Yes have been on hormones for 7 1/2 years and hace been living full time as a woman fr 7 years now. I have natural grown breast.
Specific_Questions: On December 21 2010 I had a heart attack and althoe I am doing real good i was told that I may never be able to have my SRS. Now I ask is it still posable to have my SRS and if not is there a sugery that will remove the testies and shorten the penis to where I will apear more female down there with no buldge. If so can you give a ball park priceon what it would cost for me to have my SRS or other feminizing sugeries to be able to fit in and feel a bit more normal in apearance.  Carla

Good afternoon Carla,

If you have a letter of medical clearance with reference to a stress EKG, we can do an orchiectomy under local with IV sedation, also perhaps scrotal removal.  We cannot do any surgery that requires general or spinal anesthesia in your case because the Ameican Society of Anesthesiologist’s physical status classification places you in a class 3 risk.    Please be sure your estrogen levels are carefully monitored to keep you in a safe range, as they are coagulopathic.  Can produce blood clots.

Cordially,

Harold M. Reed, M.D,.
305-865-2000

Dear Dr. Reed,

I am wanting a castration.  I am bound by the scripture found in Matthew 5: 27-30.  This procedure is not listed as one of your services but I think that you might be able to perform this.  Please contact me to discuss this. 

Thank you,

Aaron

December 29, 2011

Good afternoon Aaron,

Read the scripture.  It talks about adultery and lust.

Yes, we will consider doing orchiectomy for men such as yourself, but there are a few advisories we need to put out first.

Assuming you are not a transgendered patient, yes, we will consider doing an orchiectomy with or without scrotal removal for men such as yourself.  As this is not conventional urological surgery, a letter of psychiatric clearance from an American Boarded psychiatrist is required. We want  to be sure you are mentally stable, will be a happy and more productive person after your orchiectomy, and most importantly that you will have no remorse.  The letter should state if correct, that you have had no emotional problems or suicidal ideation.  One resource would be to look
up psychiatrists under Physicians and Surgeons in your yellow pages or any neighboring
large city.

If you are a transgendered patient, seeking to be a female or wish feminization, then you can approach 2 therapists (a list of South Florida therapists is appended below) who work with transgendered patients.

Mention should be made that there are medical (non-surgical) ways to achieve the same effect.  At least you may wish to have a clinical trial with these methods to see if this is really for you.

Next, if you are married we will need a release from your wife.  Remember this is an irreversible procedure and unless you sperm bank, you are forfeiting your right to pass  on your excellent genetic potential to the next generation.

If there is further interest, we are available for consultation.   Our fee is 250 for consultation and 2500 for the orchiectomy.  For scrotal surgery, add an additional 1500.

If you are over 40 or on medications, a letter of medical clearance with reference to an EKG  is required.  Routine lab work for all patients includes a CBC, platelet count, PT and PTT.

Typical scenario, day one consultation, day two orchiectomy, You will need to stay for two additional days with a generous amount of bed rest, and be seen before departure.

We recommend the Baltic Hotel in Miami Beach at 7643 Harding Avenue (phone 877-622-5842), where Christina the owner-manager takes a special interest in our patients.

Please no aspirin or aspirin products, no anti-inflammatory drugs such as Motrin, Advil, Alleve, or Cox 2 inhibitors such as Celebrex or Vioxx (withdrawn from the market for safety concerns) for a week before surgery. No Vitamin E or excessive alcohol or spices for a week before surgery as this may promote bruising.

Bruising can be reduced (many believe) with Bromelain 500 mg 1 twice a day, Arnica montana (Boiron brand) dose 30C (take 4 small tablets sublingually, 4 times a day), vitamin C 500 mg (3 times a day) starting 1 week before surgery. Do take these medications unless there are specific reasons why you choose not to and let’s discuss it beforehand.

Boiron brand is available at Whole Foods and on the web at http://www.vitaminshoppe.com for “pennies” and we do notice a difference.  You will need 2 vials.

We hope to have the pleasure of serving you whenever your travel plans include the South Florida area.

Sincerely,

Harold M. Reed, M.D. FICS
Senior Member of the American Urological Association
Member Society of Genito-Urinary Reconstructive Surgeons
Founding Member and Treasurer of American Academy of Phalloplasty Surgeons
Founding Member Sexual Society of North America

305-865-2000

Some patients need followup for a few days. When it comes to visiting patients at non-specified hotels/motels, sorry I do not do this. The 2 hotels we do recommend are the Baltic (advanced tourist class) with abundance of white linens, an appetizing breakfast spread and coffee in the reception area, and an amiable hostess Christina. Or Daddy O’s (more posh) with assistant manager Courtney and her lovely staff.

