I am wondering if anyone knows of a way or has heard of someone being able to have an orchiectomy before the 12-month requirement. And does surgery always require two referral letters? I am curious because I do not like taking more medicine than necessary. I just want to be on my patches. Any success stories regarding this?

Quote from: GingerVicki on December 12, 2018, 09:24:13 PM
I am wondering if anyone knows of a way or has heard of someone being able to have an orchiectomy before the 12-month requirement. And does surgery always require two referral letters? I am curious because I do not like taking more medicine than necessary. I just want to be on my patches. Any success stories regarding this?

SRS for me required one year of real life experience and two letters of referral before my surgeon would do the procedure. I don't know what the requirements are for an orchiectomy.

I am in the US.

QuoteCriteria for hysterectomy and ovariectomy in FtM patients and for orchiectomy in MtF patients:
1. Persistent, well documented gender dysphoria;
2. Capacity to make a fully informed decision and to consent for treatment;
3. Age of majority in a given country;
4. If significant medical or mental health concerns are present, they must be well controlled.
5. 12 continuous months of hormone therapy as appropriate to the patient's gender goals (unless the patient has a  medical contraindication or is otherwise unable or unwilling to take hormones).

quote from the WPATH SOC version 7 pg.60.

My goal is to be an androgynous eunuch. Please don't judge me. "Unwilling to take hormones" is apparently an available option per the guideline. Has anyone been able to do this? I am not trying to 'lawyer' this out but as it states it is a possibility.

Quote from: GingerVicki on December 12, 2018, 09:57:13 PM
I am in the US.
quote from the WPATH SOC version 7 pg.60.

My goal is to be an androgynous eunuch. Please don't judge me. "Unwilling to take hormones" is apparently an available option per the guideline. Has anyone been able to do this? I am not trying to 'lawyer' this out but as it states it is a possibility.

No worries. There is no need to worry about being judged here. Unless you're going to ask which set of clothes looks better or something.

It might be possible but my guess is the intent is for there to be roughly a year of therapy for the documentation part. I think the intent of number five is to indicate that hormones are not required if the person is a nonbinary.

One requirement for full GCS is 1 full year as a women.  I haven't come out yet at work so I can't go down that road yet.  But I am working on getting as close as I can to the two letters. 

My therapist said I could go for the Orchiectomy. I've been on HRT for almost 2 years and all you need is one year.  I'm hoping for the orchiectomy in 2019.  I can then get off the Sprio med but the estrogen I would still need to take.

Meh, I guess I could just go to Mexico. Kinda of a hassle though. I would rather get it done in the US. Not to discriminate but I'm not too young. I am in my 40s and can make these kinda of decisions without "Adult Supervision!"

I feel that I am being treated like a crazy person or a child with these guidelines. I believe that the guidelines themselves discrimination against people like myself. I am fully capable of making my own decisions. Does anyone else feel the same way?

edit: I should add that I don't see a therapist. I did informed consent.

Who's paying?

If its you fully, you may find a surgeon willing.  If insurance, you'll need to jump through whatever hoops they hold up.

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Quote from: TonyaW on December 12, 2018, 10:40:40 PM
Who's paying?

If its you fully, you may find a surgeon willing.  If insurance, you'll need to jump through whatever hoops they hold up.

Sent from my SM-G930T using Tapatalk

<sigh> At the end of the day this is the cold, hard truth.

Quote from: GingerVicki on December 12, 2018, 10:27:49 PM
Meh, I guess I could just go to Mexico. Kinda of a hassle though. I would rather get it done in the US. Not to discriminate but I'm not too young. I am in my 40s and can make these kinda of decisions without "Adult Supervision!"

I feel that I am being treated like a crazy person or a child with these guidelines. I believe that the guidelines themselves discrimination against people like myself. I am fully capable of making my own decisions. Does anyone else feel the same way?

edit: I should add that I don't see a therapist. I did informed consent.

Not really. Transition in it's many forms is a lot to take in. The doctors want to make sure that people are not going to regret it in the future. I believe this aspect is important because I feel if too many people regret the transition the government will step in and make things even worse. Look how the media is already trying to spin it that way.

