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Surgical reconstruction should not be undertaken lightly and should not be done without genetic testing to determine the chromosomal sex of the child.
They are also notable for being the first turtle shown to exhibit an XX/XY system of chromosomal sex determination, specifically with macrochromosomes.
Some reptiles and most birds and mammals have chromosomal sex determination (CSD) systems and these systems involve remarkably different chromosomes and genes [ 4].
One reason for such discordances in intersexed people is that some individuals have a chromosomal sex that has not been expressed in the external genitalia because of hormonal or other abnormal conditions during critical periods in gestation.
In addition, many physicians insist that adolescents go through the puberty associated with their chromosomal sex before they prescribe hormones that could have prevented the feminization or masculinization of a transsexual man or transsexual woman, respectively.
Although the rule was initially stated in context of diploid organisms with chromosomal sex determination, it has recently been argued that it can be extended to certain species lacking chromosomal sex determination, such as haplodiploids.