What effects does it have?
What is it?
Surgical removal of the testes (testicles) usually causing permanent reduction in testosterone levels.
It's also known as Orchiectomy or Orchi.
How long does it last?
The effects are permanent and cannot be reversed.
Orchidectomy results in permanent destruction of the testes and is irreversible. After orchidectomy you will be infertile and unable to have children unless you have previously carried out gamete storage (i.e. sperm banking).
After orchidectomy, you will need to take at least one sex hormone (oestrogen and/or testosterone) in order to prevent medical problems like osteoporosis.
In this surgery, the scrotum is cut open and the testes and the spermatic chords leading to the testes are removed through the incision, which is then sutured closed. This removes the main source of testosterone in the body.
Orchidectomy may not be suitable for people who are interested in later obtaining a vaginoplasty as it can make the vaginoplasty more difficult - check with your surgeon if you are unsure.
Orchidectomy may cause erectile dysfunction in people with penises. If this is not desired, it can be treated with sildenafil, tadalafil or vardenafil.
Cost and funding
If you have a formal diagnosis, the NHS will usually provide funding for orchidectomy. You will normally need to meet the following conditions:
- persistent and well-documented gender dysphoria
- capacity to make fully informed decisions and to consent to treatment
- if significant medical or mental health concerns are present, they must be reasonably well controlled
- two medical opinions, usually at least one from a gender clinic, that surgery is appropriate
- 12 months’ continuous endocrine treatment as appropriate to the patient’s goals (unless the patient has medical contraindications or is otherwise unable to take hormones)
- at least 12 months’ living continuously in a gender role that is congruent with the gender identity 1.
- 1 Royal College of Psychiatrists (2013) “Good practice guidelines for the assessment and treatment of adults with gender dysphoria.” [online] Available from: https://www.rcpsych.ac.uk/docs/default-source/improving-care/better-mh-policy/college-reports/college-report-cr181.pdf
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Page last updated: September 2017