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Hormone Replacement Therapy

Some insight into Sex Defining Hormones and the impact they have on our bodies. When thinking about hormones and what direction (if any) you should go in, it’s important to remember outside of what works best for you there is no right or wrong choice. For an XXY individual who does not wish to alter their gender identity but feels a necessity to administer ‘some form’ of sex hormone perhaps to offset perceived metabolic or cognitive issues, its been hypothesised the most appropriate hormones to administer are a combination of estrogen and testosterone. Male identified XXY’s who administer testosterone inadvertently get some level of estrogen through the process of aromatase, this small amount is crucial for their body to function at its optimal best and care should be undertaken to ensure it remains this way..

The XXY Project

Hormone Replacement Therapy (HRT) indicates a hormonal therapy in which the individual takes hormones either to supplement a lack of hormone production or adjust hormone levels and/or gendered hormonal categories. HRT is generally understood to refer to treatment with steroid “sex” hormones, that is, estrogen, progesterone,and androgen (generically referred to as testosterone). These therapies are used to treat a medically defined issue or modify aspects of the body related to gender. Both synthetic and/or naturally occurring (plant or animal sources) may be used, yet HRT usually refers to synthetic hormone use.

The most common uses of HRT include:for menopause;for andropause; for transgender individuals; for individuals diagnosed with an intersex/DSD (Disorder/Divergence of Sex Development) syndrome; and for non–DSD, non-transgender gendered somatic (physical and/or aesthetic) aspects (facial hair, breast growth,etc). Hormonal birth control (the contraceptive pill) and other therapies that regulate the reproductive system (such as fertility therapy), the use of androgens to treat depression, and the use of anabolic steroids for bodybuilding, are not commonly included in this category.

Sex steroids/sex hormones and gender

All of the above mentioned HRTs were historically developed in the context of a combination of a biochemical research regarding the development of the gendered body, reproductive cycles,and sexual behaviour, as well as the social conception of sexual behaviour, gender roles, and gendered somatic traits. HRTs usually match hormonal and social gender categories (independently of how their biological sex is defined),however, there are exceptions (e.g., in hormonal use not commonly considered in the HRT category, such as for bodybuilding, the treatment of depression).

The terms sex steroids, gonadal steroids, and sex hormones are usually used synonymously. Sex hormones are produced in the body by the gonads (ovaries and testes), the adrenal glands, or through the conversion from one category of hormone (found in tissues such as fat) to another.

The terms sex steroids, gonadal steroids, and sex hormones are usually used synonymously. Sex hormones are produced in the body by the gonads (ovaries and testes), the adrenal glands, or through the conversion from one category of hormone (found in tissues such as fat) to another.Their chemical make-up was understood and synthesised at the beginning of the 1920s. However, their effects on the reproductive system and the somatic aspects of the gendered body were explored through experiments with the gonads from the beginning of the 1800s (Crocetti 2013b).

The role of the sex hormones in the reproductive cycle and the development of gendered somatic traits lead them to be categorised in gendered categories (estrogens and progesterones—female;androgens—male). All three primary categories of hormones are present in all bodies at different levels, and also play a role in non reproductive health.

Literature in the medical and social sciences may attribute complex gendered social behaviours (such as gendered behaviour, gender identity, or sexual orientation) to hormonal levels, or even HRT, yet the experimental evidence is scarce. Often this literature fails to make a clear separation between the distinct categories of chromosomal sex (genotype), gonadal sex (and other gendered biological categories), somatic gender (phenotype), gender stereotypes, gender identity, stereotyped gendered behaviour, gender presentation, cognitive ability, sexual object choice, and sexual orientation

Literature in the medical and social sciences may attribute complex gendered social behaviours (such as gendered behaviour, gender identity, or sexual orientation) to hormonal levels, or even HRT, yet the experimental evidence is scarce. Often this literature fails to make a clear separation between the distinct categories of chromosomal sex (genotype), gonadal sex (and other gendered biological categories), somatic gender (phenotype), gender stereotypes, gender identity, stereotyped gendered behaviour, gender presentation, cognitive ability, sexual object choice, and sexual orientation.This confusion of categories is often correlated to the gendered brain model that states that prenatal hormonal imprinting shapes these complex social behaviours. The high percentage of human variation regarding theses aspects indicates the need for a more complex model.

