Before week 9, both males and females begin with reproductive structures that are identical in appearance. The internal structures start to differentiate in week 9 as the SRY gene on the Y chromosome causes the testes to develop in males. Between 9 and 14 weeks, the baby’s internal sex organs start to develop. In males, the testes produce hormones essential for creating the male anatomy. In females, the lack of male hormones allows the development of the ovaries, uterus, fallopian tubes and upper vagina.18
Even while the internal structures change based on the baby’s gender, the baby’s external genitalia remain similar in appearance until about 11 weeks gestation. By 12 weeks, the external genitalia have started to lengthen in males to form the penis or shorten in females to form the clitoris and labia.19 Between weeks 11 and 14, an ultrasound can determine the baby’s sex with about 75% accuracy. 20 By 14 weeks, ultrasound imaging can identify the baby’s sex with almost perfect accuracy.21