The below is the document I wrote to be sent to these physicians to help matters along:
- 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.
- 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.
- What is the structure underneath the skin at the location of a vagina?
- XX/XY hermaphroditism or other kind of intersexuality?
- Risks associated with the current physical state without any surgery?
- Surgery options with regard to creating labia and/or extending the vagina in case it is present?
- 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.