Endocrine Anomalies and the Function of the Liver

Some time ago it occurred to me that the blackouts (caused by ...fructose at a guess), exhaustion (caused by wheat..), abrupt puffiness (some meds I'll never touch again), and a few other issues might have something in common to the brain. So I started researching how the brain is fed, brain food specifically. Which led me to Cirrhosis, the state in which the liver stops functioning and passes toxins to the brain via the now impurity laden blood.

Ooooooooh and the lights snapped on!

What I had to ask causes the liver to function... and of course this was obvious that afore mentioned endocrine system, which doesn't work all that well, if at all. Oh yes, this picture comes clear and it isn't pretty. But...!... the picture is clear for a whole class of people, I just happen to be the pigeon; Impurities of toxins passing through the liver and into the brain, can we say alzheimer's (memory loss). Allow me to draw some lines in the sand, no wait lets not. Could it be that the underlying theme of significant major disease in the USA is caused by the "good living" of the USA and the torture we force our bodies to endure for a lifetime might have some effect on burning out the ability of the liver (used to call this liver disease) to function. My cause was a medication that disagreed with me, and caused nasty side effects. I can only imagine that forcing oneself to eat, breathe, and drink light toxins will eventually burn out the bodies' filter, the liver.

My world has changed to support this loss, so many bits of food and drink must now be ignored and avoided. But then my personal interaction has not suffered blackouts and memory loss since.

Speaking of fun topics I just recently read about this group: http://aiclegal.org/ or perhaps person, who wrote an interesting letter you can find here: http://www.thehastingscenter.org/Bioethicsforum/Post.aspx?id=5406&blogid=140&utm_source=constantcontact&utm_medium=email&utm_campaign=bioethicsforum20110620# . It is certainly the truth that the psychiatrists have no business dictating to me (an intersex person) what gender I can be. Intersex/DSD persons should not be subject to the DSM.

Onni

The Mayo Clinic - and - Onnineko

Thats right I visited the vaunted and hallowed Mayo Clinic. And I'm still in awe, at the complete waste of my very precious time, not to mention a small fortune spent on what amounted to this statement...."Thats right, you should not eat or drink anything with sugar because of the fructose intolerance. So no sugar. And I want you to eat at least 5 or 6 fruits every day." Like, ugh... excuse me oh amazing one, doctor, whatever you call your ebayed degree, but last time I checked FRUCTOSE is the primary sugar in FRUIT. And then there was the other comment... "you don't bleed so there is absolutely no reason for you to take any amount of progesterone. Only women who menstruate should take progesterone with hormone supplementation." What do you say to statements like that, I mean really where can I start? How about the part where if you tested every single person in the State of Minnesota (it was the Minnesota Mayo clinic), the chance of finding even one other person without a measurable level of progesterone (take the test, prove me wrong.. please...) is negligible. And yes, I really do test at no progesterone measurable, its been tested multiple times by multiple labs and most of those labs didn't believe their own results the first 3-4 tests. I had one lab send 5 separate results for three different machines/testers, and three complete repeats of the last test. So like be a good Doctor, since this being the MAYO CLINIC I find it hard to believe you are completely INCOMPETENT. No wait... I'm rapidly changing that opinion, continuing... Explain to me how it is that someone without any measurable level of progesterone, a hormone used in among other parts of the body the Brain, the Muscles, the Bones (calcium synthesis don'tcha know), the major and minor organs, the skin, and other tissues, and um practically EVERY part of the body; How is it that PROGESTERONE IS NOT USED BY NORMAL HUMANS?

Maybe I should be shouting, I wanted to shout, but that would be impolite even to an esteemed and useless Mayo Clinic Doctor who charged me considerably more than a petty fortune for this display of stupidity. Astounded, Awed, Stunned, yes all of those describe my visit to the premier clinic of America. The supposedly best, and brightest, who play Eugenicist games at the expense of their patients. Can I stress enough how thoroughly disappointed I am by the performance and skill of the so-called best of the best?

I can safely say going to the Mayo Clinic is a death sentence.

