2025 Update

 Looks like 7 year updates might be a thing.  I've divorced much of the transsexual world, as it has pushed into the Intersex communities and at least in the USA there is now a huge pushback against transsexualism.  This is a fault of communication and the institutionalization by the US Department of Education to drive transexualism into the grade schools (grades 5-12); And the absolute chaos that caused with men (natal males) competing in women's sports. It was absurd to watch the transsexual lobby force women to withdraw from women's events and lives, and for the government institutions to allow the farce.

Intersex has to stand on its own, there is no choice for the Intersex child born between gender, nor is there a sensible approach to assisting that child (long term care) to identify with a binary gender by age 12, nor are the normalized treatment plans for those intersex children to join a side of binary gender.  At best this process is haphazard and not endorsed by the APA (US National Medical Regulation body), the APA governs what treatment protocols the insurance carriers authorized doctors to execute.  

Shame on the APA for not normalizing the process of Intersex to binary gender.  

This should be a gender decision with assistance by age 12 and then proper endocrine support for the binary development of the Intersex individual resulting in a normalized 18 year old with little difference between female or male phenotypes.  The APA has failed the US Intersex community at a very fundamental level.

...

Let me add a bit of my history as I no longer work in mission critical industries and no longer need to maintain a facade of being normal.  

I was born Intersex about 1970, and the doctors of that barbaric age justified their immediate crisis teams' actions to then remove my uterus.  The organ was partially collapsed and the teams justification of this event is that "We saved you from cancer"; This occurred immediately after birth and I was not cancerous at the time. I was given a Complete Hysterectomy removing the Uterus and Ovaries, one of which was actually an Ovary and the other failed to develop properly.  My Vagina was collapsed and allowed to remian so.  

This might have been okay, but I question the Ethics of this manuever as the crisis team and the hospital immediately destroyed my medical records following this event.  It took decades of investigation to get to the bottom of this event, the lead surgeon of the crisis team maintained his own set of records at his home and that was the only remaining record; For whatever reason the surgeon declined to provide of a copy of the records, likely fearing a malpractice suit. 

If that wasn't enough, my parents whom were very poorly coached and upon there were no followups, then subjected me to the creation of a penis; As my parents chose reason and imagined that any child with a choice, for whom there was no possibility of procreation as a girl would prefer to be a boy.

Is it any surprise that by age 4 I was lost and confused about gender identifying as female, as could be expected of any child born with a Uterus; Forced and beaten when I made mistakes like acting like a normal girl.  I can say definitively from my own experience that it is nearly impossible to move forwards as a person when ones gender is incongruent; This should not be misconstrued as an endorsement for transsexualism, generally something else is an issue there and selling transsexualism to natal males as a solution to other problems should also be Medical Malpractice.

I was raised as a boy and beaten when I made mistakes or appeared too girlish, to say that the lack of followup from an early Medical Malpractice of immediate surgery and a coverup of my very existance was at best detrimental to my development should be clear and obvious even to the APA and the USA's National Institutes of Health.

The protocol for Intersex children should be passingly simple:

1. No immediate non-life-threatending surgeries, take a wait and see approach.  
2. No immediate rush to declare a gender, it takes time for a sense of gender to develop in a child 3-5 years generally.
3. The Intersex child should be given a gender marker of I, clearly indicating the child is Intersex, to alleviate the move between states also removing followup of this simple process.
4. About age 12 the Intersex child will have demonstrated whether they are male or female, I would say "any qualified psychologist" should be able to discern gender in a child with a few hours of observation; However the group of professionals have shown themselves to be remarkably poor at determining gender in transsexuals (99% of whom needed different help than transsexualism), much less Intersex children.
5. At about age 12, an Endocrinologist should work with the child to develop in the appropriate gender the child expressed, and the child's binary gender should be noted and marked.

I'd say it ain't rocket science, however the APA and the US National Institutes of Health failed in this basic execution.  There are two genders and Intersex people need merely a few years to sort it out, this isn't hard. 

Onnineko

ps. World is crazy stupid right now in the USA, an asanine exective order which completely ignored Inersex people whose birth gender should be an I for Intersex and normalized about age 12 in binary gender; This has resulted in a Passport renewel which effective is a denial, I'm not now and never was male, what part of BORN WITH A UTERUS.... is difficult.  A hysterectomy does not make me any less female.  So I will continue to forgoe releasing my personal identifying information publicly.  

Best of luck to you all.

...and then some time passed

 Hard to believe that its been 7 years since my last posting.  I've been busy.

Since I last posted, several positive events have happened with a multitude of others stepping up across the world and in the USA, their actions have created a pretty decent beginning of a conversation about Intersex.

Recently I had a chance to stop, I mean really stop, everything... to a complete halt; And for long enough that I could finally for the first time in my more than 50 years on this planet, I could begin to unpack some of the many gender and relationship events of my life, even as far back as early youth.  This necessary time of reflection has allowed, given my nearly complete understanding of everything that was done to me, everything I myself did, and all of the consequences; My first love... rejection, and loss of the person I'd thought a friend.  And many more events.

Understand, when you are in pain...living in a place so dark that suicide is a daily consideration; There isn't time to break down every side of an event, the mind becomes numb to everything it can.  And later when I have managed to pass those dark days, I practiced a different kind of purposeful avoidance of the bright hot shards of pure anguish that lay across my mental landscape.  My avoidance was practiced through work... which made me fairly "successful" in the world, I was always seeking more of that work stuff.  You might even go so far as to say, I was good at dodging the pain; I was exceptional in the realm of work.

Alas... lately I have had some time, and one by one those shards have been evaluated and analyzed.  I didn't even realize at the time why it hurt so much when the guy I thought was my friend, my so very close friend...married someone else, he broke my heart.  Why would anyone want a broken intersex person?

....

Yeh.

That.  Was. 25 years ago.  Painful as the moment I learned of it.  That my friend was leaving the country to join the girl he wanted to marry.  Ouch.  Still Hurts.

Anyway, I did work through it, finally cried it out... Not sure how often I'll update this site.  However, I wanted to say the works of the various Intersex organizations appear to be having a positive effects, and I have reached a better place (tears and all).  Oh and I'm still alive out here.

Best of Luck

XXY: Reflections of Gender in Children

A while back, I read a very sad story not related to Leelah Alcorn although that is another sad story.  This one is about an XXY child who was gender denied... (paraphrased)

I read a story from a parent recently which was so very sad. Their child was raised as a boy, the parents insisted they had checked and knew their child was a boy. Didn't need some gender doctor to tell them that, just a waste of money. Instead they did everything they could to make that child a boy.. and when he didn't fit in they punished him. When that didn't work they medicated him.. when that didn't work they encouraged people outside the home to change the childs manifest destiny to make HIM a MALE like all the other boys.
Just one problem... at the age of 16 he killed himself. 

The note left for his parents was short, to the point..(paraphrased lots more hatred in the note) "I'm female, I hate you, I hate life, I hate your friends, and I hate every damn this this world stands for."

That person is dead. Good thing to know the parent knew better than a doctor what gender to raise their child as.  The parents can take heart, by knowing better than gender specialist 1-2 hour visit about the age of 5, they saved the cost of graduating high school and college at 16. 

Irony...

