Susan's Place Transgender Resources

Other than Dr. Mark Arnkoff in Michigan, exactly which doctors, if any, will perform informed consent orchiectomies without any letters?

Any thoughts on this?

Also, for the record, I myself am an aspiring feminine eunuch who wants to get surgically castrated for sterilization purposes and, if possible, to help feminize both my body and my face. :) Of course, I also want to be able to continue being able to get erections using my penis and to have penis-in-vagina sex after my planned orchiectomy, so yeah.

Also, to clarify--I certainly still want to try getting a therapist letter for this, but I also want to keep all of my options open in regards to this. :)

You'll probably find more info on this in Gender Correction Surgery section.

Quote from: Harley Quinn on December 20, 2015, 10:24:03 AM
You'll probably find more info on this in Gender Correction Surgery section.

Thanks for this information! :)

You could have a look here:

https://www.susans.org/forums/index.php/topic,193238.msg1722909.html#msg1722909


hugs

Quote from: Laura_7 on December 21, 2015, 02:45:37 AM
You could have a look here:

https://www.susans.org/forums/index.php/topic,193238.msg1722909.html#msg1722909


hugs

Thanks! :)

Also, though, should this thread be moved to another section of this forum?

Hi Futurist,

I don't know what sort of research you're done into orchidectomies, but removing the main organ of testosterone production may seriously compromise your libido and the ability to maintain erections.

Another point of concern would relate to any future, if at all, genital surgeries, as the longer you wait post orchidectomy the greater the atrophication of any donor material and the scar tissue may also compromise any donor material.

Surgeons who conduct neovaginoplasties are best to perform orchidectomies, as they preserve as much martial as possible.

You may need to do more research into the side effects of your plans.

Speak to you as soon as I paint the verandah.

Huggs
Catherine

I am glad if it is okay to have those topics here.

Only because I may decide to take shortcuts. All treatment is so restricted here and I shan't wait half a decade to get GRS or at least stop the T. Thanks for allowing such threads.

Quote from: Catherine Sarah on December 23, 2015, 03:54:34 AM
Hi Futurist,

I don't know what sort of research you're done into orchidectomies, but removing the main organ of testosterone production may seriously compromise your libido and the ability to maintain erections.

Another point of concern would relate to any future, if at all, genital surgeries, as the longer you wait post orchidectomy the greater the atrophication of any donor material and the scar tissue may also compromise any donor material.

Surgeons who conduct neovaginoplasties are best to perform orchidectomies, as they preserve as much martial as possible.

You may need to do more research into the side effects of your plans.

Speak to you as soon as I paint the verandah.

Huggs
Catherine

Two things:

1. What about taking testosterone HRT shots to help me get erections after my planned orchiectomy? Would that work?

2. I certainly don't want to ever have a vagina.

Quote from: Futurist on December 24, 2015, 12:19:50 AM
What about taking testosterone HRT shots to help me get erections after my planned orchiectomy? Would that work?

I was under the impression you were considering feminising your body to some degree with HRT? If you aren't then you would need to take testosterone anyway to so you can avoid osteoporosis. I know that some trans women on HRT have small testosterone boosters to keep their libido up - I presume it works for the libido, I don't know how well it works for erections.

Quote from: Futurist on December 24, 2015, 12:19:50 AM
Two things:

1. What about taking testosterone HRT shots to help me get erections after my planned orchiectomy? Would that work?

2. I certainly don't want to ever have a vagina.

You could have a look here:

https://www.susans.org/forums/index.php?topic=156397.0

Well you might not say never... maybe you might change your mind later ?
Having a orchi in a way srs is possible later might be an option.
Of course it is up to you.


*hugs*

Quote from: Ms Grace on December 24, 2015, 12:39:27 AM
I was under the impression you were considering feminising your body to some degree with HRT?

Well, Yes--with HRT and/or with things such as laser hair removal, electrolysis, and maybe surgery as well.

QuoteIf you aren't then you would need to take testosterone anyway to so you can avoid osteoporosis. I know that some trans women on HRT have small testosterone boosters to keep their libido up - I presume it works for the libido, I don't know how well it works for erections.

OK.

Also, though, can you please answer my original question here, Grace? :)

Quote from: Laura_7 on December 24, 2015, 10:46:44 AM
You could have a look here:

https://www.susans.org/forums/index.php?topic=156397.0

Well you might not say never... maybe you might change your mind later ?
Having a orchi in a way srs is possible later might be an option.
Of course it is up to you.


*hugs*

Believe me--as long as I will have my current brain/mind, then I will certainly not change my mind on this. After all, in spite of my frequent cross-dreaming, I am an aspiring feminine eunuch, not a trans-woman. Plus, we certainly don't have the technology to change people's gender identity right now (and I certainly don't see such technology being developed in the next several decades as well). :(

Is your original question to acquire a list of people who can give you the treatment?

