I'd be fascinated to see the theological explanations for syndromes such as 5ARD or 17BHDD.
Groups such as the Guevedoces of the Dominican Republic.
During the early 1970s, Dr. Julianne Imperato, a Cornell endocrinologist, conducted an expedition to the Dominican Republic to investigate reports of an isolated village where children appearing to be girls turned into men at puberty. In the village, these children were known as 'guevedoces' (literally, penis at 12 years). Also known locally as machihembras ('first women, then man'), these pseudohermaphrodites were documented serially in the following photographs published originally in the American Journal of Medicne (Am. J. Med. 62: 170-191, 1977):
In an isolated village of the southwestern Dominican Republic, 2% of the live births were in the 1970's, guevedoces (actually male pseudohermaphrodites). These children appeared to be girls at birth, but at puberty these 'girls' sprout muscles, testes, and a penis. For the rest of their lives they are men in nearly all respects (see photograph 6 below). Their underlying pathology was found to be a deficiency of the enzyme, 5-alpha Reductase.
Then there's the Turnim-Men of the Sambia Tribe of New Guinea - also due to 5ARD.
And the other clusters of such conditions around the world. CNN had a good short documentary on one of them, in Jubayah in Gaza.
That's 17BHDD syndrome, which causes similar effects. Male to Female changes (like my own) happen from a variety of natural causes, but are much rarer.
Oddly enough, people like myself get little guidance from expert theologians. The people who know all there is to know about the Theology of the Body. Our existence troubles them, you see.
They can deal with most Intersex conditions - those where the appearance at birth, even if unusual or ambiguous, can be explained away as the consequence of the fall, only superficial etc. But pseudohermaphrodites, who get a natural apparent sex change... they have difficulty with. Many deny our existence. I've been asperged with holy water once, to drive me away. I felt rather sorry for the guy, actually.
Oddly enough, it appears that sex is unchangeable. That it's set in the womb, long before birth. You see, not all those who change naturally can cope. Many find the change a blessed release from the Hell of transsexuality - having a male brain in a female body. But for some, the girls..... they beg for medical intervention to end this obscene nightmare.
From Sexual Hormones and the Brain: An Essential Alliance for Sexual Identity and Sexual Orientation Garcia-Falgueras A, Swaab DF Endocr Dev. 2010;17:22-35
The fetal brain develops during the intrauterine period in the male direction through a direct action of testosterone on the developing nerve cells, or in the female direction through the absence of this hormone surge. In this way, our gender identity (the conviction of belonging to the male or female gender) and sexual orientation are programmed or organized into our brain structures when we are still in the womb. However, since sexual differentiation of the genitals takes place in the first two months of pregnancy and sexual differentiation of the brain starts in the second half of pregnancy, these two processes can be influenced independently, which may result in extreme cases in trans-sexuality. This also means that in the event of ambiguous sex at birth, the degree of masculinization of the genitals may not reflect the degree of masculinization of the brain. There is no indication that social environment after birth has an effect on gender identity or sexual orientation.
And from Gender change in 46,XY persons with 5alpha-reductase-2 deficiency and 17beta-hydroxysteroid dehydrogenase-3 deficiency. by Cohen-Ketternis:
Gender role changes were reported in 56-63% of cases with 5alpha-RD-2 and 39-64% of cases with 17beta-HSD-3 who were raised as girls. The changes were usually made in adolescence and early adulthood. In these two syndromes, the degree of external genital masculinization at birth does not seem to be related to gender role changes in a systematic way.
The Theological musings on the subject seem to me to be akin to the Theological musings about how the sun had to rotate around a stationary Earth, and the intellectual gymnastics involved in explaining away Intersex conditions - including Transsexuality - akin to adding more and more epicycles to perfectly circular orbits.
But that's just me.