In the south-west corner of a tropical Caribbean island live Belarmino and Benilda Batista and their family of ten children. Four of them were born as girls, grew up as girls but, at puberty changed into muscular men. Their eldest child, Mario, now aged 29 began as a girl called Antonia. Chichi, now a male 19-year old, began as a girl called Isobel. All 'changing' children were born with normal female genitalia and grew to have the normal female body shape; until at the age of twelve their vaginas healed over, two testicles descended and they grew full-sized penises. Their ten-year old, Virgilio, is in the process of changing from a female to a male.

After their change, the boys are on average more muscular than their normal brothers. They take on the tough jobs in the local quarry. They marry and lead a normal male sexual life - even though they have not been fertile.

The Batistas are just one of 23 affected families in their village, in which 37 children have changed. In the society of the village - a deeply religious Catholic community - these children's change has been seen as part of God's mysterious ways. They are accepted and allowed to be themselves in a way which couldn't happen in Western society.

In conversation with Dr Gautier, director of the children's hospital on the island, the parents were quite clear about their feelings towards the children. They spoke of their pride in their new sons, of the extra money the children would bring home as boys rather than girls; and they insisted that the children's adjustment to their new gender roles was immediate. Benilda admitted having feelings of sadness and worry; but, supported by a devout community, she came to see the phenomenon as God's will: "If WE made children with our own hands we would make them perfect, beautiful and complete. But God knows what he is doing."

Although girls had been changing into boys since 1930, it was not known outside the district until the first doctor went on holiday there. He published his findings about the children in an obscure Spanish journal, where it lay unnoticed until 1972. Dr Gautier's attention was originally drawn by a patient who had been in his hospital when about eight years old, and whose behaviour had then seemed completely female. And some time later he met that person working in the mountains cutting wood, and his behaviour was as a male. Dr Gautier was so surprised that he and a group of scientists began investigating the change and how it came about.

When scientists put all the family pedigrees together, they began to see the interrelationship between one family and the next. They ended up with an enormous family tree, showing 23 families going back seven generations to one woman - Altagracia Carrasco. She lived in the mid nineteenth century, and she is the commonest ancestor of the affected families. The mutant gene has been passed down from her - but shows only when both parents carry it. How these children develop in the womb has been worked out by the scientists, and it gives a new twist to the story of how male genitals form.

The egg is fertilised by a Y sperm and it first develops to a foetus with normal testes. Perfectly normally, they absorb the female parts, and testosterone preserves the male ducts. But in these children's cases, it doesn't change the external anatomy, because in their bodies the children miss a critical chemical step.

Normal men are able to process cholesterol through to testosterone - and on to a mysterious hormone called dihydrotestosterone. No-one knew what its function was. But because the Caribbean children cannot make it, and because injecting it into them stimulates their genital growth, it is clear now that dihydrotestosterone creates the male external anatomy. The pubertyal surge of testosterone in these children forces up the dihydrotestosterone level and growth that should have happened ten years before, in the mother's womb, takes place at last.

(From The Fight To Be Male from Horizon, At The Frontiers Of Medicine, Ariel Books, BBC 1983)

Gender Identity

An individual's self-image of their gender is usually very strongly fixed, especially in adulthood. Most human societies have different roles for different genders, and individuals are conditioned from birth to adopt the appropriate characteristics of behavior for their gender. It is widely believed that these characteristics are 'natural' in the sense that they are somehow in-built and would arise anyway. However, evidence does not suggest this. Ideals of 'masculinity' and 'femininity' are not universal, as we see from anthropological studies:

Among the Kgatla tribe of South Africa: The women and girls till the fields, build and repair the walls of the huts, granaries and courtyards, prepare food and make beer, look after fowls, fetch water, earth and wood, collect wild plants and do all the other housework. Men, on the other hand, have no regular daily work in the villages. The herding of livestock is done by the boys, who take the animals out in the morning to graze and bring them back again in the afternoon. Specialists like the doctors and thatchers will generally have something to do almost every day, but the rest seem to work spasmodically, and frequently spend days on end merely lounging about. (From Married Life in an African Tribe, Isaac Shapera)

Among the Manus tribe of New Guinea: For a year mother and baby are shut up together in the house. For that year the child still belongs to its mother. But as soon as the child's legs are strong enough to stand upon and its small arms adept at clutching, the father begins to take the child from its mother. Now that the child is in no such need of frequent suckling, he expects his wife to get to work. The plea that her child needs her would not avail. The father is delighted to play with the child, to toss it in the air, tickle it beneath its armpits, softly blow on its bare smooth skin. On the eve of the birth of a new baby, the child's transfer of dependence to its father is almost complete. While the mother is occupied with the new baby, the older child stays with its father. He feeds it, bathes it, plays with it all day. (From Growing up in Guinea, Margaret Mead)
 
The Tchambuli tribe of New Guinea: The women go with shaven heads, unadorned, determinedly busy about their affairs. Adult males in Tchambuli are skittish (highly strung and fickle), wary of each other, interested in art, in the theatre, in a thousand petty bits of insult and gossip. The men wear lovely adornments, they do the shopping, they carve and paint and dance. Men whose hair is long enough wear curls, and the others make false curls out of rattan rings. (From Male and Female, Margaret Mead)

Most Western societies are patriarchal, with an extreme dichotomy of power between men and women, but this is a relatively recent phenomenon in human culture. It does not reflect natural tendencies, having more to do with power and social structures. Prior to 5000-8000 BC family structures were undefined; mothers, sisters, brothers, aunts, uncles, etc. all lived together in loose groupings, and the relationships between parent and child were very different to today's norm. Sometimes there was even confusion as to whose child was whose. There was not even a word for 'father' in early Indo-European language, probably because, for centuries, people did not associate sex with reproduction, but simply believed women to be (in some cases divine) creators of life. Elsewhere in the world today there are many matriarchal cultures.

Norms of gender identity in Western culture are usually very strong, as shown in an experiment by Lloyd in 1980. Asking women to play with four six-month old babies (two boys and two girls) they had not met before, they behaved very differently depending upon how the babies were dressed. If the children were dressed in blue it was presumed that they were all boys, and they would be given toy hammers to play with; if they were dressed in pink frilly dresses it was presumed they were all girls, and were given dolls.

The evidence of the Batista children, who started life as girls and then changed into males at the age of twelve, suggests that gender identity is flexible. This is certainly the case among many North American Indian peoples. In a case where male twins wre circumcised, and the penis of one was accidentally destroyed, the child was raised as a girl and psychologically developed as a 'normal' heterosexual woman. The same is true of most individuals born with androgen insensitivity syndrome. It seems that gender identity is purely psychological.

In light of this, transsexualism has traditionally been regarded by the medical profession as a purely psychological condition. Generally, transsexuals are anatomically and physiologically 100% one gender. The deeply-felt conviction the individual holds that they are in some way 'mentally' the opposite gender to their anatomy has always been regarded as a matter for psychiatrists. However, recently researchers have discovered that there are similarities in certain parts of the brain in transsexual men and heterosexual women, suggesting that there may be a neurological basis for transsexualism.