Considering Orchidectomy...

[PrincessCrystal]

So....  I'll just jump into this while I still have a forum to do so...

Lately I've been considering getting an Orchidectomy once I'm well underway with HRT, which I hope to be within the next year.  I've always kind of wanted to get rid of my balls, even before I realized the extent of my gender issues, and they're pretty annoying as is, both in form and function: they're probably the most masculine part of my body.  They're huge and hard to tuck, they're always uncomfortable, sometimes sore, and make these hormones that give me a look I don't like...

I'm still not sure though.  Obviously there are risks and repercussions to this, and it's pretty much irreversible...  what does everyone here think?  I mean, it's a pretty common procedure, and I feel like if I had it I wouldn't care about SRS for a while, though that is an eventual goal...  if I go through with it, it'll be after I know exactly what the hormone changes will be like, so I'd be on Anti-androgens and Estrogen well  before-hand.  If it's a change I want to make, it won't just give me more feminine genitals, but it would also mean one less pill regimen (probably the most important one) I have to keep up with...

Any advice?

[JessicaSondelli]

I'm planning to have an orchiectomy as soon as I can which is in my opinion one year after starting HRT. This would be March next year for me. There is one thing that will be very permanent and that is that you will have to take hormones for the rest of your life no matter what. For me this is not a big deal as I already know that I will not stop HRT ever. But in case you want to stop it - for whatever reason- you would then have to take T for the rest of your life because your body needs either of the two sex hormones to function properly.



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[Mia]

I just completed my orchi, it was October 11th. I transitioned fully a year ago, and have been taking HRT (Estradiol and Spironolactone) since July of 2014.

The reasons for moving ahead with the orchi were:

• My SRS is scheduled 3 (effing) years out! 
  I have never done anything more rewarding in my life than transitioning. Even my worst days (being "clocked" are still my best days - I love being Mia. So going back is not an option.
  I don't want to take any meds at all, especially Spiro for a kind of cosmetic reason. The orchi got me off the Spiro and at the same time made me feel a bit more "authentic." And it saves money in the long run.
  I also had a hard time tucking - it was hard to do and uncomfortable. I'm still sore, so I can't tell you how that has turned out yet!

I contacted my GRS surgeon's office (Bowers) and they told me exactly the way the orchi should be done, which I passed on to my urologist. I've had some moodiness post-op, but as of the last few days I have felt almost euphoric over my own perception of my femininity. I have to believe that is caused at least partially by the loss of a substantial amount of T in my system.

Good luck to you!

Mia

[BeverlyAnn]

My orchiectomy (April 26) was actually before I started HRT (June 2).  However in my case, there were a couple of reasons for this.  At my age, my therapist suggested it so I wouldn't have to use anti-androgens and second reason was for medical issues.  I had been having severe orchalgia in the left testicle and the right testicle was atrophied creating a cancer risk due to being undescended as a child.  With the letter from my therapist, my urologist consulted with Dr. McGinn regarding incision placement and performed the surgery.  For those saying they will wait until after starting HRT, good idea.  The five weeks between my surgery and starting HRT were absolutely miserable with horrible hot flashes!  I will say this though, it's the best decision I have ever made.

[PrincessCrystal]

My orchiectomy (April 26) was actually before I started HRT

Eek!  I know enough to know without reading the rest that this is NOT something I'd like to go through!  :<  Right now, I'm happy I'll probably never have to go through menopause...

But in case you want to stop it - for whatever reason- you would then have to take T for the rest of your life because your body needs either of the two sex hormones to function properly.

Hence why I'm worrying about thinking about it now and not while I'm in the throes of HRT.  It means a permanent loss of the ability to go back to being a complete male if I change my mind after transitioning for a while.  I'm planning on going near-full-time after I move to another city next summer, so that'll be when I know if I'm ready to take the plunge and give up my manhood forever.

Actually, "give up my manhood forever" doesn't sound scary to me at all.

It's weird, part of me has this trepidation, but another part of me just wants to jump up and go get one right now.  Like, I've got this internal impulsiveness battling with this crippling self-doubt, and the one that does better seems to depend on my mood at the time...

What questions do you think I should be asking myself to help make this (permanently life altering) decision?

[josie76]

You should figure out if you have any doubt at all that being female is right for you. Try not to base it on what your sociological situation is but on who you are on the inside.

I'm thinking of looking into getting it done right at the start of HRT when the time comes. I really don't want to deal with the side effects of spironolactone. I'm hoping I can get the same urologist who did my vesectomy to do it. Either way the cords are already cut, tied, and burned so there's not much holding them in place now anyways. That by itself sometimes causes me pain.

[Dena]

What questions do you think I should be asking myself to help make this (permanently life altering) decision?

One simple little question. Is there anything you can think of that you value as a male. If there is nothing that you are unable to do as a female, you will not have regrets going forward. That was the question I asked myself before surgery and I could find no reason to return to my former self.

