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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!

A Farewell to a great man

Dear sex fans,

I realize this is a bit off topic for this blog, but I want to acknowledge the death of famed British neurologist and author, Oliver Sacks.

1993: Portrait of British-born neurologist and author Dr Oliver Sacks standing in the admittance driveway of Beth Abraham Hospital with his arms crossed over his chest, New York City. (Photo by Nancy R. Schiff/Hulton Archive/Getty Images)

1993: Portrait of British-born neurologist and author Dr Oliver Sacks standing in the admittance driveway of Beth Abraham Hospital with his arms crossed over his chest, New York City.

In February, he wrote an op-ed in The New York Times revealing that he was in the late stages of terminal cancer, after earlier melanoma in his eye spread to his liver.

“It is up to me now to choose how to live out the months that remain to me,” he wrote. “I cannot pretend I am without fear. But my predominant feeling is one of gratitude. I have loved and been loved; I have been given much and I have given something in return; I have read and traveled and thought and written. I have had an intercourse with the world, the special intercourse of writers and readers.”

Earlier this summer I read Dr Sacks’s memoir, On the Move.  I love it.  It’s an interesting memoir by a fascinating personality.  And while reading I discovered that we had a dear friend in common, Thom Gunn.  What a small world!  So I decided to send him a note.

Dear Dr Sacks,

I just finished reading your memoir, On The Move.  What an amazing life you’ve lived.on-the-move-by-oliver-sacks

Of all the marvelous things you’ve done and all the fascinating people you mentioned in your book nothing surprised me more than your close friendship with Thom Gunn.  I was a friend of Thom too and I lived directly across Cole Street from him.  I moved to the flat at 1207 Cole Street in 1979.  At the time I was working on my doctorate in clinical sexology at the Institute For The Advanced Study of Human Sexuality in San Francisco.

I didn’t know Thom well at first.  However, I would regularly see him walking both in our neighborhood and elsewhere in town.  He was always in his leathers, rain or shine, and used to think to myself, “What a mensch!”

It finally dawned on me that he lived across the street from me.

Once he saw me in my roman collar.  (I was ordained a catholic priest in 1975 at the age of 25 in Oakland, CA.  I had come out to my local superiors; I was a member of the Oblates of Mary Immaculate, before I was ordained.  Like I said, I was working on my doctorate to become a sex therapist and prepare for an upfront gay ministry.)  Thom smiled at me when he saw me; I blushed and told him what I just told you.  He was fascinated, but I also believe he thought I was a twit.  He probably was right.

I knew nothing about Thom other than he was my neighbor.  Then one day I was in a bookstore on Haight Street and there was a photo of Thom in the window advertising a reading.  That’s when I started asking around about him.  Despite his cult status within the gay community, he was the most unassuming person.  I was honored to have a personal connection with him.small_front

I finished my doctorate in 1981.  My dissertation, Gay Catholic Priests; A Study of Cognitive and Affective Dissonance was directed by Wardell Pomeroy.  A firestorm of media attention followed.  The media branded me as THE gay priest, as if.  I think Thom read about me in the New York Times because next time he saw me he clapped me on the back and said, “Well done.”

No sooner did I complete my doctorate, and because of the media attention my public coming out caused, the leadership of my religious community in Rome began a process of dismissal against me.  I was devastated and lost.  I was even getting death threats.  Thom was always so supportive and encouraging.

I fought the church for the next thirteen years in an effort to save my priesthood and ministry.  Alas, the writing was on the wall back in 1981 and it was only a matter of time till they had their way with me.  I wrote about the travail in a book that was published in 2011, Secrecy, Sophistry and Gay Sex In The Catholic Church: The Systematic Destruction of an Oblate Priest.

Thom was always so solicitous about my wellbeing.  He knew how difficult life had become for me.  And both of us found ourselves on the forefront of caring for friends who were dying of AIDS.  One of my landlords died in 1986.

Thom introduced my housemate and I to Augie Kleinzahler and his girlfriend, Caroline Lander, who lived only a few blocks from us in Cole Valley.  We all became great friends and copious amounts of strong drink were consumed.  I wonder, do you know Augie?