Sex hormones have been shown to have a direct role in the reproductive process, the shaping of gendered somatic traits, mood and energy level, as well as many non-gendered health aspects such as cardiac health, bone density, and tissue repair. They do not directly affect adult sexual orientation or gender identity. Increased experimental evidence regarding HRT has led to concern that the non-gendered health effects of sex hormones are understudied.

HRT for individuals medicalised for
an Intersex/DSD syndrome

HRT for Klinefelter’s Syndrome (XXY) has the duel aim of masculinising physical and social characteristics. Androgen HRT reduces the fat to muscle ratio, and increases body hair, thereby increasing male somatic traits, it also increases libido and energy levels that are socially perceived as masculine. KS patient activists have questioned the necessity of HRT for their syndrome, seeing as it does not affect functional symptoms, such as sterility and cognitive variation. They indicate HRT mainly functions to medicalise the perception of KS patients as feminine and homosexual.

HRT is used differently for Intersex/DSD based on the specific syndrome category and how the person has been medicalised. HRT is used in: Klinefelter’s syndrome (three sex chromosomes: XXY); in cases where a gonadectomy has been performed (particularly for Androgen Insensitivity Syndrome—AIS—and gonadal dysgenesis, the presence of incomplete or mixed gonadal tissue); in cases where the gonad has not formed; or where there is low hormone production as in Turners syndrome (one sex chromosome: O,X). HRT for Klinefelter’s syndrome (KS) has the duel aim of masculinising physical and social characteristics. Androgen HRT reduces the fat to muscle ratio, and increases body hair, thereby increasing male somatic traits. Androgen HRT also increases libido and energy levels that are socially perceived as masculine. KS patient activists have questioned the necessity of HRT for their syndrome, seeing as it does not affect functional symptoms, such as sterility and cognitive variation (present in rarer forms). Activists indicate the HRT mainly functions to medicalise the perception of KS patients as feminine and homosexual. However, many patients enjoy both the physical and energetic aspects of HRT. KS patient activists indicate there is a need for more research regarding long-term health effects and sterility.

Gonadectomy necessitates HRT, as hormones are important for many aspects of total body health. Gonadectomies performed in early childhood, or before the age of consent, are one of the controversial bioethical components of DSD medical care. While there is experimental evidence that mixed gonadal tissue indicates a high cancer risk, there is no data that this is the case for other DSDs, such as AIS (androgen insensitivity syndrome) (Crocetti 2013a). In AIS, gonadectomies are performed for psychosocial reasons, to insure a stable female gender identity in a person that is somatically female and has XY sex chromosomes. In the days before full diagnosis disclosure, the patient would be informed (at best) they had had a cancer risk leading to additional anxiety. While some AIS patients do autonomously choose gonadectomy, they too indicate that until an actual health risk is established, this type of operation needs to be an individual choice. AIS HRT is generally not syndrome specific, given in the form of commercial birth control (the pill) that contains both estrogen and progesterone. Finding the right dose within the standardized commercial range can be very difficult. In addition, there is speculation that androgen therapy, or a mixed androgen-estrogen therapy might produce better health effects. However, institutionally, cross-gender HRT (i.e., a HRT that does not correspond to the social gender category regardless of the chromosomal gender) is made difficult.

Androgen Insensitivity Syndrome (AIS) HRT is generally not syndrome specific, given in the form of commercial birth control (the pill) that contains both estrogen and progesterone. Finding the right dose within the standardised commercial range can be very difficult. In addition, there is speculation that androgen therapy, or a mixed androgen-estrogen therapy might produce better health effects. However, institutionally, cross-gender HRT (i.e., a HRT that does not correspond to the social gender category regardless of the chromosomal gender) is made difficult.

Topical androgen HRT may be used on the genitals for the 5-alpha reductase genetic diagnosis, to increase the genital size and indicate if the body is receptive to androgens.

Congenital Adrenal Hyperplasia (CAH) can require HRT at puberty, but primarily involves the use of glucocorticoids to reduce androgen levels produced by the adrenal glands.

Other HRTs for other DSD syndromes, like that of Turner’s syndrome, involves gender identity specific HRT, aimed at augmenting hormonal levels to a statistical norm.