A Mayo clinic doctor said, "you don't bleed so there is absolutely no reason for you to take any amount of progesterone. Only women who menstruate should take progesterone with hormone supplementation."

Another Mayo clinic doctor said, "Thats right, you should not eat or drink anything with sugar because of the fructose intolerance. So no sugar. And I want you to eat at least 5 or 6 fruits every day."

No question about it, incompetence, the mainstay of doctors at the Mayo Clinic.

People have wondered why I self treat, it is because of gross incompetence in the US medical world. After continuing to research these simple questions I have reached a couple of fairly simple solutions:
1. In the question of fructose, don't eat it. That includes all fruits and most vegetables. Fortunately I can eat several kinds of green leafy vegetables, and since I bothered to actually study this issue can safely answer my own question...that is I will gain sufficient nutrients from the green and leafy vegetables if I am careful to add select other foods while avoiding all FRUCTOSE (the fruit sugar). Pretty scary that I now can answer a question confidently that a Mayo Clinic doctor was unable, unwilling, or incompetent to answer.

2. And in the matter of progesterone, remember I don't have any naturally and everyone else in the state of Minnesota has an ordinary level men and women alike, although women because of their cycle has more for two weeks of their cycle every month, like no kidding... However, since I have none the answer adroitly sought is that Yes I should take a small amount of progesterone, topically, to avoid complications of the liver. And at the same time recognize that I was initially taking too much, and needed to drop the dosage to about 1/10th. A true specialist, should have had little difficulty reaching the same conclusion in far less time and effort in research than I had to invest. Do you wonder why I consider the Mayo Clinic specialist to be completely unwilling, unable, or incompetent?

People go to the Mayo Clinic to die, that is the quality and skill of care. I am extremely disappointed, to have received what amounted to tantrums of a petty child while spending a fortune on what I anticipated to be the best care in the nation.

Extremely disappointed in the Mayo Clinic.

XXY: Personal Experience Using Estradiol HRT

It has been several years since I started self treatment with Estradiol hormone replacement. At the beginning I started with very little, and over the years as my body adjusted to the changes I have slowly raised the amount I take from .025mg topical daily to now .2 mg topical daily. This works out to for an average sized ordinary person of about 40 pg/ml (scale of 0-400 pg/ml for an ordinary woman) per .1 mg topical application. My pretested before starting estradiol was about 100 pg/ml on the same scale. So now, I'm replacing about 80 pg/ml, and have a much lower level of testosterone about 1% of scale. What this all means is that I have replaced my body's natural production of estradiol and lowered the amount of (generally toxic) testosterone produced. My testosterone level started at 4% of scale (about 0-1200 ng/dl), it is now about 1%.

When I started this process, I was told a great many stories about what would happen to me. For example:
a. You will become a girl.
b. You will develop breasts (no kidding, really?.. I already had breasts).
c. You will lose your capability of acting rationally (a doctor actually said that.... he was male).
d. You will no longer have to deal with rampant acne. (TRUE!)
e. You might retain more bone, and thus no longer be on the watch list for osteoporosis...

Actually they didn't say E, I chose to take Estradiol for two reasons, D because I wanted the acne to end, and E, because being 35 and being concerned about osteoporosis seemed stupid if taking Estradiol would fix it. Well it did... I'm no longer in the danger range for osteoporosis or osteopenia. Indeed, I made such an Amazing Remarkable recovery you'd think the medical community would call it a miracle. Actually the results were swept under the rug. Oh well, not my problem, my rescue. :)

So here we are years later...
a. I am not a girl, I am Intersex though, I was born this way, I have not significantly changed because of Estradiol.
b. My breasts are still my breasts... no significant changes there. :)
c. Rational thought.. hmm.. what was he trying to say, I wonder?
d. Acne, is gone, as suspected although resisted by EVERY single doctor the cause was excessive levels of testosterone. Which I might add my body cannot use in more than tiny quantities, like every other male can and does. Its not odd, I have a more female orientated physical system. It is only unusual that a male doctor cannot imagine someone allegedly "male" not being all Male.
e. Within 6 months of starting Estradiol and progesterone (I've since stopped the progesterone, tests ongoing), my bone density increased more than 3 medians. This should suggest that I was lacking something either estradiol or progesterone provided. You would think so...

