Last Updated on September 21, 2023 by Shabnam Sengupta
Orchiectomy, also known as orchidectomy, is a surgical procedure that involves the removal of one or both testicles. It is commonly used as part of the transition process for transgender women and non-binary people assigned male at birth. Orchiectomy is one of the most critical surgeries among male-to-female surgeries under Gender Affirmation surgeries. The specific type of orchiectomy performed can vary, depending on the individual’s goals and the specific circumstances of their case. Before undergoing orchiectomy, individuals should consult with a qualified healthcare professional to discuss the potential risks and benefits.
Different types of orchiectomy
There are three main types of orchiectomy procedures.
Simple orchiectomy
A simple orchiectomy involves the removal of both testes through a small incision in the scrotum. Surgeons typically perform this procedure under general anaesthesia. You can undergo simple orchiectomy on an outpatient basis.
A study published in the Journal of Urology states that a simple orchiectomy is a safe and effective procedure for transgender women and non-binary people. This type of orchiectomy often results in a significant reduction in testosterone levels, which can help alleviate gender dysphoria and make hormone replacement therapy more effective.
Subcapsular orchiectomy
The subcapsular orchiectomy involves removing the tissue from inside the testes while leaving the outer shell intact. The advantage of this type of procedure is that it leaves the scrotal appearance unchanged, which can be beneficial for individuals who are not planning to undergo genital reconstructive surgery.
Research published in the International Journal of Transgender Health suggests that subcapsular orchiectomy can be a good option for transgender women and non-binary people who wish to maintain the appearance of their scrotum while reducing testosterone levels.
Inguinal orchiectomy
Finally, an inguinal orchiectomy involves the removal of the testes through an incision in the lower abdomen rather than the scrotum. This procedure is more invasive than a simple orchiectomy and typically requires a longer recovery period. A study in the American Journal of Surgery found that an inguinal orchiectomy can be more effective at reducing testosterone levels than a simple orchiectomy, but it also carries a higher risk of complications. This process is typically the most invasive type and is often used for testicular cancer rather than gender-affirming surgery.
Choosing the right type of orchiectomy is a personal decision that should be made in consultation with a qualified healthcare provider. It is important to carefully consider the risks and benefits of each procedure before making a decision.
The benefits of orchiectomy for transgender people
For transgender women, orchiectomy can serve as a crucial step in their transition journey, reducing the levels of testosterone (a male hormone) in the body, and thus, limiting the effects of masculinization. This, in turn, allows estrogen (a female hormone) to have a more significant impact on the body, bringing about changes that align more closely with a patient’s gender identity.
The two major benefits a transgender person may seek from the orchiectomy are:
Reduced dependence on hormone therapy
Undergoing an orchiectomy can significantly reduce the need for hormone therapy in transgender women. Regular intake of estrogen as well as anti-androgens forms the basis of hormone therapy for trans women, aiding them to develop more feminine physical characteristics. After an orchiectomy, the body produces a significantly lesser amount of testosterone, thus making hormone therapy less essential.
Physical and psychological benefits
An orchiectomy can also have both physical and psychological benefits for transgender women. Physically, removing the testes can help to create a smoother, more traditionally feminine
An orchiectomy, also commonly referred to as ‘testicle removal surgery,’ can entail both physical and psychological perks for transgender women. From a physical aspect, eliminating the testes can help yield a smoother, more traditionally feminine profile.
The orchiectomy procedure: What to expect
As with any surgery, an orchiectomy requires some preparation. Your healthcare provider will likely advise you to:
- Avoid eating or drinking for a certain period before the surgery
- Quit smoking or using recreational drugs to promote better healing
- Discuss any medications you are currently taking
The operation itself typically takes about 30 to 60 minutes. It involves the removal of one or both testicles, through an incision in the scrotum. This surgical procedure is conducted under anaesthesia to minimize discomfort.
Recovery tips for a smooth orchiectomy healing process
The healing process post-orchiectomy can be a challenging phase for any individual, including transgender people. It is imperative to follow certain guidelines to ensure a smooth recovery. This article lays out some of those helpful tips, all of which are supported by research.
Post-surgery care
Ensure you take ample rest and avoid strenuous activities for a few weeks after the surgery. The dressing should be kept clean and dry, and any signs of infection such as redness or swelling should be reported to the doctor immediately.
Pain management
It is normal to experience some discomfort or pain after the surgery. Your doctor will prescribe medications to manage it. Ensure to take them as directed and don’t hesitate to reach out to your doctor if the pain persists.
Emotional support
It is equally crucial to take care of your mental health. Connect with peers, support groups, or a mental health professional to navigate through any emotional distress or anxiety you may be experiencing.
Follow-up appointments
Regular follow-ups with your doctor are necessary to monitor your healing process. During these appointments, the doctor might conduct physical examinations, and any concerns regarding your recovery should be discussed.
Hormone replacement therapy (HRT)
If you were on hormone replacement therapy prior to surgery, discuss with your doctor about when to resume. It’s important to have regular blood tests to monitor your hormone levels.
Potential risks and complications of orchiectomy
Orchiectomy is generally considered a safe and effective procedure. However, like any surgical procedure, carries with it certain inherent risks and potential complications. It’s imperative that individuals considering this procedure are aware of these to make an informed decision.
Short-term complications
Some potential short-term complications are:
- Infection: Post-surgery, there is always a risk of infection, which can lead to complications if not treated promptly. (Mayo Clinic, 2020)
- Bleeding: Bleeding during or after surgery can occur, and in some cases, may require further intervention. (American Cancer Society, 2019)
- Wound dehiscence: This is a condition where the surgical wound reopens after the procedure. It can be a serious complication, requiring immediate medical attention. (National Health Service, 2018)
Long-term complications
Some potential long-term complications are:
- Sexual dysfunction: Orchiectomy can lead to sexual dysfunction due to hormonal changes, including decreased libido and erectile dysfunction. However, these can often be managed with hormone replacement therapy.
- Emotional and psychological effects: The change in hormone levels can also lead to emotional and psychological effects, such as mood swings or depression. It is crucial to have a support system in place and seek professional help if needed.
- Body image concerns: Changes to body image may occur post-orchiectomy, which can affect self-esteem and mental health. Peer support and counselling can be beneficial in these cases.
In conclusion, orchiectomy can be an empowering step in the transition process for many transgender individuals. It calls for careful consideration, preparation, and post-operative care. To avoid complications after surgery, it is necessary to consult an experienced doctor who can help you navigate this process.
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