The process of forming sex in the fetal phase involves many complexes and genes. The gene that plays the most important role in gender formation is the SRY gene or usually called the Sex Determining Y gene. However, the role of epigenetic regulation is beginning to be discovered concerning the determination of human gonads. Epigenetic regulation is the process of gene expression or phenotypic changes in an individual caused by non-genetic factors without changes in the basic DNA sequence. Epigenetic mechanisms enable organisms to integrate genomic and environmental information to change gene activity and produce a specific phenotype. Changes in gene expression allow cells to specialize and keep their identity during development. This is critical for determining gender. In addition, epigenetics can also contribute to several disorders of sexual development. These findings encourage further research to develop sex determination techniques through epigenetic analysis. © 2022 American Institute of Physics Inc.. All rights reserved.