Hi .. :) I'm Onnineko, the "guy" who works for fortune 500 type companies, who fits in more or less. For one thing, I look like a 24 year old kid though I happen to be almost 40, just like any other female I don't look my age. Learning to sing did wonders for my confidence of speaking too, which helped a great deal with my work.

The only downside that I have noticed is that when the patches, I use Vivelle Dot .1 mg patches, start to wear off the effects are immediately noticeable: my memory starts to fade, as the level of estradiol drops lower I feel strong sense of paranoia, the sense of something being wrong becomes acute, the sexual disconnection felt with gender identity dysphoria becomes more clear. In all feeling ones personal connections to stability, intellectualism, and general feeling of well-being slip away is truly terrifying, that is when it can be remembered. It is entirely possible to notice the change and forget, and then feel the paranoia lightly and then forget, and then it gets steadily worse until eventually memory kicks in and prompts changing those forgotten patches. Darn is it hard to live life on a 3 day leash. But its worth it.

Every minute lived without the devastating effects of too much testosterone, with enough estradiol, makes the world stable, removes the pain, engages memory, and enables me to live a normal fair life. To be able to engage in feelings like happiness and even sadness at all, like an ordinary person does is a wonder to me, even now years later.

I think back what it was like living a life that had no meaning, was wrong in every physical sense, and one which was only a step ahead of suicide every minute that I lived. Nothing at all could convince me I should stop taking estradiol at this point, going back to that is death. As the level of hormone falls, so too would feelings, memory, and every other function but basic survival and raw tortured intellect. I wonder if that what serial killers feel, the emptiness, the rawness, the lack of feelings or regret.

I wonder... if environmental hormone suppression is part of the cause we have behind people who cannot cope with living in a normal sense. But that matters not to me.

XXY: A small but vocal issue...

I am left today with a fear of the unknown. For more than three years now I have participated in singing studies, and my vocal range has significantly improved throughout that time. Indeed my range continues to improve, breaks are worked through, and my natural normal speaking range has changed, yet again. I have finally after all this time been told by one vocal instructor that my tone and clarity is much improved, almost acceptable or even, normal. This voice instructor went on to say that if I continue these lessons, then I can expect my normal speaking voice to change yet again...

Yet again.

So I asked myself, what if my normal speaking voice were even higher than it is now? I would be firmly in the higher range for normal women, is this a good change? So I resolved to test the current range and loaded a vocal analyzer and recorded several sets, at various normal pitch levels and lengths including generally happy, long and boring text, a bit down, etc.. Sure enough I'm ranging in pitch from 180 to 280 hz. The spectrograph shows a bit more than the average overtones that an ordinary woman would use; I have perhaps half of the harmonics a normal male would have. In this matter, science is not helping! All this singing is enabling me to use and adjust to what males would call the falsetto voice, or head voice. When I use falsetto the excessive overtones are much reduced from my full voice, ie.. closer to a natural female. And to make matters worse.. (better?) I took several sessions with another voice teacher whom started using the term counter-tenor, almost immediately. One test this instructor likes was the natural sigh, and tricky person he is, including it in the lesson without telling me about it first; But the result, middle C, was not what I expected. Middle C is the normal speaking pitch of women, and an half an octave to an octave high for 40 year old men.

All knowledge is good, the more you know, the more you understand, the more you can make personal choices about. Only in ignorance can others make choices for you. But what do I choose about the voice? If I want to present as male, then there are a number of challenges to overcome, and not the least is the appropriate speaking pitch. Males only exceedingly rarely use a pitch higher than 150 hz, and then generally only for terror, fear, or capitulation. If I were to use such a pitch, say 200 hz, then that is already one failure in presenting male.

