Endocrine-disrupting compounds (EDCs) interfere with the physiology of hormone systems. Traditionally, steroidogenic pharmaceuticals have been studied as EDCs however there has been growing evidence that non-steroidogenic pharmaceuticals can alter sex steroid levels and impair reproductive functions in fish. This is of concern as pharmaceuticals are detected in surface waters at the ng L-1 to µg L-1 range. Zebrafish (Danio rerio) were exposed to 10 µg L-1 of the pharmaceuticals carbamazepine and gemfibrozil for 6 weeks. Male-biased sex ratios were observed in the sexually mature offspring after paternal exposure, suggesting that sexual differentiation may be impacted in juveniles. Currently, the ability of pharmaceuticals to interfere with sexual differentiation of parentally exposed offspring is unknown. This thesis examined the gonad histology of juvenile zebrafish to understand how sexual differentiation was affected in the offspring of exposed parents. Paternal, but not maternal, exposure to carbamazepine resulted in a significantly faster sexual differentiation of the gonads and led to a male-biased sex ratio; these effects were not observed when both parents were exposed. Combined paternal and maternal exposure to gemfibrozil resulted in significantly faster sexual differentiation and paternal, but not maternal, exposure to gemfibrozil led to male-biased sex ratios. Interestingly, sex ratios observed in the juveniles did not always reflect those found in the same lineage at sexual maturity, suggesting a sex reversal, including a male to female transition, occurred past the juvenile sexual differentiation period in some fish. This thesis demonstrates that pharmaceuticals have the ability to disrupt sexual differentiation in the F1 offspring of exposed parents and that paternal exposure is most relevant for offspring effects. / Thesis / Master of Science (MSc) / Parental exposure to the environmentally-relevant pharmaceuticals carbamazepine or gemfibrozil led to male-biased sex ratios in adult offspring of zebrafish (Danio rerio), a common model organism. The development of the gonads in juveniles was investigated to determine how this process was impacted. Predominately, paternal exposure was found to result in a faster development of the testes and male-biased sex ratios. Interestingly, sex ratios in juveniles did not always reflect those in adults, suggesting a sex reversal may have occurred in adulthood. This study demonstrates the ability of pharmaceuticals to alter gonad development in offspring of exposed parents.

La différenciation sexuelle des Isopodes dépend d'une hormone sexuelle protéique, l'hormone androgène (HA), caractéristique des Malacostracés. Cet Insulin-Like Peptide suffit à induire par sa présence la différenciation mâle de ces Crustacés. Nous avons identifié in silico le transporteur circulant de l'HA, l'IGFBP-rP1, chez de nombreuses espèces d'Isopodes ainsi qu'à l'échelle des Crustacés. De la même façon, nous avons identifié deux récepteurs transmembranaires, l'IR1 et l'IR2, issus d'une duplication de gène spécifique des Malacostracés. Les patrons d'expression de ces gènes ont été étudiés sur notre espèce modèle, Armadillidium vulgare. Av-IGFBP-rP1 et Av-IR1 sont exprimés de manière ubiquiste et tout au long du développement. Av-IR2 est aussi exprimé à chaque stade de la différenciation mais ce transcrit est quasi-spécifique des glandes androgènes et ovaires. Une approche par ARNi a confirmé l'implication de ces trois protéines dans la voie de signalisation de l'HA. En effet, l'inhibition de l'HA, Av-IGFBP-rP1 et Av-IR1 provoquent l'hypertrophie des glandes androgènes, suggérant leur implication dans une boucle de rétro-contrôle de l'HA. L'inhibition de Av-IR2 semble seulement provoquer la différenciation d'ouvertures génitales femelles. Ces phénotypes sont comparables à ceux des intersexués mâles induits par la bactérie féminisante endogène Wolbachia. Nous montrons cependant que la bactérie altère seulement l'expression de l'HA et pas celle des récepteurs. Enfin, nous avons testé l'effet du bisphénol A mais nous n'observons pas d'altération de la différenciation sexuelle des larves lors d'expositions à ce perturbateur endocrinien exogène. / Sexual differentiation in Isopods relies on a proteinaceous sex hormone called androgenic hormone (AH), specific to Malacostracans. This Insulin-Like Peptide induces male differentiation by its mere presence in these Crustaceans. We identified in silico the circulating carrier of the AH, called IGFBP-rP1, in many Isopod species, but also on the crustacean scale. Similarly, we identified two transmembrane receptors, IR1 and IR2, coming from a gene duplication specific to Malacostracans. The expression patterns of these genes were investigated in our model species, Armadillidium vulgare. Av-IGFBP-rP1 and Av-IR1 are broadly expressed in the animal and throughout development. Av-IR2 is also expressed at each developmental stage but this transcript is almost specific to androgenic glands and ovaries. An RNAi approach has confirmed the implication of these three proteins in the AH signalling pathway. Indeed, the inhibition of AH, Av-IGFBP-rP1 and Av-IR1 induces androgenic gland hypertrophy, suggesting their implication in an AH feedback loop. Av-IR2 inhibition seems to provoke the differentiation of female genital apertures only. These phenotypes are similar to those of male intersexes induced by the endogenous feminizing bacterium Wolbachia. Yet, we show that the bacterium alters the expression of the AH only and not the one of its receptors. Finally, we have tested the effect of bisphenol A but we observe no alteration of the sexual differentiation in larvae upon exposition to this exogenous endocrine disruptor.

