Clueless Comments: transsexual rights Further, historically and currently in most cases genital intersexuality or early genital damage have been handled during infancy - obviously without input from the individual being treated. For pragmatic (if questionable on ethical and efficacy grounds) reasons this generally involves the surgical creation of a neo-vagina in cases of herms, merms, or irreparable genital damage with the later introduction of exogenous hormones (17b-Estradiol or a variant like Estradiol Valerate, sometimes also a progestin/progesterone - unlikely to reach Tanner 4/5 without the latter, but it's done) at the proper point. These people would be legally male or legally female, depending on the particular root cause, under Littleton without regard to their lives or the uniqueness of their situation. Complicating the situation further, in some instances these people are not told of the particulars of their situation and may not even know, and in some instances when they do find out they detransition - sexually reassigning children has a lousy track record at best.