HRT for menopause and andropause

The use of HRT for menopause is much more frequent than HRT for andropause. HRT maybe used for pathologically, age, and surgically
induced (removal of the gonads) menopause and andropause. Androgen Replacement Therapy (ART) is used to treat hypogonadism (low androgen
production) and the perceived effects of male ageing (andropause). The correlated symptoms range from fewer erections, reduced libido,
fatigue, depression, thinning skin, declining muscle mass and strength, and more body fat. ART side effects may include increased risks of acne, cardiac problems, liver disease, prostate cancer, and infertility. Historians indicate the use of male gonads throughout the 1800s as an elixir of life, energy enhancer, and potential cure of homosexuality, after which, these uses fell in to disrepute.

The term menopause derives from the Greek word pausis (cessation) and the root men (month), indicating the end of monthly cycles and the female reproductive phase. While noted through the cessation of the menstrual flow, menopause indicates the cessation of certain ovary (female gonad) function, such as the release of ova (eggs) and the production of the estrogens and progestogens involved in the reproductive cycle.

HRT for menopause can include both estrogens and progestogens for individuals with an intact uterus, or estrogen alone for those who have had a hysterectomy (removal of the uterus). HRT was indicated to treat the initial symptoms of menopause, such as hot flashes and mood swings. As research continued, HRT was also correlated to treatment of vaginal dryness, osteoporosis (bone density loss), heart disease, depression, sleep quality, memory loss, joint pain, skin elasticity, and general effects of ageing.

Following the discovery of high levels of estrogens in equine urine (present in both male and pregnant female horses), conjugated equine estrogens became the most common source of commercial estrogens. A popular alternative to conventional HRT is a synthetic hormone derived from the Mexican yam.

Since 2002, however, HRT for menopause has become controversial. The U.S. Women’s Health Initiative (WHI), and later the U.K. Million Women Study, released experimental results that HRT treatment coincides with an increased incidence of breast cancer, heart attacks, and strokes (Writing Group for the Women’s Health Initiative Investigators 2002). The study also found statistically significant decreases in rates of hip fracture and colorectal cancer. The WHI trial was scheduled to end in 2005, however, the combination-therapy part of the study was suspended in 2002 because the breast cancer risks associated with combination HRT seemed to outweigh the benefits. Figures indicated a drastic decrease in breast cancer rates after the mass suspension of HRT in 2002–2004 in the United States, results which, however, were not corroborated in Canada. Continued research indicates multiple factors in the risks and benefits of HRT, such as timing (immediately after menopause/ surgery, or years after), estrogen-only versus estrogen and progestogen HRT, family disease history, doses, and types of hormones.

HRT for transgender individuals

HRT for transgender individuals adjusts the balance of sex hormones in the body, with the primary aim of shifting the gendered somatic traits (the secondary sex characteristics) towards that of ones gender identity.

HRT will not reverse somatic changes produced at puberty, leading to the argument for both early therapy and/or the hormonal delay of puberty. As indicated earlier, HRT is generally gender identity specific. Transgender HRT is referred to as male to female (MTF) or female to male (FTM), as it helps shift somatic traits from that of the gender assigned at birth (and chromosomal sex in the absence of an intersex condition) to that of the individual’s gender identity.

Estrogen HRT is used for breast growth and the redistribution of body fat, and is therefore associated with the primary female somatic traits. Transgender HRT estrogen levels are often higher than replacement doses for cis-gender (having the same gendered identity as assigned at birth)women, although the official guideline for endocrinologists recommends maintaining sex hormone levels within the normal range for the person’s gender identity. Before institutional protocols were formed, many transgender women self-medicated with fluctuating doses based on availability. Doses are often reduced after gonadectomy (when performed) or in combination with anti-androgens (androgen blocking agents). The most significant risk is the pro-thrombotic effect of estrogens (increased blood clotting). Increased dosages increase health risks (estrogen sensitive cancer, heart disease, liver disease, heart disease, stroke, gallbladder disease, etc).

Progesterones are associated with fat distribution, skin elasticity, bone health, increased libido, increased energy, and increased sleep quality.
They are also associated with increase breast cancer risk in trans- and cis-gender individuals

The half-life of testosterone in the blood is about 70 minutes, so a continuous supply of the hormone is necessary for somatic masculinization Testosterone HRT includes many forms of application: injection, transdermal (patches, creams, and gels), subcutaneous pellets, oral, and sublingual (buccal).

