[GoneGirl]

I was not aware of this till now, but it is recommended by most gender health clinics that pre-op transwomen under go either SRS or an orchiectomy (removal of the testes) within 2 years of starting HRT. The reason being that continuing taking larger doses of E2 and anti-androgens for longer periods increases the risk of clotting and the danger that presents.

Orchiectomy can be performed on an outpatient basis at rather low cost. A followup operation to construct the vagina, if desired, should take place within a year or two, or before the scrotal tissue shrinks too much. Not everyone wants, or can afford, full SRS surgery. I have no idea what the cost of SRS would be for me, personally, as a Medicare patient, or if I would even qualify for Medicare coverage for SRS.

The cost of an orchiectomy is much less than the cost of the drugs needed to maintain feminization for several years.

This is a new wrinkle for me to consider ahead of my appointment at HBHC next month. They will want to discuss my long term objectives and establish a plan to accomplish them. An orchiectomy might factor into that plan along with establishing an HRT regimen.

Clara

[EvaMarie]

No offense Clara but Im kinda confused here as to why an older trans woman with hardly any T to begin with would need an Orchie???

Id think once you get to a certain age T is naturally so low the large doses of AA wouldnt be needed like a younger person might need to shut down those nasty T factories...

For a younger person looking at a very LONG life ahead, and maybe not much $$$ and still having much higher natural T levels to kill with AA's an orchie makes total sense to me though

Personally when I get there mentally and physically (I have the $$$) Id rather just do the job right instead of half way

That said Im not a doctor either

I would be interested in hearing your docs opinion on your concerns

[GoneGirl]

Well, Eve, this aspect of transition is all new to me, so take my words as my just talking out loud with the possibility of drawing out the facts from those who are really in the know. I thank you for giving me your view.

I'm not sure what my normal T level was before starting NBE. I suspect it was still quite high as it has been going back to age 30 when I was last tested and found to be at the top of the normal male range for my age. For me, indications of a healthy T level were evident even at age 66. High libido, multiple nightly spontaneous erections, no loss of body hair, advanced male pattern baldness, good energy level, and last but not least raging gender dysphoria due to T toxicity.

Even after 4 months on PM, my total T was measured at 109 ng/dl, twice the top end of a natal female's normal range. I very much doubt that T production drops to female levels in most men that are closing in on the age of 70. Sure, there are those who do suffer from very low T, I doubt that I'm one of them.

The other factor for me is the prospect for continued good health and long life. Based on my current health status and my ancestral history, I could easily have another 20 years of healthy and active life ahead of me, not counting the life extending benefits of dropping my T to female levels by having my testes removed. I certainly would not want to risk my health by taking larger doses of E and anti-androgens than necessary over that length of time.

Why do an orchi instead of full SRS? Well, that is certainly a good question that should be carefully considered. Many do just that, but, I agree that a heterosexual transwoman would not be well advised to do the surgery in two steps if she could afford the full SRS immediately.

On the other hand, a lesbian transwoman (e.g., me) in a sexual relationship with a heterosexual female (e.g., my wife) might want to consider keeping her penis if doing so wouldn't negate the objectives of her transition as a whole, but would increase the chances of preserving the relationship indefinitely. I know it is a fictional work, but the experience of the two main characters in the novel Trans-sister Radio caused my wife a lot of concern for exactly that reason.

Of course, that rationale would fly out the window if at some point my sexual orientation changed to straight, and I wanted to experience sexual intercourse with a man as would a natal female. I don't see that happening, but who knows what can happen on this crazy journey.

These are some of the ideas that I will discuss with my HRT advocate/counselor when I appear for my appointment in less than a month. I'm really getting impatient...LOL.

Clara

[SarahSchilling]

Hmm..well...I've thought about an orchie...but for about 4 times the price one could attain the real goal. So it's hard to give up on that for me.

On a side note, it will take more than 2 years for me to save up the money for SRS....so I guess the pharma drugs will kill me before then

[bobie]

As far as im aware here in the uk the norm is 2 years of living full time as a woman before the nhs will give you srs so i suspect the within 2 years you have read is just someones opinion and i wouldnt get too hung up on it, plus there are plenty of transgender individuals who never have srs anyway

[karolina]

know this is a old subject . but alot of girls digg stuff up like me and I want my opinion to show on this . iam a transsexual female . 24 years of age . I dont care who say or do wat clara is rite . an if your doctors say different you are at risk of improper care for transsexual women . especially at Clara's age higher hormones and blockers put her at risk . even younger girls like me are at risk . its best that transsexual women after 2 years of hormones get the Poison factories(testicles) removed as I call them . especially taking into account how transsexual women live by tucking . moving the testicles back in the pre puberty position . this may result in problems long-term . Androgen Insensitivity Syndrome women have testicles that must be removed . and the same protocol must be followed with transsexual women . coz they share the same risk . hope this clear up all issues .
why keep pumping a women full of pills at a dangerous dose to fight the testicles hormone production . testicles has two functions . 1 to keep you male looking by male hormones. and 2 to reproduce . after two years kiss kids goodbye for 95 % . and you take hormones to fight the male hormones an go into a female puberty . so good transsexual care will remove testicles after two years . Get IT . coz they have nomore use .

[EvaMarie]

Hi Karolina

I agree with with you there, its only been a year now on HRT for me...
I cant see going more than another year as they are even more worthless now than they were 9 months ago when I posted on this thread I considered seriously an orchie a just a few months into HRT because I knew SRS was so far off and Id rather not have to take so much AA...

Thing is Im seeing there is something to the whole "don't get an orchie if you want SRS" I think.... Im already worried there wont be enough left there for a good result already, there has been a lot of shrinkage over the last year I could see that getting a lot worse after even a year post orchie....

Besides that why go through the additional pain and suffering and expense with an extra surgery... Surgery is no fun but Id rather just get SRS and hopefully only one operation with no need for revisions...

Hopefully in the fall this year

[CalmlyAndrogynous]

Orchiectomy is simple surgery from what I understand. Nothing much can go wrong and it probably does not even need a general anaesthetic.

SRS though is a big deal I believe, hours under a general. It is a decision I will have to make when I am well in to HRT (seeing an endo in a couple of months), but the orchiectomy is a given. I want them gone. SRS ...

[bobie]

Trouble with having an orchiectomy though is that it can mean poorer results when it comes to srs if you need the scrotal skin, having thought about it (and having just had a shot) i now see the decapeptyl etc that the nhs use as a good move, the benefits of an orchiectomy without effecting the outcome of srs at a later date, knowing a bit more about it now im in the system it looks like a 4 year wait for srs on the nhs from the time you start your rle, that is unless things change for the better

[ElainMoria]

Orchie's can be done for a few reasons, one of them is testicular cancer. In those cases a silicon or other type of artificial testicle(s) can and often is placed within the scrotum to replace the missing testicle(s) so the appearance stays the same. Having an Orchie for HRT reasons.. it would be a good idea to have the testicles replaced with the implants to keep the scrotal skin stretched and in decent shape for future SRS if you can find a doctor willing to do it.

~Elain