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Denial of Health
intersexblogger
DENIAL OF HEALTH:
On 10 December 1948, the Universal Declaration was adopted by the General Assembly by a vote of 48 in favor, none against, and eight abstentions.

Denmark was one of the countries who voted in favor of the declaration.

ARTICLE 25:
Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.

This means that healthcare(medical care) is a human right.

and according to Article 30:
Nothing in this Declaration may be interpreted as implying for any State, group or person any right to engage in any activity or to perform any act aimed at the destruction of any of the rights and freedoms set forth herein.

Which means that no person, state or group, is in a position where they have the right to deny anyone the medical care they need.

ABOUT ME:
I am born with 47, XXY Kariotype, and my body developed a female phenotype, which I identity with.

According to the danish healthcare system, all people born with 47, XXY kariotype, are male and has Klinefelter's syndrome.
https://www.sundhed.dk/borger/sygdomme-a-aa/boern/sygdomme/arvelige-og-medfoedte-tilstande/klinefelters-syndrom/

INTERNATIONAL RESEARCH:
In our experience, both in research and in clinical practice, the two terms – KS and XXY – are almost always used interchangeably. Yet, the study inquiries that we received highlighted an interesting issue:

Should there be a distinction between XXY and KS?

Males diagnosed with KS will generally have an XXY karyotype, or variation
thereof. However, perhaps not everyone with a XXY karyotype should be diagnosed with KS.

KS defines characteristics that are only unusual if found in a male. Common
symptoms, such as low testosterone and breast development, are not unexpected features (or symptoms) if identified in a female.

Therefore, for an individual with an XXY karyotype who does not identify as male, KS may not be a suitable diagnosis.
http://www.genetic.org/Portals/0/Public/Library/~%20KS%20Gender%20considerations%20XXY%20Herlihy.pdf

Okay, so maybe you have to identify as male, to have klinefelter's syndrome and maybe, just maybe not all people with 47, XXY kariotype is male... let's see what else we have to support that claim.

This article describes an SRY-Negative 47, XXY female, who has one son and two daughters, one of the daughters is also 47, XXY.
http://www.ncbi.nlm.nih.gov/pubmed/11173857

Now i'll stop bothering you with international research, as
1: I think I made my point and
2: we have our very own experts here in Denmark on 47, XXY (and 45, X0)

CLAUS GRAVHOLT:
"The genetic background of KS is the presence of extra X chromosome(s), with 80% of affected individuals having the 47,XXY karyotype."

Okay, so almost all people diagnosed with klinefelter's syndrome has 47, XXY kariotype, got ya.

"The hormonal consequences of the Klinefelter karyotype is development of hypergonadotropic hypogonadism with decreased levels of androgens causing a feedback-mediated increased pituitary secretion of follicle stimulating hormone (FSH) and luteinizing hormone causing a relative increase in estrogen levels, resulting in an elevated estrogen to androgen ratio."

okay, so decreased level of male sex hormones being produced, an increased level of some hormones i haven't read up on(note to self: read up on FSH and Luteinizing Hormone) which causes an increase in estrogen. Making estrogen production higher than usual.

hm, I wonder what can happen when the brain is influenced by elevated levels of estrogen?

"The full effect of the apparent hypogonadal intrauterine milieu present in KS is not as yet understood but could very well also be exerting a negative influence, especially on neurocognition and “masculinization” of the brain."

Okay, so the effect of the low level of testosterone in a fetus(intrauterine: in the uterus) with 47, XXY kariotype is not understood, but could have a negative effect on the brains ability to work properly and on the masculinization of the brain.

I wonder what would count as a negative effect on masculinization of the brain, in a fetus that is seen as male?
http://www.hormones.gr/8592/article/klinefelter-syndrome-and-medical-treatment:-hypogonadism%E2%80%A6.html

But what happens if the brain is masculinized:
YouTube Video


So, if a childs brain is masculinized or for that matter feminized or something else(I am not able to say if a brain is able to be inbetween mascilinization or fiminization), the child will have it's own biase towards a gender identity.

