Four cases of male pseudo-hermaphrodism were seen post pubertal. All had been reared as females unambiguously since birth. Two cases developed male gender identity post pubertal, but failed to declare themselves to their families and society until a similar case had been publicized in the local newspaper. The third case did not reveal her problem to her family even after being informed by a doctor at the age of 15, and was discovered accidentally at the age of 22 on routine medical examination. The fourth was discovered accidentally at age 40 after having been married and divorced. The families of the four cases shared a strong desire for their children to be reassigned to the male sex including the third case, irrespective of being assured of her female gender identity by physicians. Psychiatric and social problems encountered pre- and post-operatively are discussed with particular emphasis on the role of culture and traditions.

Seventy-two patients suffering from hysteria were seen in the psychiatric outpatient clinics at King Fahd Hospital of the University. A semistructured psychiatric interview and the standard mental state examination were used in assessing the patients. The incidence of hysteria was 5.1%; 84.7% were between the ages of 11 and 30 years. The female/male ratio was 1.8:1, and 61% were single. Hysterical conversion was the commonest type (73%), and hysterical dissociation was rare. Twenty-six percent formed a distinct group with similarities to Briquet's syndrome. In 83% of the cases, a stressful situation preceded the onset of symptoms. No gross deviations of intelligence were noticed in the patients, and the typical hysterical personality was rare.