So, I was doing some reading about orchiectomy. And this particular website I was on was basically saying that: the body will continue to Masculinize without an orchiectomy, even on HRT.
This sounds like a bunch of bologna to me...considering that estrogen and anti androgens eventually stop testosterone production almost completely after 6 months.
Quote
As an even less expensive alternative, transsexuals in the U.S. can now take advantage of fairly easy access to orchiectomy. After orchiectomy (castration) a T-girl's body will not be further maimed [sic] by testosterone, and the feminizing effect of female sex hormones is much more rapid and more pronounced (especially in younger girls).
I'm close to calling BS (bologna sandwiches) on this tidbit of information...but it still makes me wonder...
They're right I am afraid! :(
I am over 40 years on HRT, 39 years since SRS, and I am NOT happy with the long-term changes to my body! I had a nice figure 30-odd years ago but other organs in the body continue to produce testosterone and that has an effect. It probably didn't help that my HRT was ineffective for over 15 years when I trusted it to my GP and my estrogen levels were too low - been under the care of an endocrinologist for the last 10 years and estrogen levels are where they should be but the damage that was done can not be undone.
Yes... it can. The whole issue comes down to genetics and physiology and how well your body responds to estrogen and testosterone blockers. Some do well, some middle of the road, and for some HRT makes little difference. Only time will tell. No guarantees with HRT.
What about in situations where HRT has caused T to drop to female levels or lower? What I mean is, if a person has very low levels of circulating androgens due to chemical suppression, does this have a different effect than suppressing T by removing the testes? Or does the body only continue to masculinize when HRT doesn't adequately suppress androgen production?
I've not had an orchi, but my T has tested 25 or below ever since I started HRT, even when my E levels were relatively low (as low as 72). I don't think I could ask for better results from HRT. I think it has more to do with consistent suppression of T.
Quote from: Angel in the Snow on June 04, 2013, 03:06:24 PM
What about in situations where HRT has caused T to drop to female levels or lower? What I mean is, if a person has very low levels of circulating androgens due to chemical suppression, does this have a different effect than suppressing T by removing the testes? Or does the body only continue to masculinize when HRT doesn't adequately suppress androgen production?
Again, this varies by person and by genetics. My T was super low before HRT... and now postop it's still super low. Now just because I had a low T level pre-HRT, doesn't mean I was waif either. I used to bench 320 lbs. and was a big dude. Now even postop I still can bench 150 lbs. and my cardio ouput level is about the same, if not slightly better for endurance exercises, due to my loss of muscle mass. The only way to find out is to try it and see. There is no one size fits all or even most answer when it comes to HRT. I've seen great and poor results, from both young and old. Genetics and physiology are what matter. Too many variables are involved to make this sort of guess.
I think I see what you're saying. I've had pretty satisfying results so far on HRT, but I was lucky in that my T dropped extremely low with only E (although I'm currently on blockers as well). It seems like, more simply speaking, if HRT suppresses androgen production, it should halt hormonally induced masculinization. But the other scenario you seem to be describing is how some women just have certain masculine physical features, even when they have 'normal' levels of sex hormones, just by virtue of the huge range in human gene expression.
More directly relating to the OP though, I don't really understand how an orchiectomy would have a significant benefit over HRT alone, provided the drugs are suppressing T to low levels. Aren't both scenarios basically just different means to the same end (suppression of T)?
Quote from: Angel in the Snow on June 04, 2013, 06:47:18 PM
More directly relating to the OP though, I don't really understand how an orchiectomy would have a significant benefit over HRT alone, provided the drugs are suppressing T to low levels. Aren't both scenarios basically just different means to the same end (suppression of T)?
Everything I know about MTF HRT basically contradicts the idea that an Orchiectomy is necessary in fully stopping masculinization.
An orchiectomy is just removal of the largest source of testosterone, effectively replacing the need for anti androgens. An orchiectomy would also remove the majority of "bound" T within a person's body.
The only reason I figured that the quote might have some truth to it is that I've heard feminization increases after an orchiectomy.
This is pretty much the same understanding I have. I've also wondered the same thing about supposed increased feminization after orchiectomy, just because it doesn't make sense to me (but my knowlege of human physiology is pretty limited at the moment-- I'm still an undergrad in bio). If sex hormone levels are roughly the same on HRT alone vs. orchiectomy, what could give either case a significant advantage in terms of feminization/demasculinization?
Quote from: Skye-Blue on June 04, 2013, 06:57:41 PM
Everything I know about MTF HRT basically contradicts the idea that an Orchiectomy is necessary in fully stopping masculinization.
An orchiectomy is just removal of the largest source of testosterone, effectively replacing the need for anti androgens. An orchiectomy would also remove the majority of "bound" T within a person's body.
The only reason I figured that the quote might have some truth to it is that I've heard feminization increases after an orchiectomy.
Kia or Skye Blue,
Anti androgens are also known as 'chemical' castrators and a long with other usages, I think they are still given to some people who have committed a sexual offence ...
Metta Zenda :)
Quote from: Angel in the Snow on June 04, 2013, 07:28:10 PM
This is pretty much the same understanding I have. I've also wondered the same thing about supposed increased feminization after orchiectomy, just because it doesn't make sense to me (but my knowlege of human physiology is pretty limited at the moment-- I'm still an undergrad in bio). If sex hormone levels are roughly the same on HRT alone vs. orchiectomy, what could give either case a significant advantage in terms of feminization/demasculinization?
I think I figured it out...if ones T levels are within female range before an orchiectomy, the surgery shouldn't change anything in terms of feminization...
But if a trans woman's T levels are still too high on maximum dose of hrt, feminization will definitely speed up after the remaining T is removed by an orchiectomy.