Now whats really sad is that I can relate to this story.  It touches heart strings and pulls painfully.  I remember what it was like to be caught wearing my sisters clothes, the price paid in blood and tears, the punishment to be beaten.  Nothing straightens out a young Boy more than being beaten, right?  About the age of 10, my parents decided that if I couldn't wear the clothing they decided I should then I didn't need any clothing at all.  Their latest form of torture to convince a child she's a boy, consisted of coming home for three weeks from school and wearing a diaper while the parents invited my friends (soon had none) and their friends over to watch.  As you can imagine this broke my spirit to resist, if the beatings didn't do it... the shame sure did.  Time went by.. I learned to be an angel in what ever mode the parents wanted, otherwise I would be beaten.. again, and again.  Didn't help any that learning without instructions on what the expected actions and results should be meant more beatings.  Probably the single greatest lesson in all of that I learned was to be cognizant of my surroundings, aware of the beasts and dragons in my life, and how to handle them with kid gloves at long reach.  I knew for example that when my step dad arrived at home I had to be close to the opposite door he would enter, as I would know within 2 seconds if fleeing was necessary... or if I would have to go be "present" for him to see and acknowledge as still living.  Two seconds, you see was the time to reach the door before he did.  One learns to not be present, on bad days.

To this day I hold a great deal of pain, at the age of 15 my parents divorced, mother and children off into the world without him; It was like a reprieve from hell.  Of course, my mother being a sensible woman who willfully ignored any outside opinion and only believed doctors should be seen when you were dying... unless she was sick.  Oh yes, mother, how could I ever forget?  When I was 16 and started developing breast tissue she ignored it.  When I ran into any number of problems in school, she ignored it, after all thats what Boys do, fight. 

What my mother could have done was help me with estradiol at the age of 16 to assist development of a normal female.

Instead at the age of 16, she kicked me out of the house.. said I had to learn to survive on my own.  As an XXY person I was a prodigy with mathematics, economics, social sciences, and a few other things none of which equaled the ability to survive mid-winter in Alaska with one set of clothing in below zero temperatures.  I'll never forget that week.. to say it went badly is an understatement of many degrees.  And it took time to come back from that place.  The next year had me going to school, working, paying rent, surviving... eating occasionally because there wasn't enough money for food.  Details right?  There certainly wasn't much in the way of hope.  

Everything that I am came from this experience of surviving despite the odds.  And looking back, its a wonder I lived through ages 5-15.

So you wonder.. what should have happened?  Who is really to blame here:
The willfully ignorant parents or the many doctors which no doubt caused the parents much financial pain?

My parents should have been advised by a doctor, a Family Practice Doctor... make no mistake they need to be able to guide parents to correct choices; I should have been tested about the age of 5 for Gender Identity as a child with an Intersex or DSD, raised in the correct gender, and followed by that doctor.  Hello world, I'm Female, why in the world would you expect me to understand "boy"?  At or about the age of 12 I should have been treated for the correct gender identified hormone to balance growth which in my case would have been estradiol.  The results of a treatment like that would be me, about 6 inches shorter since the leg/arm bones would have properly capped from the rising hormone levels.  I wouldn't have had to endure multiple stages of puberty as it would sputter to a start and then stop over and over as hormones rose and fell so minutely.  I would have been normal.

I could have been normal.... if anyone had cared.

My mother has memory issues, from her own willful ignorance and remembers none of this.  And I have not yet found it in myself to forgive her.  She's old now, and I try to make sure she's okay.  We don't talk about these years, her version is rosy and nice paints us kids, my sister and I, as angels with all the benefits of a perfect loving home.  Yeh... 

..

I feel a profound sense of loss, when 40 years have gone by and the medical system still, to this day, refuses to take responsibility for not educating the patient or the patient's parents of the catastrophic damage refusal to consider gender causes in the child.  Our society is so highly stratified into genders that one must have a gender.  This is a basic need, and being forced into the wrong one is a horrible experience.

XXY children need to have a Gender Identity specialist assist in determining their gender about the age of 5, and should receive gender appropriate hormone treatment about the age of 12, when luteneizing hormone begins to rise into "High" or "Very High" levels. 

This is simple.

I could have been normal...

XXY: Medical Treatment by Ignoring the Problem

First and foremost XXY is a genetic identifier which will have a variable effect on issues relating to immunological disorders depending on if you have enough hormone in your system to support the immune system or not.  All of the "diseases" like Arthritis, Osteoporosis, and for that matter Cancer are related in that they are natural body reactions to a lack of support.  You can see minor cases of what is essentially starvation/dehydration if you cease drinking water or observe someone else who has... their body stops functioning well and breaks down; This is a simple case.  When a person has a lack of hormone, the body starves too, and when the body has too much hormone the excess is exchanged into other products which cause changes which are just as bad as too little.

In XXY people we have an altered DNA state which causes differences in how we develop, and so far the medical community has agreed that it is most simple to lump all XXY people into one group and ignore the problem.  This doesn't work well for most XXY people, only a very few can tolerate the default treatment, testosterone in any amount the person wants.

Treatment for XXY people should...
1. Establish gender identity of the patient.
2. Treat for gender appropriate hormone requirements based on actual baseline and indicator testing.

Past treatment ignores the gender identity of the patient, which in large groups of XXY people counted from among the entire population, not just males, has several identified groups namely: male, female, neither, and both.  Sometimes called: Male, Female, and Intersex.  Intersex however is a proscribed term in medical science in some parts of the world.  Lumping all XXY people into the male category has caused long ongoing medical problems for most of the XXY population for the past 60 years.

I have studied and followed XXY people for over 10 years, and met/talked with thousands of XXY people.  Individuals who are self-identified in genders Female, Intersex, Male, and Neither.  And I have done a personal study with volunteers for my own edification (See Banding Study) with no intent of actually publishing results.  From this I have attained certain understandings about the XXY population.

1. The vast majority of XXY people are not male.

• About 15% of the known population are male, should be male, and tolerate testosterone well.  These XXY people can take testosterone without significant side effects, and do not require additional cocktail of drugs to counteract the bad effects of testosterone.
• About 60% of the known population are Intersex, meaning they identify with both male and female.  This group has a much smaller (part of banding study group 4) group that can tolerate testosterone with few side effects, or at least no need for additional drugs to counter the testosterone caused side effects.  Some of the (banding study group 4) group choose to try testosterone and most do not.  The remainder of the group (part banding study groups 3 and 4) should not take testosterone because it will require a cocktail of drugs that do more harm than good. 
• The last 25% are female (banding study groups 1 female, and 2 intersex female) and absolutely should not ever be prescribed testosterone.  This group is female, should take estradiol as needed.  

2. Testosterone as the default treatment for XXY people is causing more harm than good.

• Among the 20% (banding study groups 5 and part of 4) testosterone should be used because the individual can tolerate the hormone without major side effects.  This group self-identifies as male.
• The rest of the XXY (the Known XXY population) is not and has never been male.  The default treatment (assumed male and testosterone) for these people is causing detriment and harm.  
• About 10% of the XXY known population is female with a uterus and vagina, these women should not be lumped into the male only treatment ever, and yet they often are.  Doctors insist they are XXY and attempt to treat them as transsexual females or worse transsexual males.  This is abhorrent at best and criminal.  The definition of female is the presence of a uterus, and yet doctors would have you believe these people should be surgically altered near birth to remove the uterus and raised as boys.  Criminal!

3. Using XXY population as justification for treatment of non-XXY people directly harms the XXY population.  This includes:

• Transsexual XX or XY people.
• Other genetic groups such as XXYY boys.

4. The group that is XXY includes:

• Any number of X's and one Y.
• Mosaic's of "Any number of X's and one Y."