Anti-androgens block the binding of androgens to receptors in the body, instead of blocking the production of androgens. Anti-androgens may be used to encourage breast growth and may slightly reduce body hair. Anti-androgens will also reduce the size of the gonads, prostate, and bladder. There are many different chemical versions of anti-androgens with varied respective side effects (including reduced libido, cardiac, and liver disease risk).

The half-life of testosterone in the blood is about 70 minutes, so a continuous supply of the hormone is necessary for somatic masculinization Testosterone HRT includes many forms of application: injection, transdermal (patches, creams, and gels), subcutaneous pellets, oral, and sublingual (buccal). Side effects of the hormone are accompanied by side effects from the form of use. Androgen HRT cause some irreversible effects in the body, such as the deepening of the voice, increase of body and facial hair, occasional baldness, and the enlargement of the clitoris. Reversible effects instead are increased libido, redistribution of body fat, cessation of ovulation and menstruation, increased muscle development (especially upper body), increased sweat and changes in body odour, acne (especially in the first few years of therapy), and increased red blood cell count. Androgen therapy has been clinically less frequent than estrogen and progestogen therapy, and medically supervised FTM HRT has a shorter clinical history than MTF HRT, therefore the health risks are still under study. In particular cardiac health risks are to be correlated to other risk factors such as smoking and fat distribution. With long-term androgen therapy, ovaries may develop polycystic ovary syndrome that carries a risk of endometrial cancer, however, there is no significant data regarding the increase of FTM HRT associated endometrial and ovarian cancer risk. There is a risk of liver damage and liver cancer with all testosterone formulations,but this is minimal in all forms except oral or where very high levels are administered.

HRT is part of the medical paradigm for legal gender change in most nations, often the second stage after the initial psychological counselling. In addition, many nations require sterilisation or gonadectomy for legal gender change. In the case of gonadectomy, HRT is necessary to avoid osteoporosis as well as many other health risks.

HRT for non-DSD, non-Transgender gendered somatic aspects

Cis-gender individuals (and their parents in the case of children) are also subject to social pressure and insecurity regarding their gender presentation. While not part of standardised medical protocol,individuals may use HRT to increase their gendered presentation.

HRT has been suggested for female children regarding somatic aspects such as body hair and muscle mass. In female adults, progesterone has been used to attempt to increase breast growth. Testosterone, however, is used by all genders to increase muscle mass.

About the Author

Daniela Crocetti is a Senior Research Fellow at the University of Huddersfield. Daniela has researched and published on Intersex medicalisation, the social history of gendered components of the body (such as hormones), and health activism.

(1) Klinefelter Syndrome: More Than Hypogonadism

Klinefelter syndrome (KS) is the most frequent sex chromosome disorder of the male population, accounting for almost 1 in every 650 newborn males and the most frequent form of male hypogonadism. Although KS was first described seventy-five years ago [1], many issues still remain to be elucidated regarding the phenotypic variability observed. The initial report included 9 male patients with gynecomastia, sparse facial and body hair, small testes and azoospermia, whereas it was not before 1959 that the presence of a supernumerary X chromosome was described in the karyotype of KS patients [2]. This breakthrough has allowed the detection and subsequent follow-up of KS patients even since intrauterine life, revealing a broad spectrum of corresponding phenotypes.

Mental Health of a Large Group of Adults With Variations of Sex Development in Six European Countries.

Individuals with KS in our study seem to be the most vulnerable group. Not only were their autistic and attention difficulties high compared to the other variations but also their levels of depression and anxiety. Their self-reported anxiety, depression, ADHD and autism symptom levels were also higher when compared to the French reference population or population prevalence rates. Another paper on the general health status in the same dsd-LIFE cohort already showed that the participants with KS not only reported highest percentages of having physical problems but also psychiatric health problems (45%) and a lifetime psychiatric diagnosis (59%). Clearly, the stresses and strains of this most prevalent chromosomal aberration are extremely high.

Since the dsd-LIFE project aimed at improving the quality of life and care for people with VSD, we tried to identify possible factors associated with mental health. Shame and stigma around XY-VSD and XX-VSD conditions have been found by some to negatively influence wellbeing. In line with these studies, we found much discomfort and a reluctance to talk about the diagnosis to other people (55-70%). This shows that having a VSD diagnosis that may influence appearance, gender role, fertility, and sexuality often is still perceived as a taboo that is better kept to oneself.