On the positive side of this issue I no longer have serious throat pain from attempting to speak too low for too long. It is still hard to speak low, and has become more difficult to do so without being deliberate in the doing. It is disconcerting to sit down to a vocal analyzer and comfortably, naturally, speak at what is a middle voice for a woman. Another positive (?) is that as I become more competent at singing I can better hold my part, instead of following whom ever seems to know their part well. This is good, and bad. Good because I no longer automatically (well not often anyway) pitch match with other people, especially males because they still talk too low and I can end up speaking from the throat if I am not prepared. Bad because my natural vocal range appears to be +/-3 notes of middle C. I still pitch match with women who use higher pitches, because I am not as comfortable with that singing range, B below middle C to the G above.

Supposedly according to both vocal instructors that as I work out a normal high tenor full voice, this will give me an alternative to the falsetto that I find most comfortable (and not by choice!). Remember I am trying to live and work as a male, this makes doing that very awkward.

Life is...

What do to when depression cannot be avoided...

For the first 30 and some years of life, starting about the age of 12, and until 36 I felt a great deep depression. Now I'm not talking about something you can take a couple of pills and sleep on. Rather depression built upon pain. Lets see if I can pain a picture so bleak, your very world turns grey, dismal, and promises nothing more than the pain that is, the pain that will be, and the pain of merely drawing a breath. Most people will tell you they have once or twice in their lifetime had a morning so horrible that the very thought of getting up seemed too much effort to attempt, can you imagine every morning being like that... Some people know what exhaustion is, that deep binding crease through your body that drags you down constantly, muddies your thoughts, and makes a single set of stairs seem like a hurclean effort to climb. But very few people experience this effect for more than a short period of time, what would your life be like if tomorrow morning and every day thereafter you could look forwards to getting up in the morning exhausted as the last time you overdid work and was so tired that you only wanted to sleep. What would life be like... depression is physically, mentally, and emotionally taxing.

And then there is the pain... Most people have at one time or other in their life sprained a muscle, and they know that walking on a sprained foot is painful. Picking up a pen with a sprained hand is painful. Some people have broken limbs and they know the pain isn't in the break, its later, after the fact. The pain comes from trying to use that arm or leg, to push or to pull even lightly. Anyone who has thrown out their back and tried to stand up knows what pain is, it is crippling. I have seen grown men dislocate a shoulder and whimper like a child. No kidding, dislocations of any type hurt. Lets suppose just for a moment that tomorrow, the moment you were going to get up you could look forwards to the pain of dislocating or pulling a muscle in your back, every single morning, forever. In the next moment as you go to swing your legs out of bed, several other muscles were going to complain and twinge in pain. And it wasn't going to stop. Old people know the body creaks, but once you start moving the pain can be come tolerable. Motion reduces the effects of pain from joints not moving. Lets say that moving around does not reduce the amount of pain. How would you view your life then, I wonder... dim, slow, pain, grey, and dismal.

Now everyone has a choice they can accept life on its terms or they can check out (commit suicide). Sounds pretty harsh doesn't it. For my first 3 decades life hurt, it was grey, it was dismal, and I bore daily an amount of pain that would kill most people. In order to survive, you have to accept that pain is your life. And I don't say that casually, I don't think most people understand that when you have to juggle or control your own centers of pain that it might make a certain amount of sense to overload one side than the other. Neither are we talking about someone that cuts them selves to feel anything at all. No this isn't dementia, the individual need not be crazy. Rather the person can use the fact that the mind can only concentrate on one thing at a time. Sometimes it is necessary to redirect pain. I know how to do that... unfortunately...

So the basics of managing pain, depression, and overcoming insurmountable odds of accomplishment in our world. Step 1, you need a plan of action. I had a method that would result in things happening, but it required three parts to work.

A. You must train yourself to understand that when it is time to move, you HAVE to MOVE. Period. I don't care if you're lying on the ground in more pain than the world should have visited on anyone, you have to MOVE. You CANNOT NOT MOVE. Period. No exceptions, ever. I don't care if you've just been shot and are dying in the street, if your alarm clock goes off, you MOVE.

B. Keep lists of things you MUST do. When it is time to MOVE, you MUST do whatever is on the list. I don't care how much pain or exhaustion there is. The human body can operate on no sleep and in deep pain, the only limitation is you.

