Sex Determination in forensic medicine.pdf

Sex determination in forensic medicine

1. Department of Agad Tantra Evam Vidhi
Vaidyaka
Guided by --- Dr. Baby Ganeriwala &
--- Dr. Aniruddha Pan
Raghunath Ayurved
Mahavidyalaya &
Hospital
Presented By : Sandipan Sardar
Arkadeep Jana
Debkanta Samanta
Kazi Md Abdur Rahman
Subhadeep Barman
Barsha Chatterjee
Bushra Taufique
Mustafiza Farhat
Santanu Kumar Jana &
Sailavi Biswas


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2. Sex
Determination
in Forensic
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3. C0NTENT
Introduction
Aim & Objectives
What is Sex Determination?
Sex of person has to be established in
How Sex is Determined ?
Method of sex determination
Disease related to sex
Medico legal importance
Limitation
Conclusion
Bibliography
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4. Introduction
Sex is a biological term denoting the genetic,
physiological and anatomical characteristic of an
individuals based on which we can identify
ourselves in males & females.

In normal cases it is easy to determine the sex by
inspection of anatomical features of external
genitals.
Gender - Sexual identity of an individual from birth
to puberty and adulthood.
But for further case we have to investigate the other
criteria.
Intersex -Intermixing of sexual characteristics that
are not typically male or female.
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5. AIM & OBJECTIVES
DETERMINATION OF SEX IS IMPORTANT FOR –

•For the purpose of identification in living or dead.
•Sex appears doubtful.
•Sex is concealed.
•Person appears to possess “Sex organs of both
sexes”.
•Civil rights reserved to one particular sex only.
•Questionable to legitimacy, divorce, paternity,
affiliation, heir ship & any other criminal offences
like- rape etc.
•National and international sports meet and
games.


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6. What is sex determination?
The method by which distinction between male and
female is established in an organism under genetic
control.

The sex chromosomes (‘X’ & ‘Y’) are
responsible for determination of separate sex.


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7. Sex of person has to be
established in :


1.Living body
2.Dead body
3.Foetus
4.Skeletal


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8. How Sex is Determined ?
S.No. Feature Male Female
1. General built Muscular, strong stout Less muscular, slender
2. Pubic hair Thick, coarse, extends
upwards with apex at
umbilicus.
Thin, fine, horizontal,
covers mons veneris.
3. Prominent Less prominent
4. Shoulders Broader than hip Narrower than hip
5. Breasts Not developed Developed after
puberty
6. Uterus and
vagina
Absent Present
7. Penis Present Absent
8. Gonads Testes Ovaries
9. Facial hair Present Absent
A. Basic morphology –
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9. B. Sex from skeleton
•Difference between male and female pelvis -
S.No. Feature Male pelvis Female pelvis
1. General
appearance
Massive, rougher,
prominent muscular
markings
Less massive, slender,
smoother, prominent
muscular markings
2. Shape Heart shaped Flat bowl shaped
3. Sciatic notch Narrow,deep,small Broad, shallow, large
4. Pelvic cavity Conical, funnel shaped Broad, round
5. Pelvic outlet Smaller Larger
6. Body of
pubis
Narrow, triangular

Broad, rectangular

7. Ischial
tuberocity
Inverted

Everted

8. Obturator
foramen
Large, oval, base upwards

Small, triangular, apex
forwards
9. Acetabulum Large Small
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10. Picture: Male & Female Pelvis
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11. •Difference between male and female Sacrum -
S.No. Feature Male Sacrum Female Sacrum
1. General
apperance
Long, heavier, rough,
narrow
Short’ lighter, smooth,
broad
2. Breadth of
body of 1
st

sacral
vertebra
More than breadth of
one side ala
Less than breadth of one
ala
3. Sacroilliac
joint surface
Large, less sharply
angulated
L- shaped, elevated
anteriorly
Picture : Male & Female sacrum
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12. S.No. Feature Male Skull Female Skull
1. General
appearance
Large, heavier, rugged,
marked muscular ridges
Smaller, lighter, walls
thinner, smoother
2. Cranial
capacity
More capacious (1450-
1550 cc)
Less capacious (1300-1351
cc)
3. Forehead Receding, irregular,
rough,, less rounded
Vertical, round, full,
infantile, smooth
4. Supraorbital
ridge
Pronounced, ‘loaf
shaped’ ridge
Smooth, little or no
projection
5. Mastoid
process
Large, round, blunt Small, smooth, pointed
6. Palate Large, U – shaped,
broad
Small, parabolic
7. Foramen
magnum
Relatively large, long Small, round
•Difference between male and female Skull -
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13. 06/May/24 Sex determination 13