Particularly in persons with the chromosomal VSD conditions TS and KS, shame was significantly associated with depressive symptoms, showing the relevance of addressing shame in clinical care. Clinicians in multidisciplinary VSD teams should therefore not only give medical advice but also support the care seekers to find a satisfying coping style with the condition. Through open and proactive communication, affected individuals may gain a sense of control and become empowered with regard to their conditions. For that reason, it is important that mental health providers are part of the VSD team. Another form of support can take place through peer counselling, that connects care seekers with persons with similar conditions and their families. Finally, educational level was correlated with autistic symptoms in participants with TS, KS and CAH. Indeed, individuals with TS and KS can have specific learning difficulties that deserve special attention to promote their psychological well- being.

Continue reading…….

Special Brothers and Sisters

This book is for the siblings of children with special needs, disability or serious illness. It has been written in response to parents saying that there is not enough written information for siblings.

The Masculine Mystique of T

What testosterone does to and for an individual is complex. When people want to know what T does, they usually start with the gender of the person using the T. What does T do for men? For women? This approach tends to assume that people within a given group take T for the same reasons or want the same results. It also assumes that the hormone will have similar effects in bodies within those groups.

Gender Dysphoria Services: A Guide For General Practitioners and Other Healthcare Staff

This guide reflects the current practice of The National Health Service (NHS) gender clinic services in the United Kingdom (UK). The NHS offers healthcare free at the point of access. The guide describes how and when people with gender dysphoria should be referred; and what people with gender dysphoria can expect in terms of assessment, treatment, care and support from gender clinic services.

Finding Your Way With ADHD: Struggles, Supports, and Solutions

This report describes the findings from a study of how adults experience Attention-Deficit/Hyperactivity Disorder (ADHD). Qualitative interviews were carried out with 19 individuals to find out how the condition affected their lives. To date, there is a surprisingly small body of qualitative research on this issue internationally, and very little available from Ireland. Adults ranged from 18 to 53 years of age and were drawn from the Republic of Ireland and Northern Ireland. A majority were men and most of the sample identified predominantly with Attention Deficit Disorder (ADD), which is marked by inattention, with a minority referring to Attention Deficit Hyperactivity Disorder, characterised by inattention and hyperactivity. Although the participants in the study had a median age of 40, a majority had only received a diagnosis of ADHD in the past five years.

The researcher was asked by the Irish National Council on ADHD (INCADDS) to study adult ADHD with a particular focus on how adults with the condition experience education and health care services. This focus arose because, internationally, it is acknowledged that education, training, workplace and health care supports and treatment services need to be customised to meet the needs of people with ADHD. Recent international research studies show that issues such as not receiving a diagnosis in childhood, social stigma and lack of public understanding are other factors that make it more difficult for adults to adapt well to the condition. This report describes what we found in regard to health care, education and social perceptions. The findings are described using a person-centred approach, which puts diagnosis, education and health care in a wider context of how individuals experience ADHD and have been affected by the condition over their life course. Although common issues arose across the participants, there were also more fine-grained patterns attributable to age groups, gender, and social background. Ultimately, each person had a uniquely personal relationship with ADHD, seeing it variously as a impairment of cognitive skill or an aptitude for lateral thinking, as a condition to be adapted to or an integral part of personal identity, as a label that did not offer significant personal meaning or as a critical insight on the personal life narrative.

Finding Your Way With ADHD: Struggles Support & and Solutions

The X in Sex; And How It Controls Our Lives

If your interest in XXY is only that the second X is insignificant and that you are really an XY Male because you administer exogenous testosterone and by association, it makes you look more masculine, then there’s every possibility this book will not be of interest to you. If on the other hand, you have a keen interest in seeking answers as to what impact the second X might have on your wellbeing or what it is that makes us who we are, then you will most likely find this fascinating. 

It has been six weeks now. Six weeks of tireless, frenzied activity since that sperm jostled its way into that egg. So little time spent in this warm, dark, womby home, and so much achieved. First came those days of dividing—ceaseless splitting and splitting that turned a single fertilised egg into hundreds of tiny cells. Most of those cells went into making a protective hollow ball, but safe inside that ball lay another clump of cells with a very special destiny. That was four weeks ago, but how things have changed. The little clump of cells now looks recognisably like a tiny baby. It has grown, of course, but even more dramatic is the way it has organised itself into a child, with head, body, arms, legs, eyes, mouth. Really, all these bits and pieces have to do in the remaining thirty-four weeks before birth, is grow.

