If by external sex, meaning gender, then yes, because X and X makes a female because that is the female genes but X and Y is the male gene so adding the Y would change the external sex.
Out of the following given choices, the answers are;
morning stiffness in joints
swelling of joints soft-tissue swelling of at least three joints
Rheumatoid arthritis is the damage to the joint cartilage due to autoimmunity . This causes increased friction (hence wear and tear) of the bones at the joints. This causes pain at the joints and hence the subject is immobilized.