Cette thèse s’appuie sur une approche empirique et épistémologique qualitative basée sur des entretiens semi-directifs, un questionnaire auto-administré et une observation ethnographique. Elle est construite à partir de l’analyse des rapports sociaux de genre dans les représentations des femmes au sein des Églises pentecôtistes congolaises. En interrogeant différentes trajectoires de vie, d’engagement et de vocation pastorale et/ou épiscopale des femmes, elle cherche à comprendre comment articuler à la fois la dimension genrée et le désir des femmes d’exercer une profession historiquement conjuguée au masculin dont l’accès leur avait été longtemps fermé. Si, dans l’économie du temps qui court, être pasteur dans cette religion d’éveil apparaît comme un ascenseur social ou une élévation qui nourrissent l’ambition à l’acquisition de la prospérité matérielle et spirituelle, le pastorat exercé au féminin pose une série d’interrogations : comment interpréter la facilité avec laquelle on devient pasteur en République Démocratique du Congo ? De quelle manière définir le rôle actuel des femmes qui exercent le métier de pasteur ou d’évêque ? Comment penser la tension permanente entre la visibilité du travail des femmes à travers l’exercice de la profession religieuse au sein du pentecôtisme et la prégnance des stéréotypes liés à leur supposée subalternation ou à l’incompatibilité du corps féminin à des fonctions de direction restées longtemps le pré carré des clercs masculins ? Comment conjuguent-elles foi, féminité, leadership et compétences professionnelles face aux défis actuels de la société en mutation ? Comment se définissent les rôles de pasteurs ou d’évêques lorsqu’ils se déclinent au féminin ? La fonction hiératique se modifie-t-elle dans ce cas de figure ? Quelles sont les nouvelles dimensions de l’exercice de la profession religieuse ? Sont-elles sociales, familiales, se réfèrent-elles à l’intimité personnelle ou à une nouvelle dimension du sacré ? Autant de questions auxquelles tente de répondre cette réflexion qui, par ailleurs, montre de nouvelles dimensions de l’exercice de la profession religieuse par le biais des femmes et apporte de nouvelles indications sur les changements religieux qui se sont opérés ces dernières années en Afrique noire en général et en RD Congo en particulier. / This PhD is based on a qualitative, empirical and epistemological approach relied on interviews, self-administered questionnaire and ethnographic observation. The analysis of gender relationships and representations of female pastoral labor in the Pentecostal churches is the main topic of this research. We are looking for life stories items and commitment in a pastoral or episcopal female vocation inasmuch to understand gendered dimension and the motives of the young ladies to look for such a well known male profession for which they have been banned for centuries. This religion of the Reborn seems to give an opportunity for climbing the social ladder and awakens the desire for material goods and spiritual prosperity. Many questions are at stake with the female pastoral vocation. How to interpret the ease with which one becomes a pastor (how shall we figure out) the fact that it is very easy to become a pastor in the Democratic Republic of Congo ? How to define the current female role of pastors or bishops ? How to understand the permanent tension between the female vocation, the social stereotypes and the linked body alienation ? Although, they must have leadership roles that have always been the privilege of the male clerics ? Facing the current challenges of a changing society, how do they combine faith, femininity, leadership and professional skills ? What are the roles of pastors and bishops when they belong to the female sex ? Does the hieratic function change in this case ? What are the new dimensions of the religious profession practice ? Are they more concerned with social or family issues ? Do they refer to personal intimacy or to a new dimension of the sacred ? This PhD is trying to answer all these questions. It shows moreover new faces of the religious profession practice through the coming out of female pastors and bishops. It provides new indications regarding the religious changes that have taken place in recent years in Sub- Saharan Africa in general and in DR Congo in particular.

