Hi, I'm so very lost...

[TriciaM]

Hi all,

I'm hoping to learn more about myself and about you.

For a long time I identified as MtF. Actually it never felt right, and I don't relate at all to tgirls, but it seemed like what I was. I'm in a good job/money position and had been working towards transition. Heck, there's even a picture of me on the Human Rights Campaign blog about my work towards inclusive ENDA.

My mind has been a lot clearer since accepting that I'm not what I was brought up to be. One night I'm in bed half asleep and remembered something... I remembered asking my mother what's up with the scar between my legs and her telling me that all boys had that.

I nearly jumped out of bed! I stuck my hand down my pants and sure enough, a big scar where something else should be. I guess I was told so many times that it was normal that I had been programmed not to think about it. I even remember one time that my mother randomly told me that it was quite normal to have chromosomes opposite of your actual sex. I don't know why really, unless it was more programming for me to accept XX back from a test if it ever came up.

I started reading about intersex conditions and it looks like I fit the bill for CAH. Actually I was trying to get a referral from insurance to a dermatologist for cortisol deficiency. Guess I won't be doing that anymore.

So where do I go? I need screening of some sort. I don't even know the type of doctor to ask for.

Thanks for dealing with my rambling.

[spacegirl]

Dear Tricia;
It does sound like you are lost. Maybe sometimes lost people can get a true diagnosis. But you being a mtf puts you behind the 8-ball. Even the doctors who might otherwise be half-inclined to tell you the truth will be a lot more reluctant to do so. Most every doctor would rather that you be a crazy tranny than a somewhat legitimate detransitioning intersexed. And you shouldn't expect anything but scorn from both the TS and IS establishments. -- While on the other hand, ftms are called "brave" and "heroic", especially if they claim an intersexed condition, probably due to sexist double standards.

What I mean to say is that if you are lost, you might just settle for the bs answers you're likely to start out getting. You probably need acquire enough personal momentum to help you keep the faith. There are little things you can check for yourself, and minor things you could probably get your doctors to agree to without signalling your intentions.
.
One question first, if you are a mtf you might possibly be taking anti-androgens. But is that anti-androgen aldactone/spironolactone? Because that one plays tricks with your cortisol and aldosterone levels.

[TriciaM]

No, I'm not on HRT. I was planning to get that taken care of after I get back from holiday vacation, but now I'm not sure what I'll be talking to the doctor about.

[spacegirl]

Well if you haven't yet started on hrt, and if your doctor has no reason to suspect your intentions, now would be the best time to start investigating intersexed possibilities. Once you say anything about "gender" or start hrt, you're caught in a medical catch-22.

Now, if you think you might be XX and born with cah, there are a few simple tests to maybe rule that out. One would be sperm levels. If you have any sperm at all, then you have a Y chromosome. If you've ever fathered any children, that answers that. If you haven't, then getting your doctor to order a sperm count shouldn't be too hard. It's their sworn duty to keep men fertile. Anything above zero means there's a Y.

Now if you get a sperm count done, an apparent "zero" doesn't automatically mean XX, but it increases your chances a lot. There are a few conditions like 47xxy and partial ais which result in having immature sperm that seldom leave the testes.

Another quick test that doctors like doing is feeling for prostates. Even in a natural prader-5 cah XX-male individual with some prostate development, that prostate literally can't be felt by a rectal exam, due to the vaginal canal in the way.

If you do have a zero sperm count, your doctor would probably authorize a karotype test (x/y chromosome test). You should insist on a mouth swab, not on a blood test. There are too many ways for blood tests to be wrong.

If you still suspect cah, the quickest (but not safest) way to test that theory is with some hydrocortisone. One of the other members here has mentioned that you don't need a prescription for hydrocortisone cream. A 1-ounce tube of 1% cream would have 284mg of hydrocortisone in it. If you divvy it up so you're dosing yourself at 10mg 2x per day, that would be enough of a dose to see if it effects you. But only try that for a day or two, at most. And put your local emergency room on speed-dial, just in case.

If you don't have cah, it shouldn't be enough or long-enough to make you dependent, and it won't have any effect on your testosterone levels, because men's testosterone comes from their testes not their adrenals. If it lowers your testosterone, then there's a good chance of you having cah. But either way don't continue with it, wait for further investigation from your doctors. If you have cah, then even hydrocortisone cream could make you dependent.

There's also a fun and easy test you can try. Feel the back of your head near where your spinal column enters your skull. Males of every variety, even pre-pubescent children, have a sort of bony shield protecting it. But women and even xx-cah males don't. I don't know if there have been any large-scale clinical studies of this though :)

[TriciaM]

Wow, thank you! This is an amazing amount of information! Let me see how much I can answer...

