Gender Reassignment Orchiectomy: Here’s What You Need to Know

If you plan to transition from male to female you might already be taking testosterone blocking hormone and estOrchiectomy is the surgical removal of one or both testicles. It’s considered the first step if you’re planning on having vaginoplasty in the future. However, it also a treatment option for testicular cancer or tumors .

The procedure is a good option for people who don’t react positively to hormones and medications intended to make them more feminine .

Now, take note that orchiectomy is different from scrotectomy. One removes the testicle and the other removes the scrotum.

In this procedure, the surgeon takes out a portion or the entire scrotum.  If you will be undergoing vaginoplasty scrotectomy may cause some problems.

Types of Orchiectomies

For gender reassignment, there are two main types of orchiectomy to consider.

Simple orchiectomy

In this procedure, an incision is created down the scrotum’s center. After cutting the fasciae and muscle in the area, the testicles are then removed. Once they are taken out, the surgeon ties the spermatic cord with the use of non-dissolving sutures.

A simple orchiectomy is done under a local or general anesthesia. It takes about 30 minutes to a full hour to complete in an outpatient setting.

Radical Orchiectomy

Radical or inguinal orchiectomy is done on trans women to prevent scrotal scar tissue which can complicate future plans of having gender reassignment surgery.

For this procedure, the surgeon creates an incision measuring about 2.5 inches just about the pubic bone on the upper side of the testicle that is being extraction. In case you’re getting all your testicles removed, then the incision will be created bilaterally.

After creating the incision, the testicle will be pulled and the spermatic cord will be cut after being clamped off in two areas. Clamping before cutting is supposed to help prevent or minimize blood loss.

The procedure should take about 45 minutes to an hour and a half to complete.

Before the Procedure

Prior to the surgery, you may need to prove your readiness to your surgeon. For that, you’ll need to sign a consent form as proof that you are making a fully informed decision. Remember, you should only sign it if you completely understand the procedure, its side effects, and possible complications.

Apart from that, you should also be free from any unmanaged medical and mental problems. Your age will be verified, too.

Your surgeon may require you to show letters of preparedness. You need to secure them from 2 different mental health professionals. Before undergoing the surgery, you may also be required to complete a year of hormone therapy.

During the procedure

As previously discussed, there are two main types of orchiectomy performed for gender reassignment. In both types, you’ll be given an anesthetic agent and incisions will be made depending on the number of testicles removed.

Orchiectomy is considered an outpatient procedure which means that you won’t have to spend the night in the hospital. In the procedure is done in the morning, you should be able to get home within the day.

After the procedure

The recovery for the procedure can take a few days to a full week. During recovery, you’ll likely be prescribed with pain medications to make you as comfortable as possible. You will also be instructed to take antibiotics to prevent possible infections.

After surgery, your estrogen dose may decrease. On the same note, your preoperative androgen blockers may also be tapered off.

For the next couple of days after the surgery, try to increase your fluid intake. As much as possible, limit your consumption of alcoholic and caffeinated beverages.

Until your next visit to your doctor, you’re discouraged from having sex, lifting heavy objects, and engaging in vigorous and physically demanding exercises.

While you can take a shower, you should avoid taking tub baths. They can cause premature dissolving of your absorbable stitches.

The Effects of Orchiectomy

Most of the effects of an orchiectomy are due to the decrease in the level of testosterone in the body. There are certain factors that can minimize or maximize the said effects, like the person’s age as well as the number of testicles removed.

The time the orchiectomy is done plays a role, too. For example, if the bilateral orchiectomy (removal of both testicles) is done before puberty, the person won’t have to worry about developing secondary male characteristics even if he’s not placed on testosterone replacement therapy.

If the procedure is done after puberty, the person may experience loss of body hair, less interest in sex, reduction in breast size, and increased muscle fat.

As for facial hair growth, it will only slow down but not completely stopped. The voice will also remain deep.

If a single testicle is removed, the remaining testicle will work extra hard to increase the testosterone in the body. This means that there won’t be a lot of changes.

Regarding health consequences, a person who’s been castrated won’t be able to produce sufficient testosterone to stop or prevent osteoporosis from happening. Because of that, hormone replacement therapy will be required for life.

The Common Complications

Like most surgeries, orchiectomy comes with certain risks, too. The most common of them is bruising on the area of the scrotum. There can also be swelling, pain in the scrotum and abdomen, and spotting of blood.

Hematoma can also happen after surgery. It’s a condition where blood pools in the scrotal area and cause swelling. It sometimes changes the color of the skin.

These complications aren’t that serious and should subside after a couple of days or weeks. If they don’t go away after such time, it’s important to see your doctor right away. Complications can prolong healing time and may put you at risk of more serious problems.

The procedure can also lower your libido and energy. In some cases, it also results in nerve damage, injury to the surrounding organs, and infection.

Orchiectomy can also affect fertility. If you are planning on having a baby, it’s best to consider having your sperm cells saved in a sperm bank even before you start taking hormone treatments.