When a 10-day-old baby was brought to the OPD at AIIMS New Delhi, doctors immediately sensed that this was not an ordinary case.

The infant, born into a poor family, was critically ill and severely dehydrated. The parents had been raising the child as a girl, but the baby’s external genitalia did not clearly indicate whether the child was male or female.

There were no visible male testes either, leaving the family confused and anxious  Doctors began a series of tests. Blood investigations revealed low sodium and dangerously high potassium levels, while an ultrasound scan provided further clues. 

After careful evaluation, doctors explained to the parents that the child was biologically female and would require corrective surgeries later in life.

With proper medical care, they were assured, the child could lead a completely normal life. But the story took a heartbreaking turn. Just ten days later, the same infant returned to AIIMS—not with the parents, but brought in by members of the transgender community.

The baby was in shock.  A resident doctor recognised the child immediately. Despite treatment and repeated counselling, the parents refused to take the child home.  Eventually, the baby was sent to a child care home. Medical care at AIIMS continued, and at the age of one-and-a-half years, the child was adopted by a foreign national through the Central Adoption Resource Authority. 

Today, the child is healthy and thriving. Doctors say this is far from an isolated incident.

At AIIMS New Delhi, hundreds of such cases are reported where a child is born neither clearly male nor female. Many families, overwhelmed by fear of social stigma and shame, choose to walk away.  Yet doctors stress that this condition is medical in nature and entirely treatable.

“This condition is known as Disorder of Sex Development, or DSD,” explains Dr. Vandana Jain, Professor-in-Charge of Pediatric Endocrinology at AIIMS. She says nearly 150 genetic conditions can lead to DSD, affecting about one in every 4,000 to 5,000 children.

Most cases are identified at birth or in early childhood, but some surface only during puberty, when expected physical changes fail to appear. 

Sometimes it is a teenage girl who does not start menstruating or shows no breast development. In other cases, boys may notice that their testes are not growing or that they are developing breasts. 

Dr. Jain warns that these are not just cosmetic concerns. In some children, DSD can be life-threatening, as it may hide serious conditions such as tumors or kidney disorders that require urgent treatment.

AIIMS Director Dr. M. Srinivas explains that while most newborns are easily identified as boys or girls, a small number of cases require detailed medical evaluation. Blood tests, imaging and genetic studies help doctors decide whether the child is male, female, or has a disorder that needs treatment.

  He adds that gender is determined at multiple levels—genetic, physical and psychological—and AIIMS has seen lakhs of such cases over the years, both at birth and during adolescence. 

To ensure comprehensive care, AIIMS runs a dedicated DSD clinic where pediatric surgeons, endocrinologists and psychiatrists work together. This team-based approach has led to encouraging results, not only medically but emotionally for affected families. 

Doctors are firm in their message to parents: this condition is not a stigma. “If a child’s sex is unclear at birth, there is no reason to panic,” says Dr. Srinivas. “Bring the child to a specialised centre. With the right treatment—whether medicines or surgery—the child can grow up healthy.”

He also makes it clear that DSD has no connection with transgender identity. 

“This is a medical condition, and it can be treated.” Psychiatrist Dr. Rajesh Sagar, who counsels families at the DSD clinic, says the emotional impact is often profound. Parents struggle with fear, guilt and concerns about social acceptance. Many ask why this happened to their child and how they will face society.

At AIIMS, counselling is an essential part of care, helping families understand the condition, accept their child and prepare for treatment. 

Behind every such case lies not just a medical challenge, but a deeply human story—one that calls for awareness, compassion and the courage to look beyond social labels.