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Emerging from a multidisciplinary dialogue between biomedicine, the history of science, and feminist science studies, our review highlights how cultural assumptions of gender are embedded within scientific practices of analyzing sex-differences. By integrating reflexive humanities perspectives with empirical biomedical research, we argue for a more accurate and equitable understanding of female development - one that recognizes oestrogenic activity as central to sex differentiation and challenges the reduction of femaleness to hormonal absence. This cross-disciplinary engagement illustrates the transformative potential of re-examining foundational scientific paradigms through collaborative, critical inquiry. Research on how sex develops in mammals was based for a long time on a simple binary model: male development is an active process driven by androgens, while female development happens passively when these hormones are absent. Our article re-challenges this long-standing view by referring to the history of the concept of female sex development as a passive process and reinforcing the critical works already available on its continued persistence. First, we trace how this 'female as absence' model emerged in 20th-century developmental endocrinology. Second, we review empirical evidence showing that oestrogens and their receptors play active roles in shaping female genital development, and we present a model of oestrogen-dependent pathways in this process. Third, we situate the idea of femaleness as absence within its wider cultural and symbolic background, showing how scientific concepts are influenced by historical and social meanings. Bringing together perspectives from biomedicine, the history of science, and feminist science studies, we use a multidisciplinary dialogue to show how gender bias becomes embedded in both research design and clinical interpretation. Recognizing these biases is not only a matter of scientific precision but also of improving health outcomes - for example, in the diagnosis and care of people with differences of sex development or in the advancement of women's health.