Statements Which Matter to XXY people

List:
1. XXY people want good healthcare; Thats all.
2. XXY is all genders and all sexualities; What matters is that you are happy.
3. Anyone can be XXY, it is a means of identifying a unique set of parameters for living well needed by the medical profession.
4. XXY includes males, females, and intersex people.
5. XXY is a natural event and not something to be surgically adjusted to fit some arbitrary sense of beauty or to fit into the religious dichotomy of male and female.
6. XXY people will experience male and female aspects of life and how much is related to each individual.  But all XXY people will experience feelings.
7. The bottom line is that we need good health care to live good lives.

Serenity is Priceless

Lets talk for a minute about another side of my life, one that seriously complicates everything endocrine and provides me that generous excuse of why in the world anyone would want to learn as much as possible of a subject so incredibly poorly documented that it takes years to be conversant and decades to be skilled; Endocrinology is a bitch to learn and even now a decade into this path I'm still a student, an educated student.  Todays topic is Congenital Adrenal Hyperplasia or CAH, with hints of intersex, and all those things I usually don't mix up with the XXy crowd. 

You know, I'd love to be part of a group.. (really.. sort of, err.. no so much) but the idea of being part of a group has appeal.  And I have something in kind with all people 47,XXY in that I have 47 chromosomes too... except that I'm female.  Ish.. female ish.. which means more intersex really.  Or maybe I'm a feminine XXY guy lacking male parts, or damn, I hate this topic.  People ask me what gender I am, and frankly (Frank.. really?), really, I don't like hard questions.  I go with what others pick since they are less likely to take offense to me choosing something they didn't expect, saves so much indignation.  So yes, I am 47,XXY, and I have CAH of an appropriately rare version as to make me about 1 in billion or so; Doesn't feel special on this side, more like isolation, or a rock in the storm surging sea... surrounded by emptiness.

.
.
.

emptiness. ouch.

..   anyway...

So I have CAH, salt wasting version, or more specifically I don't make Aldosterone (mineralocorticoid) naturally.  The body (my... ) experiences a feedback loop for enough salt, which will always come up short since the mechanism to retain salt is broken, so the negative feedback on the circuit causes the kidneys to release high amounts of renin which in turn stimulates Aldosterone (except that very little of that happens, so little that its not detectable).  Instead of the body/kidney's retaining some salt and passing the water through both are retained causing water retention or bloating or edema depending on who you talk to.  Chronic edema is.. bad, lets leave it at that right up there with heart attack.  I have two choices, take and continue taking salt at a minimum of every two hours for the rest of my life and try to balance the blood pressure issues, along with progesterone which in turn will allow the endocrine system to make a minimum of necessary mineralocorticoids directly through their primary path; Or, I can try taking some of those designer drugs and still try to balance salt.

Two issues with the assumption of endocrinology have occurred to me, both relating to completely dysfunctional endocrine system like me.. specifically that:
1. The ideal that there is only one path between the endpoint cortisol and mineralocorticoid hormones is lunacy.  The body has at least two and probably three ways to make those absolutely necessary hormones, although the cost of creating the alternative pathway's make the alternatives far less than the preferred method; and that,
2. The alternative path's are so expensive that even having them is not enough to do more than to produce small amounts while exhausting the patient; and that..

((
I wrote about cancer last time.. wasn't kidding about the body being able to make hormones via a less than preferred pathway as needed in at least small quantities.  Usually the medical experimentation occurs on someone like me, but I see the medical community experimenting wholesale on most of the active population of the planet.  Odd, no?  The human body is absolutely amazing, in what it can survive, although we measure time in years and the body in minutes; Here we find the disparity of desire versus longevity.  Until medical science acknowledges what we already know, the study of Endocrinology is still an art, less practical.
))

When have I ever done something the easy way?  No thats not fair, I do it the healthy way, and because I don't like the effects or long term loading of the drugs choose to use bioidentical progesterone and estradiol only.  Which leaves me with balancing salt intake versus high blood pressure and progesterone.  I know from experience that it works, that it is possible, and that one can succeed in life despite these kinds of challenges.  And I know what its like to miss a dose of any of those and the hormone cascade crash that goes with it.

To set the record straight:
It is MY rock..
in MY empty Sea..
a single patch of Serenity
in the Storm of life.

What does Cancer have to do with Autoimmune Endocrine Diseases

I'm going out on a limb, into a very controversial topic which has numerous people affected, effected, and left countless people the world over in a great deal of emotional pain.  It cannot be understated how divisive the topic of Cancer.

It is unfortunate that there is so very much money to be made on the sick and dying patients, the world over.


Lets start with what cancer is:
1. ... a natural process of the human body.
2. ... uses hormones in the endocrine system to make other hormones. 
3. ... has many different variants for each localized region of the body.
4. ... is commonly described as a growth of cells in a region which can lead to a tumor.
5. ... the less benign forms kill the patient.
6. ... the common treatment, chemotherapy often kills the patient.

Cancer is an endocrine disease that directly effects and is also protected by the body's immune system.  The most common treatment is chemotherapy which destroys the body's immune system, and then finally the cancer.

All good right, we're on the same page.

When a patient enters "remission" the cancer growth stopped, the tumors stop growing or shrink, and the patient stops dying.  To get here the patient follows a guide provided by doctors which takes all of the stress out of their lives, reduces their food intake to only the most healthy foods, and specifically removes all known impacts to the human immune system.  Further, the process of following the guide helps the patient to live a far less stressful life.  All of this lowers the total load on the patients body Immune System.  Which in turn also lowers the requirements for stress load hormones: cortisol, dopamine, serotonin, etc..

I know what you are going to say.. But Onni... Serotonin and cortisol are totally different!  Well yes, and no.  Look at it this way, there are 30 major hormones and about 90 minor ones (misnamed since minor only means localized to one organ, serotonin = brain), and of those there are about 25 which deal with stress.  Lower your need for stress hormones, and if your "cancer" is related to stress then you don't need as much of that "missing" hormone and if your need falls under your threshhold of what you can make without the tumor; The tumor shrinks and cancer goes into remission.

Simple.. ? ehh... no.. Nothing about the endocrine system is even remotely simple.

Take for example, the hormone Adrenaline, it is probably the most simple case, which if you stop making it your heart stops.  Simple right, no adrenaline and you die.  A cancer of the adrenaline makes ... adrenaline and your heart doesn't stop.  The problem is the treatment, we do not have a means of feeding minute and exacting portions of adrenaline to the heart every minute or so for the human heart to keep beating.  The patient is going to die whether they are treated or not, difference in slowing the tumor is about 3-6 months of life; If you can call living in pain in a hospital, life.

Most cancers that people have today are related to regulation of estrogen and testosterone, ie breast cancer and prostate cancer.  No surprise really, our environment is full of endocrine disruptors, and even our food supply is highly compromised.  If you consider that compromised food and the oil you like to bath in are actually Poison... then it makes sense that if you bath in and eat poison for 30-40 years you'll be affected by it.  This doesn't account for kids battling cancer at the age of 2+, unless you dig deeper, which I'm not going to do in this posting.

As someone who has been researching autoimmune diseases for the past... damn I'm getting old.. the gap from osteoporosis to bone cancer isn't large.  Osteoporosis is a loss of sufficient nutrients and or an absence of estradiol for the system of bone replacement to function.  Cancer of the bone is a loss of ..(how to sum this one in one short sentence..?) it is a loss of a significant hormone in the process of blood creation, the cancer makes up the difference needed to keep making red blood cells, which without you die.

