Orchiectomy OK before SRS?
Some transsexuals, and even some SRS surgeons, dislike the idea of having an orchiectomy before SRS. Some surgeons fear that orchiectomy will permit our scrotal skin to shrink, which then reduces the raw materials available for construction of our future vagina and labia. Some pre-ops, as much as they dislike the idea of maintaining their current male parts, fear losing any donor material for their future female parts. They fear ending up with reduced vaginal depth and compromised surgical results, or needing a skin graft (and a resulting scar) from another part of their body, or possibly even needing the very invasive sigmoid colon transplant procedure.
I had my orchiectomy more than six years before my recent SRS. My scrotal skin did shrink, and I turned out to be one of those patients who required a skin graft from my tummy for adequate depth. This left me with a horizontal scar line below my tummy. My surgeon did leave this scar in an area where others won’t notice in my everyday life, and I could probably wear a bikini without exposing it. But it would be easily visible in any intimate setting, and it does often itch.
So how do I feel now about having had an orchiectomy? If anyone asks me that question, the only thing that comes to my mind is the extra six years of not having testosterone, and all of the advantages this gave me throughout my long transition. I don't like my extra scar line, but I hated testosterone a lot more than that.
If I were permitted to go back in time to the year 1998 and retain all foreknowledge of things to come for the next eight years, I still would have had my orchiectomy. I just could not have done without six years of being free from testosterone, requiring only low doses of HRT and no Spiro, saving tons of money on my HRT costs, and best of all, the positive effects on my feelings and emotions along with the knowledge that no matter what happened, testosterone could never cause any further damage to my body.
Besides, even without an orchiectomy, years of HRT with androgen blockers (Spiro or Androcur) can also cause male parts to shrink. Not having an orchiectomy does not guarantee that your male parts won’t shrink before SRS.
There were additional factors that contributed to my need for that skin graft from my tummy. If I had decided to not have an orchiectomy six years before SRS, I might still have required an additional skin graft. Without these additional factors, I might not have needed that skin graft even six years after my orchiectomy.
I decided to have my orchiectomy and enjoy the benefits of an easier transition and elimination of testosterone, at the possible expense of a necessary skin graft or reduced SRS results, and I would make that same decision again. On the other side of this issue, one TS friend has told me she not only won’t have an orchiectomy despite being several years away from her SRS, but she is also deliberately taking inadequate doses of HRT to ensure that her male parts will still contain enough material for her eventual vaginoplasty.
So my thoughts are, consider all of the pros and cons. Only you can determine whether the pros of orchiectomy before SRS would outweigh the cons in your case. I and some others decided that the pros outweighed the cons, yet some TSs have comfortably decided to forego orchiectomy and just have all of their parts removed in one surgery later on.