Plus a therapist help me acclimate to the changes. I know we all wish we can snap our fingers and be done in a instant. I dreamed many nights to wake up and have the problem solved, but it is a process. It isn't to treat us as crazy. It's a diagnostic, to make sure there isn't another issue.

I went through the process and the time went by pretty quickly. I used the year to get voice training, remove my facial hair and save up the money for the surgery. I wouldn't have been able to get SRS any faster simply because it took me that long to squirrel away that much money.

I look at it like this, nothing worth anything is easy. You have to be willing to work for it. My suggestion is that the surgery is the cherry on top. It isn't everything. Your life isn't on pause during that year.

Quote from: TonyaW on December 12, 2018, 10:40:40 PM
Who's paying?

If its you fully, you may find a surgeon willing.  If insurance, you'll need to jump through whatever hoops they hold up.

Sent from my SM-G930T using Tapatalk

Maybe, but a lot won't. My surgeon was absolute, I had to go through the process.

I had an orchie and the requirements are the same as for GRS.  If the orchie is elective it is considered GRS.  Orchies do happen for testicular cancer.

Matter of fact that is how I got my birth certificate changed to female.  Laws vary from state to state regarding Birth Cert changes but Illinois is that you must have gender confirmation surgery and an orchie qualified with a notarized letter from the surgeon that performed it.

I was required to lived a year and have the two therapists letters - same as vaginoplasty.

Quote from: KimOct on December 12, 2018, 11:38:56 PM
I had an orchie and the requirements are the same as for GRS.  If the orchie is elective it is considered GRS.  Orchies do happen for testicular cancer.

Matter of fact that is how I got my birth certificate changed to female.  Laws vary from state to state regarding Birth Cert changes but Illinois is that you must have gender confirmation surgery and an orchie qualified with a notarized letter from the surgeon that performed it.

I was required to lived a year and have the two therapists letters - same as vaginoplasty.

I wonder if a doctor would perform an orchiectomy for post-vasectomy pain?

WPATH is a set of guidelines and Surgeons don't have to follow it, though many do.

Dr Arnkoff has done this before without letters. Not sure he still does.

Dr. Puneet Masson at Penn Medicine in Philadelphia has also done it.

I'd guess if you ask around you'll find others who are willing. If you want to use insurance it's probably best to start there.

Having said all that, I don't think it's a good idea to rush into this. It's a big step and permanent.

AnonyMs beat me to it, WPATH is a set of guidelines, not set in stone. Dr Oates approved my orchiectomy at seven months of HRT.

I knew that I was going to have to do some research but at least now I know that it has been done.

thanks everyone

Quote from: GingerVicki on December 12, 2018, 09:24:13 PM
I am wondering if anyone knows of a way or has heard of someone being able to have an orchiectomy before the 12-month requirement. And does surgery always require two referral letters? I am curious because I do not like taking more medicine than necessary. I just want to be on my patches. Any success stories regarding this?

Orchiectomy can be done with informed consent. When I started hormones, the endocrinologist offered to get me one on our first meeting (which was after 1 meeting with a psychologist). I turned her down... baby steps. But yes, it is possible.

WPATH is not the law as others have stated.

However there are definitely doctors out there who will do an orchi without the year of full time or two letters.  I think that the surgeon who did my SRS does them with just one letter in many cases, but I don't know for certain.

In Colorado and with Kaiser medical, I can get an Orchi with 1 letter and HRT for at least a year.  I think this is mostly Kaiser's requirement.

A lot of the requirements are from insurance companies which are often based on WPATH requirements of various vintages.

Quote from: Colleen_definitely on December 15, 2018, 10:38:19 AM
A lot of the requirements are from insurance companies which are often based on WPATH requirements of various vintages

"...various vintages" That does not sound good.

WPATH is on its sixth or seventh edition, so there have been changes over the years.

That said, if insurance isn't paying for this then the requirements spelled out in WPATH might not apply to you.