People born with mismatched sexual organs are often unaware of their true gender until they have health problems.

According to Dr. Vu Le Chuyen, deputy head of Binh Dan Hospital, his hospital has performed several gender redefining surgeries on patients of indeterminate gender referred to as ‘bisexual’ because they have both male and female reproductive organs.

Chuyen and doctors from Binh Dan and Hung Vuong hospitals recently operated for four hours on P.D.T, 45, to remove his uterus and ovaries and improve his penis.

According to Chuyen, T. was declared male at birth. A farmer in Central Highlands in Lam Dong province, he has a wife and lived a normal life until recently, when he began to notice blood in his urine.

Examinations revealed the shocking truth that T. has a womb and ovaries. An ulcer in his uterus was causing him to urinate blood.

An examination revealed that the patient carries XX (female) chromosomes, but was assumed male since birth as a result of an abnormally high amount of excretion from his suprarenal gland, resulting in a high concentration of male hormones. Because he has male external sexual organs, despite their limited function, T. would have never discovered his female internal organs had the ulcer never appeared.

Though shocked, T. expressed his wish to remain a man. Along with having T.’s uterus and ovaries removed and penis improved, the doctors didn’t interfere with the amount of suprarenal gland excretion.

According to Dr. Le Tan Son, HCMC Pediatrics Hospital 2 performs around 250-400 surgeries on average each year to fix the congenital reproductive organ defects in children.

Dr. Chuyen named the three main causes of incidents of indeterminate gender.

The first cause is natural abnormality in sex chromosomes. The second is that during their pregnancy, mothers often take dangerous medications, particularly drugs  advertised as able to change the gender of their child.

The third is the abnormal rise in female babies’ suprarenal gland excretion or disorders in the androgen receptor gene, a gene on the X chromosome that codes the synthesis of cell receptors specific for male sex hormones.

Agent Orange and radioactive poisoning are also causes of the disorder.

Some cases have external female reproductive organs and interior testicles only detected by surgeons while operating to treat other diseases. Removal of the testicles will help these children, who have external female genitals but male chromosomes, live a normal life as females, but they won’t be able to conceive babies in adulthood due to lack of ovaries and uterus.

According to Dr. Son, one of T.’s surgeons, birth defects in reproductive organs typically occur more in males than in females.