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Sex reversal

Sex reversal is a biological phenomenon whereby an organism's phenotypic sex—the observable characteristics of male or female—differs from its genetic or chromosomal sex, resulting from disruptions in the processes of sex determination and differentiation.^[1] This condition manifests across species, including plants, humans, and various animals, and can arise from genetic mutations, hormonal imbalances, or environmental influences such as temperature.^[2] In humans, sex reversal is classified as a disorder of sex development (DSD), encompassing conditions like 46,XX testicular DSD (where genetically female individuals develop male phenotypes) and 46,XY gonadal dysgenesis (where genetically male individuals develop female or ambiguous phenotypes).^[2] The genetic basis of human sex reversal often involves key regulatory genes on the sex chromosomes or autosomes. For instance, translocation of the SRY gene from the Y chromosome to the X chromosome in 46,XX individuals can trigger testicular development, leading to male phenotypes in approximately 1 in 20,000 newborn males.^[2] Conversely, mutations or deletions in genes such as SOX9 or its upstream enhancers can prevent proper testis formation in 46,XY individuals, resulting in female phenotypes; duplications of these enhancers in 46,XX cases promote testis development without SRY involvement.^[3] Other implicated genes include NR5A1 (steroidogenic factor-1) and DHX37, which play roles in gonadal differentiation, while conditions like congenital adrenal hyperplasia in 46,XX DSD involve enzyme deficiencies (e.g., 21-hydroxylase) causing androgen excess and masculinization.^[2] Clinically, these disorders present with ambiguous genitalia at birth, infertility risks exceeding 95% in cases like gonadal dysgenesis, and elevated gonadoblastoma tumor risks in dysgenetic gonads, necessitating multidisciplinary management including hormone therapy and potential surgical interventions.^[2] In non-human animals, sex reversal is observed as a natural adaptive mechanism or experimentally induced process, particularly in species with environmental sex determination. In fish such as teleosts, sequential hermaphroditism allows protogynous (female-to-male) or protandrous (male-to-female) transitions influenced by genes like dmrt1, hormones, and temperature, with applications in aquaculture for sex manipulation using steroids.^[1] Reptiles like certain lizards exhibit temperature-dependent sex reversal, where chromosomal females develop as males under cooler conditions, impacting population sex ratios and metabolic traits.^[4] In mammals such as mice, experimental models of gonadal sex reversal via gene knockouts (e.g., Sry or Foxl2) have elucidated the molecular pathways balancing testis and ovary formation, highlighting the bipotential nature of gonadal primordia.^[5] These animal studies underscore the evolutionary conservation of sex determination mechanisms and inform human DSD research.^[5] In plants, sex reversal can occur naturally due to genetic factors or be induced for agricultural purposes, such as in dioecious species like papaya.^[6]

Overview

Definition and types

Sex reversal is a biological process in which an organism's phenotypic sex, encompassing gonadal development and external characteristics, develops in opposition to its genotypic sex determined by chromosomal composition.^[7] This mismatch occurs when the developmental pathway for gonadal differentiation is redirected, typically during embryonic stages, leading to structures such as testes in a genetically female (XX) individual or ovaries in a genetically male (XY) individual.^[8] Sex reversal occurs not only in animals but also in plants, where it can involve changes in floral morphology and reproductive structures. In systems of genetic sex determination (GSD), such as the XX/XY or ZW arrangements, sex reversal disrupts the expected alignment between chromosomes and phenotype.^[7] Several types of sex reversal are recognized based on the extent and direction of the phenotypic shift. Complete reversal involves a full switch to the opposite sex, where the gonad fully develops as the counterpart to the genotypic expectation, resulting in a functional phenotype of that sex.^[9] Partial reversal, in contrast, produces intersex traits with ambiguous or mixed gonadal features, such as ovotestes containing both ovarian and testicular tissue.^[8] Directionally, XY reversal refers to a genetic male developing a female phenotype, while XX reversal describes a genetic female adopting a male phenotype.^[8] Sex reversal must be distinguished from related phenomena like hermaphroditism. Unlike simultaneous hermaphroditism, which involves an individual possessing both male and female gonads concurrently, sex reversal entails a unidirectional switch to a single opposite phenotype without dual functionality.^[7] Sequential hermaphroditism, a natural programmed change between sexes over an organism's life stages in certain species, can represent a form of sex reversal when it results in genotypic-phenotypic discord, as seen in many fish with genetic sex determination, though it aligns with the species' reproductive strategy.^[1] The phenomenon was first described in fish during the early 20th century through genetic studies on species exhibiting phenotypic mismatches.^[10]