Yet there is one part of the baby that is still far from finished, and in many ways, it is the most important. After all, the reason why nature makes us have babies is so that those babies can have their own babies. But even though so much of the baby’s body has been mapped out, the parts that will make future grandchildren are far from complete. Deep inside the embryo’s belly, just to the side of its kidneys, lie its gonads—the organs that will eventually turn into ovaries or testicles and drive the child’s sexuality up to birth, to puberty, and long into adulthood. The gonads are already crammed full of germ cells—future sperm or eggs—but at six weeks, they still do not know which way to turn. The embryo does not yet know if it is a boy or a girl.

The jargon name for the gonads at this stage is “indifferent,” and somehow it describes them so well. They are, in fact, supremely indifferent. They are neither male nor female, but hovering in sexual limbo somewhere in between. All the rest of the sexual organs are equally undecided; simple tubular structures awaiting their cue to turn into male or female genitals.

So what is the spark of sexuality that makes a child a boy or a girl? In this book, I hope I can show you how this spark drives us to become men or women—people apparently so different, but made from the same stuff. Although many people are aware of the principles by which we are allocated our sex, I suspect that few realize that this is a story rich in history, evolution, and philosophy that challenges our views of society. We, humans, use an unusual method to decide our gender, and it can have dramatic effects on the way we live our lives. It may help many of us become “normal” men and women, but it also consigns many to a life of disease, disrupts the everyday running of our body, and even forces women to live a bizarrely double life. The actual physical entity that causes all this upheaval is a little nugget of life called the X chromosome, and this is its story.

A History of Medical Genetics in Pediatrics

Unlike other pediatric specialties, which usually started as offspring of internal medicine subspecialty development, medical genetics emerged from a basic science only one-half century ago. Scientists and physicians housed in a variety of basic science and clinical departments accomplished many of the major advances in the study of genetic diseases in children. In this article, we trace the development of medical genetics as a scientific and clinical discipline and concentrate on contributions of pediatricians or from departments of pediatrics.

Dr Michael Noble (47XXY)

Following is an opinion piece by Dr Michael Nobele XXY who was a champion advocate for XXY’s the world over, especially to those who struggled with making sense of their lives. This documented account was something that resonated with many and allowed them strength and courage to look beyond a doctor’s opinion and instead to charter their own course. As a community, we will always be grateful for such insight and as a tribute, we feel privileged to share it with you

May he rest in peace.
One Voice 47XXY

Anxiety and Depression in Klinefelter Syndrome: The Impact of Personality and Social Engagement

Klinefelter syndrome (KS) (47, XXY) is the most common sex chromosome disorder, with a prevalence of 1 in every 660 newborn males. Despite the profound adverse effects of anxiety and depression and their greater prevalence in KS populations, no research has been conducted to date to identify the determinants of anxiety and depression among patients with KS. We examined the relationships between personality traits, social engagement, and anxiety and depression symptoms among KS patients (n = 69) and a group of male controls (n = 69) matched for age and years of education.

The Centenary of Genetics: Bridges to the Future

The chromosome theory of inheritance is a cornerstone of modern genetics. It postulates that chromosomes are the carriers of Mendelian factors (genes) and are the physical basis of heredity. This theory, first proposed in 1903, led to the inseparable union of two previously distinct fields of investigation— cytological observation of chromosomes and genetic analysis of inheritance from breeding experiments. It was vital to subsequent rapid advances in genetics and the eventual understanding of the physical and chemical nature of genes.

The Darlington Statement

This is a joint consensus statement by Australian and Aotearoa/New Zealand intersex organisations and independent advocates, in March 2017. It sets out the priorities and calls by the intersex human rights movement in our countries, under six headings: a preamble, human rights and legal reform; health and wellbeing; peer support; allies; and education, awareness and employment.

Affirm The Darlington Statement

Klinefelter Syndrome Comorbidities

KS males present certain shared phenotypes such as small testes, tall stature, narrow shoulders, broad hips, sparse body hair, gynecomastia and decreased verbal intelligence. KS males also have increased risk of a wide range of additional disorders compared to the background population, i.e. comorbidities. Testicular dysfunction is prevalent in KS. It is estimated that KS causes 1–3% of all male infertility cases (5). 

