One in Fifty Children in This Dominican Town Was Born Between Sexes and the Community Had Been Accepting It for Generations

In the small town of Salinas in the Dominican Republic, a child might be raised as a girl for the first decade of their life and then, at puberty, develop male genitalia that had been present all along but invisible. For the people of Salinas, this was not a crisis or a scandal. It was a known part of life, so familiar that the community had its own word for it: güevedoces, a colloquial term that loosely translates to “penis at twelve.” It was only when an American researcher arrived in the 1970s that the outside world began paying attention, and what had been ordinary in Salinas became one of the most discussed biological phenomena in modern medicine.

The condition at the center of this story is a deficiency in an enzyme called 5-alpha-reductase, which plays a critical role in the development of external male genitalia during pregnancy. Without sufficient activity from this enzyme, the body produces lower levels of dihydrotestosterone, the hormone responsible for forming the external male sex organs in the womb. The result is that children who are genetically male are born with genitalia that appear externally female, and are raised accordingly, until puberty triggers a surge of testosterone that causes the male organs to develop visibly for the first time.

Learning About Güevedoces

When Dr. Julianne Imperato-McGinley arrived in Salinas to investigate reports of girls who became boys at puberty, she found that the phenomenon was occurring at a rate of roughly one in every 50 children in the community, representing approximately two percent of the local population. That figure ruled out any possibility of a statistical anomaly and pointed instead to a concentrated genetic condition within a small, relatively isolated community.

Imperato-McGinley’s findings, published in 1974, established the biological mechanism behind what the people of Salinas had been observing and accepting for generations. She documented that the enzyme deficiency was unusually prevalent in that region of the Dominican Republic and that the community had developed a remarkably matter-of-fact relationship with its existence. The birth of a child with this condition was received with acceptance, and the transition at puberty was treated as a natural and even celebrated development rather than a source of shame or confusion.

This is the detail that tends to get lost when the story of the güevedoces is told to outside audiences: the people of Salinas were not bewildered by what they were seeing. They had named it, accommodated it and integrated it into their understanding of human variation long before any scientist arrived to explain the enzyme responsible for it.

The Same Biology, a Completely Different Response

A few years after Imperato-McGinley published her research, a similar condition was identified among members of the Sambia tribe in Papua New Guinea, where children born with the same enzyme deficiency were called turnims, derived from the English phrase turn into man. The parallel discovery offered researchers a rare opportunity to study how two different cultures responded to the same biological reality.

Professor Gilbert Herdt of the University of San Francisco spent two decades conducting fieldwork with the Sambia and documented his findings in a body of work later compiled in a book on Sambia sexual culture. His focus was less on the biological mechanism and more on the sociocultural dimensions of how these children were treated as they grew up, and the contrast with Salinas was striking.

Where the Dominican community received the transition with openness, the Sambia regarded turnims as imperfect men. They faced rejection from their families and from the broader community, and were subject to a range of social exclusions that followed them into adulthood. “Subjects identified as male are treated differently and, for example, are not allowed to marry a woman,” Herdt explained. The same biological condition that was celebrated in one culture became a source of humiliation in another, a gap that says considerably more about social construction than it does about biology.

What Science Has Been Trying to Tell Us for Decades

The stories of the güevedoces and the turnims did not remain confined to academic literature. They became reference points in a much larger scientific and cultural conversation about whether sex and gender can be meaningfully reduced to a binary definition, and the evidence that has accumulated since Imperato-McGinley’s original research suggests they cannot.

Dr. Eric Vilain, director of the Center for Gender Biology at the University of California, has argued that while society holds categorical views about what should define sex and gender, the biological evidence does not support those categories in any clean or consistent way. “There is no biological evidence to justify it and what we find is that there are many intermediate realities,” he has said.

Nearly 40 years after these discoveries entered the scientific record, the communities and individuals who do not fit neatly into socially enforced definitions of male and female continue to face discrimination across institutions, legal systems and sports organizations that insist on binary categories the science has long complicated.

The people of Salinas had been living alongside this reality for generations before any researcher arrived to study it, and they had done so without crisis or categorization. What the outside world turned into a spectacle, that community had long treated as simply part of what it means to be human.