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, then it’s important to 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 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 to treatment, it’s vital to undertake pre-treatment blood tests to serve as a baseline for all future tests. Crucial tests are estradiol, testosterone, luteinising hormone, and follicle-stimulating hormone. One would expect the doctor to understand XXY and realise there is no standard approach, that we are all different, and when compared to XY males, we have a natural supply of testosterone which can be high or low. The significance of knowing your baseline is too much testosterone may cause physical and 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 (do not match what the body naturally produces). Annual physicals are essential, as they allow 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, indicating doctors are treating a disease of the testes and not the overall individual. These XXY’s do not view their differences as a disease and instead see them as a celebrated part of their individuality. All too often, the care of these individuals falls upon Gender Clinics who are willing to help but rarely understand the plight of XXY’s. The vast majority are not seeking gender affirmation surgeries, only access to appropriate pharmacological care that would allow them to be themselves. Compared to XY Males who also avail of this service, it’s unusual for XXY persons to 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, informing their members that people who come to reject exogenous testosterone and masculinity are atypical of an XXY experience. For this reason, those who were unable to adhere to testosterone, the standard treatment of care, are never included in research, which invariably leads to biased outcomes.