Introdução: As doenças crônicas que envolvem tratamento clínico e cirúrgico podem comprometer a qualidade de vida. Poucos estudos analisam a qualidade de vida de pacientes com distúrbios do desenvolvimento sexual (DDS). O objetivo foi avaliar a qualidade de vida de pacientes com DDS com o diagnostico etiológico estabelecido, seguidos até a idade adulta em um único centro terciário. Pacientes e Métodos: 144 pacientes adultos com DDS (56 pacientes com DDS 46,XX - 49 com sexo social feminino e 7 com o sexo social masculino, bem como, 88 pacientes com DDS 46,XY - 54 com sexo social feminino e 34 com sexo social masculino). Instrumento: A avaliação da qualidade de vida foi realizada através do questionário WHOQOL-Bref. Resultados: Os pacientes com DDS 46,XX e 46,XY apresentaram escores de qualidade de vida semelhante e comparáveis aos escores da população brasileira geral. Os pacientes com DDS do sexo social masculino tiveram melhores escores no domínio psicológico do que os pacientes do sexo social feminino, da mesma forma que a população geral brasileira. Dentro do grupo DDS 46,XY, também os pacientes com o sexo social masculino tiveram melhores escores de qualidade de vida em comparação aos do sexo social feminino. Para avaliar o impacto na qualidade de vida dos pacientes com DDS 46,XY criados no sexo social feminino, foi comparado os escores de qualidade de vida nos pacientes registrados no sexo social masculino com aqueles dos pacientes registrados no sexo social feminino e que mudaram para o sexo social masculino. Ambos os grupos apresentaram escores semelhantes de qualidade de vida. Comparou-se ainda, a qualidade de vida de pacientes com DDS 46,XY com deficiência de 5alfa-RD2 e pacientes com DDS, devido à defeitos na secreção ou ação da testosterona. Ambos os grupos apresentaram qualidade de vida semelhante entre si para as questões gerais e nos quatro domínios. A maioria das variáveis que influenciaram a qualidade de vida foram saúde geral, sentimentos positivos e espiritualidade, religião e crenças pessoais, cada um deles contribuindo com 18% da variabilidade da pontuação da qualidade de vida geral. O desempenho sexual teve pouca interferência na qualidade de vida geral, explicando apenas 4% da variabilidade deste escore. O tratamento tardio foi associado negativa e significativamente com pior qualidade de vida geral. Conclusão: Esta larga coorte de pacientes adultos com DDS, que foi seguida por uma equipe multidisciplinar em um único centro terciário, teve boa qualidade de vida na idade adulta. Ressalta-se que o tratamento tardio comprometeu a qualidade de vida dos pacientes com DSD, ao passo que o desempenho sexual teve pouca influência na qualidade de vida geral / Objective: Chronic diseases involving medical and surgical treatment may compromise the quality of life. Few studies have focused on the quality of life of patients with disorders of sex development (DSD). The aim was to evaluate quality of life in DSD patients with defined diagnoses followed until adulthood in a single tertiary centre. Patients and Methods: 144 Adult DSD patients (56 patients with 46,XX DSD - 49 with female social sex and 7 with male social sex as well as 88 patients with 46,XY DSD - 54 with female social sex and 34 with male social sex). Measurements: Quality of life using WHOQOL-Bref questionnaire Results: Both 46,XX and 46,XY DSD patients had similar quality of life scores on the WHOQOL-Bref, comparable to the scores of the Brazilian general population. Male social sex DSD patients had better scores on the psychological domain than female social sex DSD patients, as found in the Brazilian general population. In addition, among the 46,XY DSD group, the male social sex patients had better quality of life compared to the female social sex patients. To estimate the impact on quality of life of patients with DDS 46, XY raised in females social sex, we analyzed the quality of life scores of patients raised with male social sex with those patients registered with female social sex who changed to male social sex. Both groups had similar quality of life. We also evaluate the impact of testosterone in the quality of life of patients with 46,XY DSD with 5alfa-RD2 deficiency and patients with DSD due to testosterone secretion or action defects. Both groups showed similar quality of life. The most influencing variables on quality of life of all group of patients were general health, positive feelings and spirituality, religion and personal beliefs, each of them contributing with 18% of the variability of the general quality of life score. There was a positive and significant correlation between sexual performance and general quality of life, although it explained only 4% of the variability of the general quality of life score. Late treatment was associated negatively and significantly with poorer overall quality of life. Conclusion: This large cohort of adult DSD patients, which was followed by a multidisciplinary team in a single tertiary centre, had good quality of life in adulthood; in addition, late treatment compromised the quality of life of DSD patients, whereas sexual performance had little influence on quality of life

