Cloacal exstrophy is a rare birth defect that affects the pelvis and genitals. For genetic males born with this condition, it has been advocated to assign them a female sex at birth through surgery. However, some studies have found that some of these individuals later identify as male despite being raised as female. This suggests that prenatal androgen exposure plays a role in sexual identity development.

3. Cloacal Exstrophy Reiner, William G. and Gearhart, John P. Discordant Sexual Identity in Some Genetic Males with Cloacal Exstrophy Assigned to Female Sex at Birth. THE NEW ENGLAND JOURNAL OF MEDICINE, 350:333-341 (2004)

4. Cloacal Exstrophy Reiner, William G. and Gearhart, John P. Discordant Sexual Identity in Some Genetic Males with Cloacal Exstrophy Assigned to Female Sex at Birth. THE NEW ENGLAND JOURNAL OF MEDICINE, 350:333-341 (2004)