Cloacal exstrophy

Cloacal exstrophy males reassigned and raised as females

Between 1960 and 2000, doctors believed XY males with cloacal exstrophy would be happier socially as females, and surgically reassigned them. This occurred under the belief that humans were born psychosexually neutral. The practice proved controversial, after follow-ups by William Reiner found that many struggled to adhere to a female gender identity, had masculine interests, were attracted to females, or reverted to the male sex spontaneously or upon learning they were genetic males.

According to J. Michael Bailey:In terms of their sexual orientations, a 2016 academic review by J. Michael Bailey found 7 published cases of genetic males who were reassigned as females at birth and raised as girls, 5 of whom were cloacal exstrophy cases. All were strongly attracted to females. According to a 2015 article in The Boston Globe, Wiliam Reiner has followed up on the sexual orientations of approximately 70 genetic males who were raised as females. Only one reported having sexual attractions to males, "I’m more convinced than ever that sexual orientation is built in... certainly for males" he said. A 2023 review by Swift-Gallant et al. cited an additional two cases from media reports, both of whom were gynephilic (attracted to women).

Reiner's results have caused some doctors to reconsider the practice of sex reassigning genetic males. A 2011 study found that 79% of paediatric urologists surveyed favoured male assignment for genetic males with cloacal exstrophy.

Cases in the media

• Joe Holliday, a British cloacal exstrophy male who was reassigned and raised as a female. Holliday had masculine interests and is attracted to females. He found out he was a genetic male at age 25, and reverted to living as a male.
• Sophie Ottaway, a British cloacal exstrophy male who was reassigned and raised as a female. Ottaway found out about her genetic sex at age 22. She retained female identity, although believes the reassignment was incorrect. She is attracted to women.

References

References

1. Ben‐Neriah, Z.; Withers, S.; Thomas, M.; Toi, A.; Chong, K.; Pai, A.; Velscher, L.; Vero, S.; Keating, S.; Taylor, G; and Chitayat, D. (2007)." OEIS complex: prenatal ultrasound and autopsy findings". ''Ultrasound Obstet Gynecol'', 29: 170-177. https://doi.org/10.1002/uog.3874
2. "OMIM Entry - 258040 - OEIS COMPLEX".
3. "G/U Imaging:Home".
4. (May 2018). "OEIS complex with a vesico-enteric fistula". Journal of Pediatric Surgery Case Reports.
5. . ["Omphalocele, exstrophy of the cloaca, imperforate anus, and spinal defects complex"](https://rarediseases.info.nih.gov/diseases/4080/omphalocele-exstrophy-of-the-cloaca-imperforate-anus-and-spinal-defects-complex). *US Department of Health & Human Services*.
6. (March 1, 2004). "Communicating with Parents with Full Disclosure: A Case of Cloacal Extrophy with Genital Ambiguity". Journal of Pediatric Endocrinology and Metabolism.
7. "''Progress and Politics in the intersex rights movement, Feminist theory in action''".
8. Carpenter, Morgan. (December 2018). "Intersex Variations, Human Rights, and the International Classification of Diseases". Health and Human Rights.
9. Greenberg, Julie A.. (June 2017). "Legal, ethical, and human rights considerations for physicians treating children with atypical or ambiguous genitalia". Seminars in Perinatology.
10. Bailey, J. Michael. (2003). "The Man Who Would Be Queen". Joseph Henry Press.
11. (2016). "Sexual Orientation, Controversy, and Science". Psychological Science in the Public Interest.
12. Swidey, Neil. (23 August 2015). "What makes people gay? (An update)".
13. (2023-09-20). "Organizational Effects of Gonadal Hormones on Human Sexual Orientation". Adaptive Human Behavior and Physiology.
14. (2011). "Gender Assignment for Newborns With 46XY Cloacal Exstrophy: A 6-Year Followup Survey of Pediatric Urologists". Journal of Urology.
15. Chapman, Nigel. (10 August 2015). "Joe (27) was raised a female on medical advice. He feels his identity was stolen as a baby and wants it back".
16. Calkin, Jessamy. (2023-08-25). "'The doctors changed my gender at two days old – 22 years later, I discovered the truth'". The Telegraph.