-McClintock cites case of individuals with genetic condition in Sambia. causes biological males to be categorised as girls at birth as they've a labia & a clitoris. At puberty genitals change due to large increase in testosterone. genetic variation common among Sambia, & routinely accepted that some people are men, some women, & others are kwolu-aatmwol - females-then-males. however, kwolu-aatmwol judged as having a pathological form of gender dysphoria.