Two brothers moved to the Bronx, NY from a village in the Dominican Republic with a high proportion of syndrome steroid 5-alpha reductase deficiency, one of two dozen variations of conditions leading to ambiguous genitalia at birth. The Dominican syndrome which impairs metabolism of testosterone leads to a bifid scrotum that appears labia like and an absent or clitoris-like penis at birth. Children born with the syndrome are raised as girls until the age of twelve when puberty begins and male secondary sex characteristics occur. These children are known locally as Guevote ("penis at twelve"). These brothers have two other siblings who are hermaphrodite but not all want to become boys at twelve.