<unk> R2D is a rare condition, but has a worldwide distribution. A 2020 study identified 434 cases of<unk> R2D across 44 countries including Turkey (23%), China (17%), Italy (9%), and Brazil (7%). The same study also found that genitalia virilization influenced sex assignment while gender change was influenced by cultural aspects across the countries. Molecular diagnosis resulted in favoring male sex assignment in affected newborns. Many SRD5A2 mutations come from areas with high coefficients of inbreeding, including the Dominican Republic (where people with the condition are called güevedoces – "penis at twelve"), and Papua New Guinea (where it is known as kwolu-aatmwol – suggesting a person's transformation "into a male thing"), and Turkey. In the Dominican Republic, güevedoces are regarded as a third gender and experience ambivalent gender socialisation. In adulthood, they most commonly self-identify as men (perhaps because of the positions of freedom and power that men hold in their culture), but are not necessarily completely treated as such by society. In the cases in Papua New Guinea, it has been said that the "girl" is shunned when he begins his natural transformation into a male body and socially assumes a male gender role.
5α-Reductase 2 deficiency
Isolated 17,20-lyase deficiency
17β-Hydroxysteroid dehydrogenase III deficiency
Aromatase deficiency
Cortisone reductase deficiency
Androgen-induced hermaphroditism
Multiple sulfatase deficiency
Gonadotropin-releasing hormone insensitivity