An orchiectomy is a gender-affirming procedure for the lower body. It entails removing the gonads (testes) and spermatic cord. This type of surgery can be performed with or without scrotectomy, which is the removal of the scrotal sac.
What Is the Goal of an Orchiectomy?
Many people opt for an orchiectomy so that they can take a lower dose of estrogen-based medications. These medications can have adverse side effects, so having an orchiectomy will minimize the risks and effects of the drugs. If you undergo an orchiectomy, you will also no longer needing to take testosterone blockers.
A urologist performs an orchiectomy. Some folks will undergo an orchiectomy and then have a vaginoplasty down the line; however, many people have both done during one surgery.
If scrotectomy (removal of scrotal tissue) is done, the tissue will be removed that is usually used to form the vaginal lining during vaginoplasty. Additional skin grafts, like from the upper thighs, for instance, may be needed. For some, they will only have an orchiectomy.
Is This Procedure Right for Me?
An orchiectomy is an affordable surgery with a short recovery period.
It may also be an initial step towards vaginoplasty. For some folks, they will have both procedures done at once. However, scheduling them separately is acceptable, too.
Here are some other gender-affirming procedures that are complementary with an orchiectomy:
- Partial penectomy: A penectomy is when a surgeon removes a part of the penis. It is also used as a treatment choice for penile cancer.
- Labiaplasty: A labiaplasty is when a labia is constructed by using skin grafts.
An orchiectomy is also an excellent option for those who have an adverse response to feminizing hormones or are interested in minimizing the health risks and side effects that are a result of these medications. After the procedure is performed, your body will generally produce less endogenous testosterone, which means you can take lower doses of feminizing hormones.
In addition, according to research, orchiectomy surgeries may be protective metabolically for transgender women.
What Can I Expect Before and During the Procedure?
Before the procedure, your doctor will discuss the following with you:
- Whether or not you’re experiencing gender dysphoria.
- If you can consent to treatment and make an informed decision.
- Make sure that your mental health is stable or any other medical problems.
- That you are considered the age of an adult wherever the procedure will be taking place.
A doctor will request provided letters of preparedness from two separate mental health professionals. You will also need to complete a minimum of one year (12 consecutive months) of hormone therapy before you can have an orchiectomy.
The surgery itself takes about 30 to 60 minutes. Before the procedure begins, your doctor will use local anesthesia to ensure you fall asleep, so you don’t feel anything. They will then make an incision in the center of the scrotum. They will also remove one or both testes and then close the incision with sutures.
This type of surgery is an outpatient procedure meaning that you’ll go home the same day.
What Will the Recovery Be Like?
The recovery process from this procedure can be anywhere from a few days to a week. Your doctor will prescribe the necessary pain medications and antibiotics to protect you from infection.
Depending on how your body responds to the orchiectomy, your doctor may minimize your estrogen dose and taper off any androgen blockers that you were taking before the surgery.
Are There Any Side Effects or Complications?
With any surgery, there are side effects or complications. You may experience:
- Damage or injury to nearby organs
- Unhappiness with the results
- Nerve damage
- Loss of sensation or feeling
- Lower libido and energy
Transgender women who have an orchiectomy done, however, can experience positive side effects, like:
- A significant decrease in testosterone, which will likely allow you to minimize your dose of feminizing hormones
- Reduction in gender dysphoria as you will be closer to matching your physical appearance with your gender.
An orchiectomy has many benefits for transgender, non-binary, and gender non-conforming patients. As previously mentioned, it can reduce the need to take a large dose of feminizing hormones. It can also be an essential step towards having a vaginoplasty (when a surgeon creates a functioning vagina) done.