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.

XXY: Quality of Life is lower on Androgens... no kidding really?

Quality of life is reduced in patients with Klinefelter syndrome on androgen replacement therapy.

de Ronde W, de Haan A, Drent ML.

Department of Endocrinology, Vrije Universiteit Medical Center, Amsterdam, The Netherlands. p.deronde@vumc.nl
Abstract

CONTEXT: Klinefelter syndrome (KS) is a genetic disorder, characterized by an XXY karyotype, hypergonadotrophic hypogonadism and infertility, which affects approximately 1 in 700 men. KS has also been associated with neuropsychological alterations. OBJECTIVE: To investigate whether quality of life (QoL) is reduced in patients with KS on androgen treatment. DESIGN: Observational study. METHODS: Questionnaires (RAND-36) were sent to 46 KS patients on androgen treatment who regularly visit the outpatient clinic of an academic medical centre. QoL scores were compared with a Dutch male reference group. RESULTS: Forty (87%) questionnaires were returned which were suitable for evaluation. KS patients had significantly lower (worse) scores on eight of the nine domains of the RAND questionnaire compared with the male reference group. In KS patients, higher education was associated with significantly better QoL scores. CONCLUSIONS: QoL is reduced in patients with KS on androgen treatment.

PMID: 19131504 [PubMed - indexed for MEDLINE]Free Article


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I read that article and said, "Yep that about sums it up." You can find the article on www.pubmed.gov. Amazing that they have finally published what we have known for years, well those of us willing to recognize the problems caused by Testosterone. Its not a panacea, no, Testosterone for people with Klinefelter's Syndrome is one foot in the grave, with the rest of you following in about 10-15 years (or less if you take alot of it).

So Dredger, what does this say about the ethics of giving Testosterone to a patient, is it better that they live first unhappy and then die more quickly? If you didn't know, Dredger is an Ethics specialist and a Eugenicist. We have to watch those doctors who profess to Eugenics very closely, because if you or I do not fit into their perfect world it is perfectly acceptable for them to kill us and still fit into their narrow field as "being Ethical". That is, Death is Ethical if the person who dies isn't considered human. Most of the time we would call such people fanatics, to wit, imagine they happen to be our medical professionals?

Are we safe? Hardly.

Onnineko

Self-Treatment and Secondary Hypogonadism

I was writing a letter to a friend, when for some reason this topic just leapt onto the page.

The worst part of self-treatment is that even with a mountain of medical documents, lab tests, doctor's opinions (signed and certified) all of the conjecture that we mere mortals can apply to the awesome field of medicine pertaining to ourselves is casually dismissed by every single Doctor we have to talk to. And do we get a fair hearing? Never. It takes upwards of 5 hours to go through the documentation and present all of the lab tests, the chronological order, the reasoning, the other doctors' opinions supporting the prognosis, and then yet one more Doctor will calmly admit, "Hey this is a really complex case." Like no shit, really? What usually happens is that the Doctor doesn't have those 5 hours, and it takes months (...years) for Doctor A to talk to Doctor B, C, D, E, F, G, and H in order to ascertain if I can be believed when I say this is a tad complex and I need more than 15 minutes of your time to discuss treatment options for secondary hypo-everything.

Basically, simplisticly, the human body is like a binary feedback system; It functions like a state machine or a computer, if you will. A computer has chips called ALU's which do simplistic mathematical functions like, voltage high + voltage high is 1+1... The body does this too, and one of those sub-components is the Hypothalamus (a tiny organ in the base of the brain, next to the Pituitary Gland. For example, when a individuals Testosterone level is high, the feedback circuit sends a positive signal to the hypothalamus which then stops pushing out pre-hormone signals to the Pituitary Gland for Luteinizing Hormone, a precursor for the production of Testosterone, to stop the Adrenal Glands or the male testes making more Testosterone. Which is all good and wonderful when it works properly.

In pursuit of my personal medical problems, I have had to work through the pathways of mostly non-standard practices to fit together some semblance of a plan. Most of the knowledge we and the Medical Establishment has at this time is sketchy at best. Really we know very little more today, than Doctor's knew 200 years ago about how the functioning of the human body really works. Just because the body has several mechanisms which act sort of like a state machine doesn't mean the results of the whole system are that simple. Mix into this mess, Klinefelter's Syndrome and its a real mess. Or perhaps I should say, add Secondary Hypogonadism to Klinefelter's Syndrome and its far more complex than just "unknown". Thats why they call Klinefelter's Syndrome a syndrome, we do not know what causes it; The same with Hypogonadism, we can only say, "Odd, it doesn't work right."