Sperm count: I didn't think of that. There's a Planned Parenthood a block from my office that I can just drop in and get that done and have it not look funny on a medical record.

Hydrocortisone: I don't know how many tubes of that stuff I have. I use it to control rashes. I was going to try to get into the dermatologist to see if I should go with injectable or something because the creme isn't enough anymore. I feel a bit uneasy applying it to an extreme like that though without supervision.

Bony thing: I had to look it up. No, I don't have that.

So why is it such a big deal to get karotyped? It seems like it would just be regular lab work.

[The Female Eunuch]

Spacegirl wrote: There's also a fun and easy test you can try. Feel the back of your head near where your spinal column enters your skull. Males of every variety, even pre-pubescent children, have a sort of bony shield protecting it. But women and even xx-cah males don't. I don't know if there have been any large-scale clinical studies of this though

Interesting test. I felt for it on the back of my head and couldn't find it - I expected I would have it because I'm XY. But maybe the description just isn't clear enouigh for me to know what I'm looking for?

cheers,
Caroline

[spacegirl]

Spacegirl wrote:

Interesting test. I felt for it on the back of my head and couldn't find it - I expected I would have it because I'm XY. But maybe the description just isn't clear enouigh for me to know what I'm looking for?

cheers,
Caroline

According to a textbook I read on identifying skeletons intended for coroners and archeologists, that was considered a strong piece of evidence for determining sex. They showed skulls to illustrate. But maybe not conclusive evidence? I don't know. I only said it was a fun test :) It's more scientific than measuring the lengths of your fingers.

The angle of the sub-pubic bones in the pelvis was a stronger piece of evidence, but that one would require a ct or mri scan.

addendum-
Doing an image search for male skull xrays to show you, I did find King Tut :) Maybe this gives an idea of what that coroner's textbook was trying to say.
http://www.yubm.org/Obit_19.htm
I'll keep trying to find more skull images :)

[spacegirl]

Wow, thank you! This is an amazing amount of information! Let me see how much I can answer...

Sperm count: I didn't think of that. There's a Planned Parenthood a block from my office that I can just drop in and get that done and have it not look funny on a medical record.

Sounds like a plan.


Hydrocortisone: I don't know how many tubes of that stuff I have. I use it to control rashes. I was going to try to get into the dermatologist to see if I should go with injectable or something because the creme isn't enough anymore. I feel a bit uneasy applying it to an extreme like that though without supervision.

10mg of hydrocortisone would only be one gram of creme or1/28'th of a tube. But it sounds like you've been using enough of it on such regular basis that you may have already developed a tolerance/dependency, if so then this wouldn't be an accurate test for you.


Bony thing: I had to look it up. No, I don't have that.

Neither do I, and I know what I am. But Caroline said she didn't have one. So maybe while it's considered evidence for sexing skeletons, it might not be conclusive evidence.


So why is it such a big deal to get karotyped? It seems like it would just be regular lab work.
Oh, no big deal to get karotyped. Just that blood dna has been proven to never be identical to the rest of the body's dna, and there's a lot of ways for it to be wrong. It would be better to save yourself the trouble that wrong blood dna would cause and just get the mouth swab in the first place.

[notodd]

I don't have it either, however, I would like to hear more on that. I wasn't aware that there were differences, other than the brow ridge and angle of the forehead.

In males, the brow ridge protrudes more and the angle of the forehead is more swept back. In females, the brow ridge doesn't really exsist, but the forehead goes straight up, then curves back at the top.

Why, I don't know.

Jon.

[miriam]

@<hidden>: Is it the external occipital protuberance (http://en.wikipedia.org/wiki/External_occipital_protuberance) you are talking about?

Also see: http://www.upstate.edu/cdb/grossanat/hnsklatob1.shtml

http://www.upstate.edu/cdb/grossanat/imgs/sklatob1.jpg

Or this:
http://www.dipaola.org/stanford/facial/class5notes.html

Male and Female Skull Differences - Note: Male/female differences not on midterm

Skull difference between Male and Female as indicated by their letter value on the figure- fig

A- The male cranial mass is more blocky and massive compared to the females which more rounder and tapers at the top.
B- The females Supraorbital margin is sharper while the males is rather round and dull.
C- The Zygomatic bone is more pronounced on the male skull.
D- The Mandible of a female is more rounded while the male's is squared.
E- Males have a deeper cranial mass
F- The supercilary arch is large and pronounced in the male.

