Susan's Place Transgender Resources

  So , can a person get a Orchiectomy without a letter from a therapist or with an "informed consent form".

   I don't really want to sidestep the SOC, but I am curious if there is any possibility of having a doctor preform an orchiectomy with an informed consent. Has anyone had any luck with this? Does anyone know of a doctor on the west coast that will do it ?

   Although I am sure therapy would do me some good right now ( I sure could of used some twenty years ago). It seems so backwards to go to a therapist after being "full time"for awhile now, and on hormones for over a year. Not to mention the added expense of going to a therapist .

   Any help would be greatly appreciated. Hugs Roxy

Nope.
I was told it is against the law to remove them without medical need. I don't know if that is true or not but it is what I have been told by a doctor. Even though I have medical need above and beyond being trans I have had a hell of a time finding a doc willing to remove them specifically because I am trans.

Luckily I have found a local doctor who may do the job.
I find out on monday. If not, then I will go to Dr. Ngyuen in Lake Osewego. He requires 2 letters or one letter and a doctors referal for removal on medical grounds.

Maybe there you will have beter luck with this than I have.

None that I have ever heard of.  Most will not because it involves removing healthy tissue.  Dr. Nguyen up here requires the same two letters as they do for SRS.

there used to be a dr Kimmel in Philadelphia he would perform orchis on transwomen and men on request.

he retired a couple of years ago due to sickness so no not anymore it's not really illegal everyone is just too prudish and paternalistic to do it ¬.¬

Quote from: Janet Lynn on February 12, 2011, 10:38:05 PM
None that I have ever heard of.  Most will not because it involves removing healthy tissue.  Dr. Nguyen up here requires the same two letters as they do for SRS.

  Oh I know it is "healthy tissue" I wasn't going to get rid of then completely. I just wanted to be able to hang them from the rear view mirror, or under the rear bumper of my truck. :laugh: :laugh:

   Hugs, Roxy

Quote from: Erocse on February 13, 2011, 11:23:06 AM
  Oh I know it is "healthy tissue" I wasn't going to get rid of then completely. I just wanted to be able to hang them from the rear view mirror, or under the rear bumper of my truck. :laugh: :laugh:

   Hugs, Roxy

rotflmao

Roxy you are just too funny sometimes  :D

Lots of Hugs and Kisses.
Patty

Quote from: pebbles on February 13, 2011, 08:46:41 AM
It's not really illegal everyone is just too prudish and paternalistic to do it ¬.¬

Too many urologists were trained by older, paternalistic urologists before them.  Their own personal fear and insecurity prevents them from helping TG patients.  Lawyers and liability insurance companies make it worse.   It's only required one or two bad experiences for one or two urologists to make them all gun-shy of TG patients. 

Quote from: Janet Lynn on February 12, 2011, 10:38:05 PM
None that I have ever heard of.  Most will not because it involves removing healthy tissue. 

This they explain as "medical ethics".

Quote from: Janet Lynn
Dr. Nguyen up here requires the same two letters as they do for SRS.

Their insurance carrier requires they adhere to the WPATH Standards of Care in order to maintain their coverage.

I was able to e-mail Dr. Gary Alter (Beverly Hills) and he said that he would do it with 1 letter from a therapist. He originally told me I'd need to have fulfilled the SOC for SRS and I e-mailed him about why that was impossible. He replied shortly with a more relaxed standard. Sounded like he just wanted to be sure I was serious.

It occurs to me that it is a fairly straight forward procedure. It doesn't really involve any plastic surgery and infection risk wouldn't be any more than other minor operations.

Since that is the case, you may find an overseas surgeon prepared to do it.

though you're gonna need hormones afterward.

FWIW, medical necessity is entirely at the doctor's discretion.  Without prompting, the endo that I saw was pushing orchi to me because my dangly bits are undescended.  Undescended testicles are at a greater risk of developing cancer, but it isn't a huge increase in risk.  You might be able to find an American (assuming that's where you live) surgeon who's willing to interpret things more loosely than those that you've seen. 

Roxy:

In my case it didn't really take two letters, but the surgeon who performed it talked to my physician who was prescribing my hormones, and my therapist.  I had been referred to the surgeon by the physician and I had been full time for about four months at that point and had been on hormones for over eight months which meant that I was already chemically permanently castrated.

She also talked with me at length about my decision and my desire never to return to male.  At that point I had not decided on whether or not to have SRS, but I wanted a permanent psychological and physiological change to improve my mental well being.

The mayhem laws regarding the removal of healthy tissue can be overridden if there is a larger medical necessity.  In the case of MTF trans women that can be justified, but you have to have some medical support for that decision.

I wanted to tee mine up and use them for driver practice.

-Sandy(FORE!)

Quote from: Laura91 on February 12, 2011, 09:47:15 PM
I found a surgeon that did the orchi with informed consent. I didn't need any letters from anyone (although I could get them if they were needed).

I'd love to know that name...

Quote from: spacial on February 13, 2011, 08:31:52 PM
It occurs to me that it is a fairly straight forward procedure. It doesn't really involve any plastic surgery and infection risk wouldn't be any more than other minor operations.

Since that is the case, you may find an overseas surgeon prepared to do it.

though you're gonna need hormones afterward.

That's what I was thinking.

all this stuff royally pisses me off because I simply CANNOT afford a therapist. Even the cheapest possible option - at University of Memphis which is $18 (for me) also involves about $30 worth of gas to make the round trip, and if you postulate two trips a month that's basically $100 a month.

and "doing it right" for ANYTHING starts with therapy.

So you get the therapy and can't afford the hormones...or the surgery if you could get it....

