The Transgender Dictionary

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Androgen Insensitivity Spectrum

(also: AIS, Androgen Insensitivity Syndrome, Goldberg-Maxwell Syndrome)

Table of Contents

General Information

Those who have AIS have testes and XY chromosomes. The bodies of people with AIS have varying levels of insensitivity to androgens. This means that their cells do not respond typically to the testosterone being produced.

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Complete Androgen Insensitivity Syndrome/CAIS

Someone with CAIS is born with a clitoris, vulva, undecended testes, and usually has a vagina that is shorter than what is considered typical. They will not menustrate, due to a lack of ovaries and a lack of a uterus. People with CAIS have no response to androgens, and develop features consitent with an estrogen-based puberty. They will also experience gynecomastia. The body will naturally convert testosterone into estrogen through a process called aromatization.

Partial Androgen Insensitivity Syndrome/PAIS/Reifenstein Syndrome

Someone with PAIS will have less of a response to testosterone than someone who has XY chromosomes and no androgen insensitivity. Someone with PAIS will have more of a response to testosterone than someone with CAIS. They may have partially decended or undecended testicles. They may have genital differences such as a phallus that may be perceived as clitoromegaly or a micropenis, and/or a vagina that may be shallower than typical. They may have variations affecting the urethra such as a common urogenital sinus or hypospadias.

Someone who has PAIS may have genitalia that looks more like a vulva & vagina or more like a penis. Someone with PAIS may go through puberty and develop traits typically associated with both an estrogen-based puberty and that of a testosterone-based puberty.

Mild Androgen Insensitivity Syndrome/MAIS

Someone who has mild androgen insensitivity syndrome responds to testosterone less than what is typical for someone born with XY chromosomes, but more than someone with other variations of androgen insensitivity syndrome. Someone who has MAIS may have a micropenis, and will develop secondary sex characteristics associated with a typical testosterone-based puberty. As the body of someone with MAIS will convert a small amount of naturally produced androgens into estrogen, there may be visible variations regarding the amount of muscle tone, body hair, and/or facial hair developed during puberty. There is also a potential for gynecomastia during puberty.

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