Evolutionary significance

Sex reversal enhances reproductive flexibility in various species, allowing adaptation to fluctuating environmental conditions and biased sex ratios that could otherwise limit mating opportunities. This plasticity is particularly evident in sequential hermaphroditism, where individuals switch sex to maximize lifetime reproductive success, as seen in many teleost fish species.^[7] By enabling organisms to respond dynamically to demographic pressures, sex reversal contributes to the stability and resilience of populations in variable habitats.^[11] The prevalence of natural sex reversal varies across vertebrates but is most prominent in fish, where approximately 500 species—representing about 2% of known fish species—exhibit the capacity for sex change as part of their reproductive strategy.^[12] In other vertebrates, such as reptiles and amphibians, it occurs less frequently, often linked to temperature-dependent sex determination (TSD) in specific populations, though rates can increase under environmental stress.^[13] Overall, sex reversal is rare across the ~76,000 vertebrate species (as of 2025), highlighting its specialized role rather than a widespread trait.^[14]^[15] Adaptive hypotheses for the persistence of sex reversal emphasize its benefits in optimizing fitness. The size-advantage model proposes that selection favors sex change in species where fecundity or mating success increases more steeply with body size or age for one sex, allowing smaller individuals to begin as the less fecund sex and switch later.^[16] Frequency-dependent selection further supports this by rewarding switches to the rarer sex, thereby restoring population sex ratio balance and reducing competition for mates.^[17] Additionally, in environmentally labile systems like TSD, sex reversal acts as a bet-hedging strategy, spreading reproductive risk across variable conditions to minimize variance in offspring success despite potential reductions in mean fitness.^[7] Fossil and phylogenetic evidence infers that mechanisms enabling sex reversal, such as TSD, have ancient origins in reptiles, likely ancestral to the group around 250-300 million years ago, with multiple evolutionary transitions to genetic sex determination and occasional reversals thereafter.^[18] This deep history underscores sex reversal's role as a conserved evolutionary tool for coping with climatic variability over geological timescales.^[19]

Mechanisms

Genetic factors

Sex reversal at the genetic level primarily arises from disruptions in the molecular and chromosomal mechanisms governing gonadal differentiation, where specific genes and regulatory pathways determine whether an individual develops testes or ovaries despite their chromosomal sex. In mammals, the Y-chromosome-linked SRY gene acts as the primary trigger for testis development by initiating a cascade that promotes male gonadal fate; loss-of-function mutations in SRY lead to XY individuals developing ovaries and female phenotypes, accounting for approximately 10-15% of cases of 46,XY complete gonadal dysgenesis.^[20]^[21] In fish models like the medaka (Oryzias latipes), the DMY gene, a Y-chromosome-specific duplicate of the autosomal DMRT1, serves as the master sex-determining gene, directly inducing male development when expressed; its absence results in female gonadal formation in XY individuals.^[22]^[23] Similarly, SOX9, a downstream target of SRY in mammals, plays a conserved role in testis differentiation; ectopic activation through duplications in its regulatory enhancers causes XX individuals to develop testes and male traits.^[3] Regulatory networks underlying gonadal fate involve balanced antagonistic pathways that promote either testicular or ovarian development. The Wnt4/β-catenin pathway is essential for ovarian fate, stabilizing β-catenin to suppress male-specific gene expression and maintain female gonadal identity; failure or loss of Wnt4 function leads to partial sex reversal toward male characteristics in XX individuals by allowing inappropriate activation of testis-promoting genes.^[24]^[25] These networks form a bipotential state early in embryogenesis, where the balance tips based on genetic inputs, and disruptions propagate to alter the entire differentiation trajectory. Recent studies have identified additional post-transcriptional regulators, such as the miR-17~92 microRNA cluster, whose deletion in XY mice causes complete male-to-female sex reversal by disrupting gonadal differentiation pathways.^[26] Specific mutations highlight the fragility of these genetic controls. Loss-of-function mutations in sex-determining genes like SRY, often point mutations or deletions in its high-mobility group (HMG) domain, prevent nuclear translocation and DNA binding, resulting in 46,XY gonadal dysgenesis with streak gonads and female external genitalia.^[27]^[28] Conversely, gain-of-function alterations, such as duplications in SOX9 enhancers (e.g., the 32.5 kb region upstream), drive overexpression of SOX9 in XX gonads, overriding ovarian pathways and inducing testis formation.^[3] Dosage effects further underscore the threshold nature of sex determination, particularly for SRY, where protein levels must reach a critical concentration for efficient nucleocytoplasmic shuttling and transcriptional activation of male genes. A 2013 study identified inherited SRY mutations (e.g., p.V60L) that impair nuclear import, reducing effective SRY dosage below the male-determining threshold and causing familial XY sex reversal, demonstrating how subtle quantitative changes can destabilize gonadal fate.^[29]

