This very in-depth story spends a lot of time discussing mutations that lead to murky physiological gender identification. These mutations, as the story points out, are rare and it's unclear how often they are present in gender identity disorder. I urge you to watch the video included in this story. Also, I find the story where this child attempted to urinate standing up interesting. I don't consider that something that is instinctively male. In fact, Isabella seemed to know at a very young age charactersics that are generally considered male.