There are many scenarios in regards to a person who has ambiguous organs of both sexes:

[1] Before puberty, if the person has both a vulva and a penis then to determine how to consider him/her, which ever organ he urinates from, will decide how he/she should consider themselves.

[2] After puberty, if he gains a beard, experiences ejaculation with a woman or has a wet dream, he is to be considered a man. If the person gains breasts or milk from them, or experiences the menstrual cycle or conceives or she is capable of sexual intercourse, like normal women, with a man, then she is to deem herself a woman. In other words, if a person has secondary sex characteristics (eg. beard, breasts) of one sex and the reproductory organs of the other then he/she should be considered as belonging to the sex type of the reproductory organs. Appropriate surgical measures and permitted hormonal treatment can be taken to remove the other sex physical characteristics.

[3] If however there appears no such physical characteristics of either sex or they are conflicting, for example the person gains a beard and also has breasts and the status of the reproductory organs do not suggest either sex or suggest both (or in simple terms the person ejaculates like a man and at the same time experiences menstrual bleeding via the vulva), then this person is termed, in juristic terms, as “Khuntha Mushkil.” This is a rare category and specialist doctors should be able now to ascertain the cause for this abnormality through a genetic/ chromosomal analysis and prescribe appropriate treatment that phases out the abnormal aspects, leaving him/her with one sex.

The ruling for this person is, until he/she does not become certain which sex he/she belongs to, in relation to Islamic injunctions and commandments, a level of precaution will need to be adhered to. Thus, he should pray at home and not in the rows of the men or women. The Khuntha can enter the Masjid so long as he/she is not in her menstrual period. It is not permitted for the Khuntha Mushkil to travel the distance of 48 miles alone, because of the chance that the Khuntha is a female. It will also be disliked for the Khuntha to wear gold and silk, as they are forbidden for men. Marriage must be deferred until it becomes clear which sex he/she belongs to. If the Khuntha were to die he/she would be prayed over as he/she is a Muslim, however the washing of the body will be left out, and instead Tayammum will be done. (Rad al-Muhtar, Kitab al-Khuntha, vol.10, 446-449). Similarly, if a child is born with ambiguous genatalia, today doctors can do many detailed tests as those mentioned for the Khuntha Mushkil, to determine what may have caused this abnmrmality and after assessing all the factors, such as the status of internal organs, gene analysis, feasibility of acceptable hormone treatment etc. surgery should be done to make the child’s genatalia of one particular sex.