These are not the best of times, you know that. I will not walk with a doctors bag in a dimly lit corridor, in a strange budget hotel/motel to see one lonesome patient who wishes to save $25 a day on a room. If you look like a woman, in the eyes of Florida medical ethics, you are a woman, and the availability of another woman in the room if need be is a standard of care.

Christina has been looking after our patients for 4 or more years, and does many things no hotel front desk person will ever do.  For example: go to the CVS Pharmacy and pick up a prescription (they won’t deliver), make breakfast, fuss over you a little bit, provide some cheerful company during the day, etc. Call me if there is concern.

Other doctors may work differently, but that’s how we do it.

Harold M. Reed, M.D.

Hi Dr. Reed,

No I am not on any hormones, but taking herbs, to help me along the way
Specific_Questions: Well first, I want to remove both testicles,But was wondering will this make me more femmine by doing this, with out testerones I understand taht my other parts also produce the hormone.I do know that the body needs hormones to equal out the system, so as soon as these are removed could i start extenisive estrogen program, also one more question, is any of the skin that the testicles are wrapped in used for furthering my surgery, to become a female, or is it just wasted skin? thanks for the info, your web site is quite promising, thank you, Janice

November 25, 2011

Good morning Janice,

Thank you for your interest in what we do.  You can have orchiectomy without any additional procedure for the time being.  You will need 2 letters of therapy clearance as mentioned in the attached.  If you are interested in hormones to accelerate secondary sexual characteristics, we do that.

When testes are removed there is some feminizing effect, but usually not that impressive as your skin may get softer, you’ll shave less, there may be very early breast growth, but not to be compared with one breast size smaller than your mother or sister when you are on proper estrogens for 2 years.

Our fee is 600 per year as you will need to be followed every 3 months for a while.  Laboratory testing and your selection of a pharmacy for medication is additional.

The advantages of orchiectomy are reduction in the amount of estrogens you need to take daily, less toxicity and some savings.  Of course, some bulge reduction.  Most MTF patients who anticipate vaginoplasty will save their scrotal skin for labia formation and vaginal depth extension.

After reading the attached, if you believe I am the doctor or you, please initiate a consultation over the phone with our office by sending us your name, address, and telephone number in an envelope along with a check for 250.  We’ll
get started ASAP.  We’ll have a lot to talk about.

Please keep in mind.  This November is a promotional month.  Call the office and speak with Anne our amiable office
manager for details.

Cordially,

Harold M. Reed
1111 Kane Concourse, Suite # 311
Bay Harbor Islands, Florida 33154
305-865-2000

I had read on another site that you sometimes might offer grants to help cover the expenses of things like an Orchiectomy. I’m on 400 mg of spironolactone and I still feel very dissonant inside chemicaly.
I also do not have an endo, or the luxury of having one who knows very much about trans people at all.
I am 26 years old, but to me age is irrelevant when I’m in limbo like this. However, the amount of pain that has built up as a result of dysphoria is unimaginably crippling. I am a novelist. I’m an amateur musician. I have a wide variety of interests. I used to play every single day and really enjoy what I did…

.
But I feel so clogged up right now from the pain of being like this that I cannot be productive right now. What I need is real progress, however anxiety and an autoimmune disorder really amplify it and this pain has taken over my life almost completely. I fight it every single day.

I don’t mean to rant. What exactly do I have to do to meet the requirements of a grant? I want SRS, truthfully, but I might want to wait on it simply because they are experimenting with the cheek cell neovagina that I have been hearing about a lot in the online community.
I desperately need SRS and waiting is going to be torture, but I wanna make sure I’m as happy with the results as I can be. It does not make it any less desperate, and it might turn out that waiting for the better alternative wont help me.
If I could at least make some REAL progress in my transition I think I’d have the fuel I needed to get through this transition mentally stable and at least functioning.

I wanted to know the criteria because I can’t afford this at all. My parents do not have the time to really help out, or the money, and neither do any of my relatives. If the grant covered a good deal of it, I would get an orchi in a heartbeat. That is one thing I am absolutely sure of…

Thank you for your time and for listening to me. The fact that I’m sending this and looking even further into pro bono things or grants means that I haven’t given up hope completely, but I would be lying if I said that it were in adequate supply to live a healthy life; A life which is passing me by because I’m incapable of working,

and I’m incapable of working cause of anxiety and pain caused by the dysphoria. I’m 26 and I know I have potential… The problem is actually feeling like myself in the process. Thanks again for listening.

