Community Conversation > Intersex talk

What an exam of ambiguous genitalia looks like

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jamie-lee:
Hi

I have written on Susan's very long ago. I can't remember what I last wrote, so I will introduce my situation once again. I'm a trans guy and I've been living as a guy now for over a year 100% and came out maaany years ago. I'm not undergoing medical transition (T, surgeries). However, I have some health problems and I get them treated by an endocrinologist. I needed to go to someone trans friendly, because I have high testosterone levels and I don't want to get them reduced and apparently it's a problem for "regular" doctors   ::) as well as my genitalia.

TW: genitalia
So I got progesterone for my health issues and I said to my doctor that it gives me erection problems and that it's easy to spot an erection, because my clit is large. Then she asked me if it's a clitoris at all given the size, so I said that yes, because I pee from a completely differrent place  - which is apparently weird too. Whem I came back home, I examined the Prader scale once again and well, when you take a more detailed picture, everything became clear. I mean, I never thought I have anything else than a lagre clit tbh and didn't think much about it, it looks a little weird, but it's still a vagina, it has all the necessery components so to say. But a more detailed picture of where the uretha is placed explained a lot, because just in general I have a difficulty finding what is where in my organs when I look at those anatomy drawings and photos from the internet. I wouldn't freak out, but it's not the first time that books are inaccurate. And I think it was Prader 2 that oddly looked exactly like my organs drop in drop. So I'm like... geez, it turns out that I have some... urogenital sinus or something and that this piece of skin isn't something people usually have, I thought it's a persistent hymen or something. The labia minora also don't look very much like labia either, but I always thought it's because my erectile tissue is pretty big and stiff, tbh average FtM genitalia on T look like mine, so I thought... it's just my T. Plus there is something that resembles a prostate and functions like one.

So tomorrow I have a gynecologist appointment and I don't really know what to expect from it. I'm gonna say that my endocrinologist wants an exam of the clitoris? Of course it's a reccomended gynecologist who treats trans dudes... I'm also not sure what to expect. I have been to an gynecologist before but not with this particular issue. Usually it was more like the doctor takes a look and then inserts her finger to find the uterus or says to spread wide and looks for it visially and does an ultrasound. I have never been asessed in terms of what is going on with my clitoris or whether I have a DSD or it's "just" PCOS.

What is more odd is that apparently my androgens are ovarian, but the genital stuff never happens in PCOS, but happens in CAH, but I have like zero CAH characteristic hormones. I also have no ovarian cysts, just the ovaries are slightly large, but just slightly, so I started to wonder what the actual hell is going on. I generally look quite masculine physically, in terms of a general impression. I'm tall and have wide shoulders, have visible musculature, that kind of thing. I know it doesn't happen, but what if I have testes cells? Because the ovaries behave a lot like testes for sure, but that can happen in a variant of PCOS. Anyway, I don't get where the T is coming from then, it's unsettling.

jamie-lee:
Okay so maybe I'll say what it looked like. Apart from a regular gynecological exam, the doctor looked at the clitoris. It was unpleasant, but not too much, I suspected it to be more painful or something. Nothing else, really.

Battle Goddess:
Sounds mostly uneventful, J-L. At my age, that always comes with great relief!

I always thought the adrenals also produced T. Has your endo ever said anything around that?

Haley Conner:
In college I had a girlfriend who was born with undescended testicles which were later removed, but it was some time before they realized they were even there.  She didn't have a large clitoris, but she was very strong for a woman.  She was a ballet dancer, so the extra muscle was kind of a bonus for her. 

jamie-lee:
Sooo... apparently my clitoris is normal (I still think it's above average though) and everything else apparently looks normal too.

Yes, CAH is an adrenal condition and I don't have even a trace of it. So as usual, nobody knows what the cause of this all is. Apparently there is also no trace of any PCOS traits in the ovaries.

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