Like to have SRS before I start openly transitioning

[Paige]

Hi All,

So this has been bugging me for a while now.  I'm under the impression that it's much easier to get a orchiectomy than SRS.  Am I right about this?

It just seems that the two procedure both make a permanent change to your body that can't be undone.  Both make you sterile and stop T production.  Is it because of safety concerns and the fact that it's more invasive that SRS is much harder to get past the gatekeepers.

Here's the thing, I would prefer to get SRS at the start of my transition.  I guess I could get an orchi but it could affect my SRS. 

It just seems like SRS at the beginning is a more logical approach to the whole transition.   If I could seriously change my body at any time with an orchiectomy why shouldn't I be able to also have an SRS whenever I want?

Anyway, just curious what everyone thinks.
Thanks,
Paige

[Kassie]

Could not agree with you more you would think SRS would be the same as getting your testicles removed and should be just as easy the only thing I can think of is SRS has more complications and harder if not impossible to undo

[Myarkstir]

The one thing to consider is that if you get orchiectomy, most gcs surgeons will not give you gcs with depth. You will have to get the colon version. Brassard will only give you a no depth vj for example. So it is important to make your choice carefully.

[Jenna Marie]

It's *easier* to get an orchi, but I don't think it's so easy that it could be done pre-transition. (Unfortunately. My views, as I've stated elsewhere, are that trans people should have the same right as cis people to get "cosmetic" surgery done, even if sometimes it might be a mistake.)

Myarkstir : My understanding about Brassard from when I was there in 2012 is that he will in fact do full-depth GRS, but the orchi has to be done with that in mind, meaning the orchi surgeon tried to minimize scarring and arrange for the best scar placement. At least one woman I was there with had had an orchi about 10 years before, and had no trouble; she wasn't even the one who needed the thigh skin graft to increase depth. In general, I think that if GRS is likely to be desired later on,  it's wise to contact one's preferred GRS surgeon and get their opinion/requirements before doing an orchi.

[Monkeymel]

Orchiectomy does not physically alter your appearence or functional anatomy. Yes the testicles are gone but men with testicular cancer do not feel the need to transition. Erections are still possible and the normal process of orgasm remains the same.

SRS / GRS / GCS physically alters your functional anatomy. permanently. There is no going back and there are people who regret this process on this forum. There has been discussions about the need for one year RLE before surgery. For a real minority non-RLE may be their only path. But for the vast majority the gates are placed there for a reason. The first weeks are full of elation - but the mundane realization of daily dilation (upto 2-3 hours a day depending upon technique), risks of infection etc quickly eat into that. And can very quickly lead to depression.

Unless you are 150% sure of your path and have no other comorbidalities (other issues) then it can be done within a year of starting RLE. But it really is not a decision to be taken lightly as a "quick fix".

[Myarkstir]

It's *easier* to get an orchi, but I don't think it's so easy that it could be done pre-transition. (Unfortunately. My views, as I've stated elsewhere, are that trans people should have the same right as cis people to get "cosmetic" surgery done, even if sometimes it might be a mistake.)

Myarkstir : My understanding about Brassard from when I was there in 2012 is that he will in fact do full-depth GRS, but the orchi has to be done with that in mind, meaning the orchi surgeon tried to minimize scarring and arrange for the best scar placement. At least one woman I was there with had had an orchi about 10 years before, and had no trouble; she wasn't even the one who needed the thigh skin graft to increase depth. In general, I think that if GRS is likely to be desired later on,  it's wise to contact one's preferred GRS surgeon and get their opinion/requirements before doing an orchi.

My confirmation papers clearly state orchi = no depth only

[Jenna Marie]

Myarkstir : That's interesting. I wonder why he changed it? My own confirmation papers didn't say that, but it *was* 2 years ago...

If you're going to Brassard, I will warn you that like 2/3 of the informational packet is not accurate. I got there and they already had underpants/pads/etc. and the soap instructions weren't necessary either, and so on. I think they've been using the same forms for years and years without updating them!

[Myarkstir]

No worries for me Izzy lives 30 minutes from here and is helping me/mentoring me lol. Also Brassard made several changes in the last 2 years. For example I asked about there voice operation dr Belanger straight out tild me they had too many failures with it so now they require 1 year of orthophonist followup before they will do it. They could have just taken my money and say nothing but they didn't

[Jenna Marie]

Myarkstir : Wow! And yeah, good for them.

I wonder if they had similar poor outcomes with post-orchi patients, then. (I have no idea how my surgery companion fared either after she left the residence, to be honest.) Well, it's important to get the word out about him, you're right.

