DSDs can sometime make life complicated, as can having a difference in your biology if other types.
In cases where it's discovered later, it may be that the person finds that the facts about their sex contradicts how they identify.
IF the condition is 5-ARD then:
most identity as boys when they reach puberty. It's a rare condition so I don't know whether these boys always felt male and puberty is actually a relief. They'll live their lives like any man who has smaller genitals and has fertility issues. They may need monitoring or intervention if their testicles haven't descended because of cancer risk.
Some identify as girls and in these cases generally they'll have surgery to remove testicles, possibly genital & breast surgery if they want to, hormone treatment with oestrogen.*
Some may identify as girls and not want intervention as is their right.
It's no-one's business if they identify as women in their lives but they aren't female for sporting purposes and shouldn't qualify for women's sport.
As I say, it's such a rare condition that it'll virtually never come up outside these cluster situations where there should be scrutiny of the motivations of certain coaches and sporting bodies.
*I read a study about satisfaction with "reassignment" in these cases and they all seemed to be attracted to men - I don't know how strong the link is. Given that late identification can be correlated with poor availibility of healthcare and conservative communities where being a gay man might not be an option, there may be homophobia influencing outcomes. Complete speculation on my part.