If there is such one, it would be handy to have. What I read above indicates rather people are known who had done it, or who know somebody who had done it, so they could be contacted for more info.

I was lucky because I found a urology surgeon who did mine for me without any referrals needed for psych assessment or whatever.  True enough I'd been having severe pain problems as a result of complications from surgical interventions I'd had as a child, but it was the fact that I was living full time as well as having mainstream  employment as a social worker that made it easy for my surgeon to give me the nod.

It's rare for me to get an erection, but it is possible.  Bear in mind though that I'm asexual and sex interests me about as much as having somebody stick their finger up my nose.

Quote from: Lady Smith on December 26, 2015, 01:50:34 AM
I was lucky because I found a urology surgeon who did mine for me without any referrals needed for psych assessment or whatever.  True enough I'd been having severe pain problems as a result of complications from surgical interventions I'd had as a child, but it was the fact that I was living full time as well as having mainstream  employment as a social worker that made it easy for my surgeon to give me the nod.

It's rare for me to get an erection, but it is possible.  Bear in mind though that I'm asexual and sex interests me about as much as having somebody stick their finger up my nose.

What exactly is the name of this urology surgeon of yours, though?

Quote from: Martine A. on December 26, 2015, 01:32:21 AM
Is your original question to acquire a list of people who can give you the treatment?

Yes, it is.

Also, did I post this question of mine in the correct section of this forum?

QuoteIf there is such one, it would be handy to have. What I read above indicates rather people are known who had done it, or who know somebody who had done it, so they could be contacted for more info.

Completely agreed.

Quote from: Martine A. on December 23, 2015, 05:45:21 AM
I am glad if it is okay to have those topics here.

Only because I may decide to take shortcuts. All treatment is so restricted here and I shan't wait half a decade to get GRS or at least stop the T. Thanks for allowing such threads.

Where exactly do you live, though? After all, your situation certainly sounds terrible! :(

Quote from: Futurist on December 26, 2015, 01:54:18 AM
What exactly is the name of this urology surgeon of yours, though?

I live in New Zealand and I had the orchie done 21 years ago.  The surgeon was elderly then so I don't think he would be any use to you.

Quote from: Lady Smith on December 26, 2015, 05:05:00 AM
I live in New Zealand and I had the orchie done 21 years ago.  The surgeon was elderly then so I don't think he would be any use to you.

Out of pure curiosity--is he already dead or simply retired right now?

Umm... have you considered just taking anti-androgens? There is a reason most surgeons will not perform an orchi without a letter, and that's because they don't want to do something irreversible to you that you end up regretting. If you talk to a gender therapist and approach things as someone who is non-binary who wants to move toward being more feminine without fully transitioning, you should be able to get a referral to an endocrinologist that can put you on an HRT regimen focused on getting your testosterone in the castrate range.  And then in a year if you feel like the results are what you wanted, they should be able to give you a letter for surgery anywhere you'd like. I don't understand why you'd want to have an orchi without trying anti-androgens anyway. Don't you think it would be better to know how you feel with castrate levels of testosterone before you have an irreversible surgery?

Quote from: Miyuki on December 27, 2015, 01:33:48 AM
Umm... have you considered just taking anti-androgens? There is a reason most surgeons will not perform an orchi without a letter, and that's because they don't want to do something irreversible to you that you end up regretting. If you talk to a gender therapist and approach things as someone who is non-binary who wants to move toward being more feminine without fully transitioning, you should be able to get a referral to an endocrinologist that can put you on an HRT regimen focused on getting your testosterone in the castrate range.  And then in a year if you feel like the results are what you wanted, they should be able to give you a letter for surgery anywhere you'd like. I don't understand why you'd want to have an orchi without trying anti-androgens anyway. Don't you think it would be better to know how you feel with castrate levels of testosterone before you have an irreversible surgery?

If that is all that is necessary to get a therapist letter for surgical castration, then I should certainly try following this path as soon as I can! :) Seriously. :)

I had my orchiectomy earlier this year, about a year after I first started seeing a therapist. I was doing it as a part of a full MTF transition, but these days the standards of care are much less restrictive about who can qualify for what treatments. Not every therapist is willing to work with someone who is non-binary, usually due to lack of experience or knowledge about appropriate treatment, but many therapists now are willing to work with individuals with gender dysphoria in a way that allows the person being treated to direct the care. Meaning, you are not going to be forced to present as fully female (in public or private), you won't have to take estrogen if it's not something you are interested in, you won't have to do anything you are not comfortable with. You just have to explain your dysphoria in a way that demonstrates how it has impacted your life and explain why you think having castrate levels of testosterone will help you feel better. Then you can get a letter for an endocrinologist who will help start you on the appropriate medication. The only tricky thing is finding the right therapist, but how difficult that is or isn't really depends on where you live. Here in Minnesota I go to a place called the University of Minnesota Center for Sexual Health, and they have no problems at all working with non-binary people there. Unfortunately there are places where good therapists are not quite so easy to find, but I don't really know specifically how you'd find a therapist who would be willing to help you other than just calling around and asking.