I have a long history of not quoting the doctors, studies, etc.. which I pull or support information from, and I'm not going to start now.  It was notable however, recently that a study was published where the medical community finally admitted that beating Cancer to death (along with the patient) was not productive and that Cancer cannot be cured, because it is a natural process.

Chemotherapy is a drug/radiation treatment which bilks the patient out of a massive amount of wealth, without really providing anything in the way of real medical treatment.  There is so... much... money .. to be made from sickness and death.

Cancer is an Endocrine Disease, related to other Autoimmune Disorders, which can be acquired through prolonged poisoning.  Its quite simple (or ridiculously complex).

Banding Study followup...

Several people have expressed interest in the "non-published quasi-scientific study" I did for my own understanding of the XXY phenomena and how we respond to hormone intervention.  Its quite a alot more broad a topic than I have revealed to date, but the rest is mostly for my own understanding.  None of the work to date is documented or referenced because I do not want anyone picking up and republishing my work.  If the study were to be published it would be in a doctoral level peer reviewed medium.

So I have a couple of ideas for you, specifically for XXYers to better understand youy own predicament.
1. The study is devised on a concept called percent of scale, meaning that the banding group participants (male, female, intersex) which come from all parts of the world and from many testing environments can meaningfully compare their results and base hormone assays with others.  For example, someone doing a testosterone test in Australia might have a result in nmol/L in the range of 0-30, with a normal male range of 12-30; While someone in the USA might be receiving results in the range of 0-1000, with a male range of 350-900.

• Different Ranges of Results: Every company or state which does hormone testing uses devices which produce similar results with in a common error, but they are not the same. Even a lab corporate giant like Quest Labs in the USA which has testing centers in every major city (dozens of centers) has variance in their absolute ranges reported in their tests.  This is a result of using different machines which affect the total range as well as other issues which result in larger or smaller known error.  
• Error is scientific term of absolute value, known to be correct withing a range of +/- some much smaller value, and we are dealing with very small numbers indeed in the nano and pico ranges.
• We can talk about estradiol in the same fashion as testosterone, although its chemical range identifier is different representing even smaller quantities as pg/ml and pmol/L.  The 'p' is pico.
• Testosterone is expressed in ng/dl or nmol/L, and the 'n' is for nano.

2. The concept of percentage of scale is specifically the absolute value of the resultant test as a percentage of the scale represented.  For example:

• A result of 100 on a scale of 0-1000, is 100 divided by 1000 equals 0.1.  We interpret the 0.1 on a range of 0.00 to 1.00, or we multiple the results by 100, either way the percentage of 0.1 is 10%, or .. 0.1 x 100 = 10%
• A result of 4 on a scale of 0-30.  4/30 = 0.133333, and we only care for this exercise about the first three digits so 0.13 is our answer, which is 13%, or 0.13 x 100 = 13%.
• A result of 240 ng/dl on a scale of 0-1200 ng/dl, is 240/1200 = 0.20 or 20%.

3. The bands in the study are a reflection of the base hormone testosterone pre-treatment with any supplements and then tracked on graphs that correlate:  X axis: percent of scale of testosterone (0-100%) to Y axis: quantity, second as LH, FSH, and base estradiol level. There are several ways to interpret the graphed results.  I can ascertain with a high degree of confidence several factors of the individuals life including gender identity and preferred case for hormone treatment from the results.  The bands reflect the five groups which are then apparent upon the graph broken down by base testosterone quantity.

Bands:

1. Range below 4%.  Female.
2. Range below 6%.  Female or Intersex.
3. Range below  9%. Female or Intersex.
4. Range below 15%. Intersex or Male.
5. Range above 15%. Male.

Following the bands and interpreting the additional data it is fairly simple to determine the gender of the person, their gender identity, their hormone balance levels, and in simple determine how to better manage the XXY hormone replacement process.

If I can determine and hold a high degree of confidence in the results, then it is absolutely criminal what medical practitioners are doing with their forced masculinization process that is being applied to all XXY people under the "recommendation" they be given testosterone by default.

Seeking a credible PhD who would like to study and establish the population of XXY people.  Please inquire.  Thank you, Onnineko (onnineko@gmail.com).  A banding study should be done, but I no longer have the desire to follow through.

Moving Forwards...

Really, what can we ask in life: Health, Energy, Spontaneity,  Sophistication, Friends, Love, and great Food, right?

Well before all of that we have some assumptions like enough food to eat, shelter, and an expectation of those remaining sufficiently static to have leisure time.  Yet before this there is another layer and that is fundamental as breathing, it is achieving normalcy of gender congruent to ones understanding of their natural being.

For years post high school, I an XXY person, has forged a path through life; Slower, more focused than natal men and women.  It took me 20 years to have a first date, and another 4 to meet someone I cared to try a kiss.  Intercourse took much longer.  I have lived as a boy, girl, woman, man, and of late in between.  Often the path of least resistance, or which ever gender caused the least controversy.  All things in their time, with alot of life in between.  Gender was put on hold so often that it seemed the world of children could pass me by entirely, and it did.

Don't misunderstand, I have done some amazing things in the past few decades, gone places most only dream about or see in movies, intensely trained to the senior level in more than one profession, traveled extensively, etc... I do not feel sorry for my life; Not even remotely.  I lived well, and still do.

No, this issue is about something which has been put on hold so many times that the absolute drift is beginning to exceed the thresh hold of failure, or more specifically the darkness of catatonic depression; A realization there is no way forwards .. unless.. until.. gender is aligned in a single place matching the incongruence and creating a whole being.  There it is... I must change or I will die, literally or figuratively, lost in acute depression or .. or.. (no good pictures there).

Shouldn't be a surprise to anyone, XXY people take life in bits and pieces, we learn more than anyone ever dreamed was possible, and we can apply those skills practically.  Sure eventually I would get here to this minor issue, this gender problem, and it would stop the clock.  A barrier.  Something that would cause panic, frantic thoughts, concern, elevated heartbeats, and ... trepidation, even fear.

Let me put this simply:
Onnineko identifies female, happens to be XXY, has secondary hypogonadism and a thoroughly dysfunctional endocrine system which is missing progesterone and everything beyond, doctors have been expecting my imminent death for over 20 years.... An Onnineko is of mixed genitals, some might call me a hermaphrodite, if you understand none of me works in a positive sexual way.  I want to be just.. female. 


Sounds simple, no?  The point is not just to align in a female gender but be able to move forwards as a woman without restrictions enforced by genital appearance or function.  The plan is to move forwards, which means resolving this crisis before catatonic depression and that other thing (the manic no "fear or sense" side) catches up.  I  cannot do hopelessness, not again, the euphemism for "gun to the head" comes to mind.

Most people trying to transition from MtF or FtM are worried about what their coworkers and social groups think of them.  Frankly I have no idea what my coworkers or social groups think of me, most know that I am intersex, or a butch female, or a feminine gay male, or some weird alien.  I get by at the moment on the fringe of space allocated to males, butch or feminine gay, and I am going to just butch I think.  Which will cause some havoc, maybe... its been at least 10 years since I last used a women's room and that might be an issue switching now.  If I were to complete the process and just be female, it is certain that several of the males would try rape if I used the men's locker room and couldn't demonstrate at least something that appears like a penis (functional or not).  This is a new place, I've only worked there a year and its getting around that I'm intersex.. male interest is perking up as it is.. (sigh..) .  This is the downside of being a contractor, one might be among the top 1% of the experts in the world, but as contract staff you serve at the pleasure of the organization holding the contract, or in this case a military.  This particular military is not known for its kindness, understanding, or willingness to support anything outside the dichotomy.  Sometimes I think especially DSD's or Intersex people.