When Thom turned sixty I surprised him with a homemade German chocolate cake.  I told him he was the oldest person I knew.  This made him laugh and he called me a whippersnapper.

In 1992 the surviving landlord sold the Cole Street duplex and I and my housemate moved to Oak and Ashbury.  Sadly, I didn’t get to see Thom as much as before.  I move up here to Seattle in 1999 because I could no longer afford to live in SF.  I was deeply saddened to learn of Thom’s death in 2004.  He was such a great guy, what a marvelous soul.

Again, thank you for your memoir; it was grand getting to know you on a personal level.  I read The Man Who Mistook His Wife for a Hat when it came out in the mid-eighties and loved it.  But I never guessed you and Thom knew each other or that you actually visited him when I lived across the street from him.  What a small world.  I wish I had known you back then.

Anyhow, thank you for the bringing me this unexpected flood of memories of Thom.  I wonder what he would have made of yesterday’s Supreme Court decision (Obergefell v. Hodges).  I contend that we got marriage equality only because we walked through AIDS first.  I think Thom would have agreed with me.

All the best,

Richard Wagner, M.Div., Ph.D., ACS

To my astonishment, Oliver wrote back; I mean that literally, a handwritten note.  Apparently, he never used a computer.

Dear Dr. Wagner (can I say Richard?),                                                          6/60/15

I am greatly interested and greatly moved, by your letter — your courage in being honest and forthright, at a time and on a subject bound, sooner or later, to cause your ejection from the priesthood. In another few years perhaps, with Pope Francis at the helm, these last bastions of Catholic bigotry may have fallen.

I like to think of you as living across the street when I visited Thom, and glad to know that he appreciated you and your works. I still miss him deeply — there were not too many people with whim I could be entirely open — and I like to think that his ghost is pleased that my title came from his poem. (I find it a huge relief being open now to all and sundry {Oliver came out earlier this year} — I am so glad I completed my book before I became ill).

And what a liberation, an affirmation for us all that the Supreme Court voted as it did. I suspect that Ruth Bader Ginsberg, quite ill now, stayed on to ensure the 5/4 decision.

Thanks for your letter and my very best wishes,


Oliver Sacks01     Oliver Sacks02

Click on this link to see a copy of Oliver Sacks’s note.

Thank you Dr Sacks and farewell!

New Mommy Woes

Name: Megan
Gender: Female
Age: 29
Location: Toronto
I’m a new mother and this is my first child. He was born 3 weeks ago, but I am still enthralled with the miracle of it all. So far motherhood has been pretty wonderful. Sure I’m tired, but just holding my son in my arms makes me so happy I sometime cry with the joy. There is a problem, however, my husband wants to resume our sex life, but I have absolutely no interest. I love him dearly and I know I owe him this, but I have no libido. What can I do?

Yep, this is common enough complaint. This is precisely the place where new parents experience the most strain on their relationship. And when you think about it, it’s not all that surprising. Most new mothers are exhausted by the expectations of motherhood. And first babies are the most challenging. Added to these burdens her partner eagerly awaits the resumption of the sort of sex life that was in place before the pregnancy. New mothers often feel like their husband is just one more person to service, one more person with needs and demands that are keeping her from much-needed sleep.

New Mother LoveNew mothers can find sex unappealing for reasons both physical and emotional. If you’re breastfeeding, your breasts are sore, heavy, and leaky. Your body just doesn’t feel sexy, with its stretch marks, cellulite, dark nipples and dark line down the abdomen, not to mention the weight gain and varicose veins. Then there is lochia, the discharge after the birth, which lasts for 3 to 4 weeks and does not smell very good. If you had an episiotomy, the stitches are very uncomfortable and you may worry about infection. Your hormones may still be in a state of flux, so you feel moody or depressed. And you may not have a good method of birth control, so sex is the last thing on your mind!

Some doctors recommend that new mothers refrain from sex until their first post partum examination, usually about 6 weeks after the birth.NewMother

So if you and your husband weren’t warned about all this, you’re probably both totally unprepared. And if you can’t talk about it, there will be trouble ahead. Many new fathers labor under the misconception that once the baby is born, their sex life will return to normal. Besides this being completely unrealistic; it mostly puts pressure on the wife to do, as you suggest, her ”duty”. This is no way to pursue a sex life together.