Introdução: As doenças crônicas que envolvem tratamento clínico e cirúrgico podem comprometer a qualidade de vida. Poucos estudos analisam a qualidade de vida de pacientes com distúrbios do desenvolvimento sexual (DDS). O objetivo foi avaliar a qualidade de vida de pacientes com DDS com o diagnostico etiológico estabelecido, seguidos até a idade adulta em um único centro terciário. Pacientes e Métodos: 144 pacientes adultos com DDS (56 pacientes com DDS 46,XX - 49 com sexo social feminino e 7 com o sexo social masculino, bem como, 88 pacientes com DDS 46,XY - 54 com sexo social feminino e 34 com sexo social masculino). Instrumento: A avaliação da qualidade de vida foi realizada através do questionário WHOQOL-Bref. Resultados: Os pacientes com DDS 46,XX e 46,XY apresentaram escores de qualidade de vida semelhante e comparáveis aos escores da população brasileira geral. Os pacientes com DDS do sexo social masculino tiveram melhores escores no domínio psicológico do que os pacientes do sexo social feminino, da mesma forma que a população geral brasileira. Dentro do grupo DDS 46,XY, também os pacientes com o sexo social masculino tiveram melhores escores de qualidade de vida em comparação aos do sexo social feminino. Para avaliar o impacto na qualidade de vida dos pacientes com DDS 46,XY criados no sexo social feminino, foi comparado os escores de qualidade de vida nos pacientes registrados no sexo social masculino com aqueles dos pacientes registrados no sexo social feminino e que mudaram para o sexo social masculino. Ambos os grupos apresentaram escores semelhantes de qualidade de vida. Comparou-se ainda, a qualidade de vida de pacientes com DDS 46,XY com deficiência de 5alfa-RD2 e pacientes com DDS, devido à defeitos na secreção ou ação da testosterona. Ambos os grupos apresentaram qualidade de vida semelhante entre si para as questões gerais e nos quatro domínios. A maioria das variáveis que influenciaram a qualidade de vida foram saúde geral, sentimentos positivos e espiritualidade, religião e crenças pessoais, cada um deles contribuindo com 18% da variabilidade da pontuação da qualidade de vida geral. O desempenho sexual teve pouca interferência na qualidade de vida geral, explicando apenas 4% da variabilidade deste escore. O tratamento tardio foi associado negativa e significativamente com pior qualidade de vida geral. Conclusão: Esta larga coorte de pacientes adultos com DDS, que foi seguida por uma equipe multidisciplinar em um único centro terciário, teve boa qualidade de vida na idade adulta. Ressalta-se que o tratamento tardio comprometeu a qualidade de vida dos pacientes com DSD, ao passo que o desempenho sexual teve pouca influência na qualidade de vida geral / Objective: Chronic diseases involving medical and surgical treatment may compromise the quality of life. Few studies have focused on the quality of life of patients with disorders of sex development (DSD). The aim was to evaluate quality of life in DSD patients with defined diagnoses followed until adulthood in a single tertiary centre. Patients and Methods: 144 Adult DSD patients (56 patients with 46,XX DSD - 49 with female social sex and 7 with male social sex as well as 88 patients with 46,XY DSD - 54 with female social sex and 34 with male social sex). Measurements: Quality of life using WHOQOL-Bref questionnaire Results: Both 46,XX and 46,XY DSD patients had similar quality of life scores on the WHOQOL-Bref, comparable to the scores of the Brazilian general population. Male social sex DSD patients had better scores on the psychological domain than female social sex DSD patients, as found in the Brazilian general population. In addition, among the 46,XY DSD group, the male social sex patients had better quality of life compared to the female social sex patients. To estimate the impact on quality of life of patients with DDS 46, XY raised in females social sex, we analyzed the quality of life scores of patients raised with male social sex with