Lots of negative in this.. I've put it off too long.  Resolving my own gender, and doing it in my own terms by my choice. So here I am, shifting from undefined to female.  What a ride this is going to be... and perhaps moving forwards.

Engineering the Perfect Human

Hands down, the human body is a marvel of complexity.  From my point of view it is a beautiful complex machine.. and yes robotics is a hobby of mine, it is not a long stretch from engineering robotics and designing artificial intelligence to the function of a bio-system or the human body.  Engineers use some of the same relays to do the same work.  We have feedback systems just like the human body has feedback systems.  When there is voltage on the wire that means its a "1" or an "on" .. when there is feedback in the bio-circuit it is a "1" too.  Engineering the human body is .. necessary to understand.

That isn't to say that an engineering degree will get through molecular chemistry, but the addendum knowledge can be learned and applied.  This is after all why we go to to college, to learn to learn, to think and apply, to build understanding and expand knowledge.

I started in engineering of electrical systems and computer science, and since then have never stopped learning.  There have been some detours through medicine, law, and a multitude of other topics.  Life is a process of experience.

Right now, the topic is how sufficient levels of estradiol impacts the rise and fall of Insulin (yet another major hormone), and no, I do not have diabetes nor ever plan to have it.  More specifically I am planning to never acquire any of the major immune deficiencies that us XXY people are supposedly (lies, all lies!) predisposed to.  Okay, maybe the researchers have a point, in the absence of balanced hormones including estradiol people whom are XXY do and are much more susceptible to all manner of immune deficiencies.

Thats right... the medicalized person that is XXY, whom for the convience of the medical establishment are forced into the male role. Most XXY people have, less usually less, a penis, I was less lucky.  ..WE.. are pushed into the male role because to admit that we are intersex would destroy the lie of the binary gender system.  And when we are forced to grow up as male only, the system only cares if we have enough testosterone.  It should be no surprise that in the absence of medical care, we WILL develop immune deficiencies and diseases from the LACK OF ESTRADIOL.

Cause of Osteoporosis: LACK OF ESTRADIOL...
cause of all Immune Deficienies (like lupus).. LACK OF ESTRADIOL
Arthritis: LACK of estradiol.. 

Huh.. that was easy.  Well its not, not really.  There are endocrine disruptor in our environments which also cause a lack of estradiol in natal females, which is why so many are experiencing Breast Cancer, Cancers in general, and numerous other problems like Multiple Sclerosis (MS).  When you compromise the body system by inhibiting its use of estradiol the body eventually breaks down.

Simple.  Those of us whom are XXY are only more suspectable to all of these issues because we are BY DESIGN of the medical world deliberately made estradiol deficient.  That is if we continue to accept the dogma that all XXY people are male and only need testosterone.

Our highly religious binary gendered system is the cause behind the incredible stupidity shown by the medical establishment.  Oh my god, we can't possible prescribe estradiol for a male...

Yes, most all of the major problems our society fears right now related to diseases of the human body are caused by our society and its idiocy over gender.  There is also some considerable responsiblity to be laid to the feet of our EPA for the absolute idiocy which led to the shutdown of all coal plants in favor of burned oil, but thats another rant.  EPA=Idiots.

Bottom Line:
All human beings need a balanced Estradiol system or they will develop diseases.

Banding Study of 47,XXY and variants population

 I often allude to a not terribly scientific study that I have done for my own research.  Have no plans to publish, ever.  The study is a composite of more than 400 XXY people from all walks of life, using a variety of treatments including testosterone and estradiol.  They are matched by baseline hormone assay's and placed in percentile groups on a linear chart.  The break down of simple banding into 20th percentiles along that chart clearly demonstrates that there are distinct groups or bands in the XXY population, and one can infer from these bands whom will benefit most from testosterone or estradiol therapy.  It is possible in most cases to infer what gender identity the individual will have, male, female, or intersex.   It is remarkable how little is actually known about people XXY, and it is abundantly clear that the majority of the population is not and has never been male.  Forcing the XXY population into male for the convenience of not really providing treatment has resulted in poor outcomes for the past 50 years.

 Did you know that no one has yet published a study which (including Dr. Klinefelter) actually identifies the 47,XXY and variants population?  

 Klinefelter's studies all describe the natal male and variant population which believes itself to be insufficiently masculine to be male.  His studies rightfully so describe those people to be less than average in most cases in IQ.  These studies have very little to do with 47,XXY people except that some XXY people are affected by Klinefelter's Syndrome also.  

XXY is a genetic marker, just like XX or XY is for natal females or males.  There are females whom are XXY, there are males whom are XXY, and the rest are generally considered to be Intersex in that they live in both gender's.  At the moment the DSM-V takes exception to anyone using the term intersex, because their dichotomy of gender does not allow for fluid existence in more than one.  Most of the documentation, although this is slowly changing, published by the USA National Institutes of Health have been highly negative and severely lacking in facts of any form.  

Can you believe it took the medical community 40 years to finally publish in 2012 the known fact that XXY females exist?  

The medical community has known of XXY females for more than 40 years, but it is an inconvenient fact that normal XXY females can bear children just like ordinary women.  The problem is that they have been pushing all XXY people into a testosterone only forced masculinization program for those 40 years.   And the XXY population except for the 5th banding group has had very bad results, some have died as a result of testosterone use and forced masculinization protocols.

XXY people are not MALE, except for the 5th banding group.

XXY people are not FEMALE, except for the 1st and 2nd banding groups.

XXY people are often INTERSEX, including the 3rd and most of the 4th banding groups.

I've been tracking this data for about a decade, but it would be nice if an agency like the National Institutes of Health would do a formal scientific study on not just a few hundred known XXY cases, but the necessary tens of thousands to establish the population.  Until this is done, all of the work on XXY people as a class are little more than presumptions or are seriously flawed and probably cannot be trusted.

47,XXY and why the "t gut" is not based on testosterone

 

I wrote this in response to a question on a facebook group regarding the horrible Testosterone GUT that XXY people develop which is similar to but not the same in most cases of XXY to natal XY males.  XXY people are not natal males, for the most part, some few are fortunate to be able to exist in the male paradigm and experience male based care without issues.  Most XXY people require a balanced approach with charts in both MALE and FEMALE with all aspects of both genders openly discussed and dealt with.  Just like women, balancing estradiol is perhaps the single most important issue for most of the people whom are 47,XXY or variants.

*******

When you take testosterone the presumption from the Doctor is that it will give you a HUGE kick in the ass to get out and DO life, ie .. lots of physical work. Some people would call it play, because they are working .. HARD.. at playing and having a great time doing it. Others spend alot of time riding their bikes long distance, in gyms trying to impress other guys, or hiking, skiing, etc. Men whom do not actively participate in life end up with fat, primarily in the gut. What it means to have the T gut when you are on testosterone is that you get too many calories and don't use them.

Now there is a second group whom should not call their gut a "T" thing, and this includes people who do not have so much testosterone like the average XXY person whom on Australia's  scale of nmol/L would be down around 5 nmol/L or less, or in the USA on ng/ml would be under 300 ng/ml. That is because when your hormone levels are low, fat develops so that you can process what little testosterone you have into estradiol. The fat is an organ of the body which translates Testosterone into Estradiol.