Environmental and hormonal influences

Environmental and hormonal influences play a critical role in sex reversal across various species, particularly in those with temperature-dependent sex determination (TSD) or sensitivity to endocrine disruptors. In TSD systems, prevalent in reptiles such as turtles, crocodilians, and some lizards, incubation temperature during a thermosensitive period determines gonadal fate by influencing the differentiation of undifferentiated gonads. Low temperatures (typically 22–27°C) often produce one sex, while higher temperatures (30°C and above) favor the other, with the pivotal temperature—the point yielding a 1:1 sex ratio—varying by species; for example, in the Kemp's ridley sea turtle (Lepidochelys kempii), this occurs around 30.2°C. In the central bearded dragon (Pogona vitticeps), high incubation temperatures (above 32°C) override genetic sex determination, causing genetically male (ZZ) individuals to develop as phenotypic females, a process that can rapidly shift populations toward TSD under climate warming. Species with TSD are more susceptible to such reversals due to underlying genetic predispositions that allow environmental cues to modulate sex gene expression. Emerging research also indicates that gut microbiota alterations during natural sex reversal in teleost fish may facilitate the process through microbial-derived cues influencing gonadal development.^[30] Endocrine-disrupting chemicals (EDCs) from pollutants further induce sex reversal by mimicking or blocking hormones. The synthetic estrogen 17α-ethinylestradiol (EE2), a common pharmaceutical contaminant, causes feminization and complete sex reversal in amphibians at environmentally relevant concentrations (50–5,000 ng/L), leading to male-to-female shifts and intersex gonads in species like Xenopus laevis and Rana temporaria. Conversely, the synthetic androgen trenbolone, an agricultural runoff product, promotes masculinization in fish without causing full sex reversal in amphibians but altering gonad morphology and function across taxa. These EDCs interfere with steroid signaling pathways, amplifying reversal risks in polluted aquatic environments where amphibians and fish are highly exposed. Hormonal manipulations directly trigger reversal by altering estrogen-androgen balances. Inhibition of aromatase, the enzyme converting androgens to estrogens, blocks estrogen production and induces female-to-male reversal in fish and reptiles; for instance, aromatase inhibitors like letrozole cause phenotypic males in genetic females of species such as the newt Pleurodeles waltl and the turtle Trachemys scripta. Exogenous administration of androgens or estrogens similarly drives reversal: in fish, dietary 17α-methyltestosterone (MT) at doses around 60 mg/kg feed masculinizes genetic females, suppressing ovarian development and promoting testes formation in species like Nile tilapia (Oreochromis niloticus) by downregulating cyp19a1a (aromatase) expression. Estrogens like estradiol-17β can reverse males to females in sensitive species, highlighting the plasticity of gonadal differentiation. Epigenetic modifications, such as DNA methylation, mediate these environmental effects by altering sex gene expression without changing the DNA sequence. Under thermal stress in TSD species, hypermethylation of promoters for genes like cyp19a1 (aromatase) suppresses estrogen synthesis, favoring male development, as observed in reptiles and fish. In bearded dragons, high temperatures induce sex reversal accompanied by temperature-dependent global DNA methylation changes that are inherited transgenerationally, reinforcing TSD and demonstrating how environmental stress epigenetically reprograms sex determination pathways.

