On the world of Ruquelis, there are three genders, men, women, and lilim who are a female sex, with wings and clawed feet. Because of the genetics of this situation, lilim are less fertile and can give birth to all three genders, while women are more fertile, and can give birth only to men and women.

This has led to wars and atrocious behavior toward women that has been perpetuated by the presence of reincarnation anchors. Because woman and lilim children are not distinguishable before the age of 9, by which time all lilim-children have begun to transform into lilim, while no woman-child displays these signs (except for the occasional exception who begins later, but they're not spoken of), 9 is the age at which a female child who is not visibly becoming a lilim legally becomes a woman.

In the Empire of Qlaemythu, 9 year old woman-children may be sterilized by bilateral oophorectomy if they are judged to be sufficiently valuable. The others... have a much worse fate that isn't relevant to this question.

There is no hormone replacement therapy available for these sterilized young women.

My question is: How would these sterilized young women differ from an unsterilized woman in her physical and mental development? What would they be like at adulthood?

I can speculate what they would be like, but I'm looking for scientific resources that show the consequences of such an act. Because sterilising a 9-year-old girl in this way rarely appears to be done in our own society, I haven't been able to find the information I need online. Perhaps my google-fu is weak... or perhaps there really is nothing online.


Since it has been pointed out in comments that all of these people would be a different species to Homo sapiens, here are the genetics that disprove that statement:

There are chromosomes X and Y, which are the normal, human sex chromosomes. There is also a L chromosome, which carries the genes to make a lilim a lilim. This is the only artificial addition that I have made.

We therefore have crosses:

Men (XY) and Women (XX) -> ½ XY and ½ XX.

This corresponds to our familiar 50% male/female sex ratios in unions between men and women.

However, we also have:

Men (XY) and Lilim (LX) -> ¼ XL, ¼ XX, ¼ YL and ¼ XY.

In these crosses, YL is immediately lethal, as the L chromosome is missing genes necessary for survival of a zygote that is only present on the X chromosome, preventing even a single round of cell division.

This leads to lilim effectively having a birth ratio of 1/3 XY Men, 1/3 XX Women and 1/3 XL Lilim, with a slightly lower birth rate than is the case for women.

Since this question is about sterilised fully human XX females, the statement that these women are not human is disproved.

  • 1
    $\begingroup$ Comments have been moved to chat; please do not continue the discussion here. Before posting a comment below this one, please review the purposes of comments. Comments that do not request clarification or suggest improvements usually belong as an answer, on Worldbuilding Meta, or in Worldbuilding Chat. Comments continuing discussion may be removed. $\endgroup$
    – Monty Wild
    Commented Sep 21, 2023 at 12:26
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    $\begingroup$ Note that since you're essentially describing a different species from humans (have to be since the lilim can produce women that are presumably indistinguishable from the women-produced women, so that indicates a substantially different genetic makeup...) You can make the side-effects of early sterilization be pretty much whatever you want within the bounds of biological and thermodynamic feasibility. The real world is a decent starting point, but these are definitely your creatures to design as you please. $\endgroup$
    – Perkins
    Commented Sep 21, 2023 at 19:40
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    $\begingroup$ @Perkins Not so, the genetics are all worked out. The lilim traits are carried on the L chromosome which are a modified X. Lilim get it (LX), women don't (XX), there are (XY) men, and LY is lethal. It's why Lilim can produce lilim, women and men and have a lower birth rate. Simple. See worldbuilding.stackexchange.com/questions/236068/… The lilim are my creation, but human men and women are exactly as they are in the real world. $\endgroup$
    – Monty Wild
    Commented Sep 22, 2023 at 0:55
  • $\begingroup$ "There is also a L chromosome, which carries the genes to make a lilim a lilim." - Kinda begs the question, why wait for physical signs that usually but not always appear around age 9 when a simple genetic test will tell the women from the lilim earlier and with greater accuracy? $\endgroup$
    – aroth
    Commented Sep 22, 2023 at 2:30
  • $\begingroup$ @aroth Because the technology for genetic testing does not exist in the society, and so genetic testing is by no means 'simple'. It can be done, but is prohibitively expensive to all but the social elites, who mostly don't do it because most see nothing wrong with the whole F-ed up situation. $\endgroup$
    – Monty Wild
    Commented Sep 22, 2023 at 2:43

1 Answer 1


They Would Look Unusual

The best bet for an approximate equivalence here would be Estrogen Insensitivity Syndrome.