My point is this... regardless of how much testosterone you take, the Body NEEDS estradiol. And it will get it one way or another. The body could really care less about testosterone, despite that it takes testosterone to be a Man. The body HAS TO HAVE estradiol or it DIES. There is no ... oh you only need estradiol to be a woman. The BODY, Organs, Brain, and everything in it NEEDs estradiol. If you starve your estradiol supply then you will get fat when the body goes into survival mode and starts converting testosterone to estradiol.

So if you are doing it all "right" taking T and working out, and eating right... and you cannot get rid of the "T gut" then your estradiol level is low. Simple. Most guys do not require alot of estradiol. Most XXY people require anywhere from 3x to 10x as much estradiol as Men, and generally about half as much as women average in their middle years. I wrote REQUIRE for a reason.. starving yourself of estradiol will make you fat. The body/brain system will get its estradiol one way or another, regardless of what you want to happen.

Now.. I often talk about the banding study I did for my own research. Anyone in the left 4 bands (of 5) will absolutely need to balance their estradiol levels despite any desire (generally the 4th band) to take testosterone. The only group which can for the most part not worry about estradiol balance are the 5th group or right most 20th percentile of the XXY population, whom identify as male, take only testosterone and need nothing else barring significant other problem. About 80% of the known... based on my research of actual people whom are known to be XXY, need to balance their estradiol levels.

ps... most Guys.. do not eat well, exercise enough, or take care of themselves in any way. Which is why hormone balance is among the last things doctors will look for.

Reflections on the Past - Schools and Bullies

My experience with schools pre-college was entirely an ugly affair and I cannot relate to what children experience today.  The experience was so horrific that I don't often describe those events to anyone.  You might say, I have a thorough understanding of why a person might choose suicide.

Let me give you a snap shot so you understand the difference is literally night and day between the schools of today and those in 1975-1990.  Please keep in mind the overt hostility of public school staff has largely been removed from society in this age.  For most of my years in school I was short, not well muscled, and not strong like boys are expected to be.  And there was an agreement between my parents whom were terrified I would grow up to be gay, ie. I, the female identified gender-neutral child, they had adjusted to male would grow up to like boys. Imagine that.  But no, they filled out paper work which said I would be a boy, therefore I had to be a Man, at the age of 5.  From 5-11 grade school was mostly tame, some fights here and there, nothing that differed too much.  After all, until 4th grade I was the same size as everyone else, just another kid.  By fifth grade I was starting to stand out and 6th grade wasn't much better, kids were starting to grow faster and taller, except me.  Grades 7 to 12 however, were a nightmare.

In the 7th grade I was suddenly (unusual for XXY I know) not tall enough to keep up with everyone else.  I looked wrong and was excluded from all groups.  Imagine that, a young "girl" didn't fit in as a boy, not at all.

By the 8th grade the damage was done, I was a target for all bullies with the tacit approval of school staff and worse, my parents, who were so terrified I would be gay.  So it began 3-5 bullies would accost me, and I would either flee successfully, be cornered and talk it out, or be cornered without an adult nearby and be tortured until I fought back.  Which actually means that for most of the 7th grade I was cornered and beaten down by a group of bullies whom were all larger, stronger, and much more willing to hurt people than I was.

By the end of that year, my parents finally decided I needed some help to stand up to the grueling punishment of bullies and they enrolled me in the martial arts.  Little good that did, the martial arts takes many years to become capable.  That summer, I learned that fighting back at least gave some satisfaction to being beaten down... quite by accident I managed to hurt one of many attackers.  My parents had long since instituted a policy that my complaints were but lies, and would automatically believe whatever story of my misdeeds from others.  Being "grounded" was a place of safety, what a fine discovery that was.
 
I learned early that if you want bullies to avoid you, then you had to be the meanest evil person they could imagine tangling with.  If they brought sticks, I needed a Knife.  If they brought chains, I needed a roll of quarters and a razor blade.  And I couldn't threaten them, it had to be quick, you attack me ....I cut you.  No hesitation.  You and your posse of bullies corners me, I have to hurt you badly so that you FEAR me enough not to do that again

I learned to find safety in punishment details.  A gang of kids would attack me coming or going to school, it would get vicious, people would get hurt, and I .. I alone, the only participant with no friends present, five, six or seven to one, of them all, I would be singled out as the bad one and placed on a punishment detail.  Little did the powers that be understand, those adults so willing to turn a blind eye to the bullies, a "punishment detail" was actually an Adult supervised event.  Thats right, it was a SAFE place.  None of the bullies would try to hurt me there.  The school staff person might be down right mean, but it was VERBAL.  They would not attack me physically, which made it a safe place.  And if I was lucky this would occur during periods of inattentive monitors by adults, ie.. lunch, before school, or after school.  The bullies were much too lazy to wait two hours after school for me to leave a punishment detail, or to get up two hours early to goto school to ambush me.  Sad, no?  Formal punishment the only SAFE place for children at school because it has Adult supervision, and the only place where the Adult present cannot turn a blind eye to physical assault.

Ugly, no?  That was 8th - 12th grades, and the bullies never entirely went away.  The combat escalated.. got more vicious and bloody with every year.  People got hurt.  Permanently hurt.  I'll let your imagination run with this, but if you can imagine it.. it probably happened.  The only thing we didn't have (fortunately) was guns... everything else got used.  I have ugly memories of high school, and no wish to revisit them.

My parents signed paperwork and paid money to have a boy.. unfortunately nurture didn't trump nature.  They got a messed up girl with the skill to survive street combat and smart enough to get herself straightened out enough to soar into the future.

That said, I haven't forgotten, forgiven, and if anything the pain of those days still burns behind every dark moment.  Public schools sucked for me, because I didn't look like a boy, was not a boy, and could not fit in with boys.  Sucked as a term doesn't do it justice... I understand why so many children would be willing to commit suicide rather than attend public school.

XXY: Elf Zombie

If you wondered, why progesterone is such an issue.. aside from the complete lack of studies. For estradiol and other hormones like testosterone or even DHEA where are a myriad of studies available.  The data for this peculiar issue limited at best.

If you tested every person in the entire State of California seeking those without a measurable level of progesterone there are about 20 people in total.  This is not a well known or studied issue.  Indeed the first lab on my first test for progesterone actually queried the doc and asked if the patient was living, as their equipment and results suggested either the sample was of a dead person or their equipment was faulty.  The same lab ended up providing several sets of data for each of the 4 vials of blood provided once a week for a month.  The lab didn't believe their own data.  No progesterone equals DEAD. 

Everyone once in a while I refer to XXY as "Elf".  This started sometime in the last year while beset by dozens of documents and ideas from various parts of the medical profession, bloggers, writers, and other newies who all wanted to label me.  Somehow I had to be a DSD, variant, disorder, targeted for extermination, Intersex, activist, transgender, transsexual, man, woman, thing... it was too much to explain to people I was XXY, that I care about achieving good health care more than being the epitome of a gender, or a sex.. or having a life.  Elf has benefit, no one asks me what gender I am, when I reply, "Elf".  Some of them go a bit weird and dreamy though.  On the plus side those ugly statistics for rape, shows remarkably few elves are ever raped, beaten, or punished for being in the wrong restroom.  The counts for elves bullied are at a resounding 0.  All good so far, and if even one person bothers me then there will be a 100% loss of confidence in elves ability to participate in the USA like any other class of, say, white citizens.  Nice, huh?

 So this means I'm an Elf Zombie !  Yay!  I think...

Progesterone Challenge

Hard to believe another year has gone by.. almost.

I've moved on from some of the challenges which struck, or that I dredged up because at 40 its long past time to settle some of those issues of the past.  Clear the mind, relearn to accept the self.  Accepting.. is difficult for everyone, I'm no exception there.

