McClintock (2015) cites the case of individuals with a genetic condition in the Sambia of New Guinea. Males are categorized as girls at birth as they have labia and clitoris. At puberty, the genitals change due to a large increase in testosterone, the testes descend and the clitoris enlarges to a penis. This genetic mutation is common in Sambia and it was accepted that there are men, women and 'kwolu-aatmwol' (females then males). Since contact with the West, they are now judged as having a pathological form of gender dysphoria.