Bilateral Orchiectomy aka Orchi

***we are not doctors, nor is this site intended to diagnose any diease or condition. Anything contained on this site should be seen as the opinions of the author and used for education only. See a licensed physician if you intend to have any medical procedure preformed. Do not in any way attempt this procedure or any related procedure on your own, or without medical supervision.***

Bilateral Orchiectomy (also know as “an Orchi”)
- this is an out-patient surgical procedure for the removal of the testicals.

Benefits for Trans Women:

Removes the main production center of Testosterone in the body
Anti-Androgens can be significantly reduced or stopped entirely after the procedure. This reduces stress on the liver, and eliminates the side effects of long term Anti-Androgen use.
Because of the lack of testosterone, a break in hormones will not cause back tracking, or de-transitioning.
Can halt and/or reverse recent hair loss.
Possible lessening of dysphoria, and increased body image.
Increased ease in tucking and hiding genitalia under tight clothing.
Possible reduction of testosterone dependant body hair
Possible increase of feminizing effects from HRT
Cost of surgery is between $1,300 –$ 2,000 USD in most states. (updated 2008) this is a significantly easier amount to save than the $10,000 – $30,000 for SRS.

Negatives for Trans Women

Permanent Sterility
Possible loss of libido
Possible hot flashes or other hormonal side effects.
If SRS is not completed shortly after, the scrotal tissue may shrink and atrophy, resulting in a possible need for a skin graft during SRS.
Scar tissue may complicate SRS if the incision is done improperly.
After having an Orchi one will require hormone treatments to maintain levels.
Surgery always has its risks, including blood clots, infections, or other unforeseen complications.
The $1,300 could have been used instead to save for SRS.

Overall view:

There are many risks and benefits to consider when getting surgery. Things you should discuss with your doctor before having this procedure include: What risks are involved for you personally? Does the doctor know the proper way to perform an Orchi that will not interfere with SRS? How long do you think it will take to get SRS, or will you have SRS at all? Do you want to have your own children in the future? Should you bank sperm for that possibility?
Of course this is a serious medical procedure, and although it has a quick recovery time, you should always weigh the risk and benefits before deciding how to proceed.

The procedure takes between 45 min to 1 hour 30 min, depending on the circumstances. Typically it is done under local anesthetic, although some surgeons will prefer general sedation. There is typically little or no pain during the procedure, but in some cases there can be sensitive areas that need additional anesthetic to numb.

After applying the anesthetic the doctor will perform and incision. There are different techniques, including: a mid-line scrotal incision, a bikini line incision, or a side scrotal incision.

The testicals are pushed through the incision, where the doctor clamps, and removes the testicals, then cauterizes the attached cordage. The cordage re-positioned, and the incision is sewn closed.

The area is cleaned and packing is applied.

The patient is then moved to a recovery area, where they are observed and asked to drink liquids. This recovery period could be between 30 min to 1 hour, depending on what type of anesthetic was used, and how quickly the patient’s body recovers.
You will most likely be able to walk after the recovery time, although there will be soreness around the area of the surgery. Swelling is typical, and can last for several days. Driving and walking can be a problem for a few days after the surgery. Ice can be applied to reduce swelling. It is typical to feel tired or weak after surgery. Make sure there is someone with you, as you will not be allowed to leave the hospital without an adult to supervise your condition. Typically a doctor or nurse will give after care instructions, and advice of any warning signs of infection, or complications.

If dissolvable stitches are used, there may be restrictions from showers and baths for the first few days.

A word on Self Castration

DON'T DO IT!

Surgical procedures should only be performed by a licensed surgeon. Attempting to perform this procedure on yourself can lead to serious injury and/or DEATH. Cutters (unlicensed people who perform castrations) are equally as dangerous and unregulated. There have been many deaths due to cutters, and from attempted self castrations. Never use a cutter, or try to perform ANY procedure on yourself. Always check that your surgeons are licensed and competent to perform the procedure safely and effectively.