This years challenge is progesterone, and unlike 99.999% of the population I don't have any.  And I realize in the realms of doctors that limited the pool of candidates for who the "Onnineko" is to a very small group, integrity we hope will win. :) No one is offering rewards for me yet!  We'll see.

So progesterone, most people, male and female alike, exist at about 0.5 ng/mL or a bit more and the major exception is a pregnant woman who will be in the hundreds.  This is literally THE HORMONE of life, every organ in the entire body uses progesterone, so you can probably imagine my surprise that I don't have any.  Similar to individuals with the extremely rare expression of Congenital Adrenal Hyperplasia (CAH) 3Beta-Hydroxysteriod Dehydrogenase deficiency ... (to the doctor team who knows me, I know who you are too).

This past year, specifically, and years past in general I have been experimenting with what this means to have no measurable level of progesterone.  Studying why, what effects that matter, and the how/whys of treatment.  Some of them make sense, some don't... and only 1-2 researchers/highly decorated docs need to die before the medical thinking will change to a more beneficial pathway.  That is perhaps my most significant gripe with the USA medical system, they will stubbornly cling to outdated notions for decades until the original writer dies. 

Supplementing progesterone however, is not simple, unlike say taking a major sex defining hormone like estradiol.  The packaging and doctors tell me its lifetime is 20 hours, wrong.  I've found through trial and error that for.....ME.... its under 13 hours.  Which means if the me I know and trust who is smart, witty, and on top of life suddenly runs out of progesterone (a Major hormone, drives everything really) there are consequences.  For me it means the anxiety of changing hormone levels builds rapidly, most menopausal women will have some understanding of what I mean by that.  Worse for me, personally, the anxiety and panic of crashing hormones pulls out the stops on Gender Identity Disorder.. which doesn't pull any punches.  The GID problem will probably kill me someday, if it doesn't get resolved, but it is not the worst problem.  The GID issue is only a problem when my anxiety levels are up from cascading or changing hormone levels.  So yes, really its a problem that can be masked by leveling out the hormones and keeping them there.

By rights, I should simply admit I'm female, have the docs fix the problem.. be a woman, and move on.  Then I'd be just like most other menopausal or hyster-deprived women, experiencing rapid mood swings from hormone levels which just won't stay level.  Awfully tempting to do that, as it would release one of the worst nightmares of my life - the idea of not being female.  I've thought about asking the medical establishment to undo their work, take me back to the hermaphrodite I was before they "fixed" me.  Perhaps that would be enough.. and the specter of GID would leave me alone at last.

Either way, supplementing progesterone is likely to be something each person has to learn what their individual body needs and what kind of burn time you each have for it.  Most people as I said, the 99.999% don't need more progesterone, your body makes plenty.

Onnineko

ps. I need to resolve the GID issue.. damn.

Savant: Aspergers and 47,XXY

I cannot write this, it hits the page with all the narcissism dripping with sarcasm someone truly angry with the world for this ... colossal bit of grand scheme humor.  Should I ever meet this God we are going to have a long discussion on Congenital Adrenal Hyperplasia, Klinefelter's Syndrome, Asperger's Syndrome, and why ... WHY! ... I was born an ambiguous female.

Writing as such, why is it such a foul paw to harp on genius?  Savantly adroit.

What:
    in _____'s name caused my parents to suddenly, bereft of common sense, decide to raise me as a boy?
   ... part of will NEVER fit in did those parents not understand?
    ... at what point did they plan to .. EVER.. tell me the truth about this .. little issue.

Why is everyone else embarrassed, they're not living this ridiculous lie.

Even now the anger is seeping in, there isn't much to do about that... I refuse to follow the ideal that I am in any way handicapped or disabled.  It is absurd that I... could be handicapped or disabled with an IQ in the stratosphere.  There written, quite enough genuflecting.

Most people with even one of these issues has significant major problems, somehow I dodged that bullet.  Not obviously the fallout such as osteoporosis, but I found a way to eliminate that as an issue.  There are other problems most of which have been carefully researched and eliminated.  Not all people with these conditions have the ability, time, ability to understand, learn, or overcome the challenges; I get it, and hope that you do also.  An Onnineko is a diamond in a suit of one.

And I hate my life...

Does estrogen feminize XXY's?

The activity of estradiol concerned me a great deal when I was looking at estradiol (for 6 some years before trying it)... I'm feminine enough, no more needed. The real concern though was osteoporosis and breast canc

er. I have a rare reaction to testosterone that makes it toxic, just won't work for me. Osteoporosis is an expressed lack of estradiol acting upon the bone structure, thats where it started for me, I needed to get my levels up a little higher and couldn't choose testosterone. And.. I identify female so testosterone wouldn't have been an option anyway. Still.. I was looking at osteoporosis which is way more scary than the feminizing issue. 

Then there is all of this documentation about transsexual males who change to females, and they take massive doses of estradiol as well as testosterone blockers, as otherwise the testosterone they produce naturally would suppress the activity of estradiol.  Individuals whom are XXY often find they have naturally elevated levels of estradiol.  Note to doctors, it is NORMAL for an XXY person to have high estradiol, and they should be treated for both.  Bad doctor... bad.. no cookie.

So.. does estradiol cause feminization of a "masculine" XXY person..

Now we really have to talk about how testosterone affects the individuals body, because each person has a different level of sensitivity. If someone with a low sensitivity, whom also has natural testosterone levels about 7% of scale (very high for a female) then that person will not feminize from taking a low to moderate dose of estradiol. This is because it takes only a very small amount of testosterone to offset estradiol activity.

Imagine for a moment that you have small glass and large jar which can hold 1000x as much fluid as the glass. One unit of testosterone will fill the jar for each unit of estradiol which fills the glass. Or about 1000 units estradiol = 1 unit testosterone. So very little testosterone is needed to eliminate the feminizing effects of estradiol. Come to think of it, most XXY guys produce enough testosterone that any low or moderate amount (depending on sensitivity) will not cause feminization.

 So everything aside, anyone taking massive doses of estradiol in the absence of testosterone will experience feminization.  The goal for XXY people is not to take the maximum or even large doses of any drug, but to work with medical professionals to design an individual best case.

Onnineko

Testosterone Causes Permanent Damage vs Estradiol

Doctors claim to adhere to the standard of do no harm, and by all observation of their adherence to administering testosterone in all patients with 47,XXY by default they have collectively lied to us.  Testosterone causes irreversible changes in human physiology regardless of the age of the person it is administered to.  One only need look at the results of a female to male transsexual transition to see the clear changes caused by Testosterone.


If a child takes estradiol at about age 12-16, and at any point switches to testosterone they will masculinize normally. The reverse is not true for testosterone. Taking testosterone as the first choice will make irreparable changes in the child's (or adult untreated XXY) physiology.

A person put on testosterone, whom doesn't want the masculine changes would consider the result to be permanent damage. Because it is, permanent damage.

Estradiol does not permanently damage the individual.

This should be pretty simple to understand. The doctors swear to do no harm, but testosterone is their first choice and it does harm by default. Some people are okay with the changes and all the rest of which the number is growing now that support communities are recognizing such people exist, those people are NOT OKAY with the permanent damage caused by testosterone.

