"possible vs probable"

[MikeP]

Good morning all, I was wondering about the "possible vs probable" effects of an orchiectomy and also what difference there is between using medication to lower T vs surgery.   Looking for things to think about as I consider a path to take. Love to hear what you think. 

I am seeing a gender specialist and I am looking at a path to deal with dislike for being overly masculine and desire to be more sensitive and feminine.

My ideal would be to eliminate hyper-masculine features, hair, testicles,rough skin,and somewhat insensitive mannerisms and become more sensual than sexual.   

The list I am referring to

1. Loss of body hair? I have a lot and this would be a plus.

2. Loss of erections?  Not much going on there now.  Difficult at best and no benefit to marriage now.  " wife has vaginal issues"

3. Lower sex drive? I do spend a lot of time thinking "obsessive" sexually and could lend way to thinking and doing other things.

4. HOT FLASHES!  Big concern.  My wife suffers from them and hates them.  Manageable?   

5. Gynocomastia?  Boobs.?  Is it breast mass or projection. What to expect?  I enjoy what I have now 42 chest 46 bust.

6. Androgen deprivation/Chemical castration?  loss of testicle volume?  Penis shrinking? I like both

7. Cognitive function?  This is a big one for me to know about.

8. Loss of strength? Lethargy? Muscle mass is one thing but becoming lethargic is a bigger concern. 

9. Peaceful Calm?  Mental peace and satisfaction or depression?

10. Other medical issues?   


Thanks so much friends for your help, Mike from Silicon Valley

[josie76]

Confused  are you on any type of HRT now? An orchiectomy is a permanent thing.

If you have neither testosterone or estrogen in your body you will experience a lot of issues.
Osteoporosis, bone loss
Muscle loss, yes without T muscles shrink
Body hair, maybe some. Your adrenal glands still manage to produce other androgen hormones that do stimulate hair folicules.

You definitely need to spend time with a therapist and figure out things inside first. Many doctors then prefer to start you on a low dose HRT trial to see if you find the hormone switch positive or negative. If you are thinking of just castration without HRT you will not likely find a doctor who wants to do it. Long term risks like osteoporosis are bad. You need to speak with an endocrinologist. Perhaps in your particular situation you might find peace with lowered T levels instead of removal of it completely. Definitely figure it out with a therapist. Good luck.

[MikeP]

Thanks Josie, I am seeing a gender specialist right now and go to group transgender meetings.  In addition to my dysphoric questioning I have chronic orchalgia and a hydrocele on my left testicle.  The urolidgist is not aware of my gender questioning yet.  I have always thought male to eunuch fit me since puberty but never seriously pursued.  Now I deal with obsessive thoughts about my sexuality and have taken steps to find out what I can do.  HRT is something I discuss in the group and they say trial and error. 

I hope to limit the error part. I have no reservation to surgery and appearance but the emotional effects I need to understand.  So some type of HRT needs to be on the table wheather it is to find out if I do well without T or to discuss what min of T is needed to feel OK.  I am doing a lot of thinking about feminization now and how much I would want.  I like some sides of M and F.   Seems like a lot of prostate cancer guys do fine without T and add E but I need to address my dysphoric "not quite male"

Hope to get some real life answers here.  Thanks so much, Mike

[Dena]

From viewing the site I can provide general knowledge answers to your questions as your not getting many takers on this thread. Remember that YMMV applies to almost everything in the transition so these answers will cover a lot of ground.
1. Loss of body hair? I have a lot and this would be a plus.

I didn't have any body hair to lose so I can't answer this from personal experience. It seems that you will lose body hair and it will follow a feminine pattern but you may not lose all of it. It would be best to avoid body hair remove until you have gone about a year without T so you don't pay for something you don't need.

2. Loss of erections?  Not much going on there now.  Difficult at best and no benefit to marriage now.  " wife has vaginal issues"

This varies from person to person. Things become less active but many member with a little work can keep the skin stretched out for surgery. Some people lose all function but that can also apply to CIS men as they age.

3. Lower sex drive? I do spend a lot of time thinking "obsessive" sexually and could lend way to thinking and doing other things.

Sex drive will diminish but if your a sexually interested personality, it's not going to go away completely. You should find that you have better control over it and when you want it, it will be there.

4. HOT FLASHES!  Big concern.  My wife suffers from them and hates them.  Manageable?   

Estrogen will stop the hot flashes. Without estrogen, your in for a couple of years of them. They are an irritant but they won't stop life unless you let them. For health reasons, I don't recommend discontinuing estrogen other than as needed for surgery but the dosage may be dropped enough to put you in the menopause range.