So thats where I am... a pituitary/hypothalamus gland that produces the same level of pre-cursor hormones all the time. When I physically push hard my levels of some hormones do not rise like a normal person's does, instead I fatigue quickly and take hours or days to recover what takes everyone else seconds or minutes.
(borrowed from: http://www.webmd.com/cancer/tc/ncicdr0000579645-general-information-about-pituitary-tumors, the information is still good, if not perfectly formatted for my issue, I'm sure there are better references)

Hormones made by the pituitary gland include:

• Prolactin: A hormone that causes a woman's breasts to make milk during and after pregnancy.
• Adrenocorticotropic hormone (ACTH): A hormone that causes the adrenal glands to make a hormone called cortisol. Cortisol helps control the use of sugar, protein, and fats in the body and helps the body deal with stress.
• Growth hormone: A hormone that helps control body growth and the use of sugar and fat in the body. Growth hormone is also called somatotropin.
• Thyroid-stimulating hormone: A hormone that causes the thyroid gland to make other hormones that control growth, body temperature, and heart rate. Thyroid-stimulating hormone is also called thyrotropin.
• Luteinizing hormone (LH) and follicle-stimulating hormone (FSH): Hormones that control the menstrual cycle in women and the making of sperm in men.

In the past I have used progesterone to attain some semblance of managed treatment (self-treating still) for the lack of effects of all of these hormone pre-cursors. Even though it is clear that having some, if not all, of these effects occur resulted in a healthier (we're not sure) and happier me. I cannot stress enough, that no where have I found documentation to suggest anyone else has ever tried to treat this problem, and certainly not with Klinefelter's Syndrome also. And I chose to use Estradiol as my sex-hormone of choice, since that aligns with my personal views more correctly than Testosterone does.

About a year ago, I stopped using progesterone to do some tests... and then forgot all about the tests, and the intersex community, and a number of other things. The lack of progesterone had a significant and clear impact on my ability to function intellectually, and still does. I'm trying to work through, it is painful and hard to remember enough to manage this, if I should beware or take progesterone again. I mean, I must have decided to stop progesterone for a good reason. And a few days ago I finally put the whole puzzle together again, no progesterone is an unhappy Onnineko. I had wanted Doctor's to do an ACTH test for the pituitary system for testing for possible complications of CAH, and the Doctor's then refused to do the test. And I forgot about a great deal of what was short term memory. Bastards! This is the best treatment I can buy, and its barely adequate for 2-3x the cost the average corporate American pays for health care. Have I ever mentioned how distasteful it is to work with the Eugenicists in the American Medical establishment? They take our money and then give nothing in return because its against their ethics to treat people who are considered less than perfectly normal. Grrr!

I self-treat, there are no choices it is self-treat or die of neglect.

What to do .. What to do .. The US medical establishment is hopeless and becoming less competent every year. Progesterone would and has in the past had a strong positive impact on my life. And despite the Doom and Gloom cast by the doctors, I'm still here. Quite possibly because I choose to self-treat. They (the Doctor's) have been counting down my end of life for decades, and they're still wrong. I have some questions, such as:

• Would attaining a diagnosis for Secondary Hypogonadism change anything in my ability to continue self-treatment?
• Would attaining a diagnosis for Secondary Hypogonadism change treatment, at all?
• What exactly am I trying to do with treatment? (live 1000 years of course. :)
• Everything I have points to using progesterone is a definite positive.
• So why am I waiting?
  

Another simplistic view is that Secondary Hypogonadism is like CAH, there are similarities because neither the person with CAH, nor the person with Secondary Hypogonadism is getting enough cortisol. At first I thought my case might have something to do with this, and I eventually found a Doctor willing to test and eliminate this possibility, not that I could get the Doctor to help in any other way! He was willing to listen though, and willing to do a few basic tests to rule out this quite obvious question. I, just like someone with CAH, do not get enough cortisol, however taking progesterone does appear to help correct this issue. We cannot say what the long term effects are though.

I'm still mostly an overweight 5'10" androgyne at 250lbs an apple of desire :)... losing weight would be nice, I'll guess my average weight is probably around 140-155 lbs. This isn't a good snapshot of who I am though. I work out, can do 30 pushups, more situps, and practice martial arts. I walk, running hasn't worked too well, but I can walk for hours and go miles. I live on a limited diet, and really wouldn't know what to do with 2000 calories its hard to eat so much. My weight is an extension of a medical condition, not my lifestyle.

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.