In plants

Natural sex reversal

Natural sex reversal in plants refers to spontaneous changes in sexual phenotype occurring in dioecious or subdioecious species without human intervention, often triggered by environmental or developmental factors that disrupt stable sex expression. In dioecious plants like papaya (Carica papaya), which possess nascent XY sex chromosomes where XX individuals are female, XY are male, and XY^h are hermaphroditic, stress can induce shifts such as hermaphrodites developing male flowers or females exhibiting partial maleness.^[31]^[32] Similarly, in cannabis (Cannabis sativa), genetic females (XX) can produce male flowers under stress, reflecting the species' high sexual plasticity linked to ethylene modulation.^[33]^[34] These reversals are commonly prompted by abiotic stresses, including variations in light intensity, nutrient availability, and physical damage. For instance, high light intensity has been observed to promote male traits in certain species, such as increased maleness in monoecious ragweed (Ambrosia artemisiifolia, Asteraceae).^[35] Nutrient deficiencies, particularly nitrogen scarcity, and water stress can shift hermaphroditic papaya toward greater maleness by reducing carpel number in flowers.^[36]^[37] Wounding or mechanical damage similarly induces hermaphroditism in cannabis, where female plants develop pollen sacs as a stress response.^[38] At the mechanistic level, these changes often involve phytohormonal imbalances, with gibberellins favoring male flower development and ethylene promoting femaleness across various species.^[39] In cucumber and spinach, for example, elevated gibberellin levels suppress female structures, while ethylene inhibits male tendencies.^[40]^[41] Additionally, in subdioecious plants like papaya, instability in young sex chromosomes contributes to reversible sex expression under stress, allowing phenotypic flexibility beyond strict genetic control.^[31] A notable example of pathogen-induced reversal occurs in Silene latifolia, a dioecious plant with XY sex determination, where infection by the anther smut fungus (Microbotryum lychnidis-dioicae) causes female flowers to develop male-like structures, effectively masculinizing them.^[42] This fungal manipulation exploits host hormonal pathways, reducing sexual dimorphism and altering gene expression in a sex-specific manner.^[43] Such instances highlight how natural pressures can override genetic sex cues in plants.

Induced reversal in agriculture

Induced sex reversal in plants has been employed in agriculture since the 1970s, initially for hemp (Cannabis sativa), where exogenous applications of chemicals like auxins and gibberellins were shown to alter sex expression in dioecious varieties.^[44] Early experiments by Ram and Jaiswal (1970, 1972) demonstrated that treatments could induce hermaphroditic inflorescences, facilitating controlled breeding without separate male plants. By the 2020s, these methods have gained prominence in the cannabis industry for producing feminized seeds, driven by legalization and demand for high-THC cultivars. Recent multi-omic studies (as of 2025) have elucidated the genetic basis of this sexual plasticity in cannabis, identifying ethylene-responsive genes that enable phenotypic reversal.^[45]^[46] Key techniques involve disrupting natural hormonal balances, such as the antagonism between gibberellic acid (GA3), which promotes maleness, and ethylene, which favors femaleness. In cannabis, foliar applications of GA3 at doses of 50–100 μg per plant can reverse female plants to produce male flowers, though efficacy varies by strain and application timing.^[46] Similarly, aminoethoxyvinylglycine (AVG), an ethylene biosynthesis inhibitor, induces male flower development on female cannabis plants when applied at 250–500 ppm, blocking ethylene's feminizing effects and yielding viable pollen for breeding.^[47] In papaya (Carica papaya), induced reversal supports seed production by converting male trees to hermaphrodites, which bear marketable elongated fruits and self-pollinate effectively. Ethephon (ethrel), a ethylene-releasing compound, applied at concentrations of 500–1000 ppm, promotes female or hermaphroditic flowers on male plants, enabling fruit set and seed harvest without relying solely on natural hermaphrodites.^[48] A 2023 study on cannabis confirmed AVG and silver thiosulfate (AG3, an ethylene antagonist) efficacy, with AVG at 100 µg per plant inducing male flowers in treated females, producing pollen viable for feminized seed creation at rates comparable to traditional methods.^[49] These practices enhance agricultural yields by enabling uniform female crops—ideal for fiber, fruit, or cannabinoid production—reducing the space needed for male plants.^[50] However, risks include the development of intersex traits, such as unstable hermaphroditism, which can lower fruit quality or seed viability in subsequent generations due to reduced pollen fitness.^[51] Environmental concerns arise from hormone runoff, as synthetic regulators like AVG may persist in soil and waterways, potentially disrupting non-target plant hormone signaling and aquatic ecosystems, though gibberellins degrade more rapidly.^[52]

