If you are an XXY individual it’s important to understand your uniqueness, how what works for one individual may not work for you. If you are seeking pharmacological intervention which primarily consists of the sex defining hormone testosterone, then it’s important to realise the greatest impact it will have is that it will cause your body to virilise which may or may not be in your best interest. Before getting to that point it’s highly recommended you work through any issues you may have with a Psychologist who will assist you in making a decision that’s right for you. From the experiences, of others who didn’t see this as an important first step pre-treatment or who were not made aware that seeing a psychologist was a recommended cautionary procedure and went ahead with treatment only to later reject it and suffer the lifelong psychological consequences, we believe it’s imperative to seek this counselling first. Successful outcomes wherever they may lead are best achieved when we tick all the boxes beforehand.
For those of you who have affirmed your gender identity and are given the green light to progress to treatment, it’s important to undertake the following blood tests so that you’ll have a baseline to gauge future tests from. Important tests your doctor should undertake are your natural estradiol, non-medicated testosterone, luteinizing hormone, and follicle stimulating hormone levels. It’s expected the doctor will have an understanding of XXY to realise there is no standard approach that we are all different, that we do have a natural supply of testosterone which in some instances is high and in others low in comparison to XY Male yet average for an XXY individual. The significance of knowing your baseline is too much testosterone may cause physical and/or psychological side effects, whereas too little will not achieve the desired outcome.
The trouble with most forms of exogenous testosterone is they are not Bio-Identical to that which the body produces naturally (endogenous). This is one reason why yearly physicals are recommended so your doctor can monitor your health. Too much testosterone can thicken your blood and increase hematocrit levels (red blood cells). In extreme cases, this is called Polycythemia. For older XXYs, another danger of too much testosterone is enlarging the prostate (BPH – benign prostate hyperplasia). This is not cancer. Over a certain age (45-50) you should get yearly prostate digital exams.
XXY’s who were raised male but identify their gender as something else usually seek alternative sex hormones but find conventional medical practices reluctant to prescribe them, which is clear evidence doctors are treating a disease of the testes and not the individual who would usually know what works best for themselves especially if they’ve followed the protocol mentioned above. This group do not view their differences as a disease but as a celebrated entity of their individuality. All too often the care of these individuals falls upon Gender Clinics who are willing to help but, seldom understand the plight of the XXY who lands on their doorstep. The vast majority are not seeking gender affirmation surgeries, but rather access to counselling as well as an enhancement of their natural estrogen and progesterone. Unlike XY Males who avail of this service, it’s very unusual for an XXY individual to also require a testosterone inhibitor unless of course, their natural testosterone was high from the outset. The plight of this group is made worse by established XXY/Klinefelter Support Organisations who see them as a threat to the status quo and if they do get a mention at all, it’s usually along the lines of people who come to reject exogenous testosterone and masculinity are atypical of an XXY experience. Because they are seen as atypical they are not included in any research pertaining to XXY where subjects are always sourced from the above organisations invariably leading to biased outcomes.