Girls can develop hernias, but the incidence of inguinal hernias is significantly lower in girls than in boys, with a ratio of approximately 15:1. This is due to congenital differences in the anatomy of males and females. In males, a congenital abdominal wall defect is formed during embryonic development and during the descent of the testes, and later the sphincter gradually closes and the abdominal wall muscles become stronger, thus sealing the internal ring opening. In contrast, girls do not have the process of testicular descent, and their only presence is the round ligament of the uterus, so the abdominal wall and inguinal region are more intact, but they are also prone to cysts of the round ligament of the uterus. Of course, there is also a local area of occult weakness of the round ligament of the uterus that penetrates the abdominal wall, and hernias can also occur, but they are very rare in clinical practice. Therefore, if a girl presents with a swelling in the inguinal region, the presence of a round ligament cyst, inguinal hernia, or enlarged lymph nodes in the inguinal region may be considered. It is possible that femoral hernias are also present, including transwomen, especially since the incidence of transwomen’s femoral hernias is higher.