In animals

In fish

Sex reversal in fish encompasses a range of natural phenomena, prominently featuring sequential hermaphroditism, where individuals change sex during their lifetime to optimize reproductive success in dynamic environments. This strategy is particularly prevalent among reef-associated species, allowing adaptation to social hierarchies and resource availability. Sequential hermaphroditism occurs in two main forms: protandry, where fish transition from male to female, and protogyny, where the change is from female to male.^[53]^[54] Protandrous hermaphroditism is exemplified by clownfish (Amphiprion spp.), which are born as males and live in hierarchical groups within sea anemones, with the largest individual functioning as the breeding female. Upon the female's death or removal, the dominant male undergoes gonadal restructuring to become female, a process driven by social cues and size advantages, ensuring continued reproduction in the harem. This reversal is irreversible and typically occurs in adulthood, highlighting the plasticity of sex determination in response to group dynamics.^[55]^[56] In contrast, protogynous hermaphroditism is common in wrasses, such as the bluehead wrasse (Thalassoma bifasciatum), where most individuals begin life as females and transition to males after spawning, often triggered by the absence of a dominant male in the population. This change involves rapid behavioral shifts, including increased aggression and courtship, and is adaptive in polygynous mating systems on coral reefs, where larger males gain territorial advantages. The medaka (Oryzias latipes) serves as a key model for genetic sex reversal, where instability or mutations in the Y-linked DMY gene (also known as dmrt1bY) can lead to XX individuals developing as phenotypic males, demonstrating how genetic factors underlie spontaneous reversals.^[57]^[58] Sequential hermaphroditism has been documented in approximately 30 fish families, spanning multiple orders, and is especially adaptive in coral reef ecosystems, where it enhances lifetime reproductive output by aligning sex with optimal body size and social roles—smaller individuals often benefit from one sex, while larger ones from the other. This prevalence underscores its evolutionary significance in about 2% of all fish species, though concentrated in specific lineages like Labridae and Serranidae. Interactions with population density further modulate reversal rates; for instance, in overcrowded experimental conditions, social stress can elevate sex change incidence by up to 15%, as seen in density-manipulated groups of certain teleosts, amplifying adaptive responses to resource competition.^[54]^[59]^[60] Hormonal induction, such as with methyltestosterone, can experimentally trigger reversals in gonochoristic species, but natural forms predominate in wild populations.^[61]

In amphibians

In amphibians, sex reversal occurs when environmental factors override genetic sex determination, leading to discrepancies between genotypic and phenotypic sex. Many species, particularly in the family Ranidae, exhibit genetic sex determination via XY or ZW systems, but these can be labile, allowing temperature or chemical exposure to induce reversal during larval stages.^[62] Temperature plays a key role in bidirectional sex reversal in species like the common frog (Rana temporaria), where cooler temperatures during development feminize genetic males, while warmer temperatures masculinize genetic females. This plasticity was first demonstrated in classic experiments showing that exposure to low temperatures (around 15–18°C) during tadpole stages promotes ovarian development in XY individuals, whereas high temperatures (above 28°C) trigger testicular formation in XX individuals. Such effects highlight the sensitivity of amphibian gonadal differentiation to thermal cues, potentially linked to shifts in hormone signaling during metamorphosis.^[63] Anthropogenic pollutants, especially endocrine-disrupting chemicals, frequently cause sex reversal in amphibians. For instance, exposure to the synthetic estrogen 17α-ethinylestradiol (EE2), a component of birth control pills, induces male-to-female reversal in the African clawed frog (Xenopus laevis), with concentrations as low as 6.5 ng/L resulting in 80–100% feminization of genetic males (ZZ individuals) by adulthood. This occurs through interference with androgen signaling and promotion of estrogenic pathways during the sensitive thermosensitive period of gonadal development (stages 46–52). Similar disruptions have been observed across amphibian species, underscoring their vulnerability to aquatic contaminants.^[64] Natural and induced reversals are evident in wild populations of green frogs (Lithobates clamitans), where 5–10% of individuals exhibit sex reversal even in relatively pristine habitats, as detected through molecular markers for sex chromosomes. In these ranid frogs, genetic females (XW) develop as phenotypic males at rates up to 10.6% in some ponds, potentially driven by subtle environmental variations. Additionally, the synthetic androgen trenbolone, an environmental pollutant from cattle feedlots, induces female-to-male reversal in species like the black-spotted pond frog (Pelophylax nigromaculatus), with concentrations of 162–520 ng/L causing complete sex reversal and increased mortality in genetic females during larval exposure.^[65]^[66] These reversals have significant ecological implications, contributing to skewed sex ratios and population declines in wild amphibians. A 2019 study on green frogs found sex reversal in 12 of 16 populations, suggesting it exacerbates demographic imbalances that may accelerate declines, particularly when combined with habitat loss and disease. Such patterns emphasize the role of environmental stressors in amphibian biodiversity threats.^[65]