I recommend seeing a gender therapist to make sure you are on the correct path and receive the needed papers. A sex hormone will need to be taken after the orchi. After an orchi your libido will drop considerably as well a the ability to achieve a full erection. Most all doctors today will want some form of referral from competent health care providers.

Good luck,

Rachel

Quote from: Miyuki on December 28, 2015, 12:18:46 PM
I had my orchiectomy earlier this year, about a year after I first started seeing a therapist. I was doing it as a part of a full MTF transition, but these days the standards of care are much less restrictive about who can qualify for what treatments.

If so, then that is certainly extremely great news! :) After all, I absolutely loathe "gate-keeping" both for transgender people and for aspiring eunuchs. :(

QuoteNot every therapist is willing to work with someone who is non-binary, usually due to lack of experience or knowledge about appropriate treatment, but many therapists now are willing to work with individuals with gender dysphoria in a way that allows the person being treated to direct the care. Meaning, you are not going to be forced to present as fully female (in public or private), you won't have to take estrogen if it's not something you are interested in, you won't have to do anything you are not comfortable with. You just have to explain your dysphoria in a way that demonstrates how it has impacted your life and explain why you think having castrate levels of testosterone will help you feel better. Then you can get a letter for an endocrinologist who will help start you on the appropriate medication. The only tricky thing is finding the right therapist, but how difficult that is or isn't really depends on where you live. Here in Minnesota I go to a place called the University of Minnesota Center for Sexual Health, and they have no problems at all working with non-binary people there. Unfortunately there are places where good therapists are not quite so easy to find, but I don't really know specifically how you'd find a therapist who would be willing to help you other than just calling around and asking.

OK; however, I would like to point out that I also see extremely large value in surgical castration for sterilization purposes. After all, all non-drastic forms of birth control (including vasectomies) can and sometimes do fail and thus I want a form of birth control which can never, ever fail--surgical castration. :) Indeed, we unfortunately have (in the words of Laura Wish Morgan) a strict liability of sperm in regards to child support here in the U.S. :( Also, in regards to hormones, I am certainly open to taking estrogen replacement therapy either on a full-time or on a part-time basis if I will still be able to get erections using my penis and to have penis-in-vagina sex afterwards. :) Else, though, I will have to take testosterone replacement therapy instead while seeking to feminize my body in other ways, such as with laser hair removal and electrolysis and maybe with facial androgynization surgery as well if my insurance is going to be willing to pay for this surgery. :)

Quote from: Cynthia Michelle on December 28, 2015, 08:28:50 PM

I recommend seeing a gender therapist to make sure you are on the correct path and receive the needed papers. A sex hormone will need to be taken after the orchi. After an orchi your libido will drop considerably as well a the ability to achieve a full erection. Most all doctors today will want some form of referral from competent health care providers.

Good luck,

Rachel

Can't one or both kinds of hormone replacement therapy and/or Viagra help deal with the erections part, though?

Also, I am certainly willing to see a gender therapist if this is not going to be a never-ending process which is never going to result in me getting a therapist letter for my desired and planned orchiectomy. :(

I've a feeling you're making it seem more complicated than it is. Unless you have no money its not going to be impossible (and even then maybe not). I'm absolutely sure I could do what you're trying to do if I wanted to. I've been looking about how to get SRS without presenting female; I'm sure I can do that and I'd think that would be more difficult than getting an orchi. There's so many ways of working the system.

Personally I'd find a decent psych to talk to with the intent of getting letters, plus the therapy can he helpful. No harm done it that proves not useful.

If you have any psychological issues apart from gender then I'm not sure what will happen. I don't so I've not considered it. You'd really want to find a good psych in that case.

Get on anti-androgens and see how you feel about that. If you want some feminisation get on estrogen and see how you feel about it. The main thing is to start and see how it goes. Personally I'd not get an orchi without trying that as its such an easy step along the path. I never understood what it would be like to have HRT until I did it. Reading other peoples stories only takes you so far.

Quote from: Futurist on December 28, 2015, 08:37:29 PM
Can't one or both kinds of hormone replacement therapy and/or Viagra help deal with the erections part, though?

