An Iranian boy has been born without a penis — and surgeons controversially want to craft him a vagina instead. The unidentified boy’s condition, medically called aphallia, is so rare it is thought to only occur in up to one in 30million births.
Fewer than 100 cases have been documented in medical literature.
The boy, who was 14 months old when his case was published in a journal, still had an intact scrotum and two testicles.
This image shows the boy’s urinary system after he was given a rectal enema with a special dye that would be highlighted by a scan. It shows how the connection between his bladder and his rectum
Yet he urinated through his anus as a result of his extraordinary defect.
Aphallia occurs when genitalia fails to develop normally in the womb during the first few months of pregnancy.
It is a similar process that causes diphallia, where boys are born with two penises.
Medics who reported the case in the journal Radiology Case Reports said the boy was born normally in a ‘good general state’.
His mother, who also wasn’t named, reported no problems during her pregnancy.
Special tests carried out months after he was born allowed doctors to work out how his unique urinary system worked.
A special dye revealed a fistula, an abnormal connection between his bladder and his rectum.
Surgeons nowadays craft boys born with aphallia a penis, in a procedure known as a phalloplasty.
Aphallia is an incredibly rare condition only occurring in one in every 10million to 30 million births
They can also be given a urethra, with doctors connecting their urinary system together again.
But in this case, medics controversially said the recommended treatment is gender reassignment and feminisation surgery to create a pseudo-vagina.
They also recommend oestrogen therapy during puberty to repress changes in his body such as the development of facial hair and the deepening of the voice to conform to his new gender.
While this historically been how aphallia has been treated, with the boys then raised as girls, intersex and DSD charities have criticised this approach as it is usually driven by societal expectations of gender and sex, not for a medical reason.
The medics at Zahedan University of Medical Sciences did not state if the boy was going to get feminisation surgery, however.
Boys born with aphallia are also known as intersex.
It has been estimated that aphallia only occurs in one every 10million to 30million births.
However, some experts believe that cases are underreported due to social stigma surrounding the condition in some parts of the world.
Scientists don’t know what triggers aphallia to happen in the womb.
What is aphallia and what happens to those with the condition?
Aphallia is name for an extremely rare condition where a boy is born without a penis.
How does it happen?
Experts don’t know what causes it, but it occurs in the womb as the foetus develops its urinary system and genitals.
Something goes wrong in this process causing aphallia.
How do people with aphallia urinate?
Sometimes a hole develops in the perineum for the boy to urinate from.
In other cases the bladder may connect to the rectum and urine passes out of the anus.
How is treated?
Each case is individual with the malformation that results in aphallia sometimes impacting kidney function.
Boys with aphallia sometimes have feminisation surgery and are raised as girls, though this is controversial as it is generally done because of social expectations, not for medical reasons.
Can people with aphallia have children?
This depends on if their testicles developed correctly, and if they were not removed as part of feminisation surgery.
Thanks to IVF technology it is technically possible for people with aphallia to have children if their sperm can be extracted.
