Many transgender patients choose to start their surgical transition process with an orchiectomy. Orchiectomy is a procedure where a surgeon removes the testicles.
For transfeminine patients, having an orchiectomy may also make your hormone regimen simpler later on. That’s because after the testicles are removed, the amount of testosterone (or male hormone) that your body makes drops to almost zero.
By dropping the amount of testosterone that’s produced by your body, you may be able to take less estrogen.
Taking less estrogen may also lower your chances of developing blood clots and other health problems that may be associated with high doses of estrogens.
Hormones can be complex. It’s best to talk with your doctor who’s prescribing your hormones before you have an orchiectomy so that you understand exactly how your hormone therapy will change after surgery.
WPATH Standards of Care
The providers follow WPATH Standards of Care, which require TWO letters of support from qualified mental health care professionals prior to the surgery.
Criteria for Orchiectomies
- Persistent, well documented gender dysphoria;
- Capacity to make a fully informed decision and to consent for treatment;
- be the age of majority in a given country;
- If significant medical or mental health concerns are present, they must be well controlled;
- Twelve 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).
Orchiectomy is a simple procedure performed inside an operating room. You will be under general anesthesia so you won’t feel any pain. The procedure takes about 20 minutes.
Your surgeon will make an incision (or cut) about an inch long in the middle of the scrotum. Then your surgeon will clamp your spermatic cord and tie some strong stitches around it to prevent bleeding. After that, your surgeon will cut your spermatic cord and remove your testicles. Your surgeon will then close your incision with absorbable stitches that will dissolve on their own.
You will have some bruising in your scrotum area after the surgery. Complications are mostly related to bleeding inside the scrotum.
The medical term for blood that accumulates (or pools) in the scrotum is a hematoma. But less than five percent of patients get hematoma after having an orchiectomy.
Like any surgery, you may have pain around your cut or where your testicles were removed. But this is also rare.