is also described as pseudohermaphrodism with normal virilisation at puberty. 5 Alfa reductase deficiency presents with ambiguous genetalia with small hypospadiac phallus, blind vaginal pouch with normal testis and woolfian duct and absent mullerian ducts. It has a 46 XY karyotype and autosomal recessive disorder. The child is usually raised as female and at puberty she shows signs of virilisation and changed gender identity of incomplete masculine male due to 5 Alfa reductase deficiencies.