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Gender identity
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==== Other cases ==== One study by Reiner et al. looked at fourteen genetic males who had suffered [[cloacal exstrophy]] and were thus raised as girls. Six of them changed their gender identity to male, five remained female and three had ambiguous gender identities (though two of them had declared they were male). All the subjects had moderate to marked interests and attitudes consistent with that of biological males.<ref name="pmid14736925">{{cite journal | vauthors = Reiner WG, Gearhart JP | title = Discordant sexual identity in some genetic males with cloacal exstrophy assigned to female sex at birth | journal = The New England Journal of Medicine | volume = 350 | issue = 4 | pages = 333β41 | date = January 2004 | pmid = 14736925 | pmc = 1421517 | doi = 10.1056/NEJMoa022236 }}</ref> Another study,<ref name=":3" /> using data from a variety of cases from the 1970s to the early 2000s (including Reiner et al.), looked at males raised as females due to a variety of developmental disorders ([[penile agenesis]], cloacal exstrophy or penile ablation). It found that 78% of those males raised as females were living as females.<ref name="pmid25667367">{{cite journal | vauthors = Saraswat A, Weinand JD, Safer JD | title = Evidence supporting the biologic nature of gender identity | journal = Endocrine Practice | volume = 21 | issue = 2 | pages = 199β204 | date = February 2015 | pmid = 25667367 | doi = 10.4158/EP14351.RA }}</ref> A minority of those raised as female later switched to male. However, none of the males raised as male switched their gender identity. Those still living as females still showed marked masculinisation of gender role behaviour and those old enough reported sexual attraction to women. The study's authors caution drawing any strong conclusions from it due to numerous methodological caveats which were a severe problem in studies of this nature. Rebelo et al. argue that the evidence in totality suggests that gender identity is neither determined entirely by childhood rearing nor entirely by biological factors.<ref name="pmid18287184">{{cite journal | vauthors = Rebelo E, Szabo CP, Pitcher G | title = Gender assignment surgery on children with disorders of sex development: a case report and discussion from South Africa | journal = Journal of Child Health Care | volume = 12 | issue = 1 | pages = 49β59 | date = March 2008 | pmid = 18287184 | doi = 10.1177/1367493507085618 | s2cid = 46058150 }}</ref>
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