[Lady Sarah]

HRT and atrophy had drawn my testes inside me enough that it caused immense pain. Dr. Brandt was wonderful and I was walking around with no pain the same day as the orchiectomy. I have never regretted it.
There is zero chance of me wanting to detransition. I would rather face menopause.

[Sharon Anne McC]

*

Both Mia and BeverlyAnn wrote something very important regarding the technical matter; or they can correct me if I'm otherwise being wrongly informed about something I'd like to add.

I have been reading that orchi seems to be among one of the options of the current M-F transition process.  But in this advance, many candidates could be selecting the operation performed by a surgeon who may not be alert to future GCS / SRS.

Some GCS / SRS surgeons may decline a patient whose orchi was done either improperly or contrary to their standards.  GCS / SRS surgery requires clean skin for grafting.  If your skin has been scarred from a prior surgery, then that might void the application of that skin for your GCS / SRS.

As Mia wrote, if you are already planning GCS / SRS with a specific surgeon, then ask for their guidance and arrange for both surgeons to consult as to correct technique.  Otherwise, correspond with GCS / SRS surgeons you are likely to consider and seek their advice.

Certainly, the last thing you need is to be fully ready to go and your GCS / SRS surgeon sees you on the table and tells you 'No' because your orchi did not comply with their necessity.

Please accept my wishing the best for you.

*

[Janes Groove]

1. HRT may solve the problem of large testicles for you. It can cause pretty significant atrophy and shrinkage of the testicles, in some cases very rapidly. 

2. Also, I  think some surgeons can use the scrotum for increasing the depth of the vagina during GCS, if that is an issue.  But if a significant portion of the scrotum is removed during orchidectomy then that will not be an option.

[PrincessCrystal]

I  think some surgeons can use the scrotum for increasing the depth of the vagina during GCS, if that is an issue.  But if a significant portion of the scrotum is removed during orchidectomy then that will not be an option.

I hear it makes good labia.  I don't have any problem with the scrotum, I just know that, were I to keep going to the point where some permanent alteration would be desirable, the balls would be the first thing to go...

[Lady Sarah]

My surgeon did not remove any scrotal skin, and left a scar only ahalf inch long. However, that skin shrank away. If I can ever get GCS, I will need skin grafts taken from somewhere else. Please keep that in mind.

[Josilyn]

I am 5 months into hrt, and I am thinking about getting an orchiectomy.  Any advice as to if this would be a good time to do it to get off of spiro or should I wait until I am on hrt for a longer period of time before doing that?

[PrincessCrystal]

My surgeon did not remove any scrotal skin, and left a scar only ahalf inch long. However, that skin shrank away. If I can ever get GCS, I will need skin grafts taken from somewhere else. Please keep that in mind.

Sounds like upkeep would be a thing to worry about here... Like I said, this is a ways away, so I'll have time to think about it.

[BeverlyAnn]

Both Mia and BeverlyAnn wrote something very important regarding the technical matter; or they can correct me if I'm otherwise being wrongly informed about something I'd like to add.

I have been reading that orchi seems to be among one of the options of the current M-F transition process.  But in this advance, many candidates could be selecting the operation performed by a surgeon who may not be alert to future GCS / SRS.

In my case, I emailed Dr. McGinn's office and they emailed me back with their phone number suggesting my surgeon call them which he did.  This is important because scar tissue can mess up later surgery.  If your surgeon won't consult, you might want to try another doctor.

[Floritine]

My surgeon did not remove any scrotal skin, and left a scar only ahalf inch long. However, that skin shrank away. If I can ever get GCS, I will need skin grafts taken from somewhere else. Please keep that in mind.

My doc did the same and have it is a small price to pay when I may need a skin graft later when / if I choose to get the last bits chopped
I had my orchi earlier this year in march and it was one of the best thing I did, I already knew the pros and cons, but my urologist I saw still made me get a letter from my psych and I also discused it with my endo both had no problem and gave me letters,
Since having it I more confident as they arent down there and wearing clothes are better fits .....

Cheers Tracy

[Roxy]

Yes, I trying to arrange orchi at the moment.
Love to be off spricolontane.  Estrogen works so much better after orchi.
What concerns me is location of the incision. I don't want skin in that area damaged for later SRS.
The understand is possible for the incision to be above the pubic area and the testicles removed that way leaving scrotum skin untouched.
Can anyone advise if this is way the SRS surgeons recommend

[BeverlyAnn]

The understand is possible for the incision to be above the pubic area and the testicles removed that way leaving scrotum skin untouched.
Can anyone advise if this is way the SRS surgeons recommend

My understanding from what my surgeon told me in consulting with Dr. McGinn is she recommended a high mid-line scrotal incision and not inguinal (abdominal) incisions.

[JoanneB]

One of the too many Trans-Ironies in my life is having been very well endowed. I say been because after a year or two on HRT I was down to half size. Now at the 7 year mark about 1/3 of what I was. Testes also