The default body plan is female, and initial development (including uterine development) would be normal because the gonads would be present until age 9 (when puberty could well have already kicked off, depending on a variety of environmental factors including nutrition).

Mental development (provided that the surgery was done humanely and didn't induce PTSD in the victims) should be pretty standard with an important caveat; as outlined extensively in Testosterone Rex by Cordelia Fine, sex hormones have surprisingly little bearing on the way the brain develops after adolescence. Without elevated estrogen and testosterone, though, it is a reasonable supposition that these victims' sex drive will be far reduced from what it might have been.

The caveat, however, is that without the surge in estrogen and testosterone, victims of this surgery would experience a failed puberty. No growth spurt, no secondary sexual characteristic development. In the recorded cases of EIS, the sufferers still developed pubic hair, but this could have been a result of testosterone, since the hormones were still being produced, just not having an effect.

So they would look underdeveloped for whatever age they actually were - their organs would be ageing but wouldn't look fully adult for some time (possibly ever, as typically delayed puberty isn't allowed to linger indefinitely in modern cases, and concomitant pathologies make separating out just the absence of sex hormones difficult in most syndromes that have that effect). They would be shorter than their peers, they would likely moderately androgynous, and they would probably suffer from osteoporosis pretty early in their adult life, in the same fashion as it is much more likely to affect women after menopause.

(Also, it goes without saying that without progesterone and estrogen, the menstrual cycle will never start.)

Most of the mental characteristics connected to diagnoses of primary ovarian failure largely have to do with social stigmas and the loss of potential futures, not physiological symptoms. That said, unless there was a very strong social system that could help the victims of this barbaric practice, it's hard to imagine the combination of physical oddity and the sense of being a by-blow of the empire's barbaric practices not doing a number on their mental well-being.

Addendum: The onset of puberty in the United States (as an example) for females ranges between 8-13 years. By age 9, it would not be unusual for a fair number of the victims of this surgery to have already started puberty and received the first boosts of hormones speeding development, which would throw all the previous estimates clean out the window, since you'd be combining the sudden cessation of those hormones with the trauma of a surgery.

As many as 1 in 5000 children experience precocious puberty, which for female children means the onset of menses before age 9. If there's a sufficient population of these victims, that brings the odds to a near-certainty that at least a few would go through this extra roll of the dice.

  • $\begingroup$ Thanks, that's very useful. The information you provided led me to nejm.org/doi/full/10.1056/NEJMoa1303611, which shows that such women will probably reach adult height, and possibly low weight with reduced bone density. $\endgroup$
    – Monty Wild
    Commented Sep 21, 2023 at 4:57
  • $\begingroup$ As for the social/psychological situation, no women are allowed to reproduce, and another question I asked showed that there's not even any good reason why not. However, most of the sterilised women will live much longer lives than the others. The choice for these girls is to be sterilised or die young, if they're given that choice at all. $\endgroup$
    – Monty Wild
    Commented Sep 21, 2023 at 5:20
  • $\begingroup$ @MontyWild - in the study you linked, as with EIS, the subject had the advantage of still having normal levels of testosterone in their system, which might confound certain variables like height development - the acne with which they presented is characteristic of relatively high testosterone. $\endgroup$
    – jdunlop
    Commented Sep 21, 2023 at 16:13
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    $\begingroup$ Huh. Reading through the description of failed puberty, I find myself remembering a friend of mine from high school who looked elementary school age all through high school (to the point where she got detained during one choir trip because a teacher at the school we performed at refused to acknowledge she wasn't from that school). It apparently ran in her family. No idea on osteoporosis, but knee problems were an issue, and she did have several broken bones early on (ended her gymnastics career). $\endgroup$ Commented Sep 22, 2023 at 4:40
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    $\begingroup$ estrogen doesn't drive libido much, it's progesterone that's more responsible for that. Ofc that's also mostly produced in the ovaries so the effect would be the same (but for a different reason) $\endgroup$
    – Tristan
    Commented Sep 22, 2023 at 14:39

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