those patients registered with female social sex who changed to male social sex. Both groups had similar quality of life. We also evaluate the impact of testosterone in the quality of life of patients with 46,XY DSD with 5alfa-RD2 deficiency and patients with DSD due to testosterone secretion or action defects. Both groups showed similar quality of life. The most influencing variables on quality of life of all group of patients were general health, positive feelings and spirituality, religion and personal beliefs, each of them contributing with 18% of the variability of the general quality of life score. There was a positive and significant correlation between sexual performance and general quality of life, although it explained only 4% of the variability of the general quality of life score. Late treatment was associated negatively and significantly with poorer overall quality of life. Conclusion: This large cohort of adult DSD patients, which was followed by a multidisciplinary team in a single tertiary centre, had good quality of life in adulthood; in addition, late treatment compromised the quality of life of DSD patients, whereas sexual performance had little influence on quality of life

Parmi plus de 20000 espèces de trématodes hermaphrodites, les Schistosomatidae ont un statut particulier car ils sont gonochoriques (i.e. deux sexes séparés). Le gonochorisme chez ces espèces, et leur dimorphisme sexuel, seraient en fait une stratégie d’adaptation à leur habitat : le système veineux des vertébrés à sang chaud, dont l’Homme. Malgré un mode chromosomique de déterminisme du sexe (i.e. hétérogamétie femelle ZW), les individus mâles et femelles demeurent phénotypiquement identiques durant tous les stades larvaires de leur cycle de vie hétéroxène. La différenciation sexuelle n’a lieu qu’après l’infestation de leur hôte définitif. Dans ce travail, nous nous sommes intéressés aux facteurs moléculaires déclenchant cette différenciation chez Schistosoma mansoni. Nous avons établi le profil d’expression sexe-dépendant de gènes conservés de la cascade de détermination/différenciation chez les animaux : les DMRT (Double-sex and Male-abnormal-3 Related Transcription Factors). Nous avons par ailleurs généré un transcriptome comparatif mâle/femelle (RNA-seq) sur 5 stades de développement in vivo, dont 3 stades « schistosomules » inédits. Cela nous a permis d’identifier de potentiels gènes « clés » de la différenciation sexuelle et de souligner l’importance de l’interaction hôte-parasite. Enfin, par la combinaison de cette approche transcriptomique et d’une analyse épigénomique (ChIP-seq), nous avons montré une dynamique de la compensation de dose génique au cours du cycle de vie chez les femelles ainsi que la mise en place d’une stratégie transcriptionnelle particulière chez les mâles, optimisant leur développement dans l’hôte et ainsi, leur succès reproducteur. / Parasitic flatworms include more than 20.000 species that are mainly hermaphrodites. Among them, the hundred species of Schistosomatidae are intriguing because they are gonochoric. The acquisition of gonochorism in these species is supposed to provide genetic and functional advantages to adapt to their hosts: warm-blooded animals. Sex of schistosomes is genetically determined at the time of fertilization (i.e. ZW female heterogametic system). However, there is no phenotypic dimorphism through all the larval stages of its complex lifecycle: sexual dimorphism appears only in the definitive host. The molecular mechanisms triggering this late sexual differentiation remain unclear, and this is precisely the topic of our present work. We performed transcriptomic (RNA-Sequencing and quantitative-PCRs) and structural (ChIP-Sequencing) analyses at different stages of Schistosoma mansoni development. Here, we present data suggesting that the sexual differentiation relies on a combination of genetic and epigenetic factors. In a genetic point of view, we show a sex-associated expression of the DMRT genes (Double-sex and Mab-3 Related Transcription Factors) that are known to be involved in sex determination/differentiation through all the animal kingdom. In addition, we propose new potential sex-determining key genes and a pivotal role of host-pathogen interaction at the time of development. In a structural point of view, we highlight a dynamic status of dosage compensation in females and chromatin modifications in males. This intense remodeling reveals a specific transcriptomic strategy which optimizes male development and beyond that, schistosomes reproductive success.

