A five-year-old Australian child born genetically male will grow up as a sterilised female after a court agreed to her having surgery.
The child, known only as Carla, identifies as a girl but has no female reproductive organs, Family Court documents show.
The court approved a request by Carla's parents to surgically remove male gonads inside her body.
People with a combination of sex characteristics are called intersex.
'Stereotypically female' behaviour
When Carla turned five, her parents wanted to clarify if they needed court permission for the complex and irreversible surgery.
The Family Court heard Carla was born with female-appearing genitalia and exhibited "stereotypically female" behaviour, which included never wanting to be referred to as a male and a preference for "female toys, clothes and activities".
Court documents seen by the BBC show medical experts testified that surgery would remove the risk of Carla developing tumours and that she had no certainty of future fertility. The surgery should happen before puberty, they said.
What is intersex?
If you are born with a mix of male and female sexual characteristics, this means you have a disorder or difference of sex development (DSD), also known as being intersex.
There are numerous different conditions which come under this umbrella term. Taken together, they are more common than you might think - experts say perhaps one in 2,000 babies are born with some kind of sex development difference.
These conditions occur when the reproductive organs and genitals do not develop as expected.
As a result, you might have female sex chromosomes but your reproductive organs and genitals are male - or the opposite way round. Or you may have a mixture of male and female organs and genitals, or some that are neither clearly male nor female.
This occurs because of how your particular genes respond to the sex hormones in your body.
DSDs can be treated with hormone therapy, psychological support and sometimes surgery.
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