An orchiectomy is the removal of a testicle. My variation of the procedure was a simple bilateral orchiectomy; simple meaning relative to radical, in which more tissue is removed (this is usually reserved for treatment of testicular cancer); bilateral meaning both testicles. Some trans women do not feel a sense of embodied gender dysphoria, and are content to keep their penises and sometimes testicles. For me, having any of this kind of apparatus feels physically wrong in a way that I could not make sense of or articulate until I understood that I was actually a girl. All of it has always felt wrong, and contributed greatly to my depression; depression which mostly came on with puberty.
You may wonder why I would bother with this surgery, when my ultimate goal is GRS. The reason is that I got the orchi done about a year ago, while I am just now finally in line for my GRS, which is scheduled to take place on February 4, 2020. This is a stopgap solution, but it is better than not addressing the problem at all until the Trump administration, if it lasts so long, has already entered its fourth year.
One of the things that trans women's HRT does is suppress testosterone. Ultimately, at my peak dose, I was taking 5mg medroxyprogresterone and 200mg spironolactone daily to suppress it. This suppression created half of my sense of hormonally-related physiological relief. My experience of the world softened. The other half was the introduction of estrogen via 1-4mg estradiol daily (the dose changed every so often; this was not a choose-your-own-adventure of estrogen each day kind of thing). But the point is that I wanted to not have testosterone in my bloodstream. At all. Ever again. Ever. Removing my testosterone factories seemed like a good way to do that.
Women's underwear is typically not designed to accommodate much in the way of external genitalia. Many trans women "tuck," or draw the penis back through the legs, and set things into place in such a way that can be contained by some panties comfortably. Some also use tape to keep things in place, although I never went there, myself. But the point is that removing some of the bulk between my legs would naturally mean better-fitting women's bottoms in general. Removing my testicles seemed like a good way to do that. I was thinking in terms of volume, of space occupied. I had no way to understand how to think about the weight until it was gone.
It turns out I was right on both counts, although I did, in the year since, ultimately argue for (and win) the reintroduction of both of testosterone-suppressing meds I had been taken off of following the surgery. I wanted to add medroxyprogresterone back in order to mitigate or eliminate the occasional erection that had begun, ahem, popping up. Having an erection is generally a very unpleasant experience for me. While in theory, medroxyprogesterone should not have had any impact (since there should not be any testosterone to suppress), it did actually all but halt erectile function, making a marked impact on the volume and frequency. I returned, in that regard, to my pre-op, post-start-of-HRT state, and that was very nice.
I asked for spironolactone to be reintroduced in order to try to hormonally induce more breast development. I'd heard anecdotally that cis women who had been prescribed it for some other purpose experienced breast development, regardless of their age, and induced breast development regardless of age is a thing I'd like just a touch more of. My breast development appeared to have ceased following the removal of the drug from my schedule. It has noticeably continued since adding it back, to my pre-op amount, same as the medroxyprogesterone.
A last-second emergency surgery came in and bumped me from my slot just before they were going to put me under. I remember being very upset, sad for myself because I had been waiting for so long to have this done. But when the surgeon came to console me about being bumped, I told him I was only upset for myself, and that I was happy to give up my spot for an emergency surgery. That I hoped the other patient, the other veteran, would be helped. He assured me I would be scheduled for the first available slot, which turned out to be January 22, 2016; the very next day.
People ask about whether girls like me regret this kind of surgery. Some just assume we will regret it, though the data generally do not support that. For myself, I can say that I did regret when I did it, though I do not regret actually having done it. I posted vlogs about my recovery weekly for awhile, and in some of them, talked about that. I regretted it because my post-surgical state strained my already damaged relationship with Kim, and so the timing of it certainly was a large factor in the end of our relationship. I wished I had done it at some other time, some other time that would let me have the orchiectomy that has brought me so much relief, without losing the love of my life.
Overall, my health in regard to gender dysphoria and embodied gender dysphoria has improved greatly as a result of my successful orchiectomy. I have less actual weight between my legs. Tangentially, as a result of continued conscientious HRT adjustment, I also have slightly more weight on my chest, and the sensations that these simultaneous states produce are becoming closer and closer to what my brain experiences as "right," when it comes to how it feels to live in my body.
Plus, now everything I do is balls out.