O objetivo deste estudo foi avaliar a influência da exposição a níveis normais ou reduzidos de testosterona durante a vida intrauterina no desenvolvimento psicológico, social e sexual dos pacientes com DDS 46, XY. Pacientes e métodos: Trata-se de um estudo retrospectivo. Os 53 participantes são pacientes portadores de DSD 46,XY devido a defeitos de produção de testosterona ou deficiência da 5alfa-RD2, todos eles com genitália ambígua que resultou na atribuição do sexo feminino ao nascimento. Os pacientes foram divididos em dois grupos: Grupo 1 (G1) - pacientes com DDS 46, XY, devido a defeito na produção de testosterona, constituído por 29 pacientes, 8 deles com deficiência de 17beta-HSD3, 7 com hipoplasia das células de Leydig, 7 com disgenesia gonadal parcial, 6 com deficiência 17alfa-hidroxilase e 1 com deficiência 3beta-HSD2; Grupo 2 (G2) - constituído por 24 pacientes com deficiência de 5alfa-RD2. Foi utilizado um questionário com 32 perguntas abrangendo aspectos do desenvolvimento psicológico, social e sexual destes pacientes. Resultados: Foi encontrada uma diferença significativa nos seguintes aspectos do desenvolvimento psicológico, social e sexual dos participantes do estudo: maior incidência de masturbação, fantasias eróticas e desejo de ter filhos em pacientes com deficiência da 5alfa-RD2 com sexo social masculino. Nas pacientes com sexo social feminino o desejo de ter filhos foi maior naquelas com DDS 46, XY por defeitos na produção de testosterona do que naquelas com deficiência da 5alfa-RD2 (p < 0,05), enquanto que o desejo de ter filhos foi maior nos homens com deficiência 5alfa-RD2 (p > 0,05). O número de indivíduos casados foi significativamente maior no grupo dos pacientes com DDS 46, XY por defeitos na produção de testosterona do que no grupo dos pacientes com DDS 46, XY por deficiência da 5alfa-RD2 (p = 0,003). Em conclusão, nossos resultados indicam uma possível influência da exposição aos andrógenos durante a vida pré-natal no desenvolvimento psicológico e social, bem como em aspectos da vida sexual dos pacientes adultos com DDS 46, XY / The aim of this study was to evaluate the influence of exposure to normal or reduced levels of testosterone during intra-uterine life in psychological, social, and sexual development of patients with DSD 46, XY. Patients and methods: This is a retrospective study. The 53 participants were patients with DSD 46, XY due to defects in production of testosterone or deficiency of 5alfa-RD2, all of them with ambiguous genitalia and female sex assignment at birth. These patients were divided into two groups: Group 1 (G1) - patients with DSD 46, XY, due to a defect in the production of testosterone, consisting of 29 people, 8 with deficiency of 17beta-HSD3, 7 with Leydig cell hypoplasia, 7 with partial gonadal dysgenesis, 6 with 17alfa-hydroxylase deficiency ,1 with 3beta-HSD2 deficiency, Group 2 (G2) - consisting of 24 patients with deficiency of 5alfa-RD2. We used a questionnaire with 32 questions covering aspects of psychological, social and sexual development of these patients. Results: A significant difference was found in the following aspects of psychological, social and sexual development of these patients: higher incidence of masturbation, erotic fantasies and desire for children in patients with deficiency of 5alfa-RD2 with male social sex. In patients with female social sex, the desire to have children was higher in those with DSD 46, XY by defects in the production of testosterone than in those with deficiency of 5alfa-RD2 (p < 0.05), while the desire to have children in men was higher in those with 5alfa-RD2 (p > 0.05). The number of married individuals was significantly higher in the group of patients with DSD 46, XY by defects in the production of testosterone than in the group of patients with DSD 46, XY by deficiency of 5alfa-RD2 (p = 0.003). In conclusion, our results indicate a possible influence of exposure to androgens during prenatal life in psychological and social development, as well as in aspects of sexual life of adult patients with DSD 46, XY

