As a rule of thumb, you can reduce female hormones by one third after orchiectomy. My bias is to keep estradiol ranges betwen 125 and 150 to avoid thrombo-embolic phenomena, such as strokes and coronary events.
An MTF oriented patient wrote yesterday: can he have orchiectomy even if not on hormones. My reply was yes, but two letters of therapy clearance are needed, one from a licensed therapist with a doctoral degree and another from a therapist with at least a masters degree.
We can all relate that this is irreversible surgery and all patients should be advised to consider sperm banking just in case there is a change of heart, especally before the real life test. This individual cannot dress en femme at work and keep his job .
Harold M. Reed, M.D.