After he tried to commit suicide at age 13, he was told that he had been born with male genitalia, which he underwent surgery to reconstruct. Nature versus nurture Although the formation of gender identity is not completely understood, many factors have been suggested as influencing its development. Hormonal influences are also complex; sex-determining hormones are produced at an early stage of foetal development,  and if prenatal hormone levels are altered, phenotype progression may be altered as well, and the natural predisposition of the brain toward one sex may not match the genetic make-up of the fetus or its external sexual organs.
Emergency Medicine 6e presents evidence-based clinical management and treatment advice for emergency medicine students and practitioners in Australasia. Different amounts of these male or female sex hormones within a person can result in behavior and external genitalia that do not match up with the norm of their sex assigned at birth, and in a person acting and looking like their identified gender.
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