[Carrie Liz]

So, at the beginning of transition I was one of the people who was all gung-ho about SRS and insistent that the 1 year of RLE shouldn't be necessary. I wanted the surgery really badly, to the point that it was making me cry, and I hated that I had to wait in order to get it.

Well... I'm glad that I waited. Because I honestly don't think I would have been mentally ready for it at the time. I know for me, and probably for a lot of people in that similar situation, we look at SRS as this sort of ultimate confirming thing that would validate our womanhood, and imagine that somehow we'd be more comfortable presenting as female in public if we had the proper anatomy.

Well, as it turns out, I really needed to go full-time before I could have made an informed decision. Because going full-time was what I really needed to validate my femaleness, not a surgery that's almost completely just a cosmetic procedure for the comfort of the subject that has NO effect whatsoever on your social life. It changes nothing about how you look. (Like, seriously, how many people see you naked in your entire adult lifetime? Like 5? 6 maybe?)

What I'm saying is that to me surgery was the biggest deal in the world pre-transition, but it's because I wasn't full-time, and I was looking for some sort of grand feminizing confirmation that would solidify my place in the world as a woman. And I believe that there are many others out there just like me.

It's VERY hard to tell what you really are going to be comfortable with early in transition, because it's a period of such rapid change, and so many hypotheticals floating around. Having gone to support groups for quite a while, I've noticed that just about everyone goes through a "confirmation" phase where they're basically doing everything they can to assert their femaleness and feel validated after a lifetime of being forced to suppress it. And I've met a LOT of people were completely transfixed on SRS early in transition who later decided that they didn't even want it once they'd been full-time for the required year. (I do still kind of want it, but it's no longer an "OMG I HAVE to have it!"

IMO, you really need to be full-time in your new gender role for a while, and settle in, and get past that "confirmation" phase and into the phase where being female is just a mundane part of your life that you don't even think about anymore, before you can really work out your thoughts on the matter.

I'm not saying that nobody should get it early, because some people really are that certain about it, I'm just saying that for many they really do need the RLE first.

[mrs izzy]

I just wonder the same Jenna with if the skin grafts on post orchi patients has caused less then successful results and now made it a requirement for no GCS?

As for GCS before transition. Talking about setting yourself up for a very rude awaking.

It's no picnic, it is a whole year of your life dedicated to your Vajayjay.

So many with in realistic expectations.

Transition sorry to say was the hardest thing I ever did in my life, to live my life as female.

Still shaking my head. Sigh!!!

[dkl]

What Carrie Liz said.

I never thought I could wait the required time before I got SRS, I felt I needed it NOW!! But truth be told I was not ready, transition is the hardest part, learning to feel comfortable in any situation, dealing with friends, family, co-workers, and after a while being authentic without trying; even finding your style. Anyway I had SRS 6 years after starting hormones, and 5 years after going full time. I had the money, so that was not the issue, I started to realize I was already living as a woman and that the surgery wasn't as urgent. When I finally had it (4 months ago) it was rather anti-climatic. I'm glad I had it, hell I'm ecstatic, but other than the aftercare, it was a piece of cake. The aftercare now isn't even that bad, just bothersome at times

[Donna Elvira]

Hi All,

Here's the thing, I would prefer to get SRS at the start of my transition.  I guess I could get an orchi but it could affect my SRS. 

It just seems like SRS at the beginning is a more logical approach to the whole transition.   If I could seriously change my body at any time with an orchiectomy why shouldn't I be able to also have an SRS whenever I want?

Anyway, just curious what everyone thinks.
Thanks,
Paige

Hi Paige!
Setting aside the pros and cons of getting an orchi as of now, why do you think  that getting SRS (the most totally irreversible step in the transition process)   done from the outset  looks like the most logical place to start your transition ?
Hugs
Donna

[TinaVane]

Orchiectomy does not physically alter your appearence or functional anatomy. Yes the testicles are gone but men with testicular cancer do not feel the need to transition. Erections are still possible and the normal process of orgasm remains the same.

Wait what ? I never knew this so you can still bust one and get hard with the balls gone ? That is the main reason I want mines gone and to be able to tuck better

[crowcrow223]

Wait what ? I never knew this so you can still bust one and get hard with the balls gone ? That is the main reason I want mines gone and to be able to tuck better

I've asked about it in the past as well, and another transwoman seconded M's words. Even with your testicles gone, you will still be struggling with erections and tucking. and having orchi done may obstacle the success of your srs. Keep your money and dont do it

[Ms Grace]

The testes are the primary, but not the only, source of T production in the male body. As noted above  an orchi won't stop all sexual function of the penis.

