Depends on the individual.
Some XY individuals are completely androgen insensitive. They appear completely female on the outsdie, but have no ovaries. They cannot have children, but most identify as female without any surgery.
Others display a mixed presentation, not completely male or female. The debate is nature or nurture. In the past, the prevaling feeling was nurture was more important, and many of these intersexed children were surgically altered to appear female with some success and some not so successful results.
Today many people are asking "Why not wait until the child develops a sexual orientation, then make the body match the mind?" As long as there are no immediate urinary issues, I think this is a valid question.
We cannot predict who will become gay or transexual even with physical genitallia that matches chromosomal sex, let alone any of the less common conditions.
