Orchiectomy an option to relieve gender dysphoria among transfeminine patients. The procedure consists of removing the testes.

Which is better, orchiectomy or vaginoplasty?

There is no one correct answer to this question, as this decision is specific to each individual’s situation and preferences.

If I receive an orchiectomy, can I still get a vaginoplasty later?

Orchiectomy can be performed prior to or during vaginoplasty. Orchiectomy can also be performed in isolation, without requiring a vaginoplasty afterwards.

Many individuals choose an orchiectomy as a preceding step to vaginoplasty, separating the two procedures. A future vaginoplasty may be predetermined at the time of orchiectomy or decided at a later time following the orchiectomy. Therefore, those who may not be sure if they would like to proceed with vaginoplasty may opt to first undergo orchiectomy. For some, optimal satisfaction is reached with an orchiectomy, and a vaginoplasty is not necessary. A vaginoplasty can be performed later if this is the individual’s preference, as long as they remain eligible for the operation.

It is important to note that an orchiectomy is not reversible. Please discuss with your surgeon to determine the best procedure for you.

What are some reasons people opt for orchiectomy over vaginoplasty?

There are many different reasons why one may opt for an orchiectomy or vaginoplasty. This decision is a personal one and it depends on each individual’s goals and preferences.

Vaginoplasty provides female external genitalia and the neovagina allows for penetrative intercourse. However, it is a larger and longer procedure. Orchiectomy may be preferred as a less complex option. Orchiectomy typically results in a faster recovery and less risk of complications than vaginoplasty. This procedure may fulfill an individual’s needs, particularly if penetrative intercourse is not important to the individual.

Another benefit to orchiectomy is the ability to stop anti-androgen (i.e., anti-testosterone) medications following the procedure. This is because there is a decrease in natural androgen production after the testes are removed in an orchiectomy. Therefore, if orchiectomy is a preceding procedure to vaginoplasty, separating the two simplifies management of hormonal therapy before vaginoplasty. This may make preparing and recovering from vaginoplasty easier to comprehend and experience. However, separating the two procedures also means you will be undergoing an additional operation.

You will have the opportunity to further discuss your options with your surgeon at a pre-operative appointment.

How can I learn more about orchiectomy at BWH?

For more information, please speak with your surgeon and/or visit the Center For Transgender Health.

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