Girls who become men at puberty could well be diagnosed with

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5α-Reductase deficiency is a condition that affects male sexual development before birth and during puberty. People with this condition are genetically male, with one X and one Y chromosome in each cell, and they have male gonads (testes). However, they often appear female at birth and are usually raised as girls. During puberty, affected individuals can develop male secondary sexual characteristics, such as increased muscle mass, deepening of the voice, and growth of facial hair. This condition is caused by a mutation in the SRD5A2 gene, which impairs the body's ability to convert testosterone to dihydrotestosterone (DHT), a hormone critical for male sexual development.

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