In reptiles

In reptiles, sex determination frequently relies on temperature-dependent mechanisms (TSD), where the incubation temperature of eggs during a critical embryonic period dictates gonadal development, overriding or interacting with genetic factors in many species such as crocodilians, turtles, and certain lizards.^[67] This system contrasts with genetic sex determination (GSD) in other vertebrates and allows for environmental influences on sex ratios, with two primary TSD patterns identified: Pattern Ia (MF), in which low temperatures produce males and high temperatures produce females, prevalent in numerous turtle species; and Pattern II (FMF), where low and high temperatures yield females while intermediate temperatures produce males, observed in crocodilians like alligators and some turtles.^[68] These patterns enable adaptive responses to environmental conditions but also facilitate sex reversal when temperatures deviate from typical ranges. For instance, the American alligator (Alligator mississippiensis) follows the FMF pattern, with female development at low incubation temperatures (around 30°C) and high temperatures (above 34°C), and male development at intermediate temperatures (32–33°C).^[69] Similarly, many turtles exhibit TSD, with the common snapping turtle (Chelydra serpentina) displaying Pattern II, where females develop at low (below 25°C) or high (above 29°C) temperatures and males at intermediate ranges (26–28°C).^[70] These temperature thresholds influence population sex ratios and are sensitive to nest microclimates, underscoring the evolutionary flexibility of TSD in ectothermic reptiles. Sex reversal occurs in reptiles when high temperatures override GSD, leading to discordance between genetic and phenotypic sex, as seen in lizards like the central bearded dragon (Pogona vitticeps). This species employs a ZW chromosomal system (ZZ for genetic males, ZW for genetic females), but incubation at high temperatures (above 32°C) induces ZZ individuals to develop as functional, often highly fertile phenotypic females. Documented in a seminal 2015 study, this reversal was first reported in wild Australian populations, where warmer nest conditions—exacerbated by climate change—produced ZZ females that outcompeted ZW females in reproduction, facilitating a rapid evolutionary transition toward predominant TSD within just a few generations. Hormonal interventions further demonstrate the lability of sex determination in TSD reptiles; in snapping turtles, application of aromatase inhibitors during female-producing temperatures blocks estrogen synthesis, causing genetic females to develop as phenotypic males. This reversal highlights the pivotal role of estrogen signaling in ovarian differentiation and parallels natural overrides by temperature extremes. In wild reptile populations facing climate-induced thermal stress, sex reversal frequencies can reach notable levels, with observations in bearded dragons indicating its occurrence in specific hotspots where high nest temperatures prevail, potentially altering population dynamics and accelerating shifts in sex-determining modes.

In birds

Sex reversal in birds, which employ a ZW sex-determination system where males are ZZ and females are ZW, occurs naturally at low frequencies in wild populations, particularly in Australian species. A 2025 study of free-living birds in southeastern Queensland identified sex-reversed individuals in five native species, with prevalence rates ranging from 3% to 6.9%; for instance, laughing kookaburras (Dacelo novaeguineae) exhibited the highest rate at 6.9%, while Australian magpies (Gymnorhina tibicen) showed 4%.^[71] In these cases, 92% of reversed birds were genetically female (ZW) but developed male reproductive organs, such as testes, while one genetically male (ZZ) laughing kookaburra displayed female traits, including large ovarian follicles, a distended oviduct, and evidence of recent egg-laying.^[71] The genetic basis for such reversals stems from instability in the ZW system, where imbalances in sex chromosome gene expression can disrupt gonadal differentiation. In birds, the W chromosome carries female-determining factors, but disruptions—potentially including aneuploidies like ZZW or ZO—can lead to incomplete or reversed sexual development.^[72] Estrogen imbalances in wild populations may exacerbate this, with environmental contaminants acting as endocrine disruptors to elevate estrogen levels or mimic hormonal signals, prompting phenotypic males from genetic females.^[73] These factors highlight the sensitivity of avian sex differentiation to both genetic and exogenous influences beyond strict chromosomal control.^[72] Experimentally, sex reversal can be induced in birds through hormonal manipulations, demonstrating the plasticity of their sex determination pathway. For example, subcutaneous implants of diethylstilbestrol, a synthetic estrogen, in immature male chickens (Gallus gallus domesticus) trigger feminization, including oviduct development and female-like plumage patterns.^[74] Similarly, embryonic exposure to estradiol or overexpression of aromatase—an enzyme converting androgens to estrogens—reverses ZZ males toward female gonadal structures, though full functionality varies.^[75] These interventions underscore how estrogen signaling overrides genetic cues during critical developmental windows.^[72] Despite their rarity, sex reversals in birds are associated with notable changes in plumage, behavior, and reproductive capacity, potentially impacting population dynamics. Reversed individuals often exhibit mixed traits, such as male-like aggression in genetic females or altered mating displays, which may reduce fitness in wild settings.^[71] A 2018 review in Current Biology emphasized that such cases, while infrequent, reveal the evolutionary lability of avian sex determination and parallels to other vertebrates, including incomplete reversals akin to polled intersex syndrome in goats.31268-5)

