• Castration

Definition

Castration  is also known as gonadectomy or orchiectomy is  surgical  procedure to remove one or two male testicles.

The testicles, which are male reproductive organs that produce sperm, sit in a sac, called the scrotum. The scrotum is just below the penis.

There are two common orchiectomy procedures for transgender women: bilateral orchiectomy and simple orchiectomy. In a bilateral orchiectomy, the surgeon removes both testicles. During a simple orchiectomy, the surgeon could remove either one or both testicles.

Bilateral orchiectomy is the more common type of orchiectomy for transgender women.

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Pre-Operation

To prepare for the procedure, your doctor will likely require proof that:

  • You’re experiencing gender dysphoria.
  • You’re able to consent to treatment and make a fully informed decision.
  • You don’t have any unmanaged mental health or medical problems.
  • You’ve reached the age of adulthood in the country that the procedure will take place

Generally, a doctor will ask you to provide letters of preparedness from two different mental health professionals. You’ll also likely need to complete one year (12 consecutive months) of hormone therapy before you undergo an orchiectomy.

The Procedure

The procedure will take 30 to 60 minutes. Before surgery begins, your doctor will use local anesthesia to numb the area or general anesthesia to make you fall asleep so you don’t feel anything. A surgeon will then make an incision in the middle of the scrotum. They’ll remove one or both testes and then close the incision, often with sutures.

The surgery itself is an outpatient procedure. This means that if you were dropped off in the morning for the procedure, you’ll be able to leave before the end of the day.

Post Operation

Physical recovery from the procedure will last anywhere between a few days to a week. Your doctor will likely prescribe pain medications to manage pain and antibiotics to prevent infection.

Based on your reaction to the orchiectomy, your physician may reduce your estrogen dose and taper off any preoperative androgen blocker medication.

Complications

You may experience side effects and complications that are typical to surgery. These may include:

  • bleeding or infection
  • injury to surrounding organs
  • scarring
  • dissatisfaction with results
  • nerve damage or loss of feeling
  • infertility
  • decreased libido and energy
  • osteoporosis

Transgender women who undergo an orchiectomy are also likely to experience a number of positive side effects, including:

  • a drastic decrease in testosterone, which may allow you to reduce your dose of feminizing hormones
  • reduced gender dysphoria as you take a step closer to matching your physical appearance with your gender identity