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Types of Sex

by Lynae Brayboy, MD
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    00:01 Hi. Today, we’re going to talk about female puberty milestones. First, let’s talk about the different types of sex. There are three types of sex, genetic sex, gonadal sex, and phenotypic sex.

    00:15 First, let’s talk about genetic sex. Genetic sex is your XX or XY; 46, XX being female, 46, XY being male.

    00:26 That sex usually and typically determines your gonadal sex. Gonads can be either ovaries or testes.

    00:34 Those ovaries or testes make hormones. The hormone production during fetal development or the hormone production during puberty will determine external phenotype.

    00:44 Those differences will also be seen in the brain. During fetal production of hormones, you get sexual differentiation of the external genitalia. That leads to sex assignment at birth and gender rearing. While at puberty, secondary sexual development is due to the production of hormones either from the testes or ovaries which leads to gender identity.

    01:09 The genetic sex determination is made by again, XY in the male or XX in the female.

    01:18 There are certain genes that are upregulated or downregulated depending on whether there is the presence of a Y. The Y chromosome encodes SRY. SRY will downregulate the genes that are important for female development, Wnt4 and Rspo1 and will upregulate Sox9, Fgf9 in the Sertoli cells. While in the female, Sox9 and Fgf9 are not present, therefore, Wnt4 and Rspo1 will be upregulated. This will lead to a female phenotype. In the gonad or in the ovaries of the female, oogenesis occurs. Oogenesis begins around the fourth week of gestational age.

    02:04 Around the midgestation, around 20 weeks, you will see that oogonia, the cells that produce eggs will begin to make follicles. Those follicles will undergo a process called atresia or apoptosis or programmed cell death which will decrease the number of follicles that are present which will continue to decrease throughout the life of the female fetus.

    02:29 Now, depending on whether or not you have Sertoli cells that make AMH or anti-Müllerian hormone, you will develop either paramesonephros in the female or mesonephros in the male.

    02:44 We both though start out with an indifferentiated stage. In the female, paramesonephros equals the Müllerian duct. In the male, the mesonephros equals the Wolffian duct.

    02:57 So normally in the female, you don’t have AMH produced by the Sertoli cells.

    03:03 Therefore, you make fallopian tubes a uterus and the upper third of the vagina.

    03:08 However, if you are male, you do produce AMH from the Sertoli cells. Those Sertoli cells inhibit Müllerian development or paramesonephros. In the male, you will see mesonephric ducts which lead to the epididymis, the vas deferens, and the urethra. Now, if your gonads produce testosterone or estrogen, that will make your phenotypic sex or the sex that you show with your external differentiated genitalia. In the female, the glans penis will become the clitoris.

    03:44 The labioscrotal ridge will actually not fuse and there will be an introitus for the vagina.

    03:51 You will have a labia minora and a labia majora. However in the male, testosterone, DHT to be specific causes the glans to become the penis. You will see that the labioscrotal swellings will become the scrotum and that there will be a fusion of the labioscrotal folds so that you have a penile raphe.

    04:12 In the female fetus in the first trimester, germ cell migration occurs. You can also see that there is development of the external genitalia. The Wolffian ducts should degenerate leading then to the second trimester. There is development of a uterus and onto the vagina.

    04:31 Now, let’s look at male development. In the first trimester, you see that there is germ cell migration, spermatogenic cords. There’s also Leydig cell development which will make testosterone.

    04:42 There’s differentiation of the external genitalia. There’s also Wolffian duct differentiation.

    04:47 Remember that the paramesonephros or the Müllerian ducts will regress. You see here in the second trimester that we have testosterone synthesis. That will cause the growth of the external genitalia and the descent of the testes from the abdomen into the scrotum.

    05:05 Normally, you’ll see pediatricians will check for the descent of testes at the time of birth.


    About the Lecture

    The lecture Types of Sex by Lynae Brayboy, MD is from the course Normal Puberty and Disorders of Sexual Development.


    Included Quiz Questions

    1. Genetic sex (XX, XY)
    2. Hormone production during fetal development
    3. Hormone production at puberty
    4. Gender identity
    5. None of the options are correct
    1. Y chromosome encodes for SRY which downregulates the genes Wnt4 and Rspo1.
    2. SRY downregulates SOX 9 and Fgf9.
    3. SRY acts on the granulosa cells
    4. XX acts on sertoli cells
    5. XX upregulates SOX9 and FGF9
    1. Wnt 4 - downregulated in Sertoli cells Rspo1 - downregulated in Sertoli cells Sox9 - upregulated in Sertoli cells Fgf9 - upregulated in Sertoli cells
    2. Wnt 4 - downregulated in Sertoli cells Rspo1 - upregulated in Sertoli cells Sox9 - upregulated in Sertoli cells Fgf9 - downregulated in Sertoli cells
    3. Wnt 4 - upregulated in Sertoli cells Rspo1 - upregulated in Sertoli cells Sox9 - downregulated in Sertoli cells Fgf9 - downregulated in Sertoli cells
    4. Wnt 4 - upregulated in Sertoli cells Rspo1 - downregulated in Sertoli cells Sox9 - downregulated in Sertoli cells Fgf9 - upregulated in Sertoli cells
    5. Wnt 4 - downregulated in Sertoli cells Rspo1 - upregulated in Sertoli cells Sox9 - downregulated in Sertoli cells Fgf9 - upregulated in Sertoli cells
    1. 20 weeks fetus
    2. 14 weeks fetus
    3. 24 weeks fetus
    4. 32 weeks fetus
    5. 8 weeks fetus
    1. The Leydig cells produce anti-Mullerian hormone.
    2. The Paramesonephros helps in the formation of the fallopian tubes, uterus and upper one-third of the vagina in females.
    3. Mesonephros helps in the formation of external male genitalia.
    4. The glans penis in the females forms the clitoris.
    5. The DHT helps in the formation of the penis.
    1. Spermatogenic cords are developed in the first trimester in males.
    2. Germ cell migration occurs in the 2nd trimester.
    3. Wolffian duct regresses during the development of male genitalia.
    4. Mullerian duct regresses in the formation of female genitalia.
    5. Testosterone synthesis occurs in the first trimester in males.

    Author of lecture Types of Sex

     Lynae Brayboy, MD

    Lynae Brayboy, MD


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