David Strachan Intersex Audio-Visual Materials.


David Iris Cameron Strachan is a retired intersex advocate whose life experience living with XXY has helped him educate others about body type variations and difference. He has written papers and given lectures as “David Cameron” and served on the San Francisco Human Rights Commission’s LGBT Advisory Committee, 2003-2006, being the founding member of their Intersex Task Force. Strachan also served on the San Francisco Transgender Civil Rights Implementation Task Force.

The KS Story (You are not alone)

The KS Story has been compiled by a person with Klinefelter’s Syndrome (47,XXY), from reputable medical, research and support group sources, and with the help and support of several UK and international scientists in the fields of biology, cytogenetics, endocrinology, neuroscience and sexology. To balance the overwhelming amount of data there is a degree of comic relief in the writing, with a sprinkling of cartoons. All that is asked, is that you please put aside any preconceived ideas or stereotypes and view the guide with a respectful and open mind.

Living With 47XXY, 47XXX & 47XYY (English with Spanish Translation)

We consider this an excellent resource by Virginia Isaacs Cover MSW and we are especially grateful for her taking the time out from life to write it. This is the nitty-gritty of Sex Chromosome Variations filled to the rafters with information and experiences less spoken of. It’s definitely one you’ll find difficult not to finish in one sitting and one we hope you will continue to reference throughout your life.

This guide contains lifespan information covering infancy,childhood, adolescence and adulthood for each of the supernumerary sex chromosome variation groups: Klinefelter syndrome and variations; 47,XYY syndrome; and Trisomy X and the variations affecting females, Tetrasomy and Pentasomy X. The sections regarding Klinefelter syndrome are longer than those addressing 47,XYY, and Trisomy X, largely because there has been more research on KS than on the other conditions. There is also far more medical information on hormone supplementation, infertility treatment, and co-morbid health complications, for KS indi- viduals which do not affect those with 47,XYY, or Trisomy X.

Most readers of this guide will be doing so because they themselves have the diagnosis, or a loved one, often a child, has been diagnosed with SCA. The most important thing to remember in reading through the guide’s discussions of SCA through the lifespan and the impact of SCA on quality of life is that most affected individuals manifest some, but not all, of the possible symptoms and differences associated with the diagnosis. In many people, SCA has a mild/moderate presentation. Responsive parenting, a good educational program, and competent medical care can help the individual to meet their challenges and achieve independence and a satisfactory quality of life. That is not to say that there are not persons with SCA who experience substantial disability throughout their lifetimes, but this is not the norm for the SCA trisomies. At the same time, it is necessary to be candid about the range of disability that is possible.

Most readers of this guide will be doing so because they themselves have the diagnosis

What this guide does do is to counter the myths about SCA that originated in the early studies of XXY and XYY in the population of inmates of prisons and mental hospitals. These biased samples were used to describe a population of persons who had criminal records, as well as high rates of intellectually disability (mental retardation) and severe mental illness. Unfortunately, these early descriptions of criminals and mental patients made it into medical texts commonly used by physicians even into recent years. And although XYY and XXY refer to male aneuploid conditions, many people associate Trisomy X with these two conditions, and then assume that the Trisomy X females are similarly affected.

Despite considerable recent published research providing evidence to the contrary, misinformation continues to pervade material available on the internet, which ties SCA to intellectual disability and criminal behaviour.

Continue reading……….

La versión en castellano de este libro ha sido posible gracias al esfuerzo de muchas personas que han contribuido tiempo y experiencia a traducir y revisar los distintos capítulos de este libro. La variante elegida ha sido el castellano de España, y esta versión cuenta con notas al pie explicativas en los casos en los que el contenido no queda claro fuera de un ámbito social o cultural ajeno a EEUU. Nuestro sincero agradecimiento a Ana Martínez, Angélica Vélez, Patricia Baro, Vicky Hlavac, Maria Aurora Córdova, Magda Menocal, Pilar Roque, Clarisse González, Cyndia Marrero, Johanna Hurtado, Laura Johnson and Sylvia Baker. Todas estas mujeres voluntarias provenientes de todas partes del mundo han trabajo juntas y en armonía para producir la versión en castellano de este libro.

Sigue leyendo………

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