Clitoral surgery for intersex conditions was promoted by Hugh Hampton Young in the United States in the late s. Affected individuals are usually taller than average and have slender builds. Chromosomes are the structures that carry genes which in turn transmit hereditary characteristics from parents to offspring. It is the most common cause of intersexuality in females with 46XX, where untreated girls develop an outwardly male appearance. Most women are 46XX and most men are 46XY. Typical sexual development is the result of numerous genes, and mutation in any of these genes can result in partial or complete failure of sex differentiation. Subsequently, a standardized intersex management strategy was developed by psychologists at Johns Hopkins University USA based on the idea that infants are gender neutral at birth. It is, therefore, responsible for the initiation of male sex determination during embryo development. This disorder, also called adrenogenital syndrome AGSresults from a genetically caused deficiency of cortisol, a steroid hormone produced by the adrenal cortex.