I think you can't say someone is male or female by checking only one trait. Please don't forget these traits are use to describe males and females in general. In other words: individuals may or may not have the traits associated with the group they belong to.

Groeten, Miriam

[Aseras]

There's also a fun and easy test you can try. Feel the back of your head near where your spinal column enters your skull. Males of every variety, even pre-pubescent children, have a sort of bony shield protecting it. But women and even xx-cah males don't. I don't know if there have been any large-scale clinical studies of this though :)

I have that and my gf does too. Of course I also have a gynecoid pelvis much larger than my gf, my hips are 41" and my waist is only 27". Skeletal differences are only possibilities. It's not like Bones or CSI where they can tell for sure by looking at bones, only probabilities. I know plenty of women with android pelvis that are usually male.

I also have heard of the hand and finger size stuff. My index and ring fingers are the same size. My hands are slightly larger than my gf's and and sister and mom's. My fingers are the same size. Only my palms are slightly larger. I actually attribute this to my 4 years of testosterone making them bigger. Palms, feet and and digit girth as well as ears and noses grow throughout your life, their growth plates never really close. Same with the skull. If your hormones are messed up long enough things will change to match what is going on. I have the smallest nose out of anyone in my family. My sisters is twice as big. My chin is smaller too.

[spacegirl]

Groeten Miriam
Of course, the art of identifying skeletons probably wasn't created with consideration for the intersexed. If anyone was going to be an exception to a sexually dimporhic bone structure, we would be.

It would be interesting to know how intersex people of different kinds have their occipital protuberance. We could add to the science, then they might be able to know how many ancient intersexed people are buried in old tombs :)

Aseras; I don't know about your girlfriend, but haven't you been saying you are a chimera? If they haven't completely mapped your XX and XY areas, maybe you have XY head bones and XX pelvis bones? :)

But you also said you've had a pelvic mri, so now you can measure the angle of your sub-pubic arch, which is considered much stronger evidence than the width of hips.

Reading up on 2d:4d finger measurements, that seems like a sillier science than head bones. It's already been disproven by radiologists who used xrays to get the real finger measurements instead of just using apparent finger measurements from the outside. {mine are equal to within 1mm, and I got a lot of prenatal androgens :( }

Notodd; Hi Jon. It's all in fun, isn't it? :) I can't remember if you said you were xxy. But if you are maybe that's why you don't have that bony thing on the back of your head? Maybe this is an area where intersexed research could be conducted :)

I would have put more smiles in this post, but it wouldn't let me have more than 5.

[Aseras]

I really don't know. Genetics are just potentials, not absolutes. They just point the way. I don't really know a lot about my genetics and now I have very little faith in them.

My pelvic bones don't show up well in the mri, there's too much other stuff covering them. I'm actually really disappointed in the MRI. it was blurry, a few of the scans are so fuzzy they are completely unusable. The ones that did turn out well had slices take so widely apart it would be easy to miss things. I picked out a place that was expensive and had the best equipment I could find and basically either a bad tech, or poor calibration ruined a lot of it.

[notodd]

[QUOTE=spacegirl;22103]Notodd; Hi Jon. It's all in fun, isn't it? :) I can't remember if you said you were xxy. But if you are maybe that's why you don't have that bony thing on the back of your head? Maybe this is an area where intersexed research could be conducted :)
QUOTE]

Well, it's actually more interesting than you know.

Like Aseras, my hip measurement is 41" and when I was younger, my waist was 29", but I've filled out since then and is now 34". (Must do more exercise!) My chest is 34" and my bust is 37". For the moment I am keeping quiet about whether I am xxy or not, as I'm still waiting for conformation on that and my hormone levels. Hopefully, that information will arrive before Christmas and I can stop going slowly out of my mind!:confused2

(As I said before, I was seen by an endo and without any tests, he said 'Oh yes, Klinefelters! I don't see myself as Klinefelters, more xxy, as I don't consider myself totally male).

I am rather worried though, as I've read in these pages, that blood tests aren't the most accurate tests, but that is all that was offered.

One thing I would like though, is information. I still seem to be experiencing problems with extremely sensitive nipples. I use nipple cream, to stop them rubbing, but more and more frequently now. Hormone changes?

One quick thing though, why do xxy's have long arms? Are there differences in the upper and lower arms of xy's and xx's?

[spacegirl]

Notodd; Hi Jon. It's all in fun, isn't it? :) I can't remember if you said you were xxy. But if you are maybe that's why you don't have that bony thing on the back of your head? Maybe this is an area where intersexed research could be conducted :)


Well, it's actually more interesting than you know.