C. Never make a decision about anything important in less than 8 hours. Once your decision is made, DO NOT EVER second guess your choice.

This method kept me moving in a grey fog of pain and shock for 3 decades. I'm only glad I don't need it anymore.

Using this method, I have finished a college degree, completed a black belt in a martial arts, and worked as a professional in the IT world and achieved success. I have owned businesses and property. But I did not have anything resembling happiness, this was earned through determination. Life is, learn to live with it...


**
an aside, I no longer use this method, the pain of my first three decades has become managable. I no longer experience depression as a constant companion. Most of the pain of life has become managable. But this article is to talk to my years from 12 to 35.. :) there is hope. Although, I had to find my own answers the medical profession remained vocal and completely wrong.

...psychiatrist, priest, rabbi, and a psychologist

He wanted to know if there was a good enough reason to see a psychiatrist, psychologist, rabbi or a priest. How he figured I'd be a good person to ask, I don't know. You don't carry physical marks of your time talking to a confessor. Yes, I have talked with one or two or more over the course of my life. And I am much the better for those opportunities to understand better human nature. How people think of us, matters less than most of us would assume, because we know exactly what we think of ourselves.

The difference between types of confessors is really simple, the priest or rabbi will cast their aid in a form of religion. Should someone go see one? If the phrase, "Remember the time you did a bad thing, and someone suffered because of it?" causes you a sudden feeling of remorse; Then yes, you should go see a confessor and get that bad thing off your mind. Those little bad things weigh you down, and eventually pull you into a depression generated abyss.

The first time I visited a psychiatrist it was over my personal embarrassment. I was so certain based on everything I had read, that if I could not identify as male living in a strongly masculine male world then I had to be a transsexual. I have since learned a great deal more about this, but at the time this concept was really ripping me up inside. Now at the same time, I am strongly homophobic (that too, is not the right word). However, the very thought of being touched by a male makes my skin crawl, its worse than fingernails on a chalkboard. Which led me to believe I should be a normal male... except that didn't work either.

I hope you can understand this was a very serious mentally challenging problem, not to mention highly embarrassing should my co-workers in the pro-military industrial complex ever find out.

It took me a year of talking to a psychiatrist, before I began to believe that there were good reasons to continue living. To even dream of finding joy and happiness. My world then was a dim dark grey place that wasn't too bad, didn't hurt too much, most of the time. To put it mildly my physical challenges and surroundings had left me a mental train wreck. Fortunately this was all long ago and through many talks with someone who had different insight I got alot better. :)

Today I am better balanced, my own failures pale next to the pressure I felt society was demanding of me, and those I now know are not all consuming. Psychiatrists help us to learn how to think around sticking points in the societal fabric. As do all other confessors. We can learn to be better people, we can learn to think better of ourselves, we can learn... if we but choose to do so.

XXY: Osteoporosis

I've written quite a bit about osteoporosis... but I'll go over it again here, this is a cross post from another site. Invariably people have questions about this, and there is so little written on the topic specifically applying to Klinefelter's Syndrome. It galls me that doctors are the source of most of the mis-information concerning osteoporosis. Know the facts before meeting a doctor, you might just save your own life.

The mechanism in biology that is called osteopenia and osteoporosis consists of losing bone faster than it is replaced. To understand whats happening you have to understand how you gain bone in the first place. The body takes calcium, vitamin D, trace minerals like manganese, and using progesterone does a series of chemical conversions to create osteoblasts (new bone structure), which is then attached to existing bone. The second part of this mechanism we have to understand that bone structure does not last forever, and the body has a process to break down old bone structure, this process works faster in the absence of estradiol (higher the estradiol the more bone retained). We can say that at no point in the process of building new bone or removing old bone does the body require testosterone, ie.. testosterone is not required at all. For some reason this common misunderstanding that high testosterone is required to stop osteoporosis continues, probably because it is easier than to tell males that if they have enough testosterone then their body will naturally convert some into estradiol.

The basics of osteoporosis and hormones:
You need progresterone to make new bone.
You need estradiol to prevent the wasting away of bone.
Testosterone has nothing at all to do with bone.

