Infotrans

Bilateral Orchiectomy

Who can undergo the surgery?

People who meet the following requirements can undergo bilateral orchiectomy surgery:

  • persistent and well documented gender dysphoria / gender inconsistency
  • age of majority in the given country
  • ability to make a fully informed decision and to provide consent to treatment
  • absence of medical or psychological problems not adequately stabilized
  • 12 continuous months of hormone therapy appropriate to the person's gender goals (unless there are medical contraindications to hormone therapy for the person)
  • court ruling with authorization to gender affirming surgery

These requirements are indicated in the scientific publications listed in the "Bibliography" section.

When the necessary criteria for carrying out the surgery are met (see above), the person concerned must:

  • identify a specialized clinical center (Infotrans.it offers a list of structures, present on the national territory, able to provide this type of services in the "Service Map" section)
  • schedule a urological consultation

It is not necessary to stop hormone therapy. In general, if one is taking any prescription medication, this should be discussed with the health provider. It may be necessary to stop taking it even several days before the surgery. Drug therapy may be resumed at the doctor's discretion.

Bilateral orchiectomy is a surgery that consists in the removal of both testes and helps to stop the production of androgens (male sex hormones). Each testis is extracted from its envelope (scrotum) in association with the epididymis and funicles (sacs and canals that contain spermatozoa). The testes will be sent to the laboratory for histological analysis to rule out the presence of a testicular cancer. This surgery is often part of penile and scrotal inversion vaginoplasty or colon vaginoplasty, but it can also be done independently. The intervention irreversibly precludes the ability to reproduce.
The surgical procedure lasts about an hour and takes place under general or spinal anesthesia.

The surgical procedure is performed on a day hospital basis or short hospital stay, depending on the characteristics of the person and post-operative recovery.

In the 2-3 weeks following the surgery it is recommended to avoid:

  • weight lifting
  • take hot baths
  • take a sauna

The person will need to be seen or returned to the hospital if:

  • has a fever
  • has severe pain
  • notices that the wound starts bleeding or shows a light discharge. 

Like any surgery, there is a risk of bleeding, infections and adverse reactions to anesthesia.

National Health Service (NHS): no cost.
Private practice: at the discretion of the provider.

Coleman E, Bockting W, Botzer M, et al. Standards of Care for the Health of Transsexual, Transgender, and Gender-Nonconforming People, Version 7. Int J Transgend. 2012; 13(4): 165-232.
Hembree WC, Cohen-Kettenis PT, Gooren L, et al. Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2017;102(11):3869-3903. Erratum in: J Clin Endocrinol Metab. 2018; 103(2): 699. J Clin Endocrinol Metab. 2018; 103(7): 2758-2759.