Orchiectomy is performed for trans women who would like to avoid, or stop, taking testosterone blockers like spironolactone which can have significant long term side effects or who simply wish to improve the dysphoria associated with the testicles. Testosterone production stops immediately with removal of the testes and accelerates the feminizing effects of estrogen therapy and induces feminization in those who can not use estrogen due to expense or medical contraindications.
Dr. Sherie will also perform orchiectomy for males who wish to remain male with a recommendation from a licensed mental health professional.
For trans women who do not plan to pursue vaginoplasty in the future we remove the scrotal skin, leaving a very light, thin scar and a smooth area from the base of the penis to the anus.
For those who are considering vaginal creation in the future we will leave the scrotal skin in place and make a small incision through the middle of the scrotum to perform the orchiectomy. The scrotal skin will retract, or shrink towards the body, after removal of the testes.
Orchiectomy is a low risk procedure out patient which requires a short time under anesthesia and is performed in our private operating rooms. You will be attended by the same staff you met and spoke to during your phone or in-office consultation. You will be able to go home with your care-giver after a short time in recovery. We can also provide a caregiver for you the night of surgery if needed.
You can shower the day after surgery; and can drive when you are no longer taking the postoperative pain medications. The procedure is done under anesthesia or deep sedation; and during the procedure, Dr. Sherie will inject numbing medication throughout the area. Most patients have mild discomfort and swelling in the area for a few days after surgery. You may also experience occasional crampy or spasmic feelings where the testicular cords are cut. That will subside after the first 24-72 hours postop.
Orchiectomy causes permanent infertility and an increased risk for osteoporosis, loss of muscle mass, decreased sex drive, and breast enlargement. Per WPATH standards, we require one letter from a licensed mental health provider prior to orchiectomy. We will also consider a letter from your medical physician if you are already taking testosterone blockers or estrogen therapy.