Like Aseras, my hip measurement is 41" and when I was younger, my waist was 29", but I've filled out since then and is now 34". (Must do more exercise!) My chest is 34" and my bust is 37". For the moment I am keeping quiet about whether I am xxy or not, as I'm still waiting for conformation on that and my hormone levels. Hopefully, that information will arrive before Christmas and I can stop going slowly out of my mind!:confused2
(As I said before, I was seen by an endo and without any tests, he said 'Oh yes, Klinefelters! I don't see myself as Klinefelters, more xxy, as I don't consider myself totally male).

A lot of people with klinefelter's say that too, about what they feel like. And most of them appear to be saying they hate the testosterone their doctors try to push on them. Just my opinion, I think that fate is offering you a choice, and there's nothing wrong in choosing to accept what nature is offering you. Your wife might have a different opinion though. But still, it seems like a lot of people have tales of how they were pressured into medical treatments they regretted later.


I am rather worried though, as I've read in these pages, that blood tests aren't the most accurate tests, but that is all that was offered.

Hopefully the finding out will be a good christmas present for you :)


One thing I would like though, is information. I still seem to be experiencing problems with extremely sensitive nipples. I use nipple cream, to stop them rubbing, but more and more frequently now. Hormone changes?

Yes, that is considered a beginning sign of hormonal changes, changes towards higher estrogen and further breast development.


One quick thing though, why do xxy's have long arms? Are there differences in the upper and lower arms of xy's and xx's?

I'm not sure, and an expert of 47xxy probably knows more about this than I do, but I think it's supposed to be that having less/no sex hormones when you're growing up means that your extremeties keep growing for longer than they would otherwise.

[Aseras]

Hi Tricia

Welcome. I'm sorry I haven't responded to you directly yet. I was reading the thread and got caught up :P

Scars can be from anything really. I would doubt that you would be a prader 5 and not have had serious health problems. I suppose it is possible. So many things here challenge normalcy and the impossible.

Your regular doctor would probably be your best bet. You could have a baseline hormone panel done, LH, FSH, E2 Estradiol and total testosterone. If anything comes off as odd there, you would know where to look.

Scar can be from anything. If your mom is anything like mine, good luck getting info out of her. My mom only lets things out by accident and has been way over protective of me my whole life.

I hope you find your answers and honestly you would be much happier just being a plain MTF TS trust me. Being intersex does not make anything easier as far as transition is concerned.

[TriciaM]

I've had time to think about it and you're right, it doesn't matter if I'm IS or TS or whatever the heck I am... at this point all roads lead to Rome. It's all the same HRT and legal name change and everything else that I already had planned out.

I'm not getting anything from my family. I know enough to figure out that I was normalized and that's really enough for me I think. I won't go into the rest of what I know. I'm still in the same spot.

OK I totally know what I wrote sounds like a total bummer, but I'm actually very happy lately. :lol:

Actually yesterday I got outed to my supervisor, who then called me in to her office. I was expecting a "so what exactly do you plan on doing in my office?" but instead got a "if people mess with you, I have zero tolerance." yay

[notodd]

Actually yesterday I got outed to my supervisor, who then called me in to her office. I was expecting a "so what exactly do you plan on doing in my office?" but instead got a "if people mess with you, I have zero tolerance." yay

GOOD FOR HER! Wouldn't life have been better, if more of our bosses had the same view point. From a personal perspective, I normally didn't say or do anything, as I've been treated before, like a plague carrier. She sounds wonderful. Very good luck to you.

[galens47]

You may be able to palpate for your ischial tuberosities (sits bones), measure the distance between them apex to apex, them measure the distance vertically from floor to pubic symphasis to triangulate the angle of degree of your sub-pubic arch. An MRI may be less invasive...

Plus this is a statistical variance between "male" and "female", it helps to identify skeletons, but is not very helpful for us fleshy folks.

Cheers,

G

[TriciaM]

GOOD FOR HER! Wouldn't life have been better, if more of our bosses had the same view point. From a personal perspective, I normally didn't say or do anything, as I've been treated before, like a plague carrier. She sounds wonderful. Very good luck to you.

Yeah that was some amazing luck. She said her son came out to her as being gay, so she got involved with PFLAG, eventually being the chapter president. She said that was about the time that PFLAG expanded to the parents to trans and intersexed kids so she was very well educated. She really just asked for my transition timeline.

Anyway, I'm off to San Francisco for about a week and a half where I'm going to be away from anyone I know and be myself for a bit!