Furthermore, a large-scale epidemiological study in Iran also screened SRY gene status in 46, XX DSD individuals and found that approximately 85% of testicular DSD patients carried a translocated SRY, while the remainder were SRY-negative, prompting investigations into SOX9 upregulation and other autosomal modifiers (Rastari et al., 2025). This evidence concerns the gene SOX9 and disorder of sexual differentiation.