued his story. The blowjob started out very tentatively. The little woman was doing all she could to suppress her natural inclination not to gag as she got closer to his johnson. But then she finally relented. And, after all those years of patiently waiting and fantasizing about this moment, she took a deep breath and wrapped her lips around the head of his dick.

He was so overjoyed and completely lost in the moment when somehow he let pass from his lips, the unfortunate word — cocksucker — in reference to the mother of his children down there between his legs smokin’ his pole. Where this word came from; he couldn’t say. It wasn’t a word he could ever remember consciously using before in his life. But there it was on that night of nights. And that, dear Lilla, was all she wrote. Before the husband knew what was happening, his wife spat out his boner with a yelp and fled to the bathroom to wash out her mouth with soap.

From that night to weeks later when they found themselves in my company, not only were there no more blowjobs, but no nookie whatsoever.

It took us weeks and weeks to uncover the root of the wife’s aversion to oral sex — giving or receiving. An unhappy childhood, an abusive father, catholic guilt, countless messages about sex being dirty, low self-esteem and her being pre-orgasmic all fueled her disconnect with sex in general and oral sex in particular. This coupled with the unfortunate and untimely exclamation by the husband was the straw that broke the camel’s back.

Isn’t it amazing how one word can short-circuit the whole shebang?

homophobia002I suppose you see where I’m going with this, huh Lilla? Your little comment triggered a landslide in your BF’s psyche. The delicate house of cards he was able to assemble to hold on to his homophobia and still take it up the ass, was simply not strong enough to withstand the word “gay,” joking or not.

Clearly your BF has issues. But I’m probably telling you something you already know. I can’t really say if there’s a possibility for the two of you to overcome this on your own. Is there any chance your BF would acquiesce to some counseling? If yes, that would be the way to go. He needs to do a bunch of reprogramming on himself, don’t cha know.

If counseling isn’t in the cards all I can suggest you do is stroke his masculinity as much as you can. There will be a price to pay for this, but maybe you’ll be able to address that later. You can tell him that you’ve been reading all over online about how much straight men are getting into ass play these days. How they are throwing off the yoke of their ass-phobia and enjoying all the god-given sensations their backdoor has to offer. You might even offer up your pucker by way of example.

If he ever does relent and allow you to touch him “down there” again that would signal that the crisis is over, but you won’t be out of the woods quite yet. If the ass play does resume, you could chat him up sometime (not in the bedroom though) as to why he had such a virulent response to your joking. If he is honest with you, he will tell you what you already know from reading my response here. And I’d be willing to bet my last dollar on that.

Good luck

Help! It hurts when I do this.

Name: Dylan
Gender: Male
Age: 23
Location: Australia
Hi Dr Dick, I’ve got a painful and irritating problem that my GP wasn’t able to help with, so I’m hoping you can. After I spend time edging, or develop blueballs, I get an intense burning sensation in my urethra. It usually doesn’t happen until after I cum, then urinate, but occasionally it’ll happen while edging. If I sit on the toilet and push as though urinating, it calms down significantly, but returns when I stand up. It usually goes after about half an hour of. I had a STI check (Urethral Swab. Oww. No sounding for me thanks) and it came back all clean, and in all other respects my junk is normal. Any ideas about what’s going on, or how I can fix it? Thanks!

This reminds me of the old joke where a guy goes to see his doctor about a pain he is having. The doctor sits him down and asks him where it hurts. The guy says, “It hurts when I do this.” And he takes his hand, makes a fist and punches himself in the side of the head. The doctor nods knowingly and says, “Stop doing that, and I guarantee the pain will subside.”

give up dickListen Dylan, whatever the root cause of the burning sensation you report is — and I can honestly say you have me stumped there — I pretty much can guarantee that it will subside if you cease the edging you are doing, or at least cut way back on that.

Like I said, I’ve never encountered this particular phenomenon before, so I can’t advise you further. And if your GP couldn’t put his finger on it, so to speak, and the burning sensation only happens when you edge or practice orgasm denial, then simply stop doing that and things will get better. I promise. After all, it’s not like you can’t live without edging. If, on the other hand, you said that you had discomfort every time you had an erection, then there’d be cause for alarm. But if the owie is only associated with something self-induced, then that’s a horse of a different color. See what I mean?

And here’s a tip: if you’re doing something that is causing pain or discomfort — and that’s not your intention — then your body is sending you a message that whatever you are doing it’s too much or it’s unhealthy. I am of the mind that we all ought to listen more closely to the messages our body sends us about what it needs and what it doesn’t need.

Oh, and for those in my audience who don’t know what the fuck “edging” is, it’s a stop/start masturbation technique designed to prolong the time it takes a guy to reach his climax. An edger will begin to wank like normal, but when he gets near to cumming — he stops stroking, sometimes even squeezing his cock till the urge to shoot subsides. Once the urge to cum quiets down, he begins to stroke again. Stopping again whenever he approaches climax. He repeats this whole ‘stop and start’ cycle for as many times as he would like, so that when he finally shoots he’ll have a stronger orgasm and he’ll spew more spunk.edging

I know a lot of men who edge and they swear by it. I also know that a number of these men are doing themselves a disservice, even harm, because they are practicing an extreme version of edging. In the end, despite the stand-up nature of our dick, it is a very delicate instrument. Intense edging, especially accompanied by nasty squeezing or slapping to quell the building ejaculation can be injurious.

So maybe, Dylan, just maybe ya oughta take a break from edging for a while and see if this burning issue doesn’t resolve itself.

Good luck

Hey dr dick! What’s that toll-free podcast voicemail telephone number? Why, it’s: (866) 422-5680. DON’T BE SHY, LET IT FLY!

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