If you are XXY, it’s essential to realise your uniqueness and know what works for others may not work for you. To that end, if you are seeking the intervention of testosterone, it’s important you realise the most significant impact it will have is that it will cause your body to virilise, which may or may not be in your best interest. For this reason, we suggest working through any concerning issues you may have with a Psychologist who will assist in making a decision that’s right for you.
For those who have affirmed their gender identity and received the green light to proceed with treatment, it’s vital to undertake pre-treatment blood tests that will serve as a baseline for all future tests. Significant tests are estradiol, testosterone, luteinising hormone, and follicle-stimulating hormone. One would expect the treating doctor to understand XXY and realise there is no gold standard approach, that we are all different, and when compared to XY males, we have our own natural (endogenous) supply of testosterone which can be high or low. Knowing your baseline is important because too much testosterone may cause physical and psychological side effects, whereas too little will not achieve the desired effect.
The trouble with most forms of exogenous testosterone is they are not Bio-Identical (do not match what the body naturally produces). For this reason, annual physicals are essential, allowing your doctor to monitor your health closely. Too much testosterone can thicken your blood and increase haematocrit levels (red blood cells). In extreme cases, this is called Polycythemia. For older XXYs, too much testosterone can enlarge the prostate (BPH – benign prostate hyperplasia). Annual prostate digital exams are essential from forty-five years of age onwards.
XXY’s who are raised male and identify their gender as something else often seek alternative sex hormones but find conventional medical practices reluctant to prescribe them. This is a clear sign that doctors are treating a disease of the testes, not the overall individual. These people do not view their differences as a disease but rather a celebrated part of their individuality.
All too often, their care falls upon Gender Clinics who are willing to help but seldom understand our issues which are atypical when compared to Transgendered. The vast majority are not seeking gender affirmation surgeries, only access to appropriate pharmacological care that would allow them to be themselves. Unlike XY Males who also avail of such clinics, it’s highly unlikely XXYs will require a testosterone inhibitor unless the individual was mosaic and their natural testosterone was high from the outset. The plight of these people is exacerbated further by XXY/Klinefelter Support Organisations, who see them as a threat to the status quo, and inform their members that people who come to reject exogenous testosterone and masculinity are atypical of an XXY experience. For this reason, those who come to reject the gold standard masculinity approach are never included in research, which invariably leads to biased outcomes.