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POPS Diethylstilbestrol (DES) in 46XY Individuals the Merck manual states, "Although biologic factors, such as gender complement and the prenatal hormonal milieu, largely determine gender identity, the formation of a secure, unconflicted gender identity and gender role is influenced by social factors, such as the character of the parents' emotional bond and the relationship that each of them has with the child". Merck is a major pharmaceutical company and was one of the numerous manufacturers of DES. the volume of the central subdivision of the bed nucleus of the stria terminalis (BSTc), a brain area that is essential for sexual behaviour, is larger in men than in women. A female-sized BSTc was found in male-to-female transsexuals. size of the BSTc was not influenced by sex hormones in adulthood and was independent of sexual orientation. In my OPINION.. prescriptions are one thing, but what about exposure by other means and how it affects you, meaning hormones in your diet.