Vitamins and Minerals needed for bone health:
Calcium 1400 mg daily.
Vitamin D 1000 UI daily.
Manganese (take a multi-vitamin, you need an incredibly small amount).

So about Vitamin D... the experts really don't have a clue how much you need. Until 2007 they assumed that 400 UI was enough because 60 years of studies showed it was enough to eliminate rickets. But gasp in 2007 the new target became 1000 UI. I personally take 2000 UI, and thats probably closer to the target. I would not be surprised if in 10 years from now, circa 2020 the new target for Vitamin D is closer to 10,000 UI daily. For all the concern about UV caused cancer, we need sunlight exposure or some form of UVB replacement. A white skinned person gains 10,000 UI of vitamin D in about 10 minutes of full body exposure to sunlight near the topics.

Estrogen Blockers:
Be very careful with these, since blocking your estradiol is perhaps one of the most dangerous things you can do. The lack of estradiol causes bone wasting, ie.. osteoporosis.

What you can do:
1. Get your hormones balanced. I don't care if you choose male, female, neither, both, or whatever.
2. Do weight bearing exercise for at least 3 hours every week.
3. Get a balanced diet of foods, and take vitamins.
4. Avoid smoking.
5. Get a normal level of 5 hours per week of basic stamina building exercise, like walking 3.5 miles in an hour.

So what does Klinefelter's Syndrome have to do with Osteoporosis...
If you are XXY, and lead a sedentary life you will get osteoporosis, if you lead an active life and have a bad diet you will get osteoporosis. Be aware of this, and get healthy. Unlike the average population we are at risk for osteoporosis from childhood if we are sedentary.

Testing for osteoporosis:
Dexa Scan will determine the level of relative bone structure that exists.
Low progesterone is an indicator of many problems.
Low estradiol is an indicator of bone loss.

If after a dexa scan that is positive for osteopenia or osteoporosis your doctor does not test you for progesterone and estradiol then you have a problem and need a better doctor. Unfortunately most doctors are ill-equipped to provide treatment for people with Klinefelter's Syndrome, so you have to protect yourself.

XXY: Maintaining Good Health through Walking

From personal experience jogging is too harsh on the body, especially the out of shape or overweight body, and lifting weights alone doesn't lose weight. Cardio exercise is what helps people to lose weight, and most serious fitness people include an element of cardio in their workouts for this reason. There is a misconception, mostly among men, that working out to lose weight means going to a gym and lifting weights. While it is true that increasing muscle will help the body to burn more fat, the benefit pales next to the action of doing a cardio workout. If you are just starting out to lose weight, start with the cardio and work forwards.

Cardio (weight loss):
I recommend simply walking at a hastened pace for as long as you can and gradually work that up to 1 hour. Your target speed is 3.5 miles per hour, and about 5 kilometers. If you're using a jogging machine, skip all of the uphill/downhill/fancy options and set a hastened pace and walk. Make sure you drink plenty of water.

A second option is swimming laps. Hop in a pool setup for lap swimming, do a front crawl (nothing fancy..) and swim as far as you can at a slightly hastened pace. Your target is to develop the ability to swim for 1 hour at a hastened pace.

Second requirement for losing weight:
Eat healthy. That means Mediterranean diet and no fast food. A Mediterranean diet consists of 2/3rds vegetables, few or very minimal sauces, some fruits and nuts, and very small amounts of meats, breads, or pasta's. No sugars or oils. And limited amounts of dairy products. If you cannot tolerate, like some people cannot eat/drink dairy then find a normal substitute. Avoid manufactured foods.

Lastly drink lots of water....People have suggested its possible to drink too much, and yes technically it is possible but its extremely unlikely that anyone who isn't running marathons will ever reach the point of too much water. It is really hard to force yourself to drink too much water, without first forcing your endurance far beyond the limits. By the time you have worked a physical regimen to the point where you have achieved sufficient physical fitness to push to the limits (this isn't possible at the start) then you will understand this better. For now, don't worry about it.

