Yes, it is possible for a person to be born with both penile and vaginal tissue, or with genitalia that have features of both. These variations fall under a broad category of conditions known as differences of sex development (DSDs), sometimes referred to as intersex traits. Experts estimate that up to 1.7% of the population is born with some form of intersex variation, though the specific combination of having both a penis and a vagina is rare.
That said, no one is born with a fully developed, fully functional penis and a fully developed, fully functional vagina at the same time. As Cleveland Clinic puts it plainly: that concept, once described by the outdated term “hermaphrodite,” isn’t biologically possible. What does happen is a range of anatomical variations where elements of both male and female reproductive structures develop in the same person.
How Both Types of Tissue Can Develop
During the first several weeks of pregnancy, all embryos develop along the same path regardless of chromosomes. The same early tissue has the potential to become either a penis or a clitoris, and either a scrotum or labia. What steers development in one direction or the other is primarily a gene called SRY, found on the Y chromosome. The protein this gene produces triggers the formation of testes, which then release hormones that shape the rest of the male reproductive system.
When this process doesn’t follow the typical path, the result can be genitalia that look neither clearly male nor clearly female, or a mix of internal and external structures that don’t match. This can happen several ways:
- The SRY gene lands on the wrong chromosome. In about 10% of cases of ovotesticular DSD, the SRY gene gets accidentally moved onto an X chromosome during cell division. A person with two X chromosomes (typically female) then develops both ovarian and testicular tissue, which can lead to a range of genital presentations.
- The SRY gene is damaged or missing. A person with XY chromosomes (typically male) can develop female-typical structures like a uterus and fallopian tubes if the SRY protein doesn’t function. In partial cases, the external genitalia may have features of both sexes.
- Hormone exposure during development. Conditions like congenital adrenal hyperplasia cause an XX fetus to be exposed to high levels of androgens (male-typical hormones) in the womb. This can enlarge the clitoris significantly, sometimes enough that it resembles a small penis, while a vaginal opening is still present.
Ovotesticular DSD: Both Gonad Types in One Person
The condition most closely matching what people imagine when they ask this question is ovotesticular DSD, formerly called “true hermaphroditism.” A person with this condition has both ovarian and testicular tissue, sometimes in separate gonads on each side of the body, sometimes combined into a single organ called an ovotestis. The diagnosis is based entirely on the presence of both tissue types in the gonads, not on what the external genitalia look like.
External anatomy in ovotesticular DSD varies widely. Some individuals have genitalia that appear mostly male, others mostly female, and others somewhere in between. A person might have a phallus that resembles a penis along with a vaginal opening, or a single opening that serves both urinary and reproductive functions. The internal anatomy is equally variable. Most cases are identified during infancy when a newborn’s genitalia don’t fit neatly into typical categories, prompting further evaluation.
Male Anatomy on the Outside, Female Structures Inside
Some conditions create a situation where a person looks entirely male on the outside but has internal female organs. Persistent Müllerian duct syndrome is a clear example. People with this condition have normal XY chromosomes, normal external male genitalia, and functioning testes, but they also have a uterus and fallopian tubes hidden inside.
This happens because of a problem with a specific hormone signal. During typical male development, the testes produce a substance that causes the early female-type ducts to break down and disappear. When the gene responsible for either producing or detecting that signal has a mutation, those ducts survive and develop into a uterus and fallopian tubes. The person usually has no idea until these structures are found incidentally during surgery for an undescended testicle or a hernia, which are common first signs. About 85% of cases trace back to mutations in one of two specific genes involved in that signaling process.
What “Both” Actually Looks Like
The popular image of someone with a fully formed penis next to a fully formed vagina doesn’t reflect how these conditions present in real life. Because the same embryonic tissue gives rise to both structures, development tends to go partially in one direction and partially in another rather than fully completing both paths. The result is typically intermediate anatomy: a phallus that’s larger than a typical clitoris but smaller than a typical penis, a urethral opening in an unusual position, labial folds that are partially fused, or a shallow vaginal canal alongside a penile shaft.
Functionality is also mixed. A person with ovotesticular DSD may produce some eggs or some sperm, but rarely both in quantities sufficient for reproduction. Menstruation has been documented in some individuals with this condition, including those raised as male who have enough functional ovarian tissue to cycle. Fertility is uncommon but not unheard of, particularly on the ovarian side.
Why the Language Has Changed
If you’ve searched this topic before, you may have encountered the word “hermaphrodite.” Medical and advocacy communities have moved away from that term. A 2006 international consensus of endocrinologists, surgeons, geneticists, psychologists, and patient advocates recommended replacing “intersex,” “hermaphrodite,” and “pseudohermaphrodite” with “differences of sex development” (DSD) in clinical settings. The older terms were considered inaccurate (since no one is fully both sexes) and often felt stigmatizing to affected families. The term “intersex” is still widely used by advocacy organizations and individuals who identify with it, while “DSD” is more common in medical literature.
How These Conditions Are Managed
Most of these conditions are identified at birth or in early childhood when a baby’s genitalia appear atypical, or when expected puberty changes don’t happen on schedule. In some cases, like persistent Müllerian duct syndrome, the discovery doesn’t come until adulthood.
Management depends entirely on the specific condition, the anatomy involved, and the individual’s needs. Some people require no medical intervention at all. Others may benefit from hormone therapy during puberty to support development in a direction consistent with their identity. Surgical options exist but have become increasingly controversial, particularly when performed on infants who cannot consent. Many advocacy groups and medical bodies now recommend delaying irreversible procedures until the individual is old enough to participate in decisions about their own body.
People with these conditions live ordinary lives. The medical complexity is real but manageable, and the psychological impact depends far more on how the person is supported by family and healthcare providers than on the anatomy itself.