14. C. Diagnostic index for determination of sex -
S.No. Index Formula Male Female
1. Washburn /
Ischiopubic
index
??????���� �� �����
??????����� �� �������
×100
73-94
(average
75)
91-115
(average
100)
2. Sacral
index
??????��������� �������� �� ���� �� ������
??????������� ����� �� ������
×100

<114 >114
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15. Methods
1.Physical morphology
2.Microscopic test
3.Gonadal biopsy
4.Gene-based test
5.Metric system
6.Radiological examination
7.Assay of testosterone levels
8.Histological examination ---


Barr body
Davidson-Smith body
Quinacrine dihydrochloride
Fluorescent Feulgen reaction
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16. 1.Physical morphology : External examination is
done to determine the sex.
2.Microscopic test : Buccal epithelial cells or hair
folicle cells are examined microscopically to
detect the presence of ‘Barr body’.
3.Gonadal biopsy : Detection of ‘internal gonads
and sex chromosome’, i.e., the identification of
testes.
4.Gene-based test : Polymerase chain reaction
(PCR) is use to detect SRY gene and/or the
DYZI region of Y chromosome. SRY gene is
expressed in a small group of somatic cells of
the developing gonads, and it is responsible for
the expression of a male. ( the H-Y antigen).
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17. 5.Assay of testosterone levels also help s in
differentiating the sex of an individual.
For females, they should have levels <10nmol/l
(lower than the lower limit of normal for male).
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6. Chromatin positivity in males & females
Test Male (٪) Female (٪)

Barr body 0-4 20-80
Davidson body 0 6
Fluorescent feulgen 0-2 50-70
Quinacrine dihydrochloride 45-80 0-4

18. Disease related to Sex
Klinefelter syndrome – It is the most common
sex chromosome disorder associated with male
hypogonadism, most common presentation
being 47XXY karyotype.

Prevalence is 1:500 to 1:1000 males.

These individuals are anatomically male, but fail
in external genitalia examination, and have false
positive Barr body testing..
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19. Continuation…..
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Turner syndrome – It is the most common
sex chromosome disorder associated with
female hypogonadism with 45XO karyotype.

Prevalence is 1:2000 to 1:2500 newborns
females.
These individuals are anatomically female, pass
in external genitalia examination, but have false
negative Barr body testing.

20. Medico-legal Importance
Identification of Victims – Sex determination
helps in identifying human remains, especially
in cases of mass disasters, accidents, or crimes
where the body is severely decomposed or
mutilated.
Criminal Investigations – In cases of sexual
assault or rape, determining the sex of the victim
can provide valuable evidence for the
investigation and legal proceedings.
Paternity Testing – Sex determination is
essential in paternity testing to establish
biological relationships between individuals for
legal purposes such as child custody,
inheritance and immigration.
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21. Legal Documentation – In legal matters such
as issuing identification documents,
marriage certificates and birth certificates,
accurate sex determination is crucial for
proper documentation.
Forensic Medicine – Sex determination can
assist in reconstructing events leading to injury
or death . Especially in cases of homicide or
suspicious deaths.
Genetic Disorders – Determining the sex of an
individual can be important in assessing the risk
of genetic disorders linked to specific sexes,
which may have implications for medical
treatment and genetic counseling.

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22. Medico-legal Reports – Sex determination
findings are often documented in medico-legal
reports, which serve as crucial evidence in legal
proceedings, especially in cases involving
violence, abuse or discrimination based on sex.

Forensic Anthropology – Sex determination is
also significant in forensic anthropology for
identifying skeletal remains and providing
insights into demographics, migration patterns
and population studies.

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23. Limitation
Identification of sex of an individual may become
problematic in –

Transvestism
Concealed sex
Decomposed or Mutilated bodies
Hermaphroditism or intersex state
Transgender
Transsexuals
Skeleton Remains
Gonadal agenesis
Gonadal disgenesis
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24. Conclusion
•Determination of sex is very important for the
identification of both living and dead person.
•Microscopic examination is the most important
positive sign of sex identification just next to
gonadal biopsy.
•Intersex may result in an error in diagnosis of
true sex from external genital examination
therefore a through knowledge of this subject is
a must for every forensic expert to identify the
true sex of an individual.
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25. Bibliography
•Forensic Medicine & Toxicology(5
th
edition) –
Goutam Biswas
•The Essential of Forensic medicine &
Toxicology(33
rd
edition) – Dr. K.S. Narayan
Reddy & Dr. O.P. Murty
•Essentials of Forensic Medicine and Toxicology
– A.K. Gupta
•A Textbook of Medical Jurisprudence &
Toxicology – K. Kannan
•Medical Jurisprudence & Toxicology Digest –
Anoopam Modak

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26. Thanks
for
YOUR
ATTENTION! .
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27. Do you
have any
questions ?
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