Existence of the genetic 5-alpha reductase enzyme deficiency is more common in New Guinea and the Dominican Republic than in most other parts of the world, leading subgroups of these cultures to

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In New Guinea and the Dominican Republic, communities with a higher prevalence of 5-alpha reductase deficiency often recognize and accept individuals with this condition, sometimes acknowledging them as a third gender. This condition can lead to ambiguity in physical sexual characteristics, prompting a more inclusive cultural response.

Existence of the Genetic 5-Alpha Reductase Enzyme Deficiency Is More