Gender Construction Kit Logo

Orchidectomy

What is orchidectomy?

Surgical removal of the testes (testicles) usually causing permanent reduction in testosterone levels.

It's also known as Orchiectomy or Orchi.

What does orchidectomy do?

  • Fertility

    Causes permanent infertility

  • Body hair

    Reduces and thins

  • Muscles

    Weakens and makes smaller

  • Lower body

    Makes it easier to tuck, shrinks genitals, reduces erections

  • Face

    Softens skin, lessens acne

Who can have orchidectomy?

  • You must have had 12 continuous months living as your gender identity

  • You must have had 12 continuous months of HRT, unless you’re unable to

  • You must have capacity to consent for this treatment

  • If you have significant medical conditions, these need to be “reasonably well-controlled”

  • You need to be at least 16 in Scotland, but at least 17 in other parts of the UK

  • You typically need a BMI of less than 30

  • Outside of Scotland this is only commissioned as a part of vaginoplasty, labiaplasty or clitoroplasty

How long does orchidectomy last?

The effects are permanent and cannot be reversed.

What should I be aware of?

Warning

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).

Warning

After orchidectomy, you will need to take at least one sex hormone (oestrogen and/or testosterone) in order to prevent medical problems like osteoporosis.

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.

How do I get an 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.

NGICNS maintains a list of NHS surgery providers providing various gender-related surgeries. At the moment, all of these surgeons are based in England, so you will have to travel if you live in another part of the UK.

How do I get ready for surgery?

Doing some preparation in advance can help make sure everything goes smoothly during your hospital stay and recovery. To help you avoid forgetting to do or buy something we have created a Getting ready for gender surgeries page.

How much will it cost?

The cost of an orchidectomy performed in the UK is currently around £3000-4000 (last updated October 2020).

If you have a formal diagnosis, the NHS will usually provide funding for orchidectomy.

Outside of Scotland, orchidectomy is usually only funded as part of vaginoplasty, clitoroplasty or labiaplasty.

If you're receiving certain benefits, or are on a low income, you may be able to get help with the cost of travel for NHS treatment. Further information about help with travel costs can be found:

References

  1. 1.
    Royal College of Psychiatrists (2013) “Good practice guidelines for the assessment and treatment of adults with gender dysphoria.” Link

Errors and omissions

Is there something missing from this page? Have you spotted something that isn't correct? Please tweet us or message us on Facebook to let us know, or file an issue on GitHub.