Doc's bombshell to woman, 24: You're male
All her life, Mary had been the rose in her family of boys.
Even though she grew up with three brothers, she enjoyed doing the things any girl did - hanging out with her BFFs, shopping for dresses and collecting cute figurines.
Sure, she started out being a bit of a tomboy, preferring pants instead of skirts, and comic books instead of dolls, but which girl wouldn't growing up with three boys?
But when Mary turned 13, she found it strange that she did not have her period - like the other girls in her class.
She has never had her period.
It was only earlier this year that Mary, 24, found out why - she was actually male.
The svelte 1.8m-tall lab technician from Malaysia got the news from a doctor here.
"I was shocked. My parents were equally shocked," Mary tells The New Paper on Sunday in an interview over Skype.
"It took me quite a while to piece together what the doctor had told me."
We are not using Mary's real name at her request. She does not want her friends and extended family to know about her situation.
Mary suffers from a rare condition called Androgen Insensitivity Syndrome (AIS), where a person is genetically male, but is resistant to male hormones. As a result, the person has some or all of the physical traits of a woman.
Mary said that after getting the shocking news, she was in emotional turmoil for a week.
By all accounts, Mary bears no man-like traits.
She was born a girl and brought up as one, even though she admits to being "a bit of a tomboy growing up", she says.
She adds: "But that was attributed to the fact I have brothers and was hanging out with them."
Mary's brothers are aged 19, 20 and 29.
She says: "Growing up, I love reading comics, especially the ones that have violence in them.
"I've always thought this was due to my brothers' influence. I never thought it was because of me."
She said there were clues about her condition when she was a teenager - such as the lack of menstruation - but she didn't think anything of it at the time.
"I did not get my period when I turned 13, but I wasn't anxious. I was told some girls get theirs much later." When she was 17, with no sign of her period her parents took her to a doctor in Malaysia.
"I was given medication, hormone pills I think, but there was no result," she says.
Then Mary went away to college for a few years.
She recalls: "I felt embarrassed and did not bring up the matter to anyone or discuss my problems at college.
"Besides, I was concentrating on doing well in my studies. My body could wait. I didn't even want to see a doctor."
It was only some time in the middle of this year that her mother suggested she consult Dr Christopher Chong, her mother's gynaecologist in Singapore.
She agreed. "What harm can that do, I thought."
Dr Chong, who has a clinic in Gleneagles Hospital, tells TNPS that when Mary first saw him in July this year, he didn't sense anything amiss.
"Mary looked completely female with small breasts and a normal looking vagina," he says.
But when he did an ultrasound scan of her pelvis, he could not locate a womb or ovaries.
Finding it unusual, Dr Chong did a blood test for karyotype (which looks at the chromosome cluster in cells) to see if there were any genetic problems.
He says: "That was when I discovered that she is genetically male."
Knowing this, Dr Chong immediately searched for the testes.
"Undescended testes are at a high risk of cancer (of the testes), so I did a CT (computerised tomography) scan of the abdomen and pelvis," he says.
"One was found in the inguinal (thigh fold) region and the other in the abdomen. I later removed them."
Mary is now on hormone replacement therapy as she will be "deemed to have early menopause, giving rise to problems such as osteoporosis", Dr Chong says, adding that Mary will still be able to have sexual intercourse.
What the future holds
As for Mary, she says she felt her whole world had crumbled.
She says: "I was confused. Of course, I was upset. The whole premise of who I am fell apart.
"I had been a girl all my life. Now I don't really know who I am any more."
Mary says her parents, who were there when Dr Chong announced the blood test results, were equally shocked and upset.
She says: "I don't know if they cried. If they did, it wasn't in front of me. It is not that they know much about chromosomes and genes... What they understand is that I was supposed to have been a boy, but I was born a girl.
"My parents are pragmatic people, and they decided I will always be their daughter.
"Instead of grieving over something that cannot be changed, they focused on making arrangements with the hospital for my surgery."
Mary says she allowed herself "only one week to be upset and after that week, I simply got over it".
"Life goes on," she adds.
She says she has only confided in her older brother.
"The other two are still too young and may not be able to understand the implications," she says.
Currently unattached, Mary intends to be honest with the man she eventually dates, but "only when I'm sure he is trustworthy".
"I have to be honest with him," says Mary, who has not had a boyfriend before. She admits to having had a crush on a boy in secondary school.
"I do understand that is the risk I would have to take, that he might reject me. I can't go telling every guy who tells me he is interested in me. They might start spreading rumours.
"I would like my condition to remain my secret, not because I feel ashamed but I don't want others to be confused."
"I was confused. Of course, I was upset. The whole premise of who I am fell apart. I had been a girl all my life. Now I don't really know who I am any more."
- Mary, suffers from a rare condition called Androgen Insensitivity Syndrome
Rare condition that strikes only one in 115,000 women
WOMEN WITH AIS: American jazz singer Eden Atwood (above) and Indian athlete Santhi Soundarajan (top). - PICTURES: AFP, MUSIC KARMA
What is Androgen Insensitivity Syndrome (AIS)?
It occurs when the patient's body is not able to recognise or respond to androgens, the male hormones.
To what degree can AIS happen?
- Complete: When the patient looks like a woman.
- Partial: When the male genitalia is not fully formed.
- Mild: When the patient looks like a man
How rare is AIS?
It is very rare. A recent Netherlands study shows that only one in about 115,000 people suffer from it.
How is AIS usually diagnosed?
When patients seek help for abnormal genitalia, abnormal secondary sexual characteristics such as breasts in men and excessive hair growth in women, and menstrual issues, doctors can diagnose AIS via blood tests.
Some famous women who have AIS:
Santhi Soundarajan
During the 2006 Asian Games in Doha, Qatar, Soundarajan, then 25, represented India and won the silver in the women's 800m race. She was stripped of her medal after the International Association of Athletics Federations' (IAAF) panel of doctors examined her and found her to have AIS.
Caster Semenya
She won a gold medal for the 800m race at the 2009 IAAF World Championships in Berlin when she was 18, beating some of the world's fastest women. But her win was tainted by news that she had been gender tested by sporting authorities at the African Junior Championships three weeks before. However, she was allowed to keep her medal despite testing positive for AIS.
Eden Atwood
The American jazz singer first addressed her condition in the liner notes of her 2002 album Waves: The Bossa Nova Session. She went on to co-found an advocacy group for those who have a similar condition, called The Interface Project.
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