Non-Klinefelter XXY

47,XXY is a chromosomal arrangement where a person has 2 X chromosomes and 1 Y chromosome. The apparent majority of individuals with the XXY karyotype are males and some of those are considered to have Klinefelter syndrome. However other individuals use estrogen and identify as female (some are born with a female phenotype and with SRY negative 47,XXY) and some 47,XXYs choose to be androgynous, and/or use no hormone treatment. The choice of identification and hormonal or surgical treatments may follow gender identity counselling. It is not known what percentage of 47,XXYs identify as male, as female, or otherwise. These individuals identify as men, may take testosterone, and are, for all practical purposes, ordinary males. They may be challenged by development of breast tissue called gynecomastia for males and should learn to do breast self exams since they are at risk for breast cancer if they do not choose to have mastectomies. They may or may not consider themselves to have Klinefelter syndrome and may choose to go by XXY Males. Infertility can be a concern for this group.
Female
These individuals identify or choose to identify as women, take estradiol. Some of them can and have been documented as bearing children.
Non-binary
This group of XXY people often feel they are neither exact binary gender (associated with many possible non-binary or genderqueer identities, aside genderlessness, often described as agender), but usually pick one side of the binary of male or female gender as their main identity for presentation due to expected binary roles present in culture and society. They may take hormone supplementation in the form of estrogen or testosterone as needed to avoid issues with a variety of medical problems (such as osteoporosis), which can affect people with low base hormone. Non-binary XXY people do not have Klinefelter syndrome; possessing breasts is not always a challenge to their gender identity and they are comfortable with their female phenotype. Although, they should learn to do breast self exams since they might have a higher incidence of breast cancer.

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