Some women in our community choose bilateral orchiectomy prior to or instead of vaginoplasty. This medical procedure is also called orchidectomy or gonadectomy and is commonly known as castration or by the abbreviations “orch,” “orchi,” “orchy,” and “orchie.” Bilateral orchiectomy involves removal of both testicles, which eliminates the sources of androgen production.
This procedure is most often performed by urologists or endocrinologists and is sometimes done for treatment of prostate cancer and testicular cancer in non-trans patients.
Because it is considerably less expensive than vaginoplasty, orchiectomy may be a good intermediate step for those with limited finances. It eliminates the need for antiandrogens and allows patients to take lower doses of feminizing hormones. However, it can affect the amount of tissue available for vaginoplasty over time and leaves small scars which may affect a later vaginoplasty result.
Orchidectomy is less drastic than vaginoplasty, but it has historically been difficult for transwomen to obtain it.
Because an orchiectomy is irreversible, you must make sure you understand your reproductive options before undergoing this procedure.
If you intend to get vaginoplasty at a later date, you should speak with the surgeon(s) you are considering before getting an orchiectomy. Some of them may have suggestions or recommendations about incision placement to ensure a better vaginoplasty result at a later date.
Some women have been able to change legal documents following orchiectomy. You will need to ask your surgeon for a letter affirming that the surgeon performed irreversible genital surgery as part of a sex change procedure.
Unqualified people performing the procedure
When our community was still frequently denied access to medical services last century, some consumers sought out this procedure from people without adequate medical training or equipment. Some attempted to perform the procedure on themselves, which frequently led to hospitalization. This is very dangerous and can lead to death or serious injury. I strongly urge you to seek out a qualified practitioner to perform this procedure under the safest conditions.
Physicians performing the procedure
Below are medical professionals who currently perform orchiectomy or have performed them in the past for trans people.
- Marc Arnkoff (Detroit, Michigan, USA)
- Jenelle Foote (Atlanta, Georgia, USA)
- Christine McGinn (Philadelphia Pennsylvania, USA)
- Harold M. Reed (Miami, Florida, USA)
- Timothy Terry (Leicester, United Kingdom)
- Tuan Nguyen (Lake Oswego, Oregon, USA)
No longer active
- Robert Barham Portland, Oregon, USA (retired)
- Michael Brownstein San Francisco, California, USA (inactive)
- Murray Kimmel Philadelphia Pennsylvania, USA (retired)
- Felix Spector Philadelphia Pennsylvania, USA (inactive)
Consumer experiences with unnamed surgeons
Ruby’s Journal: The orchiectomy chronicles (September 2003)
My orchidectomy by Ellen Rugowski, Wisconsin USA (2001) [original link: rarely works] http://web.quick.cz/transsexualita/BoV/orchidectomy.htm http://www.annierichards.net/orchidectomy.htm
Jessi’s orchiectomy experience by Jessi (2000)
http://www.geocities.com/WestHollywood/Village/1183/orch.htm [no longer available, see archive.org]
Note: many links below contain graphic images.
• LINK: Orchidectomy as a first stage towards gender reassignment: A positive option by Russell Reid (1996)
A nice published study by a psychiatrist which follows 14 orchiectomy patients.
• LINK: Castration by Sherry Joanne (1999 through 2003)
By far the most comprehensive resource, written by a woman with first-hand experience. Pages include:
- Orchiectomy for transsexuals
- Changing legal documents after orchiectomy?
- Orchiectomy OK before SRS?
- Castration surgeons
- Castration resources
- Castration effects
- The why of castration
- Is castration right for me?
• LINK: Bilateral Orchidectomy by Over The Rainbow, Australia http://www.overtherainbow.org.au/surgery9.htm
• LINK: Orchidectomy for the transsexual woman by Annie Richards http://www.secondtype.com/orchidectomy.htm
• LINK: Bilateral Orchiectomy by Looking Glass Society (1998)
• LINK: Orchiectomy by Caitlin H. (a revision of the Looking Glass materials) http://www.road-less-traveled.com/orchi.html
• LINK: Orchiectomy by Surgery Encyclopedia