We have to consider that chromosomes after the fertilization of the sperm on the ovocyte, both inherit the same regions in homologous chromosomes, which means both have the same organization in each one. For sexual chromosomes, which are those ubicated in the 23 position, it can be inherited one from the male parent (Y), and one from the female parent (X).
The Y chromosome uses to be shorter than the X chromosome, for this reason, we can say that the patient from this karyotype is a female patient, because the two chromosomes are of the same size.