*sigh*

I need a #$%^ @#$%ing JOB!!

But my short list once I'm working is

1. laser
2. hormones
3. orchi

After that, if money seriously delays further (physical) progress I think I can deal with it.

some some therapists best get ready to get on with writing a letter. I shall not be denied!!!

Hi Roxy,

Is there any evidence of prostate cancer in in the family? In which case you can 'demand' it. Same as females with BRACA 1&2 genes having breast removals.  Secondly I have no clue of the USA laws , but as a private patient in Aus I can go to a plastic surgeon and have any procedure  done, I'm sort of hoping for a boob job this year, no certificates beyond I can pay.


Visa advert: have your hair coloured,  wonderfu;l Buying Patsy Roses on Valentines Day (and you better have had) glorious. Getting your balls cut off, perfect. That's why we have Visa.

:laugh:
Cindy.

Quote from: CindyJames on February 14, 2011, 03:07:12 AM
Visa advert: have your hair coloured,  wonderfu;l Buying Patsy Roses on Valentines Day (and you better have had) glorious. Getting your balls cut off, perfect. That's why we have Visa.

:laugh:
Cindy.

I would love to see that commercial!   ;D :D :laugh:;D :D :laugh:;D :D :laugh:;D :D :laugh:;D :D :laugh:

-Sandy

QuoteIs there any evidence of prostate cancer in in the family? In which case you can 'demand' it.

How does this work? I understand that T promotes the cancer but won't the doctor just say that a anti-androgen is sufficient?

Both my Dad and my uncle died of aggressive forms for prostate cancer and I'm at a much higher risk for that type of cancer. They put my Father on T-blockers when he was diagnosed and when my his cancer kept coming back they put him on a fairly high does of estrogen which was supposed to slow it down. Strange to think we were both on HRT but at different times and for very different reasons. I remember him complaining about how much his boobs hurt. Little did I know at the time I'd be finding out how much it does hurt but I'm happy about it.

Quote from: Hannah_Irene on February 14, 2011, 08:13:20 AM
How does this work? I understand that T promotes the cancer but won't the doctor just say that a anti-androgen is sufficient?

Both my Dad and my uncle died of aggressive forms for prostate cancer and I'm at a much higher risk for that type of cancer. They put my Father on T-blockers when he was diagnosed and when my his cancer kept coming back they put him on a fairly high does of estrogen which was supposed to slow it down. Strange to think we were both on HRT but at different times and for very different reasons. I remember him complaining about how much his boobs hurt. Little did I know at the time I'd be finding out how much it does hurt but I'm happy about it.

Ooh sicence I love science.

Testosersone blockers interfere with the interaction between the Androgen Receptor and testosersone normally depending on the blocker it stops 99.5% of all T from binding.

The problem if you've ever studied cancer you will see it's a sick mockery of life. Often times prostate cancer will express somewhere between 10-100times the normal amount of Androgen receptor gene and it usually won't remove the activated receptors choosing instead to bath itself and surrounding cells in growth factor.

in those cases where you have massive amounts of AR overexpressed simply adding T blockers might not be enough because either the cancer will mutate the AR so that it can still bind to T dispite but no longer to the T blocker. Or the sheer amount of AR means T blockers aren't strong to supress it and that 0.5% absolute sensitivity still is 150% senstivity compaired to a normal person.

In those cases Adding E lowers the bodies T production or removing the testis means there can't be any T circulating to trigger cancerous expansion.

Thanks Pebbles, cool stuff.

I guess it still boils down to, will a doctor do an Orchiectomy as a preventative measure simply because you have an elevated risk?

I just got the greenlight for an orchi today.
I have to wait until I have healed from the bypass I am having on the 2nd of march. So it will be down the road but I no longer need to worry about finding someone to do the job for me.

Quote from: Hannah_Irene on February 14, 2011, 08:13:20 AM
How does this work? I understand that T promotes the cancer but won't the doctor just say that a anti-androgen is sufficient?

Both my Dad and my uncle died of aggressive forms for prostate cancer and I'm at a much higher risk for that type of cancer. They put my Father on T-blockers when he was diagnosed and when my his cancer kept coming back they put him on a fairly high does of estrogen which was supposed to slow it down. Strange to think we were both on HRT but at different times and for very different reasons. I remember him complaining about how much his boobs hurt. Little did I know at the time I'd be finding out how much it does hurt but I'm happy about it.

That's assuming all GPs in the UK (physicians elsewhere?) are the same, but they're not... 

The decent kind will help if you show you are rational and that you need something done/authorised to be done.

Then's there's another who is a right tool talking about not doing a procedure "unless it's absolutely necessary."  This second kind infest the NHS allowing the elderly to pass away 'naturally' in our hospitals when that person could have been saved easily, it's the horrendously long hours and the many patients they see which are too blame, it dehumanises the patients in the overworked doctor's eyes, like seeing something horrible over and over and over again.  Still humans are capable of great callousness anyway, it's a trait that is horrorifying it it's implications.
These callous doctors get a kick out of playing God, take their authority away from them do not allow them to pretend they even have a clue what they are talking about, the life they mess around with is not theirs IT'S YOURS.

Empathic doctors will have concern and this is normal and healthy.  Those second kind there comes a point where one has to bypass certain individuals. 

Em, is it normal if I find an orchi terrifying? I saw videos on Youtube and........T.T I just want it the same day as srs.  :-\ I also think that it's a stupid thing to require to legally change gender.

These callous doctors get a kick out of playing God

Perhaps, but I think a lot of the distance that doctors have comes from the fact that they are not god and they know it.  Lose enough patients and the distance comes naturally.