True hermaphroditism in older patients: problems of diagnosis and management.

Four new cases of true hermaphroditism in older patients are herein presented. The diagnosis was delayed in all 4 patients and not made in 3 until feminization had occurred. The clinical features, the sex of rearing, gonadal locations, sex chromosomes, treatment and fertility potentials of these patients are discussed. Problems encountered in the management of these older patients underscores the need to exclude at birth bisexuality in any patient with perineal hypospadias and crytorchidism.