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It's what you want that matters.

Before you decide that you want testosterone treatment, an operation to  remove gynaecomastia or any other surgical procedure which isn’t essential, it is important that you read this.

Is the baby a boy or a girl?

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.

The gender rainbow

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’.


This applies to XXY people 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 Difference in Sexual Development (DSD) which is the new nomenclature for  intersex. The KSA prefers the usage Variation of Sex Characteristics (VSC).

Only the individual knows whether they feel male, female, neither or both regardless of how they appear to others. 

KS/XXY bodies

After puberty XXY children may develop some female characteristics such as breast formation and a lack of body hair. Some youngsters may be very unhappy if they appear less male than their peers, others may not. Some may want to have an operation to remove any breast tissue to make them appear more ‘male’ – others may not be concerned. Some may really want to have testosterone treatment – others may not.

Hormone treatment

Hormone treatment doesn’t just alter the body. It also has an effect on personality and identity. Testosterone will increase ‘male’ characteristics such as facial hair,  assertiveness and libido.

This is fine for someone who wants to be more ‘male’ but may not be helpful for someone who is happy the way they are, who values their differences and who doesn’t want to be changed. There are still others who wish to be more ‘female’.

Do all KS/XXYs have testosterone treatment?

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 who must be allowed to make the decision free of external pressure. Some level of gender assessment or counselling may be useful.

The important thing to remember is that, ultimately, only  you can make these decisions about your body.

It has to be your decision as to whether or not you want treatments or procedures which may help you to conform or feel better about yourself.

You are the only one who knows how you feel.

No-one should expect you to make decisions about your body until you are ready.

Your parents/carers and other adults should support you whatever your choice.

These treatments are life changing and these decisions should not be made until you are ready  to make them. 

Gender and sexual orientation

Gender is different from sexual orientation or sex. Those 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.


This is a sensitive and complex area. You might need support  from counselling or psychological services. Your medical professionals should arrange this.