TORONTO -- A 2 -year-old Siamese twin who was joined to a brother at the pelvis and shared a single set of genitalia had his sex changed to female during an operation that successfully separated the siblings, doctors revealed Monday.
Win and Lin Htut of Burma, who also shared some organs, were separated by a 43-member surgical team in a 17 -hour operation completed early Sunday to applause from staff at the Hospital for Sick Children.
Doctors said Win was 'quite stable' after a second emergency operation undertaken 12 hours after the separation to halt bleeding found in a small blood vessel.
Both children were genetically male but only Lin received the male genitalia in the operation, while Win underwent a procedure to give him female characteristics.
'We created a vagina for Win and removed the male gonads so they will not affect her through masculinization,' said Dr. Robert Filler, who led the surgical team.
Doctors said the child will be injected with hormones and will grow up with female characteristics but will remain genetically a male and will not be able to have children.
Prior to the operation, doctors advised the parents that their twins could grow to adulthood as either two girls, or a girl and a boy.
'Their family wished to have one boy and not to have both girls,' said Filler.
He said 'Lin was the more aggressive infant and psychologically he seemed the appropriate one to leave as a boy.'
'Win will need to have expert (psychological) care. It will take years and years,' he said.
'They certainly will be better off than a child who is a paraplegic,' Filler said. 'They have excellent brains and they will be excellent people.'
The children, who have lived all their lives in a hospital in Rangoon, Burma, had shared a third, deformed leg as well as male genitalia, liver, intestinal and urinary tracts and some bones.
Each child now has only one leg but they are normal above the diaphragm. They each will eventually be fitted with an artificial leg.
Filler said both babies were sedated heavily but were 'probably cognizant' they had been separated.
'Lin is doing extremely well at this stage,' Dr. Geoffrey Barker said. 'Lin is awake, alert and being assisted with the help of a ventilator.'
He said Win was in a 'sleeplike state' but 'quite stable' after the second operation Sunday to stop bleeding from a small blood vessel.
'She is about 24 hours behind the progress of Lin but we expect her to catch up with Lin in the next 24 hours,' he said,
In the twins' hometown of Saggaing, Burma, their father, Nyi Htut, said he and his wife were glad the surgery to separate the twins had been successful.
'I'm very happy,' he was quoted as saying in the Toronto Star. 'I've been worrying all the time. My wife is happy, too. She's been worrying very much -- more than me.'
Htut, an official of a railway technical training center, said he and his wife could not afford to travel to Toronto with their children. The couple also has a 7-month-old daughter.
The twins were flown to Toronto July 18 for the operation to separate them.