Here's the fun part of cardio for an hour at a hastened pace. When you're done, right after finishing, you should immediately drink a beverage that will restore electrolytes. My personal favorite is about a pint sized portion of chocolate milk (about 6 oz or less). A small energy drink is also acceptable, provided it is not loaded with caffeine. This should have some sugar, salts, and potassium. This burst of sugar is your reward for success, and the electrolytes will help your body recover from the stress of exercising. When it is available I like to make a blue berry and vanilla yogurt sundae, as my treat (again, limited to 6 oz or less).

The Importance of Using Vocal Resonance

Everyone, but especially Americans with our culture of listening to music, have to at some point in their lives learn to resonate the pitch and tone of their voice. I am starting this process at this late date in my life, because I recognize the importance of doing so. A proper vocal expression does not cause pain to the participant in 5 minutes of speaking or singing.

You see, I experience pain, soon to be a thing of the past, when I speak at the low pitch I have found commands respect from males. This is a common problem for males in the American society, our culture dictates that we speak lower to attain the valued age (older people have a naturally lower pitch). Our culture dictates that respect and income is a function of age for most wage earning jobs. That and our non-singing society that spends its time "listening" not participating in song, has not learned to resonate vocal pitch and tone.

So you're probably asking, what does this have to do with someone whom is intersex?

Hi, I am either a high Tenor, or a counter-tenor, or a contra-alto, or maybe just an alto... it depends on your view of gender. In the world of singing they are extremely stratified on gender. Men are Bass, Baritone, or Tenor and anything expressed in a higher vocal range is falsetto (a partial expression of the full male voice). Women are alto or soprano. Never shall there be a male who is an alto, nor a woman who shall be a tenor. Lets suppose for a moment that someone whom is intersex did not have the vocal drop that males incur during puberty. There is a good book that I'd recommend to anyone wanting to learn to make a better vocal expression: "Is Your Voice Telling On You?" This book describes children of 9 years age as having a vocal range centering on or about middle C (piano keys, page 58). Males when they reach puberty experience a vocal drop of about an octave, and females about half an octave. So how much of a vocal drop do Intersex people experience? This is an entirely individualistic experience for intersex people, so it could be some, none, or all of what the distinct gendered people experience. My own experience is that I can sing from F3 to G5, or mid-tenor to soprano. Because I can sing into a full male voice for the bottom 4 notes D3-G3, transition to a female voice and then sing A3-G5.

I have encountered some specific challenges with vocal range. I hit a puberty cycle about every 5-7 years since 20 years of age. During that time, my vocal range changes, yet again each time. Based on my range, I have someplace between a tenor and an alto range. And I choose to sing tenor in the choir that I participate in, because it is a more interesting part. :) Yet I still experience a challenge, because the bottom of the normal tenor range is too low for me. When I try, as I have done too many times, to sing that low I quickly experience pain, hoarseness, and vocal loss. It is difficult to simply stop singing when in a group, yet with the men, I have to do that for my own protection. Simply does not do to spoil a fun participatory event by going hoarse or incurring personal pain.

So back to resonance. All people generally learn to resonate young, because most cultures have a strong component of singing. However, American's are deficient in this matter. Our culture of Radio, Television, and other pastimes do not encourage participation in singing. As such we are not learning to use natural resonance. You can see this effect in people that experience pain in speaking for more than a short time, for example teachers, public speakers, etc... In my case, I often speak to large groups in a professional capacity. I learned early that males command respect through a low vocal pitch, and I have to use every tactic since I look literally 10-15 years younger than my peers. However, use of a low pitch D3, the very lowest pitch I can reach also causes me considerable pain. The book I referenced above suggests that people should talk in a normal range 3-4 notes higher than their lowest note. However, that pitch D3+4= A3, is in a normal female range, and A3 is considered very high for a male. This poses something of a challenge for me.



The referenced range for a piano, is found in the book on page 58. The book describes middle C, as C4, with each C beginning a range. So the keys are the set = {C,D,E,F,G,A,B}, and on the piano there are 7 full sets. The book tabulates using only the white keys on a piano keyboard.