Overview Clinical Symptoms & Characteristics

Today I visited my GP. She was quite receptive to my Dissociative Identity Disorder (DID) diagnosis, having experienced some of my other personalities before. She promised she'd arrange an appointment with a urologist and gynaecologist at the local hospital. I'll be called with the details later.

The below is the document I wrote to be sent to these physicians to help matters along:

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Facts

• Low testosterone level prior to beginning hormone therapy (~2 nmol/L; normal for men 7-20, for women <0.7). Using 25 mg Cyproteron a day for suppressing testosterone. With male to female transsexuals 100 mg/day is common.
• Feminine formed skeleton including pelvis and skull; no forehead ridge.
• Index and ring finger are equal in length. With men the latter is generally longer due to higher testosterone levels.
• No Adam's apple.
• Relatively minor facial hair, referred to by beauticians as 'severe fuzz'.
• Average female dress sizes and feminine build including muscles.
• No ovaries or womb. Confirmed through ultrasound at Twenteborg hospital, Almelo.
• Current chest size is 75A. Weight ~61 kg. Height 175 cm.

Speculative

• Present prostate is probably a female prostate: before hormone therapy ejaculation was possible, but was akin to female ejaculation, not male. Ejaculate has not been examined.
• After starting hormone therapy ejaculation no longer possible.
• Formation body and genitalia matching XX/XY hermaphroditism most closely. Examination of white bloodcells and cheek slime cells showed presence of XY in these cells.
• Externally the genitals seem male. Right testicle hasn't fully descended, sensations during stimulation do not match those of a male member.
• Experience of orgasm is indicated as being feminine.
• At location of vagina a kind of hole can be felt through the skin, which relaxes and contracts depending on the state of sexual excitement. This is also a very erogenic zone. Penetration of a few centimeters possible, limited by the flexibility of the skin.
• Presence of vagina/proto-vagina?
• Two German private clinics determine presence of blind/closed off vagina on MRI scan, in the Netherlands this interpretation isn't shared. The black tube which is visible is either ignored, or described as being air in/outside the rectum. This structure is identical on all three MRI scans.

Research questions

1. What is the structure underneath the skin at the location of a vagina?
2. XX/XY hermaphroditism or other kind of intersexuality?
3. Risks associated with the current physical state without any surgery?
4. Surgery options with regard to creating labia and/or extending the vagina in case it is present?

Practical

• Removal of testicles considering the lack of use for these, both before the hormone therapy as afterwards. Use of Cyproteron for testosterone suppression gives higher risk on thrombosis as side-effect, and also strains the liver.
• An exploratory surgery is possibly the most effective way to answer research question #1.

Maya