It may or may not surprise you to find out, it is possible you may be able to continue getting erections even after an orchiectomy, without additional treatment. Usually it will be softer than it was before, and it won't happen spontaneously like it used to, but if you focus on it and try you should be able to get an erection hard enough to perform sexually. Personally this is not something I'm interested in, and I don't see keeping my ability to have erections as a positive thing, but I actually think people who completely lose the ability to have erections on MTF HRT are in the minority.

Quote from: Futurist on December 28, 2015, 08:37:29 PM
Also, I am certainly willing to see a gender therapist if this is not going to be a never-ending process which is never going to result in me getting a therapist letter for my desired and planned orchiectomy. :(

I really doubt this would be the case. The only way that would happen is if you got involved with a bad therapist that was big on gate-keeping or just trying to drag things out for money. I got my letter for HRT at my very first appointment, although that was mostly because I had already been self medicating, and usually my therapist did like to have a few more appointments before writing a letter. Another bonus of getting an official letter which I forgot to mention, is that it opens up the possibility of getting an orchiectomy covered by insurance. While an orchiectomy to treat gender identity issues is usually put under the same category as SRS by insurance companies and not covered, there are a few that do cover those types of surgeries and there are many more that will cover an orchiectomy if it is coded as a treatment for the "testicular atrophy" that usually occurs after enough time on HRT. That's how I got it covered. ;)

Quote from: AnonyMs on December 28, 2015, 09:24:53 PM
I've a feeling you're making it seem more complicated than it is. Unless you have no money its not going to be impossible (and even then maybe not). I'm absolutely sure I could do what you're trying to do if I wanted to. I've been looking about how to get SRS without presenting female; I'm sure I can do that and I'd think that would be more difficult than getting an orchi. There's so many ways of working the system.

Care to please elaborate on this part?

QuotePersonally I'd find a decent psych to talk to with the intent of getting letters, plus the therapy can he helpful. No harm done it that proves not useful.

If you have any psychological issues apart from gender then I'm not sure what will happen. I don't so I've not considered it. You'd really want to find a good psych in that case.

Get on anti-androgens and see how you feel about that. If you want some feminisation get on estrogen and see how you feel about it. The main thing is to start and see how it goes. Personally I'd not get an orchi without trying that as its such an easy step along the path. I never understood what it would be like to have HRT until I did it. Reading other peoples stories only takes you so far.

OK.

Quote from: Miyuki on December 28, 2015, 10:23:29 PM
It may or may not surprise you to find out, it is possible you may be able to continue getting erections even after an orchiectomy, without additional treatment. Usually it will be softer than it was before, and it won't happen spontaneously like it used to, but if you focus on it and try you should be able to get an erection hard enough to perform sexually. Personally this is not something I'm interested in, and I don't see keeping my ability to have erections as a positive thing, but I actually think people who completely lose the ability to have erections on MTF HRT are in the minority.

OK, and thank you very much for sharing this information with me! :)

QuoteI really doubt this would be the case. The only way that would happen is if you got involved with a bad therapist that was big on gate-keeping or just trying to drag things out for money. I got my letter for HRT at my very first appointment, although that was mostly because I had already been self medicating, and usually my therapist did like to have a few more appointments before writing a letter. Another bonus of getting an official letter which I forgot to mention, is that it opens up the possibility of getting an orchiectomy covered by insurance. While an orchiectomy to treat gender identity issues is usually put under the same category as SRS by insurance companies and not covered, there are a few that do cover those types of surgeries and there are many more that will cover an orchiectomy if it is coded as a treatment for the "testicular atrophy" that usually occurs after enough time on HRT. That's how I got it covered. ;)

Thank you very much for all of this information! :) Also, the reason that I mentioned "gate-keeping" here is because I know that some aspiring eunuchs were unfortunately unable to get surgically castrated (as in, get an orchiectomy) in a safe, medical setting and thus had to perform dangerous self-orchiectomies or seek dangerous "back-alley" orchiectomies instead. :(

Quote from: Futurist on December 28, 2015, 10:36:58 PM
Care to please elaborate on this part?

I think I already did in my other post. By the way what's the problem with using Dr. Arnkoff? Have you called him?

Quote from: AnonyMs on December 29, 2015, 01:54:50 AM
I think I already did in my other post.

OK.

QuoteBy the way what's the problem with using Dr. Arnkoff?

In theory? Nothing. However, I dislike the fact that he is located so far away from me (indeed, I myself live in Orange Country, California). :(

QuoteHave you called him?

No, not yet. However, I will certainly call him after the New Year's (I would prefer to wait until then because I suspect that he might not be at work right now due to the fact that this time is vacation time for many people due to Christmas and the New Year's). :)