Callo: The first known case of ambiguous genitalia to be surgically repaired in the history of Medicine, described by Diodorus Siculus

Markantes, Georgios K; Deligeoroglou, Efthimios; Armeni, Anastasia; Vasileiou, Vasiliki; Damoulari, Christina; Mandrapilia, Angelina; Kosmopoulou, Fotini; Keramisanou, Varvara; Georgakopoulou, Danai; Creatsas, George; Georgopoulos, Neoklis A.

doi:10.14310/horm.2002.1608

Cited by 4 publications

(5 citation statements)

References 4 publications

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“…This was most probably a case of cryptorchidism manifesting as heterosexual puberty and male pseudohermaphroditism. A patient who failed to develop male sexual characteristics during childhood, due to relatively low androgen levels, but with an impressive transformation with the rapid development of male secondary sexual characteristics during puberty, due to the presence of high levels of active androgens [29]. In ancient Greece, the "one sex body" was a concept that defined societal gender relations.…”

Section: Discussionmentioning

confidence: 99%

Hermaphroditism, surgical reconstruction of the anatomy of the gonads in ancient Greece as described by Diodorus Siculus (ca 80-20 BC)

Tsoucalas¹,

Kakagia²,

Panagouli³

et al. 2019

Int Med

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Background: Ancient Greek medico-philosophers comprehended a series of genitalia disorders and were able to perform surgical operations for their correction. Although researchers believe that the first plastic surgery of pseudo-hermaphroditism was performed by Persians in 11th century AD, a series of intersex individual cases were reported in the work of the ancient Greek historian Diodorus Siculus. Methods: Bibliographical study of Diodorus' treatises. Results: The report of a patient named Callo, who was raised as a female and was surgically transformed into a young male, was included in Diodorus' works. Diodorus described that the operation was performed surprisingly by a pharmacist, testifying the extent and depth of medical knowledge among ancient Greeks. The operation included cicatrization and placement of an artificial urethra in the non-perforated penis. Conclusions: The operation was for the era an innovative procedure ahead of its time, a hallmark of cosmetic and plastic surgery.

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Section: Discussionmentioning

confidence: 99%

Hermaphroditism, surgical reconstruction of the anatomy of the gonads in ancient Greece as described by Diodorus Siculus (ca 80-20 BC)

Tsoucalas¹,

Kakagia²,

Panagouli³

et al. 2019

Int Med

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“…Upon cutting into this swollen area, male genitalia appeared and Callo "transitioned" from female to male. Most likely, Callo had 17β-HSD or 5α-reductase deficiency [128,129]. Şerafeddin Sabuncuoğlu, a 15th century surgeon in Ana-tolia, wrote a three-volume pediatric surgical atlas "Cerrahiye-i Ilhaniye" in which he discussed the surgical treatment of various genital anomalies [130,131].…”

Section: History Of Surgery For Dsdmentioning

confidence: 99%

The Long Path to Our Current Understanding Regarding Care of Children with Differences/Disorders of Sexual Development

et al. 2022

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Testes were associated with maleness from antiquity, and ancient societies had fanciful myths about the origins of the sexes and about fetal sexual development. 17th century anatomists developed the concept that mammals developed from eggs and discovered sperm in semen; in 1878, Hertwig observed sperm entering eggs (of sea urchins), establishing the cellular basis of sex development. Individuals with atypical genitalia were known clinically in the 17th century, with much debate about their origins, but by the late 19th century it was generally accepted that gonads determined sex, and that sex determined gender role. Testosterone was isolated in 1935, and Alfred Jost showed that both circulating testosterone and diffusible anti-Mullerian hormone were needed for male development. Patients with apparent androgen insensitivity were reported in 1937 and shown to be unresponsive to exogenous androgen by Lawson Wilkins in 1957; androgen receptor mutations were reported in 1989. Steroidogenic errors were associated with differences in sex development (DSDs) starting in the 1940s, and finding mutations in the responsible enzymes explained many forms of hyper- and hypo-androgenism in both sexes. Sex chromosomes were identified in the early 20th century; Y was associated with maleness, and the responsible <i>SRY</i> gene was identified in 1991. Early efforts to manage patients with DSDs were confounded by philosophical perspectives on the relative roles of prenatal biology versus postnatal environment. Approaches to natal sex assignment evolved in the later 20th century and now emphasize a team approach based on data, not guessing, parental involvement, cultural considerations, and the acknowledgement of uncertainty.

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“…If the parents chose to raise a female, gonadectomy and surgical correction of the external genitalia are indicated to avoid masculinization, with vaginoplasty for a healthy sexual life. An estrogen-only hormone replacement therapy must be administered these patients throughout life until the 50th year of age (3) . In New Guinea, where tribal culture is gender-segregated with very traditional male and female roles, rituals and rules, the upbringing and transition from female to male is very difficult for 5AR2D individuals (7) .…”

Section: Diagnosismentioning

confidence: 99%

“…When a physician operated him, he discovered male genital parts with a functioning urethra, which he was able to bring to surface. Thus, the individual became a fully functioning male named Callon (3) .…”

Section: Introductionmentioning

confidence: 99%

5-Alpha-Reductase 2 Deficiency in Newborns: A Review

2020

IJOP

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Disorders of sex development (DSD) are mostly associated with gender ambiguity at birth and poses a real challenge in diagnosis. 5 alpha reductase 2 deficiency (5AR2D) is one such DSD associated with deficiency of a key male sex hormone called as Dihydrotestosterone (DHT) due to lack of 5 alpha reductase type 2 enzyme which converts testosterone to Dihydrotestosterone. This hormone is very vital for the development of external genitalia during embryogenesis, and the deficiency leads to partial or abnormal male external genitalia in the affected neonate. 5AR2D is due to mutation in steroid-5-alpha-reductase, alpha polypeptide 2 (SRD5A2) genes on chromosome 2, band p23. Clinical presentation of these children vary from normal male genitalia to a completely female genitalia. 5AR2D is associated with deficiency of DHT and normal or increased testosterone levels. Most of the children with 5AR2D are raised as females and gender conversion to male happens at around puberty due to masculine and voice changes caused by testosterone. Early diagnosis is beneficial in treating this problem. Elevated testosterone: DHT ratio with administration of beta human chorionic Gonadotropin (HCG) is the gold standard test in diagnosis of this defect. Most patients of 5 alpha reductase 2 deficiency are considered infertile, but with recent advancements in assisted reproductive techniques a few 5AR2D have been successful in giving birth to their offsprings.

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Callo: The first known case of ambiguous genitalia to be surgically repaired in the history of Medicine, described by Diodorus Siculus

Cited by 4 publications

References 4 publications

Hermaphroditism, surgical reconstruction of the anatomy of the gonads in ancient Greece as described by Diodorus Siculus (ca 80-20 BC)

Hermaphroditism, surgical reconstruction of the anatomy of the gonads in ancient Greece as described by Diodorus Siculus (ca 80-20 BC)

The Long Path to Our Current Understanding Regarding Care of Children with Differences/Disorders of Sexual Development

5-Alpha-Reductase 2 Deficiency in Newborns: A Review

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