Sex is a spectrum, with man and woman at the ends but variations in between. XX and XY chromosomes don't always correlate with physical traits, leading to ambiguity in sex determination post-birth.
Genetics play a complex role in determining sex. The SRY gene on the Y chromosome, along with other factors, decides the formation of testes. Mutations can lead to mismatch between chromosomes and physical traits, challenging traditional views of sex.
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