Human hermaphrodites fall into a number of discrete classes according to morphological appearance and probable causation (1). The origin of three is related to neoplastic growth of endocrine tissues, such as adrenal cortex (adrenogenital syndrome), ovarian medulla (arrhenoblastoma) and testicular blastema (chorioepithelioma of the testis). Their pathological nature, as well as the immediate causative factors, are easily recognizable. The afflicted individuals are distinctly sick patients, and operative removal of the tumors, if performed at the proper time, may restore normalcy, even with full reproductive capacity. More enigmatical is the nature of sex intergrades of healthy appearance and without endocrine disturbances that might point directly toward the cause of their condition. However, it is fairly certain that many, possibly the large majority, of the cases have some hereditary background and that, with respect to the sex which suffers transformation, this hereditary group is divided in two classes.
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Witschi et al. (1942) studied this question.