5. Gynocomastia?  Boobs.?  Is it breast mass or projection. What to expect?  I enjoy what I have now 42 chest 46 bust.

If your not on estrogen, don't expect boob growth. Normally male estrogen is produced when there is an excess of testosterone - the body coverts testosterone to Estrogen in both females and males. If your on estrogen, you will develop boobs. Low dose will slow the process but you should expect to eventually reach your genetic potential. This means you could end up a AA cup size or a DDD just with estrogen.

6. Androgen deprivation/Chemical castration?  loss of testicle volume?  Penis shrinking? I like both

AAs can have the same effect as castration (see above) and testicles can shrink. It will also produce all the mental effects so I would recommend trying AAs long enough to make sure the effects are right for you. Once the right dosage is determined, the effects can kick in pretty quickly.

7. Cognitive function?  This is a big one for me to know about.

Some people report they lose some ability to concentrate. I suspect the effect is temporary and tends to be associated with higher estrogen levels. My levels have never been that high and I find the lack of distractions from Gender Dysphoria helps me concentrate better.

8. Loss of strength? Lethargy? Muscle mass is one thing but becoming lethargic is a bigger concern. 

I never lost much muscle mass because I never had it. I could never chin my self in PE and pushup at best I could only do a few. Sit ups were another matter and I aced that one. Member who were into body building have reported a loss of muscle mass. You can maintain much of your strength if you continue to work out but it might not be at the same level you were at previously. Lethargy only happens if you let it. If you continue to be active and interested in life, it's not a problem. Children are extremely active and they have neither T or E in their system but they have a natural curiosity about life.

9. Peaceful Calm?  Mental peace and satisfaction or depression?

If your transgender, it aids in ending depression. Just remember that dysphoria can be body dysphoria or social dysphoria. Not addressing those means your only addressing half the problem. I am aware of members who have only attacked the testosterone side of things and they still experience social dysphoria.

10. Other medical issues?   


If you have prostate issues, it's a nifty treatment for it. Other than that, it can affect blood sugar and you may find weight easer to gain. A few members have had issues with DVTs to the point where the doctor stopped estrogen for an extended period of time. This is very rare but it does happen.

[jill610]

I am a little confused about what is leading you to these desires, please make sure you understand the long term consequences here. Some are not reversible. Anyways, a few thoughts...

1. Loss of body hair? I had a lot and this would be a plus.

Yes, some thinning but highly individualized. I ended up getting laser on my chest, torso, and arms because it was not really thinning and I got tired of shaving. HRT has virtually no effect on facial hair unless you are pre-puberty.

2. Loss of erections?  Not much going on there now.  Difficult at best and no benefit to marriage now.  " wife has vaginal issues"

Mostly, and think raisins for testicular volume. After 11 months HRT I have zero ejaculate and T <3 ( so, not measurable)

3. Lower sex drive? I do spend a lot of time thinking "obsessive" sexually and could lend way to thinking and doing other things.

I had zero sex drive until I started taking progesterone, and I came mostly back.

4. HOT FLASHES!  Big concern.  My wife suffers from them and hates them.  Manageable?   

That is a sign of menopause or a hormonal imbalance. You will not have this unless you and your dr engineer a hormonal experience that mimics cis cycles. I do this... 28 day cycle and trans pms is a real thing.

5. Gynocomastia?  Boobs.?  Is it breast mass or projection. What to expect?  I enjoy what I have now 42 chest 46 bust.

You will get some growth. Ymmv.

6. Androgen deprivation/Chemical castration?  loss of testicle volume?  Penis shrinking? I like both

Yes to reduced testicular volume and no to penile shrinking.

7. Cognitive function?  This is a big one for me to know about.

Your IQ and intelligence won't change. Your thought processes and EQ likely will.

8. Loss of strength? Lethargy? Muscle mass is one thing but becoming lethargic is a bigger concern. 

Lethargy is a real issue if your T is too low.

9. Peaceful Calm?  Mental peace and satisfaction or depression?

Most say yes, but in the sense that the dysphoria went away. For me the peace did not happen until I was presenting full time, had my name and documents changed and could start to see my face as more feminine than masculine. I am having FFS in a few months because I still have massive dusphoria due to me seeing a man when I look at myself in the mirror.

