In addition to the anatomy of the external genitalia and the infant-parent relationships—the more easily observable components in the production of gender identity—there is a third, usually silent component: a congenital, perhaps inherited biological force. In the normal, the three work together in the same direction to produce an intact core gender identity, a fundamental awareness of being male in males and of being female in females. In anatomically intersexed patients where one or both of the observable components is absent, the effects of the silent biological force are occasionally uncovered and then can be seen. Cases are presented in which this occurred.