In mammals

Sex reversal in mammals typically involves disruptions in the genetic or hormonal pathways that determine gonadal development, leading to individuals with atypical sex phenotypes despite their chromosomal constitution. In non-human mammals, such reversals are rare but well-documented in certain species, often resulting in infertility or reduced reproductive success. These cases provide insights into the plasticity of mammalian sex determination, which is predominantly governed by the XY system where the SRY gene on the Y chromosome initiates testis formation.^[8] A prominent example occurs in domestic goats (Capra hircus), where the polled intersex syndrome (PIS) causes XX individuals to develop as phenotypic males with testes instead of ovaries. This autosomal dominant mutation, linked to the absence of horns, results from a 11.7 kb deletion upstream of the FOXL2 gene, which disrupts ovarian differentiation and leads to female-to-male sex reversal in homozygous XX goats. Affected animals exhibit male external genitalia but are often sterile due to underdeveloped gonads.^[76]^[77] In rodents, natural XY sex reversal is observed in the wood lemming (Myopus schisticolor), where approximately 25% of females possess an XY karyotype yet develop as fertile females. This occurs due to a mutation on the X chromosome that suppresses the male-determining function of the Y-linked SRY gene, allowing ovarian development and normal female fertility in these individuals. Such reversals contribute to female-biased sex ratios in wild populations, with up to 75% females in some groups.^[78]^[79] Key causes of sex reversal in mammals include genetic translocations of the SRY gene to the X chromosome in XX males, as seen in some bovine species, and mutations in genes like FOXL2 that promote ovarian maintenance. In mouse models, combined loss of FOXL2 and WNT4 triggers female-to-male reversal by allowing ectopic expression of testis-promoting factors. Hormonal disruptions during pregnancy, such as exposure to anti-Müllerian hormone (AMH), can also induce reversal, particularly in livestock.^[80]^[81]^[82] In cattle breeding, freemartinism exemplifies hormonal-induced reversal, affecting about 90-95% of XX female calves twinned with XY males due to shared placental circulation. The female fetus is exposed to AMH and testosterone from the male twin, leading to masculinization of the reproductive tract, underdeveloped ovaries, and sterility, while the male twin remains unaffected. This condition impacts livestock productivity, as freemartin heifers are typically culled to avoid breeding losses.^[82]^[83] Naturally occurring sex reversal in wild mammals is uncommon, with prevalence generally below 1% across populations, though it reaches higher frequencies in specific lineages like the wood lemming. In laboratory models, targeted disruptions elevate rates; for instance, deletion of a SOX9 enhancer in mice causes complete XY male-to-female reversal by preventing testis differentiation. Similar enhancer duplications or deletions around SOX9 have been modeled to study reversal mechanisms.^[8]^[84]^[3] These mammalian examples parallel certain human mutations, such as those in SOX9 or FOXL2, highlighting conserved pathways in sex determination across species.^[3]