It's all just a matter of ones T level on hrt before an orchiectomy.
Mystery solved.
:)
Quote from: Kuan Yin on June 04, 2013, 07:31:47 PM
Kia or Skye Blue,
Anti androgens are also known as 'chemical' castrators and a long with other usages, I think they are still given to some people who have committed a sexual offence ...
Metta Zenda :)
Hmm, I forgot about that...
Apparently Spironolactone is also given to patients with prostrate or testicular cancer, as it impedes the growth of new cells within the general areas; the same goes for cyproterone acetate.
I actually welcomed the libido decreasing effects of HRT, while sex offenders see anti androgens as the worst thing that could happen to them...oh the irony.
Quote from: Skye-Blue on June 04, 2013, 07:52:40 PM
Hmm, I forgot about that...
Apparently Spironolactone is also given to patients with prostrate or testicular cancer, as it impedes the growth of new cells within the general areas; the same goes for cyproterone acetate.
I actually welcomed the libido decreasing effects of HRT, while sex offenders see anti androgens as the worst thing that could happen to them...oh the irony.
Kia Ora Skye,
Yes it is quite ironic, but....as the old saying goes "One [wo]man's meat is another [wo]man's poison !"
Meta Zenda :)
The adrenal glands still produce testosterone regardless of SRS and orchiectomy. Without anti-androgens, testosterone from the adrenal glands alone may be high enough to start masculinising the body, as is the case, potentially, in genetic women.
Quote from: Nicolette on June 05, 2013, 03:46:15 AM
The adrenal glands still produce testosterone regardless of SRS and orchiectomy. Without anti-androgens, testosterone from the adrenal glands alone may be high enough to start masculinising the body, as is the case, potentially, in genetic women.
This is not true. In a healthy individual, the adrenal glands in a cis-female or postop MTF trans will not produce enough T by themselves to cause masculizing effects. The only exception would be if there is some other physiological problem, brain tumor, etc, causing overstimulation of the adrenals.
Quote from: JennX on June 05, 2013, 08:58:49 AM
This is not true. In a healthy individual, the adrenal glands in a cis-female or postop MTF trans will not produce enough T by themselves to cause masculizing effects. The only exception would be if there is some other physiological problem, brain tumor, etc, causing overstimulation of the adrenals.
In addition to what you have said, if E is higher (by a large amount) then T, the E will have blocked the majority of hormone receptors in the body. Majority of E causes feminization, majority of T causes masculinization; the degree of the change is reliant on how much E or T there is.
So even though the adrenal glands produce a small amount of T, as long as your E levels are high enough the T wouldn't affect your body appearance.
Quote from: JennX on June 05, 2013, 08:58:49 AM
This is not true. In a healthy individual, the adrenal glands in a cis-female or postop MTF trans will not produce enough T by themselves to cause masculizing effects. The only exception would be if there is some other physiological problem, brain tumor, etc, causing overstimulation of the adrenals.
I agree. That's the potential bit. But I reckon my adrenal glands, post-op, sans anti-androgens would push my T levels higher then they are now pre-op with aa. I hope I will be wrong.
Regarding the OP. If one's T levels are monitored and are low there shouldn't be any further masculinisation in a non-op state. 19 years of HRT is my proof. It's all scaremongering sandwiches.
Quote from: Nicolette on June 05, 2013, 09:14:21 AM
I agree. That's the potential bit. But I reckon my adrenal glands, post-op, sans anti-androgens would push my T levels higher then they are now pre-op with aa. I hope I will be wrong.
I'm postop and mine have not changed much. In fact many SRS surgeons want their MTF patients to use T cream to up the T level a bit to balance things out and increase libido if needed. Optimum postop T levels are between 20-60 ng/dl. I don't do this, but know several other postop girls who do.
Quote from: JennX on June 05, 2013, 09:26:01 AM
I'm postop and mine have not changed much. In fact many SRS surgeons want their MTF patients to use T cream to up the T level a bit to balance things out and increase libido if needed. Optimum postop T levels are between 20-60 ng/dl. I don't do this, but know several other postop girls who do.
60ng/dl is 6 times my current level. With that level, my hair will fall out and my body will explode with body hair and muscles. I exaggerate, but I think I have a little T-phobia! We'll see what happens once I'm post-op. Kind of one of my paranoias.
I would think that the effects of the T are not only influenced by your genetic sensitivity, but also by your SHBG (sex hormone-binding globulin). It seems the cascade is DHT, then T, then androstenediol, estradiol, estrone -- meaning that DHT and T are the first to be eliminated by the SHBG, reducing the free levels significantly.
After the first 6 weeks of taking E-only, my T level had dropped to 424 ng/dl, which is still right in the middle of the male range. Yet it turns out I have a genetic predisposition (which I know of via 23andme, and am very, very thankful for) for high SHBG levels, meaning my FAI (free androgen index) was only 17, which is not quite in the female range (7-10), but anything below 30 is considered "potentially T deficient". My endo nevertheless supplemented anti-androgens at that point, as the drop was not enough in her book.
I would think orchi simply helps ensure that you don't have odd spikes or similar, but unless you are overtly sensitive to T, you should be fine once your measured T is in the female range (or even earlier, see above :)).
If my total testosterone is <14ng/dl or <0.5nmol/L, on 100mg of CPA would I have high free T/DHT?
Turns out that my clueless doc didnt know to test for that and as a result I could have potentially masculinized in the last 7 months,which means that I should add in some dutasteride and other stuff until I get my srs in 2 months time,assuming its still worth it to continue?
You can't state doses on this forum. If your T is under 14 ng/dl, chances are you won't be masculinizing any further. No worries, in my opinion.