Most, though not all, of us aspire to full vaginoplasty. The path to that holy grail is often difficult on our bodies and sometimes dangerous.
I want to put the case for bilateral orchiectomy instead of anti-androgen drugs.
I have a vested interest: I've had one.
To me anti-androgens are a poison. Okay, that's a bit strong. But they really did my body no good. None of the medications used by MtF transgender are intended for the purpose. Their use as anti-androgens is secondary to their clinically approved usage.
Some people are fine on them but it's only since I came off them that I've fully appreciated how damned awful they made me feel. I had elevated blood pressure, was breathless, dizzy, scratchy and that's before the nasty reactions on top:
Spironolactone very nearly killed me (very very low blood pressure).
Bicalutamide set off a horrible and dangerous chest infection
Dutasteride made me totally spin out with dizziness and poor circulation
Finasteride made me anxious and irritable
Cypterone Acetate gave me awful depression
... in other words they all had their downsides. They are drugs that fight against what the body is producing and, for me, that was both physiologically and psychologically damaging.
Now, I know that for many of us it's our only option. We have to take them and the dysphoria is worse than many of those side effects. So they are the lesser of two evils.
But I want to sing the praises of a bilateral orchiectomy. Yes it costs money. Yes it can cause some scarring for the tissue that will go into your new vagina but these days the latter is fairly obsolete with good surgeons. Re. the former: well, yes, it cost me $3800 at what I consider the best clinic in Thailand (PAI) but that's offset against the cost of medication. Surgery does, needless to say, always carry some risk so I praise the surgery only in the sense that you should consider it through your normal medical guidance. But it's one of the best decisions of my life.
I feel absolutely wonderful. Estrogen dosage can now be lower too of course. And as an added bonus I've been lucky not to lose any libido. Actually the opposite seems to have happened.
This post is put out to stimulate thinking that there is an alternative to anti-androgens. For those who are fine with the medications then I say: all power and praise to you. That's genuinely great. But for the rest of us: at least consider the orchiectomy option.
Love, Chen x
