Endocrine Abstracts

The picture showing a markedly virilised central figure with an infant at the breast and a shadowy figure in the background was painted in 1631 by Jose Ribera, a Spaniard living in Naples. It was commissioned by Ribera’s patron, the Duke of Alcela. The painting is of a real named person. The provenance of the painting is well known and through the Duke’s family inheritance it returned to Spain and is to be seen in the Muse Fondacion Duque de Lerma in Toledo. It can also be found on Google by searching for Spanish painters then Ribera (1591–1652) and his works by title.

The case for a possible diagnosis of an underlying medical condition, which could explain all the features evident in the painting will be made. A differential diagnosis and the relevant possible investigations of someone presenting with similar problems in the 21st century will be sought from the audience. The manner in which such a person might have been treated in the 17th and subsequent centuries will be compared to the way in which gender issues are managed today.