47,XXY females documented by pubmed

http://www.ncbi.nlm.nih.gov/pubmed/15755052
http://www.ncbi.nlm.nih.gov/pubmed/1483688
http://www.ncbi.nlm.nih.gov/pubmed/19732585
http://www.ncbi.nlm.nih.gov/pubmed/21540567
http://www.ncbi.nlm.nih.gov/pubmed/20464469
http://www.ncbi.nlm.nih.gov/pubmed/11173857

It is astonishing to me that despite documented cases of women with 47,XXY the various institutions including groups in the USA continue to insist that 47,XXY must only be Klinefelter's Syndrome.  Dr. Klinefelter studied a gendered issue regarding males whom did not feel themselves to be sufficiently masculine.  It was found in the hodge podge of science which uses XXY people as test subjects mostly that there are people whom are assumed to be male whom have womens breasts, a more feminine features or the lack of masculine markers.

It was only recently that OII Australia asked a research group that had never before considered that XXY people could be female if they were only interested in XXY males.  The research group responded with this statement suggesting that XXY and Klinefelter's Syndrome be separated in the light that there are non-male XXY people.   Download 

With the advent of new DNA sequencing systems and the costs falling rapidly I expect we will find far more XXY females in this world than expected.  The lack of knowledge in this regard stems from the lack of genetic testing done on women, and a very narrow view promoted by medical science as an establishment.

Returning to the links posted at the top, as much so I don't lose them as anything else.  It is important to note that current thinking in the origin of the X's from parents has a great deal to do with the gendered identity of the XXY person.  Not to mention the degree of effect of the chromosomes upon the physical appearance of the individual.  This is a rather fascinating topic, right at the cutting edge of medical science.

OII responds to the DSM-V-TR and Diversion into managing hormone levels

The fundamental problem for XXY people attaining medical treatment, especially with the new draft of the DSM-V-TR that was released by the American Psychological Association has been addressed by a document prepared by OII Australia et al see here OII Australia Comment on the DSM5 and SOC7 .

And I support OII in this endeavor, to change the language of the DSM V such that intersex people like all XXY persons have access without the transsexualism mandate and gatekeeper system that exists for people whom are on a different path in their life.  Transsexualism is a journey with an ending for certain people, Intersexualism however is a lifetime challenge for each and every person so affected.

My life is an example of the hell intersex people must deal with when working with medical professionals who cannot think outside the binary, hello, I am not male and not female and ... and I just want to be a normal person like everyone else.  I am not a transsexual, I personally identify as not male, which causes as I have written else where numerous issues with social interaction and expectations.  As an XXY non-male person I use estradiol... and thats all.  It s notable in the world of XXY people that I am fortunate enough to have stood up to medical professionals and insisted on using estradiol.  Found that was all I needed, and haven't looked back since. 

The post below is a comment on a closed forum, in response to a couple of questions about testosterone and estradiol supplementation for individuals XXY.  Although certain closed minded people at the American Psychological Association, whom happen to be involved in the re-writing and pathologizing of intersex people in the DSM-V-TR, there is hope that researchers have begun to recognize that not all XXY people are male.  That XXY and other intersex people are not transsexuals.  And that XXY and all intersex people need normal access to medical treatment which does not assume a sexual binary of male/female; But allows access to male and female, and recognizes the terms Both and Neither also.

--

Yes, precisely. Taking aromatase blockers is the same thing as an estrogen blocker for men, we however we want to be male are not 46,XY. Once a person recognizes what they are not, and begins working towards what they want to be all of this makes more sense. If he needs testosterone to achieve his goal then he needs testosterone. Pushing his testosterone level up even slightly will overcome any amount of estrogens.

Second thought for you, don't bother with non-hormone based supplements, use medically prescribed hormone treatments or nothing. Supplements are meant for normal healthy people who want a little pick me up feeling or placebo; Placebo is a substitute that mimics the act of receiving support and gives the same feel good feeling of achievement, power of the mind and all of that which helps us not at all.

Let me give you a simple example of taking a hormone from the perspective of biology. An average person whom identifies as male, approximately 6 quarts of blood, which when you are measured for testosterone or more specifically %Free Testosterone provides a measurement how much excess testosterone your system is not using right now. Think of the %Free Testosterone as a way of measuring if you need more or less, when is high you could have less, when its low you probably need more. To clarify this we test Luteinizing Hormone (LH) which is the precursor for the testosterone production system of the body and brain. LH goes up when the brain wants more testosterone and down otherwise.
So..
%Free Testosterone low, LH high = Need more testosterone.
%Free Testosterone low, LH low = probably okay.. how does the patient feel?
%Free Testosterone high, LH low = no need for testosterone.
%Free Testosterone high, LH high = Problem! See a Doctor.
Simple right? Well yes and no. First of all, there are a number of issues surrounding testosterone which cause further issues for the patient. One of those is that the patient's natural production of testosterone will be destroyed by taking testosterone, Doctors will not tell you this. Another is that to manage the side effects of testosterone at higher levels than your body is prepared for, you may need additional drugs to counter those side effects.

Anyway don't let me turn you away from testosterone, heck, male and wants to be male, you need testosterone to do it. Just take that conversation back to the main boards where we are not discussing estrogens. Thanks, Onni.

______ Warning: Estrogen discussion continues!

For those who are curious here is how estrogens work for people who identify as not male or female. Women and men (shock!) have about the same amount of blood or roughly 6 quarts. This is important because when you do blood tests for aggregate levels of various hormones it is a percentage of body mass as an expression of the blood quantity, ie. in estimating how much of a drug you need the mass matters. Those using estrogen care about more than just testosterone and should be looking at estradiol, estrone, LH, and testosterone at the minimum. The estrone-estradiol axis is of particular importance in certain cases which I'm not going to go into here.

So..
Estradiol what is high or low? Thats where we have to start because the natal female varies by 300 or more pg/ml on a scale of 30-400 pg/ml a month. Older women who are not on a cycle tend to hover about 35 pg/ml on that same scale. Those lovely words.. in my experience .. a XXY person should be using the baseline estradiol level of about (and it varies by person!) 120 pg/ml (0-400 pg/ml scale), testosterone level less than 50 ng/dl (0-1000 ng/dl scale), Luteinizing hormone level under 6 (0-70 scale).

At or below these levels the target is that the individual will meet the minimum requirements of estradiol to lower their LH levels into the normal range and therefore reduce the release of cortisol and other stress causers. The individual will not experience feminizing effects, excepting only that they will not experience age appropriate masculinizing effects of testosterone either. This type of treatment will balance the body and brain's inherent need for balanced hormones. Some variance in levels is expected for each individual, unlike 46,XX females and 46,XY males there is as yet very little actual medical knowledge about 47,XXY people.

Estradiol target is 120 pg/ml or 120/400 30% of the scale.

How you wonder do we intepret estradiol levels... well its more complex than testosterone. The most basic case is estradiol (under 30%) and LH is high, needs more estradiol. All of the other cases, because of how we measure by percentage of blood (ie free and roaming vs used) are actually meant to measure other things related to significant major problems. Because of that they read more like this:
Estradiol high (over 30%), LH low = testosterone low and FSH high = Contact medical center for full blood work up and metabolic panels.
etc...
This is not because there is something wrong but rather because the estradiol system is way more complex than testosterone, and all of the tests surrounding it are designed for significant issues. Think of estradiol as the hormone that drives (in conjunction with many others) the body and brain and every single cell included. Testosterone works by supplementing estradiol at certain specific tasks, as do a number of other hormones. So you do really need someone who knows how the whole system works to manage estradiol, typically the endocrinologist. However, what I have just written here is out on the bleeding edge of medical knowledge, and most endocrinologists are decades behind. Good luck with that.