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.

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