Previous reports suggested that humans and mice differ in their sensitivity to the genetic dosage of transcription factors that play a role in early testicular development. This difference implies that testis determination might be somewhat different in these two species. We report that the Fog2 and Gata4 transcription factors are haploinsufficient for testis determination in mice. Whether gonadal sex reversal occurs depends on genetic background (i.e., modifier genes). gonadal sex reversal ͉ haploinsufficiency ͉ sex determination ͉ Sry ͉ Sox9 D uring human fetal development, differentiation of the bipotential gonads into ovaries or testes depends on the proper dosage of transcription factors. For example, the presence of only a single functional copy of the autosomal transcription factor-encoding genes SF1, SOX9, or WT1 can result in the development of XY females, and duplication of a chromosomal region containing SOX9 can lead to the development of XX males (1-5). In contrast, the proper dosage of the transcription factors Sf1, Sox9, and Wt1 appears not to affect testicular development in mice because XY mice containing only a single copy of these genes develop testes (6-9). This apparent species difference suggested that the correct dosage of gonadal sexdetermining transcription factors is necessary for normal testis development in humans, whereas mice are less sensitive to these gene dosage effects (10-12).Studies in our laboratory indicate that genetic background plays an essential role in the process of gonadal sex determination in mice. Specifically, mice of the C57BL/6J (B6) inbred strain are exceptionally sensitive to disturbances in the early events of gonad development and thus provide a genetic ''litmus test'' for identifying genes that cause sex reversal. For example, the Sry POS gene carried on the Mus domesticus poschiavinus Y chromosome causes ovarian tissue development when present in C57BL/6J (B6) mice but not in DBA/2J (D2) or (B6 ϫ D2)F1 mice (13,14), and a mutant allele of the X-linked transcription factor Dax1 (Nr0b1) causes gonadal sex reversal in B6 but not D2 or (B6 ϫ D2)F1 XY mice (15). This ''B6 sensitivity'' is even stronger if the AKR/J Y chromosome (Y AKR ) is present. For example, if B6 mice are heterozygous for the T Orl mutation, they develop testes. If the Y AKR chromosome is present, however, they develop ovaries (16,17). These findings suggest that genetic background, not species differences, could explain apparent differences in transcription factor dosage sensitivity for gonad development in XY humans and mice. The fact that not all XY humans are sex-reversed if only a single copy of a normal SF1 or WT1 allele is present (18-20) supports this possibility, as does the fact that XY males carrying a mutant SRY gene can pass this allele on to XY daughters (for review, see ref. 21).To test the hypothesis that testis determination in XY mice is sensitive to levels of transcription factor gene dosage in a genetic background-dependent manner, we conducted experiments to determine wh...