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The Castration Procedure

Many have asked me questions about how I was castrated and about my recovery.  There will be some variations in you own experience depending on which doctor performs you orchiectomy, but if your doctor knows what he is doing then castration is a minor procedure which should not require an overnight stay in any hospital.  Even with a competent doctor there is a small chance of serious complications, because there is always that risk of something going wrong with any surgery or procedure.  But if you see a good doctor, then chances are the procedure will be only mildly unpleasant and you will recover fairly rapidly.

Those who attempt any type of do-it-yourself castration will likely have a vastly different experience.  Because you are dealing with the genital area, you will likely suffer serious or deadly bleeding, and the risk of infection is very high.  Those who seriously attempt self castration often do not suceed, but usually end up seeking emergency treatment for bleeding or infection.  I should also mention that you will suffer extreme pain without any anesthesia.  I know almost nothing about tools such as elastrators and burdizzos so I will not comment on these methods.

COST

In 1999 I paid Dr. Spector $1600 for my orchiectomy.  As of this time (2001) Spector has raised his price to $2000.  In addition you will spend money on travel costs and lodging unless you live very close to your castration doctor.  Spector prescribed antibiotics for me which cost $54.  Overall I spent over $2600 for the procedure plus travel, one week at a bed and breakfast, the antibiotics, and time taken off from work.  Some transsexuals have paid less for castration because being full time and on hormones gave them more options, though they do spend more money on therapists to get the recommendation letters for orchiectomy.


THERAPY

Anyone seeking castration soon learns that very few doctors are willing to perform orchiectomies, and most doctors that do will require that the patient first consult a therapist about their issues.  Doctor Spector does not require you to see any therapists.  When I first saw Spector, he and I discussed my issues and asked me why I was seeking castration to make sure I really wanted this.  Just before the procedure I signed a consent form stating that I consented to the orchiectomy procedure, accepted infertility, impotence, and the other effects, and realized that there was a small risk of complications.


PREVENTION OF INFECTION

Dr. Spector gave me a prescription for one weeks worth of Cipro antibiotics which I started to take two days before my surgery date and continued for five days after.  The dosage is two pills per day.  I gave Dr. Spector the phone number of a pharmacy only a few blocks away from my home and picked them up there weeks before my surgery date.

When Dr. Spector did my orchiectomy he used an office in his own home with was a bit cluttered and also contained a desk, a computer, and several cabinets.  I would have preferred a more sterile setting, but I didn't know of anyone else who would castrate me and I really wanted to have this done, so I went ahead with it anyway.  Today the doctor operates his own gender clinic a short distance from his home, so the setting may have improved, but I have never seen this clinic.

The doctor does use common precautions for the surgery, such as the wearing of gloves and sterilizing the surgical tools.  Spector will ask you to shave your genital area before your appointment, and he will apply betadine on the area before he starts cutting.


ANESTHETIC

Spector uses a local anesthetic for orchiectomy.  I found the injections to be more painful than ordinary vaccinations.  First the doctor gave me two injections in the lower abdominal area a couple of inches above the genitalia, and I thought those were nasty until he gave me a third injection through the bottom of the scrotum.  Spector's nurse had to coach me through that last one as if I were a woman in labor.  Dr. Spector says the anesthetics usually take effect in 20 minutes or so but some of us do take longer.  The doctor did not start cutting me until about 45 minutes after the first shots, and he did give me two more injections to speed up the effects, but I did not feel these shots at all.


SURGERY DURATION AND OTHER FACTORS

My own procedure lasted about two hours from the time that Dr. Spector started cutting.  The doctor extracted my testicles through a vertical incision in the center of my scrotum.  This is a minor procedure, but it must be done carefully because of the many blood vessels and the potential for infection.

Dr. Spector does offer to remove the scrotum at additional cost, but as much as I hated that extra mass down there I declined because I wasn't sure if I would need it for future SRS.  Spector does not do SRS or penectomies.


RECOVERY

Spector closed my incision with six or eight stitches, and then I walked the three blocks back to my bed and breakfast to rest there for the evening.  The doctor requests his patients to return the day after for follow up care to make sure that everything is healing OK and to give instructions on aftercare.  Spector does not charge any additional fee for this aftercare.  In fact I stayed in town for a whole week to save money on airfare and the doctor examined me daily for five days at no extra charge.

Spector drove me around downtown Philadelphia the day after my surgery, and I let him drop me off at the Franklin Institute on the second day, after which I walked a mile and a half back to the bed and breakfast.  After that I would see Dr. Spector in the morning and then become just another tourist in the downtown.

Most patients eventually have a doctor in their home town remove their stitches, and some have removed their own stitches.  Because I stayed in town longer, Spector himself was able to remove my stitches on the fourth and fifth days.  The doctor drove me to the airport for my flight home on the fifth day.

I returned to work six days after my surgery.  I still had some discomfort in the genital area, but this improved with each passing day.  What really bothered me was that the doctor instructed me to keep the area dry and I did not get to shower for ten days after the surgery.  My goodness, the area did smell!  I have heard of some patients washing the area anyways because they were concerned about infection.

About three weeks after the procedure the incision had closed up entirely and left a barely discernable scar along the center of my scrotum.

I have heard of many patients being active even more quickly than I, and the woman at the bed and breakfast told me of one person who walked many miles back home the day after his surgery.  Personally I think you deserve to take it easy and rest for a few days after your surgery, and you should definitely not do any heavy lifting for a while.


PAIN RELIEF DURING RECOVERY

Spector told me that most of his patients take only Tylenol or other other the counter medications.  I was one of his more sensitive patients and I did receive three pain pills at no extra charge.  I took one pill each night before going to bed and got by on Tylenol during the day.  If you think you will need prescription pain relief, just ask.


TRAVEL AND LODGING

Airlines usually charge less if you book your flights several weeks or more in advance and stay a whole week.  My bed and breakfast cost $60 per night, but my round trip plane tickets were only about $260.  If I had left Philadelphia sooner I would have paid the airlines more than $1000.

Spector will refer you to bed and breakfast places you can stay at.  The farther ahead you plan in advance, the better.  You will be recovering from a surgery and will want to stay at a bed and breakfast hosted by a sympathetic person near Spector's office who will not judge you for what you are.

If you feel up to it there are many tourist and historical attractions in downtown Philadelphia.  Someone advised me against renting a car, and I'm glad I heeded their advice because parking is almost impossible and the traffic I am used to at home does not compare with that of downtown Philadelphia.  I took a cab from the airport to the downtown, and Spector drove me back to the airport one week later.


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