O objetivo deste estudo foi avaliar a influência da exposição a níveis normais ou reduzidos de testosterona durante a vida intrauterina no desenvolvimento psicológico, social e sexual dos pacientes com DDS 46, XY. Pacientes e métodos: Trata-se de um estudo retrospectivo. Os 53 participantes são pacientes portadores de DSD 46,XY devido a defeitos de produção de testosterona ou deficiência da 5alfa-RD2, todos eles com genitália ambígua que resultou na atribuição do sexo feminino ao nascimento. Os pacientes foram divididos em dois grupos: Grupo 1 (G1) - pacientes com DDS 46, XY, devido a defeito na produção de testosterona, constituído por 29 pacientes, 8 deles com deficiência de 17beta-HSD3, 7 com hipoplasia das células de Leydig, 7 com disgenesia gonadal parcial, 6 com deficiência 17alfa-hidroxilase e 1 com deficiência 3beta-HSD2; Grupo 2 (G2) - constituído por 24 pacientes com deficiência de 5alfa-RD2. Foi utilizado um questionário com 32 perguntas abrangendo aspectos do desenvolvimento psicológico, social e sexual destes pacientes. Resultados: Foi encontrada uma diferença significativa nos seguintes aspectos do desenvolvimento psicológico, social e sexual dos participantes do estudo: maior incidência de masturbação, fantasias eróticas e desejo de ter filhos em pacientes com deficiência da 5alfa-RD2 com sexo social masculino. Nas pacientes com sexo social feminino o desejo de ter filhos foi maior naquelas com DDS 46, XY por defeitos na produção de testosterona do que naquelas com deficiência da 5alfa-RD2 (p < 0,05), enquanto que o desejo de ter filhos foi maior nos homens com deficiência 5alfa-RD2 (p > 0,05). O número de indivíduos casados foi significativamente maior no grupo dos pacientes com DDS 46, XY por defeitos na produção de testosterona do que no grupo dos pacientes com DDS 46, XY por deficiência da 5alfa-RD2 (p = 0,003). Em conclusão, nossos resultados indicam uma possível influência da exposição aos andrógenos durante a vida pré-natal no desenvolvimento psicológico e social, bem como em aspectos da vida sexual dos pacientes adultos com DDS 46, XY / The aim of this study was to evaluate the influence of exposure to normal or reduced levels of testosterone during intra-uterine life in psychological, social, and sexual development of patients with DSD 46, XY. Patients and methods: This is a retrospective study. The 53 participants were patients with DSD 46, XY due to defects in production of testosterone or deficiency of 5alfa-RD2, all of them with ambiguous genitalia and female sex assignment at birth. These patients were divided into two groups: Group 1 (G1) - patients with DSD 46, XY, due to a defect in the production of testosterone, consisting of 29 people, 8 with deficiency of 17beta-HSD3, 7 with Leydig cell hypoplasia, 7 with partial gonadal dysgenesis, 6 with 17alfa-hydroxylase deficiency ,1 with 3beta-HSD2 deficiency, Group 2 (G2) - consisting of 24 patients with deficiency of 5alfa-RD2. We used a questionnaire with 32 questions covering aspects of psychological, social and sexual development of these patients. Results: A significant difference was found in the following aspects of psychological, social and sexual development of these patients: higher incidence of masturbation, erotic fantasies and desire for children in patients with deficiency of 5alfa-RD2 with male social sex. In patients with female social sex, the desire to have children was higher in those with DSD 46, XY by defects in the production of testosterone than in those with deficiency of 5alfa-RD2 (p < 0.05), while the desire to have children in men was higher in those with 5alfa-RD2 (p > 0.05). The number of married individuals was significantly higher in the group of patients with DSD 46, XY by defects in the production of testosterone than in the group of patients with DSD 46, XY by deficiency of 5alfa-RD2 (p = 0.003). In conclusion, our results indicate a possible influence of exposure to androgens during prenatal life in psychological and social development, as well as in aspects of sexual life of adult patients with DSD 46, XY