10. Other medical issues?   

All sorts of potential complications of HRT DEPENDING ON YOUR BIOLOGY, health history, the specific drugs and dosages you are on, etc.

Increased risk of blood clots and breast cancer. Fun part is now you are on the risk list for things that affect both males by genetics and females by biology/hormones. And you still have a prostate so still have to worry about that.

[Donna]

Good morning all, I was wondering about the "possible vs probable" effects of an orchiectomy and also what difference there is between using medication to lower T vs surgery.   Looking for things to think about as I consider a path to take. Love to hear what you think. 

I am seeing a gender specialist and I am looking at a path to deal with dislike for being overly masculine and desire to be more sensitive and feminine.

My ideal would be to eliminate hyper-masculine features, hair, testicles,rough skin,and somewhat insensitive mannerisms and become more sensual than sexual.   

The list I am referring to

1. Loss of body hair? I have a lot and this would be a plus.

2. Loss of erections?  Not much going on there now.  Difficult at best and no benefit to marriage now.  " wife has vaginal issues"

3. Lower sex drive? I do spend a lot of time thinking "obsessive" sexually and could lend way to thinking and doing other things.

4. HOT FLASHES!  Big concern.  My wife suffers from them and hates them.  Manageable?   

5. Gynocomastia?  Boobs.?  Is it breast mass or projection. What to expect?  I enjoy what I have now 42 chest 46 bust.

6. Androgen deprivation/Chemical castration?  loss of testicle volume?  Penis shrinking? I like both

7. Cognitive function?  This is a big one for me to know about.

8. Loss of strength? Lethargy? Muscle mass is one thing but becoming lethargic is a bigger concern. 

9. Peaceful Calm?  Mental peace and satisfaction or depression?

10. Other medical issues?   


Thanks so much friends for your help, Mike from Silicon Valley

This is some list
Antiandrogens , chemical castration or orchi. All different result but similar
1-yes you will have it but each method affects hair differently. Some cause hair lose, other hair thinning and some cause head hair thickening
2-I have this and am on antiandrogen and chemical castration and scheduled for orchi
3-my sex drive disappeared almost a year ago with maybe three semi erections in that time
4-oh yes. You will get them. Some worse than other but lupron gave me the worse ones. Eligard caused them as well but estrogen has smoothed them out some
5-there is no way possible to know where, when and how much you will get. Your body will dictate that but you seem to be doing fine at 42D I was a 40 C at the start of estrogen in January and I'm now 38DDD. These are my results and very likely not typical
6-one testicular is the size of a pea but has an unshelled peanut size cyst on it. The other one has 4 cysts so know way to know how much is left ( these issues are not from HRT) My penis is hidden inside me and about 1/2 inch long now. May or may not be from HRT but I love it.
7- it's been describes to me as pregnancy brain fromthe dropping T and rising E
8-about a 29 percent lose for me. Resistance training helps
9-absolutely for sure. You will live it
10-muscle and joint pain mostly
These are my observations and everyone is different

[MikeP]

Thanks for all your responses so far.  Other than my physical need to address my hydrocele and long time pain I am hoping like it has been said that I could concentrate on more important issues that need my attention rather than endless searching for answers to the unknown reasons for my gender variations all my life

I am doing all this with advice of my MD and would like input for what to try to see if ADT or HRT is right? 

Love you all, look forward to your input, Mike

[GordonG]

MikeP thanks for posting this. I'm considering a surgical castration after I test the waters with a chemical one.

[Donna]

Chemical is not cheap if you have to pay yourself,  just be warned if you go with an injectable. Lupron was $1800 (6 month shot)when I took it. I just picked up my second eligard for tomorrow and it's dropped to $1450 (4 month shot). But it will really let you feel the changes and hot flashes and breast pains. I love these as they are all
Signs of good things to come.

[MikeP]

MikeP thanks for posting this. I'm considering a surgical castration after I test the waters with a chemical one.

Gordon what are you going to use?  I would be interested. I will be talking with a endo soon.  My understanding is spiro is the anti androgen but I see others have tried Lupron.  My biggest concerns are hot flashes.  Seems there is a lot of trial and error in this HRT.  Love to know more before seeing the endo.  Smiles!

[MikeP]

I am a little confused about what is leading you to these desires, please make sure you understand the long term consequences here. Some are not reversible. Anyways, a few thoughts...

