They are mostly fake; you can really tell when they are screaming. Also, most he-she's "transvestite" (man with breasts & really nasally whinny voice) have a really small dick.
If anyone knows where I can find real she-he's "hermaphrodite" (woman with a dick) this seems more rare, please let me know
There is only 1 real one that I have posted here, I think her (it) name was Yuka. She (it) looked really cute, that I had a difficult time figuring out if she (it) was real or not.
Search this thread for "Yuka 超A級美少女ニューハーフ" and you will find her (it).
Here is a picture of the cover