The main issue that is debated on is if surgical modification (to make the affected individual's genitals more feminine) should take place at birth or allow the individual to make the choice themselves in adulthood. 

Rutgers University

XX individuals can also be exposed to androgens in utero causing them to be masculinized. One possible cause is congenital adrenal hyperplasia (CAH) where the adrenal glands instead of producing corticosteroids, produce androgens. 

Congenital Adrenal Hyperplasia (CAH)

Breedlove, S. & Watson, N. (2017). Behavioral neuroscience, eighth edition. Oxford University Press.

Behavioral Neuroscience 8th Edition

Controversy Regarding CAH

There are a number of differences between the typical female and individuals with CAH, including:

• Having more masculine personality traits

• Perform well on spatial ability tests that typically favor males

• Greater anogenital distance (tip of the clitoris or penis to the anus), which is more consistent with males

• Higher proportion of those with homosexual orientation compared to general women population

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