The Gemara on our daf deals with two types of people whose sexual identity is questionable – an androgynous, who appears to have both male and female sexual organs, and a tumtum, who does not appear to be either male or female.
Rabbi Yose suggests that an androgynous is a berya bifnei atzma – a unique creature who cannot be treated either as male or as female. The rishonim have different approaches to the definition of berya bifnei atzma. Tosafot understand the concept as a permanent situation of safek, of doubt, suggesting that since we cannot expect to ever ascertain whether the individual is male or female we refer to such a person as a unique creature. The Ramban, on the other hand, accepts the simple meaning of the expression, and rules that an androgynous is truly viewed by the halakha as a creature that is neither male nor female.
Medicine recognizes two types of androgynous. A true androgynous has both male and female sexual glands, while a Pseudohermaphrodite has the appearance of both male and female sexual organs, although the individual actually has only one set of sexual glands.
The Gemara describes a tumtum as someone whose gender cannot be determined. Under certain circumstances, the physical covering that hid the sexual organ may be removed (in the language of the Gemara it is nikra, or “torn” off) and the individual can be identified as male or female. Nevertheless, the likelihood that a man whose testicles have developed within his body will be able to have children is slim at best. This is certainly the case in someone who was truly a tumtum, that is to say that their sexual organs did not develop because of a low level of hormones. In such a case, even if the person’s physical situation improves, he will not be able to father children.