In humans

Sex reversal in humans manifests as disorders of sex development (DSD), where genetic or chromosomal factors lead to atypical gonadal differentiation and phenotypic sex that does not align with the expected chromosomal sex.^[85] In 46,XY DSD, individuals with a male karyotype develop female external genitalia and internal structures due to failure of testicular development, often resulting in streak gonads.^[86] Complete gonadal dysgenesis, also known as Swyer syndrome, is a primary form where mutations in the SRY gene on the Y chromosome disrupt testis-determining pathways, leading to a female phenotype despite the 46,XY karyotype; such SRY variants account for 10-15% of 46,XY gonadal dysgenesis cases.^[87] Conversely, 46,XX testicular DSD involves individuals with a female karyotype developing male external genitalia and testes, frequently due to duplications upstream of the SOX9 gene, which overexpression drives testicular differentiation.^[88] These conditions highlight the critical dosage-sensitive roles of genes like SRY in mammalian sex determination.^[3] The prevalence of sex reversal in humans is estimated at approximately 1 in 20,000 births, encompassing both 46,XY and 46,XX forms, though 46,XX testicular DSD specifically occurs in about 1 in 20,000 phenotypic males.^[85] Affected individuals are typically infertile, with 46,XY cases featuring nonfunctional streak gonads that produce no hormones, leading to primary amenorrhea and lack of secondary sexual characteristics without intervention, while 46,XX cases often have small, azoospermic testes.^[89] A significant clinical concern is the elevated risk of gonadal tumors, such as gonadoblastoma, estimated at 15-33% in 46,XY gonadal dysgenesis due to dysgenetic gonadal tissue harboring germ cells with Y chromosome material.^[90] Diagnosis involves multidisciplinary evaluation, including karyotyping to confirm chromosomal sex, hormone assays (e.g., elevated FSH and low anti-Müllerian hormone in 46,XY DSD), pelvic ultrasound for internal structures, and genetic testing for mutations in SRY or SOX9 regulatory elements.^[91] Management focuses on preventing complications and supporting development; prophylactic gonadectomy is recommended early in 46,XY cases to mitigate tumor risk, followed by hormone replacement therapy with estrogen for feminization and, later, progesterone for menstrual induction.^[92] In 46,XX testicular DSD, testosterone replacement addresses hypogonadism, though gonadectomy may be considered if tumor risk is present.^[93] A 2016 study identified NR5A1 variants as contributing to dosage imbalances in gonadal development, underscoring the need for tailored surgical timing in DSD management.^[94] Historical cases of sex reversal were first systematically reported in the 1950s, with Swyer syndrome described in 1955 based on phenotypic females with 46,XY karyotypes and nonfunctional gonads.^[95] Advancements in understanding regulatory mechanisms came with a 2018 study demonstrating that duplications or deletions of core enhancers upstream of SOX9 directly cause 46,XX or 46,XY sex reversal, respectively, by altering gene expression dosage.^[3]

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Oct 29, 2016 · Ongoing research has identified high rates of sex reversal (28% XX male) in nests of an alpine population of B. duperreyi (fig. 2), but it is ...
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Natural sex reversal is rare in vertebrates, being most common in fish, less so in amphibians and reptiles, and not normal in birds and mammals. In humans, sex ...<|control11|><|separator|>
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Several studies now indicate that TSD is the likely ancestral state in reptiles from which GSD evolved independently multiple times, with reversals occurring ...
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Familial Mutation in the Testis-Determining Gene SRY Shared by an ...
In humans, mutations in the testis-determining gene SRY result in XY sex reversal with pure gonadal dysgenesis (PGD). However, only about 10–15% of the ...
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The Japanese medaka fish Oryzias latipes has an XX/XY sex-determination system. The Y-linked sex-determination gene DMY is a duplicate of the autosomal gene ...
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Taken together with the previous data, our results indicate that DMY is the sex-determining gene in medaka. Thus, DMY is the first sex-determining gene to be ...
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temperature and water stress can lead to a shift toward maleness, in the form of a reduction in the number of carpels (normally five) comprising the fruit.<|separator|>
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Incidence, Prevalence, Diagnostic Delay, and Clinical Presentation ...
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Risk of gonadal neoplasia in patients with disorders/differences of ...
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Evaluation and Management of Disorders of Sex Development
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Management of 46,XY Differences/Disorders of Sex Development ...
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Aug 4, 2016 · We propose NR5A1, previously associated with 46,XY DSD and 46,XX primary ovarian insufficiency, as a novel gene for 46,XX (ovo)testicular DSD.
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Swyer syndrome was first described by Dr. Swyer in 1955 in two women with primary amenorrhea, with normal appearance of external genitalia and normal vagina ...