Paige, the reason SRS is harder to get than an orchi is because SRS is an incredibly more complex procedure - many fewer surgeons can do it.

[Paige]

Thanks everyone for the responses.

Paige, the reason SRS is harder to get than an orchi is because SRS is an incredibly more complex procedure - many fewer surgeons can do it.

Hi Ms Grace,

I guess it's more complicated but wouldn't the fact that it's expensive be enough to stop an increase in surgeries?  I got to think my approach would be rare anyway.  As someone else said bodies are being operated on all the time and pretty drastically without this sort of gatekeeper restriction.  It does seem a bit like discrimination against transgenders.

Maybe I'm a little nuts to think this, but my motivation for asking this is that in my dream I would like my wife to get use to the changes before anyone else.  I could be wrong but I would think you could live your whole life without the world knowing you've had SRS.

So in my dream world,    here's the order I would like to transition.
1) SRS
2) start HRT, maybe low dose at first
3) start body hair removal
4) hair transplant 
5) voice surgery about a year after SRS

Depending on how the hormones affect me, I could stay stealth for a while where only my wife and I know.

Crazy idea?
Paige

[Jessica Merriman]

Crazy idea?

In my personal opinion it is illogical. You want to do everything in the reverse order you should for a stable and successful transition.

The surgeons I have been talking to require HRT before SRS. I believe you would be best off at this point to consult a Therapist preferably with gender experience. They can make sure that your transition goes as smooth as possible and you will have to have two letters anyway before you can get SRS. Most areas even require one letter for HRT. Please get some expert guidance before you plan to far ahead. 

[Genevieve]

"Orchiectomy does not physically alter your appearence or functional anatomy. Yes the testicles are gone but men with testicular cancer do not feel the need to transition. Erections are still possible and the normal process of orgasm remains the same".

I have to respectfully disagree on this. While an orchiectomy doesn't alter your functional anatomy altogether, it can affect erections & the libido both, far more than before the procedure. And the orgasm is not the same, it's a drier release & the fluid is much clearer. I speak from my own personal experience here. One would have to take testosterone supplements to restore a healthy libido in a fair number of cases. And men with testicular cancer likely aren't on lifelong estrogen therapy as transwomen are, so it really isn't the same comparison.

As for an orchiectomy not altering one's physical appearance, that also isn't altogether true. Provided one continues on estrogen therapy after the surgery, the feminizing effects become more pronounced as estrogen can work unopposed & unhindered after the massive drop in T levels. Even if one isn't on hormones, there is still some feminizing effect, though not as much as if one were on HRT. Besides which, an orchiectomy is irreversible, so if a transwoman ever had to stop taking hormones for a financial or medical reason, there is no masculinization reversion, so the feminine effects are locked in, along with there being a greater psychological effect to the individual.

Unfortunately, many of us haven't got the funds for SRS, which I would have preferred over having an orchi, but personally speaking, I have no regrets in doing it. My self-confidence has gradually increased & I feel much better about myself. I'm still planning on SRS someday. However, if it doesn't happen due to lack of funds, I am very pleased that I'll never produce massive amounts of testosterone again. Having the T factories gone means freedom for me. I'm enjoying the bulge reduction & tucking is far easier. My quality of life is better.

Ultimately, it's a decision that varies from person to person. Some may have been able to put money aside for SRS, in which case, I might wait & have castration done then. But in my opinion, while an orchi isn't as invasive as SRS, it's certainly a viable precursor.

[AnonyMs]

So in my dream world,    here's the order I would like to transition.
1) SRS
2) start HRT, maybe low dose at first

Speaking as someone who'd also prefer to get SRS before social transition, I'd definitely recommend doing HRT before everything else. It's quite enlightening, and could change you thinking about everything. And what if you didn't like it? It's easy enough to start HRT and I think by far the safest option. I'd go so far as to say the other way is dangerously risky (assuming you're not non-binary anyway, no idea about that).

I'd also suggest that if you want to do something so far outside the norm, and do somehow work out a way of achieving it, that you make as sure as far as possible that are mentally capable of fully understanding what you are doing (I'm not suggesting you're not, but its something to be careful of).

I've had no trouble real hiding the effects of HRT for 5 years, although I guess that depends on the size of your breasts and what clothing you can wear.

I believe the reason its more difficult to get SRS than orchiectomy is cultural, rather than a shortage of doctors. We (or most of us) live in a capitalistic society and supply and demand would soon fix that. Also note that the WPATH Standards Of Care has the same requirements for both, with the additional requirement of 1 year RLE for SRS, and I don't see that as being related to the supply of doctors. I don't see much difference in the risks between orhci and SRS, but that could just be me, and also that I've not had either.