Do individuals with CAIS have female sex organs? Or do they have male sex organs?

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[–]Kai_Decadence 1 insightful - 1 fun1 insightful - 0 fun2 insightful - 1 fun -  (3 children)

I remember watching a little briefing on CAIS and if I remember correctly, they do possess female sex organs. The complication that comes up with them is that they are also born with internal gonads but they're non-functional and are dormant.

I don't think there's been a condition where a person born with male genitalia, was also born with a uterus.

[–]MarkTwainiac 7 insightful - 1 fun7 insightful - 0 fun8 insightful - 1 fun -  (2 children)

they are also born with internal gonads but they're non-functional and are dormant.

Kai, the testes of persons with CAIS are NOT "non-functional" or "dormant." They work fine in performing one of the main tasks of testes, which is to produce testosterone. Persons with CAIS produce normal amounts of testosterone from their testes - and some of them produce T in levels that are much higher than males normally do.

However, because their androgen receptors don't work, their bodies can't use the T their testes produce - and the T gets converted into estrogen through a process known as aromatization.

It's not accurate to say that persons with CAIS "do possess female sex organs." They don't have ovaries, Fallopian tubes, a uterus & cervix, or a fully developed vagina. They have the lower portion of a vagina, and their vaginas have different properties to a normal woman's vagina. Persons with CAIS historically had vaginoplasties to create a cavity that was capable of having penetrative sex with a penis. Today, the custom of routinely doing vaginoplasties on persons with CAIS is going out of fashion. However, these persons still have to dilate if they want to have PIV, and my understanding is that they have to use exogenous lubrication as well. Coz whereas regular vaginas are muscular tubes that are highly elastic and lined with special mucous membranes, the so-called vaginas of persons with CAIS do not possess these characteristics.

Males with PMDS have rudimentary internal Mullerian structures, including an undeveloped uterus.

[–]Kai_Decadence 5 insightful - 1 fun5 insightful - 0 fun6 insightful - 1 fun -  (1 child)

But still, women with CAIS still develop as a female despite the genital complications from what I've read which is why it's best to just call them women because they are more than likely gonna go through life experience as a young female child no?

[–]MarkTwainiac 7 insightful - 1 fun7 insightful - 0 fun8 insightful - 1 fun -  (0 children)

If you go by outward appearance alone, yes persons with CAIS develop a largely female-looking phenotype. But that doesn't mean they have "female sex organs" as you claimed. By making that statement, you appear to be taking a very male view of what female humans are, implying that all it takes to be female is not to have a penis or balls and to have some kind of hole for males to stick their penises into.

I have no problem calling persons with CAIS girls and women. But still, it's not true that they "develop as a female" the way you say. They are in a unique position, very different to standard males and standard females. It insults them and us female people both to say they are exactly like us.

And no, persons with CAIS do not go through the same life experience as a female persons do, not even in childhood. Sure, there will be many similarities. But there will be many differences too.

For example, one of the major childhood milestones for girls is getting your period and learning to deal with it, and learning to cope with all the myriad changes that occur in the female body over the course of the 28-day ovulation-menstrual cycle. The average age for first period is shortly after turning 12, but many girls get theirs at 11, 10 or even 9. In my family, all the girls got our periods at 10 or just after turning 11. It's only considered too early and abnormal if a girl starts menstruating before age 8.

Periods and the monthly cycle are huge issues in girls' lives, and our lives once we grow up and become women - but persons with CAIS will never have to deal with any of that. Because their estrogen comes from converted testosterone made by their testes, persons with CAIS have the same steady state of hormones day after day - which is nothing like what females go through. Just as they will never menstruate, experience menstrual flooding and leakage, have cramps or have to deal with the passage of alarmingly large blood clots from their "vaginas," persons with CAIS will never go through the sorts of changes - which often include mood fluctuations, bloating, breast tenderness, insomnia, appetite changes, marked differences in libido and sexual response, etc - that girls and women go through each month as a matter of course.

Similarly, once they become sexually active, persons with CAIS who have sex with males never have to worry about contraception or deal with an unplanned pregnancy, which are issues that weigh very much on the minds of sexually active girls & women with female repro organs who have sex with males. Persons with CAIS have to deal with infertility, but so do many bog standard XX women with the full set of female sex organs. Moreover, in dealing with infertility, persons with CAIS won't have to go through any of the testing & treatments that are pushed on XX women, often to the detriment of their physical health and mental wellbeing. No one will ever suggest that someone with CAIS should consider undergoing grueling drug regimens and invasive procedures to harvest her eggs, withstand interventions like IVF and IUI or at-home "artificial insemination," or consider using donor eggs.

Persons with CAIS also don't go through menopause and all the changes that brings both during the menopause years (and before them during peri-menopause) and in the decades afterwards. The life experience of persons with CAIS is actually very different to the the life experience of us "standard issue" women with female reproductive systems and female physiology.

There are many other differences in the life experiences I could list, but I think I've made my point.