Of course, new fathers can help their partner move beyond those feelings of sexual disinterest by being an involved parent and helping around the house.

There are loads of sex things new mothers can do that will pleasure their partner that don’t involve full-on fucking. Hand jobs and blowjobs are always welcome. Reading erotica aloud to each other can be fun. Mutual masturbation, or even watching him and cheering him on as he squeezes one out is also an option. But probably the thing that will get your libido back is a lot of touching, massaging, hugging, kissing, and snuggling and not as a prelude to sex, but just for the joy of it. These things, without the pressure to perform will help reestablish the pair-bond between you and your old man, which will inevitably lead to the long awaited fuckfest.

Good luck

I’m confused

Name: sexdout
Gender: Male
Age: 28
Location: Toledo
My wife wants to have sex every night, but it’s been three years and I just can’t fuck like I used to. What do I do?

REALLY? You’re 28 and you can give up the bump at least once a day? Holy cow; what’s up with you? Are you stressed out; sleep deprived; or overweight? Are you on any medications like antidepressants or antihistamines?sexual-enrichment

If you can’t fuck like you usta; what can you fuck like? Is this a libido thing? Is it an interest thing? Or is it a boredom thing? Would you know how to pleasure your wife without taxing your pathetic worn-out peanut? If not, that’s where I think you oughta start looking for answers to your question; “What do I do?”

There’s so much more to sexual satisfaction for both women and men than the old in and out. Here’s where your biggest sex organ, the one between your ears, will come in handy. Try some sex toys, read some erotica, look into some kinky stuff. Check out the category pull-down menu in the sidebar to your right. Scroll down till you see the ENRICHMENT category. There’s a subcategory under that called Sexual Enrichment. Choose that and you will be presented with a treasure trove of ideas in both written and podcast form. There are tons of topics under the LIFESTYLE/RELATIONSHIPS Category and the SEX THERAPY Category too. Check ‘em out; you’ll be glad you did.


Gender: Male
Age: 21
Location: NEW YORK

facialThis is called a facial, pup and it’s completely safe. Unless, of course, you get your partner gets his spunk in your eyes. THAT STUFF WILL BURN LIKE CRAZY.

Good luck you guys!

If That Don’t Beat All!

Name: Ned
Gender: Male
Age: 59
Location: usa
My wife enjoys using my penis as a tic tac dispenser. I insert one (or several) into my urethra. Shortly afterwards, she sucks them out. It’s enjoyment for both of us. My question: sometimes there’s a little discomfort that usually goes away in a day or two. Is there something I can use to lessen this sensation? Is this practice too risky to continue? Can I do damage to myself?

tic-tac-fresh-mintAlrighty then; this is pretty out there, Ned. I have to say; no one’s ever reported being a human tic-tac dispenser before. So you get some extra points for the novel use of your pecker. But I’m sitting here trying to imagine how this play got started. I mean, who had the brilliant idea to shove tic-tacs in your piss slit first — you or your wife?

It’s not like I haven’t had guys tell me about the odd things they’ve slipped into their urethra. And ya know what? It’s generally a guy thing. I’ve not had a woman report such activity. I do know a couple of women who are into using urethral sounds, but nothing more exotic than that. In terms of the guys though, I could tell you stories that would make your hair stand on end.

You say “sometimes there’s little discomfort that usually goes away in a day or two.” Ya don’t say! Several things could cause the discomfort you report. Two come immediately to mind. 1) The mint in the tic-tacs will no doubt be an irritant to the sensitive mucosa in your urethra. 2) You’re probably forcing the tic-tacs into your piss slit without using lubrication too, right?a little nuts

Is the practice risky? Probably! I’d never suggest anyone insert anything into his urethra that is not sterile. However, if you insist on continuing this play; the least you could do is add a drop of lube on each tic-tac before insertion. Just know that if you’re not careful such behavior carries a risk of severe irritation; tearing your urethra; or a nasty urinary tract infection, which can become more serious if it spreads to your bladder or kidneys.

My rule of thumb when considering unique uses for one’s body parts is if there is pain, something is amiss. If you can diminish the pain by being more thoughtful and careful about how or what you are doing then, things will probably be better than if ya don’t.

Good luck

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