It's a personal mash-up of the Agender, Intersex and Transgender symbols, and a little bit of inspiration from dog desexing tattoos. I'd been questioning since late puberty if I might be Intersex, I never grew an Adam's apple and hardly any body hair despite family genetics. I came out as trans femme non-binary in my early 20s, but it wasn't until the third doctor I saw for hormones that questioned if I might have an intersex condition. The first doctor I saw never questioned that my T was well below the male range because I wanted to start HRT anyway. But he also still put me on T-blockers which have some awful side-effects, including dropping my T to completely zero. Thankfully I'm off those these days and estrogen alone keeps my T where it needs to be.