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the ruling that applied then was to reckon solely with that which is
visible, so it remains in our times.1

The Avnei Nezer (Yoreh De’ah 322) describes a true androginos. He
writes: “The structure of an androginos is that there is an opening to
the womb as in a female from which he urinates and the organ is in-
side the womb and when it has an erection the organ protrudes exter-
nally. Urine flows through this organ internally into the mouth of the
womb and from there it flows out. He can therefore marry a woman
and be married. So long as the organ cannot have an erection, he is
like a female and can be married [to a man]. He can marry because
when the organ has an erection it protrudes outside and according to
halachah he can marry but cannot be married.”

I found a similar argument to the above [i.e. that external appear-
ance determines gender] in the Tzitz Eliezer (1, 78), concerning a
baby with the external appearance of a female, with female external
organs. However, inside one of the labia was a mass that appeared to
be a testicle. Special tests were conducted to determine the gender of
the body cells and male chromosomes (XY) were found. The baby
underwent surgery and no internal organs of gender were found. A
biopsy was taken from the mass in the external labium which looked
like a testicle and it was established that the mass was indeed a tes-
ticle. In short, the child had the external appearance of a female but
was actually a male.

The Tzitz Eliezer responded concerning this case: “The child is
considered a female not an androginos, for the features of an androgi-
nos are described in Yevamos (83) namely, that there are both male
and female [external] organs. So too rules the Rambam (Hilchos Ishus
2,24): “A person who has both a male organ and a female organ is
an androginos and it is uncertain whether he is a male or a female…”
The child in this case has the external organs of gender of a female
and there is no external indication whatsoever of a male organ. Only
the special tests that were performed showed male cells in the body.

1. For a similar idea concerning the ‘two thousand years of Torah’ in regard to the
topic of terefos, see earlier, siman 252, quoting the Chazon Ish (Yoreh De’ah 5:3).

158 1 Medical-Halachic Responsa of Rav Zilberstein