Good to know.

But what are the recommendation for treatment of a person with 47, XXY?

What does the good doctor Gravholt say about treatment:
"Long-term male hypogonadism comprises a significant health risk by introducing a vicious circle of insulin resistance and obesity further worsening the hypogonadism and, along the way, leading to comorbidities, including loss of muscle and bone mass, the metabolic syndrome and type 2 diabetes which again entails further comorbidity as, for instance, heightened blood pressure and cardiovascular disease but also a markedly decreased quality of life."

"Thus, in most cases of KS testosterone treatment is recommended according to current guidelines on androgen deficiency to prevent this vicious circle from either occurring or running out of control."

"Testosterone treatment in non-Klinefelter hypogonadal males has been used for more than 70 years and has proved beneficial regarding obesity, blood pressure, glycemic control, bone mineral density, muscle mass and overall mortality as well as quality of life."

"new studies with treatment early in life have shown promising results in improving behavior and neurodevelopment and could thus have an overall positive effect on social integration."
http://www.hormones.gr/8592/article/klinefelter-syndrome-and-medical-treatment:-hypogonadism%E2%80%A6.html

I wonder what the possitive effects on social integration, behavior and quality of life, would be for a 47, XXY individual, with a feminized brain, who identifies as female or any other person who desn't identify as male or who doesn't wish to have their body masculinized any further?

I also wonder why the good doctor Gravholt, doesn't say anything about possitive effects on estrogen treatment, of people with 47, XXY kariotype.

But I will be looking forward to seeing his research on the subject, as soon as he catches up with the research performed by scientist from the rest of the world, who already for years, have recognized the existence of women with 47, XXY.

He is the expert after all, so it must be in his own interest to be up to date.

FURTHER COMMENTS:
it seems that if a person with 47, XXY kariotype, male, female or otherwise, doesn't produce an adequate amount of hormones themselves, they are at an increased risk of a lot of nasty sicknesses(not saying that every person with 47, XXY kariotype has this issue, but i do) and therefore the best thing to do would be to give them hormone treatment as soon as possible.

The normal thing to do, according to Claus Gravholt, the expert in the field in Denmark, is to give testosteron treatment in "most" cases.

I wonder if a case where a person with 47, XXY kariotype, who doesn't identify as male, would be a subject for treatment with some other sex hormone than testosteron?

Unfortunently that remains to be seen, as when I was under the care of the dear doctor, he only offered me testosteron treatment and told me that if i wanted treatment with estrogen I had to get the diagnosis of transsexualism, under the WHO, ICD-10.

Side Note: Which is seen as a psychiatric illness under national healthcare in Denmark, which has a myriad of other issues pertaining to human rights issues.
https://amnesty.dk/emner/lighed/transrettigheder/brevmodul-transrettigheder

Further more he offered to have my breast removed.

BUT WHAT DOES IT MEAN:
This means that to acquire a standard of living adequate to the health and well-being of myself(article 25 of the universal desclaration of human right), I have to prospone the health part of that equation until the national health department, decides that I am transsexual, through a process of inhuman, degrading and pathologizing treatment, that may take 2 or more years to go through, until i can get access to the hormones I need to acquire an adequate standard of well-being.

Should I be in need of any further treatment in relation to having male characteristic, while not identifying as male, it may take even longer. Mind you breast removal, i can get without having to get a psychiatric diagnosis.

This leaves me at a state where i either have to take testosteron treatment, which masculinizes my body, to help with the health of my body, which severly messes with my well-being or to wait for a very long time, to get treatment that helps with both my health and well-being.

On top of this, if the national healthcare system decides that i can't be diagnosed as transsexual, I won't have anywhere to turn to within the national healthcare system, to acquire an adequate standard of health, except for treatment with testosteron, which in my case would be ill treatment.
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All I know, is that I know nothing - Sokrates
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