Is this what YOU want?

Before you consider testosterone treatment, an operation to  remove gynaecomastia or invasive sperm retrieval, it is important that you think whether this is really what you want and not just what will make you fit in with the expectations of other people.

The society we live in is based on the notion that everyone is either male or female. It is the first question which is asked when a baby is born – is it a boy or a girl?

The answer is usually obvious. We look at the baby’s genitalia – if it has a penis it is a boy, if not, it is a girl.  Well, no, it isn’t always that simple. Sometimes the internal reproductive organs don’t match the external ones. For example, a child with a penis may  have ovaries. What is the answer then?

In the general population babies are sometimes born with ambiguous genitalia. For example, it may be difficult to tell if the baby has an enlarged clitoris or a small penis. What is the answer then?

The answer is that not everyone fits this rigid stereotype, some can’t be classified and many don’t want to be. There is now a growing awareness, in society as a whole, that gender identity isn’t two fixed points but, instead, is a spectrum – some males are more ‘male’ than others and some females are more ‘male’ than others. Most people’s gender matches their sex, but for some the two don’t agree. Some people are very clear as to what gender they are, others less so. Some may feel ‘gender fluid’.

Only you know whether you feel male, female, neither or both regardless of how you appear to others. This applies to people who are XXY and to those who aren’t too. Most are male, a few are female and others are neither – or both.
It is perhaps a little more complicated for XXY folk because, although most XXY babies appear to be male, their chromosome pattern (47, XXY)  isn’t male (46,XY) or female (46, XX).  KS is classified as a Disorder of Sexual Development (DSD) which is the new nomenclature for  intersex. The KSA prefers the usage Variation of Sex Characteristics (VSC).

After puberty you may have developed some female characteristics such as breast formation and a lack of body hair. This may make you feel very unhappy or it may not bother you. You may want to have an operation to remove any breast tissue to  appear more ‘male’ – or you may not be concerned. You may really want to have testosterone treatment – or you may not be sure.

The important thing to remember is that, ultimately, only you, the KS/XXY person  can make these decisions. It has to be your decision as to whether or not you want treatments or procedures which aren’t medically required, but which may help you to conform or feel better about yourself. Only you know how you feel and what is right for you. 

Hormone treatment doesn’t just alter the body. It also has an effect on personality and identity. Testosterone will cause you to develop ‘male’ characteristics such as facial hair, increased assertiveness and higher libido – which is great if you want to be more ‘male’. However, it may not be helpful if you are happy the way they are, valuing your differences or if you wish to be more ‘female’.

These treatments can be life changing and you should think about what you want before you make a decision. It is important to realise that, although  testosterone replacement may suit many, it isn’t the best option for everyone. There is no ‘correct’ decision – it is down to the individual and you should make the decision yourself without others trying to persuade you. If you are unsure, some level of gender assessment or counselling may be useful. Gender is different from sexual orientation or sex. People with KS/XXY have intersex bodies, but may be male, female, neither or both and their sexual orientation may be straight, gay or both– just like anyone else. There is no research to indicate that being XXY increases the incidence of being gay and there is only anecdotal evidence to suggest that the incidence of gender fluidness may be higher in the XXY community.