Determination of sex in dead (or living) persons

Examination for sex is important in:

• Civil law e.g. marriage and inheritance of a case of inter sex.
• Criminal law, in exchange of babies in hospitals, sexual perversions, in criminals who conceal their sex.

Inter sex states:

These are conditions in which male and female characters (e.g. gonads, physical form and sexual behavior) coexist in varying proportions in the same individual. These are:

1. Gonad agenesis: here testes and ovaries have never developed (nuclear sexing is negative).

2. Gonad dysgenesis: The testes or ovaries are present but at puberty they fail to develop e.g.: in Klinefilter syndrome where sex chromosome pattern is XXY (47 chromosomes) and in Turner syndrome where chromosomal pattern is XO (45 chromosomes).

3. Hermaphrodite: which is either:

   1. True hermaphrodite: the same individual possesses both non functional testicles and ovaries.

   2. False (pseudo) hermaphrodite: There is lack of clear cut differentiation of the external genitalia while the internal genitalia are isosexual. It is either:

* Male (masculine or testicular) hermaphrodite:

• The person has testicles that are present in abdominal cavity.

• The general features are mixed of both feminine and masculine characters.

• The external genital organs resemble those of the female but not well developed e.g. cul-de sac vagina without uterus.

*Female (feminine or ovarian) hermaphrodite:

• The gonad is the ovary.

• The external configuration and external genital organs resemble those of a male.

In examination for sex (in dead and living), the following steps are followed:

Clinical examination:

• Clothes cannot be relied upon as any person can wear any type of clothes of the other sex. This entails:

1. Presumptive data.

- General features where males are usually more heavily built and larger body dimensions than females.

- Deposition of fat especially in gluteal area is more in females than males.

- Hair distribution where in males there is beard & moustache. Pubic hair in male extends up to the umbilicus while in female it is straight.

- Males have prominent large larynx than females, also, their voice is harsher than females.

2. Highly presumptive data:

• Presence of vagina, uterus, prostate, seminal vesicles and penis. This is due to the presence of certain operations to change sex with reconstruction; here sex chromatin test defines the origin of the person

3. Certain data:

• Presence of the ovaries in females and testicles in males.

N.B: In mutilated bodies, non pregnant uterus and prostate resist putrefaction longer than abdominal organs

Category: Forensic Medicine Notes