1. Loss of body hair? I had a lot and this would be a plus.

Yes, some thinning but highly individualized. I ended up getting laser on my chest, torso, and arms because it was not really thinning and I got tired of shaving. HRT has virtually no effect on facial hair unless you are pre-puberty.

2. Loss of erections?  Not much going on there now.  Difficult at best and no benefit to marriage now.  " wife has vaginal issues"

Mostly, and think raisins for testicular volume. After 11 months HRT I have zero ejaculate and T <3 ( so, not measurable)

3. Lower sex drive? I do spend a lot of time thinking "obsessive" sexually and could lend way to thinking and doing other things.

I had zero sex drive until I started taking progesterone, and I came mostly back.

4. HOT FLASHES!  Big concern.  My wife suffers from them and hates them.  Manageable?   

That is a sign of menopause or a hormonal imbalance. You will not have this unless you and your dr engineer a hormonal experience that mimics cis cycles. I do this... 28 day cycle and trans pms is a real thing.

5. Gynocomastia?  Boobs.?  Is it breast mass or projection. What to expect?  I enjoy what I have now 42 chest 46 bust.

You will get some growth. Ymmv.

6. Androgen deprivation/Chemical castration?  loss of testicle volume?  Penis shrinking? I like both

Yes to reduced testicular volume and no to penile shrinking.

7. Cognitive function?  This is a big one for me to know about.

Your IQ and intelligence won't change. Your thought processes and EQ likely will.

8. Loss of strength? Lethargy? Muscle mass is one thing but becoming lethargic is a bigger concern. 

Lethargy is a real issue if your T is too low.

9. Peaceful Calm?  Mental peace and satisfaction or depression?

Most say yes, but in the sense that the dysphoria went away. For me the peace did not happen until I was presenting full time, had my name and documents changed and could start to see my face as more feminine than masculine. I am having FFS in a few months because I still have massive dusphoria due to me seeing a man when I look at myself in the mirror.

10. Other medical issues?   

All sorts of potential complications of HRT DEPENDING ON YOUR BIOLOGY, health history, the specific drugs and dosages you are on, etc.

Increased risk of blood clots and breast cancer. Fun part is now you are on the risk list for things that affect both males by genetics and females by biology/hormones. And you still have a prostate so still have to worry about that.

Thanks so much for the information and I apologize for not replying sooner.  All the information that has been provided is helping me talk with my therapist about next steps.  I was wondering about 7. and what EQ means?  Thanks so much. 

#7 Your IQ and intelligence won't change. Your thought processes and EQ likely will.

[jill610]

Thanks so much for the information and I apologize for not replying sooner.  All the information that has been provided is helping me talk with my therapist about next steps.  I was wondering about 7. and what EQ means?  Thanks so much. 

#7 Your IQ and intelligence won't change. Your thought processes and EQ likely will.

EQ is emotional intelligence, how you relate to other people and take that into account in the way in which you interact with them.

[MikeP]

EQ is emotional intelligence, how you relate to other people and take that into account in the way in which you interact with them.

Now that would be a great positive.  It has been tiring to read all the Possible side effects that are published knowing that most are not probable for each person.  Do you know of the preferred ways of AD before having a orchi that closely mimic the effects of the surgery?  Thanks so much.

[GordonG]

Gordon what are you going to use?  I would be interested. I will be talking with a endo soon.  My understanding is spiro is the anti androgen but I see others have tried Lupron.  My biggest concerns are hot flashes.  Seems there is a lot of trial and error in this HRT.  Love to know more before seeing the endo.  Smiles!

Mike
I'm just starting my third week on spiro. Have increased the dose a little each week. Really haven't had any side effects yet except feeling tired once in awhile.  I'm not wanting to grow breasts so have made a diary to log weight and some key measurements.  If the chest starts expanding then i have to decide what to do.  Continue or decide on surgery or stop.

[Donna]

Even though I'm taking eligard I still take spiro for fluid and BP. My hot flashes wee several times a day until the T dropped very low and then when I started estrogen it smoothed out the hot flashes. Now I may get a couple a day or none for a couple days. In my mind I figure the hot flashes are due to what I want to happen( feminization) so I will live with them.

[GordonG]

I'm just finishing my third week of Spiro and have had two hot flashes so far and a general decrease in sexy thoughts.  The morning erections are way down too. I'm liking it so far except for the tiredness. I've resorted to drinking a energy drink once a day a few times, but know that I shouldn't go too far in that direction. I have some coworkers where I work that drink like 2-4 of them a day! That is just way too much right?