A 26-year-old woman in China who had never menstruated discovered that she was biologically male.
She later learned that she lacked a uterus, ovaries, and fallopian tubes. The diagnosis ultimately caused her to break up with her boyfriend.
According to Chinese reports, Ms Li Li (pseudonym name transliterated from Mandarin) sought medical attention at the age of 19 and was initially diagnosed with an “infantile uterus”.
The doctor explained that her uterus was underdeveloped and smaller than normal, adding that there were no particularly good treatment options available at the time and advising her to wait and observe.
Source: PR Image Factory on Canva, for illustration purposes only
At 26, during a company-sponsored physical examination in Shenzhen, an ultrasound revealed that Ms Li Li “had no uterus, ovaries, or fallopian tubes inside her body, and had a symmetrical cyst on each side of her abdominal cavity”.
That was when she learned she had been born without a uterus or ovaries.
She was even more shocked when subsequent chromosomal testing showed that her karyotype was actually 46, XY — male chromosomes.
After detailed examination results were disclosed, it was revealed that Ms Li Li was suffering from a rare condition known as Complete Androgen Insensitivity Syndrome (CAIS).
This indicates that Ms Li Li is biologically male, but because her body is insensitive to androgens, she developed a female physical appearance.
She shared that she found it hard to accept the result.
Doctors explained that Androgen Insensitivity Syndrome (AIS) is a genetic condition primarily linked to mutations in the androgen receptor (AR) gene.
Normally, individuals with male chromosomes develop along a male physiological path.
Source: Guancha
However, in cases of CAIS, although testicular tissue is present and secretes androgen, androgen receptors in the body’s cells function abnormally and cannot properly receive androgen signals.
As a result, typical masculinisation cannot be completed.
This is why Ms Li Li possesses a female appearance, a female physique, female external genitalia, and a vagina, but lacks an internal uterus and ovaries, leaving her unable to menstruate or become pregnant naturally.
Follow-up examinations further revealed that the abdominal cysts detected during her physical exam were not typical, but rather undescended testicular tissue that had failed to descend into a scrotum.
Source: 大河报 on Weibo
Furthermore, the testicle on one side had already developed a risk of pathological changes.
Acting on medical advice, Ms Li Li underwent surgery to remove the left undescended testicle.
After learning about her condition, Ms Li Li disclosed her diagnosis to her boyfriend. The revelation led to their breakup due to “clashes in their personalities.”
In June, Ms Li Li experienced gastrointestinal discomfort.
An ultrasound discovered a mass with abnormally rich blood flow signals inside her abdominal cavity, the remaining, unremoved undescended testicle.
After assessing the risks, doctors strongly recommended prompt surgical removal of the lesion.
Ultimately, the gynaecology team performed a successful minimally invasive laparoscopic tumour resection.
Currently, Ms Li Li has been discharged from the hospital and is taking prescribed hormone therapy under medical guidance.
She has since returned to her normal work routine.
Ms Li Li told Taiwan media that she loves children and completed a major in early childhood education.
She added: “I might consider adopting [a child] in the future.”
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Featured image adapted from PR Image Factory on Canva, for illustration purposes only, and Anirudh on Unsplash.