The question addressed in the present report is whether the large birth weight differences in dizygotic twin pairs of opposite sex (DZos), especially in 'male first' couples--observed by Blickstein and Weissman (Blickstein I, Weissman A. Birth weight discordancy in male-first and female-first pairs of unlike-sexed twins. Am J Obstet Gynecol 1990;162:661-663) and replicated in the present study--can be explained by two general influences on birth weight, viz. sex and birth order, or whether some specific effect on fetal growth has to be assumed that is present only in twin pairs of differing sex. The associated enhanced health risk would hit the female twin (from a male first-female second couple) in the first place. If the hypothesis is correct, then one may expect that birth weight of twins is somehow dependent on the sex of the co-twin. This was studied in 3069 twin pairs born in The Netherlands since the end of 1986. Results show that among DZ twins, birth weight is not affected by the sex of the co-twin. Therefore, birth weight differences in DZos pairs have to be ascribed to the general effects of sex and birth order. There is no effect that is specific to DZos pairs only.