Reports on the development of gender identity (GID) and role of a pedigree of 6 Omani Arabs aged 3-28 yrs with male pseudohermaphroditism due to 5 alpha reductase-2 deficiency, identified between 1986 and 1995, and on what appeared to be the determining factors in the development of their gender status. All Ss were raised as girls since birth. The Ss' external genitalia of 'pseudovaginal perineoscrotal hypospadias' was identical. Although these Ss were a homogeneous group in terms of their sex of upbringing, phenotypic appearance, endocrinological profile and sociocultural background, the development of the GID and role was not uniform. Their psychosexual make-up was closely related to the transaction of their life experiences. These cases provide further insight into the interaction between various factors involved in the development of GID and role in male pseudohermaphrodites in an Eastern culture.