If you are born male, you are a male

But...

In 1983, the Conference of Rulers issued a fatwa prohibiting Muslims from undergoing sex-change procedures, with the exception of khunsa or hermaphrodites (which in their case means being both male and female at once).

Hermaphrodites can either be both sexes simultaneously, or else they swap from one to the other. Some slugs and snails take gender-bending to an extreme: they start off male, become both and finally switch to female.

Over the last few years the Islamic religious authorities have expressed serious concern over the increasing number of transvestites and Muslims undergoing sex-change operations.

Both are considered haram in Islam.

However, Islam rules that if the transvestite or Mak Nyah (the preferred local term rather than the derogatory pondan) is a khunsa (hermaphrodite), he is accepted by the religion.

There are two types of khunsa. One is called wadhah, where the two sex organs are well-formed, but only one functions - usually the female organ. The other khunsa is known as musykil where both organs are not properly formed, but are functional, and the person has a tendency towards the female side. Both problems can be corrected by doctors.

Sometime, the children's male sex organs were hidden at birth and began to appear only as they grew older.

But... it's haram for anyone to change God's creation. That is clear cut.

What Islam acknowledges is the existence of hermaphrodites, where both the male and female genitalia are functional. For instance, they can pee with both organs. In such cases, Islam allows the person to seek medical help to determine which organ is stronger and do away with the weaker
organ.

REMINDER:

Any constructive criticism and comment that would contribute to fair, frank and informed discussion on this posting to help achieve our national objective will be most appreciated. We need to have more open exchange of ideas on this sensitive but important subject in the context of the national vision and security.