Some are simply underdeveloped and actually appear to fall somewhere between male and female. Intersex is defined as "A sexual intermediate individual that has developed as a male (or female) up to a certain point in its life-history and thereafter has continued its development as a female (or male). Owing to the suppression of one type of sex tendencies by the other, intersexuals usually show a mixture of male and female parts and are almost invariably sterile." (Diamond) The variations from what many doctors consider the male and female mold are many and include the following: small or micro penis (less than 1 inch), undescended testes, an enlarged clitoris (more than 3/8 of an inch), absence of a vagina, or the presence of both a penis and a vagina. These conditions are referred to as ambiguous genitalia. This happens during the eighth week of fetal development, when the sexual organs begin to develop. (Diamond) In some cases the sex can be determined by a biopsy of the gonadal tissue. If it can be determined that the gonads are made up of ovarian or testicular tissue the determination of the baby's sex is sometimes made at this time. Cases of intersexed children are one in two thousand in North America. .
Further attempts to determine a baby's sex include chromosome tests. If the chromosome type shows normal XX (female) or XY (male) chromosomes then this is used in the determination of the baby's sex. The problem lies with the babies that appear to be either male or female yet have gonadal tissue of the opposite sex or chromotype of the opposite sex. A condition called congenital adrenal hyperplasia (CAH) causes some XX female fetuses to develop male-like external genitalia. Their adrenal glands produce large amounts of androgens. These children will sometimes menstruate through the penis after puberty. A second condition called androgen insensitivity syndrome (AIS) causes XY male fetuses to develop female external genitalia.