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For example Nadia may have had a very femine appearance etc... technically a man but unlike most men have female tendencies, maybe he grew some breasts of just genuinly spoke like a woman.
Incidents like this happen a lot such as Haemaphrodites (again whatever), the parents choose to have lets say the Penis removed only to discover that the baby in question turns out to be VERY masculine.
There are many transexual's out there who change gender out of choice, but even more do it because genuinly there is something physically wrong... medically Nadia may have been a woman in a man's body.