Sincerely,

Kendra

Good afternoon Kendra,

Thank you for your interest in what we do.  Yes, we are having a promotional month this November. Kindly call Anne for details.

Your dose of Spironolactone 400 mg a day is way too high.  Please seek out an endocrinologist at your county welfare care center.

Lastly please keep in mind 50% of our patients come in with a sponsor.

For example yesterday we did a lady from Arkansas, full MTF vaginoplasty, and there was a real nice gent who wrote out the checks and is with her now.

Cordially,

Harold M. Reed
1111 Kane Concourse, Suite # 311
Bay Harbor Islands, Florida 33154
305-865-2000

Dear Dr. Reed,

I have already had an orchiectomy and scrotal removal. I also have a penis implant with the pump located between my anus and penis. I would like to know how much it would cost to have a pernament perienal urethral reroute with the slit being as large as you can get it. You might have to relocate my pump to the top of my penis instead of it being underneath. Is there a doctor in Phoenix AZ that you know of that could do this or would you have to do it and how much would it cost? Elton

Good morning Elton,

You should not have to travel out of Phoenix.

Any urologist there should be happy to see you.

Sincerely,

Harold M. Reed, M.D.

 i am on estregon anD spironolactone. I have been on them for about 2 1/2 years and been living as a women for the past 2 years
Specific_Questions: Im interested in having my testicles removed. my main concearn is I don’t want them showing and was wondering if it would be possible because they are removed through a incession in the abdomen if the could be placed in the adomen about where a female would have her ovaries rather than completly removing them.  Stephanie

Good morning Stephanie,

Testes are in the scrotum because they need to be 8 degrees cooler than body temperature.  Otherwise there is a potential, albeit small, for malignant degeneration.

For this reason, I will not perform the abdominal transplant you are seeking.  We do many orchiectomies the conventional way every month. The scrotal incision usually heals imperceptibly.

Sincerely,

Harold M. Reed, M.D.
305-865-2000

Dr. Reed,

No, not on hormones. Am only interested in the orchiectomy at present.
Specific_Questions: Hello, I’m not seeking full conversion but am seeking a bilateral orchiectomy, preferably with scrotum removal. I live in the UK. Is this something you’d be able to help with and if  so can you advise what documentation (if any) i’d need to provide you with? Would it be possible to visit your surgery and obtain the necessary documentation locally?

July 23, 2011

Good morning Mitchell

Are you a transgendered patient?

Sincerely,

Harold M. Reed, M.D.
305-865-2000

Dear Dr Reed,
Thank you for your reply. No, I’m not in fact transgendered but I have given this matter considerable thought over many years and am absolutely convinced it is right for me and that I would not in any way regret the procedure. I am seeking the procedure partly for personal  and aesthetic reasons but also to allow greater control over my own testosterone levels.

 I am not seeking re-assignment so would not anticipate any future need for the scrotal skin in that respect. I appreciate that this is not as common a request as for full reassignment surgery but the photos on your website give me hope that you would be able to help with this very carefully thought through wish. I have no desire to risk my health by using less orthodox means to achieve this result even though that is something I have considered. I can assure you that if you are able to assist it will mean as much to me as it does to the patients you are able to assist with full reassignment surgery.

I hope very much that you would be able to assist me and look forward to receiving your reply.

Regards

Mitchell

Good morning Mitchell,

As this is unconventional surgery, a letter of clearance from a board certified psychiatrist in the United States is required stating you are emotionally stable, understand the irreversibility of the procedure, that you will be a happier person afterwards, and that the likelihood of remorse will be very low.

There are patients who E-mail orthopedic doctors saying they’d like their right arm removed for personal and aesthetic reasons, so you can see where I am coming from.

Sincerely,

Harold M. Reed, M.D.
305-865-2000

This seems to contradict what I always thought was required for orchiectomy.  While I knew orchiectomy and SRS both required 2 therapy referral letters, I
thought it was only SRS that required 1 year of real life in the desired gender role. Where does that leave a person who wants an orchiectomy before undergoing
hormone replacement? It would obviously be impractical for one to live in the desired gender role for a year before even undergoing HRT. So, is what you’re
saying that a therapist will not or should not write someone a referral letter for even an orchiectomy until satisfying the same requirements of the real life
test for a whole year? Also, why is it then that a woman could get a hysterectomy done as a “preventative measure”, but a man cannot do the same for
an orchiectomy, whether it’s really a “preventative measure” or for part of a transition into a new gender role? So, theoretically, a FTM could setup a
hysterectomy with a physician and call it a “preventative measure” for health issues, but a MTF cannot do the same for an orchiectomy? It all seems very
unfair.

Diana

Re: for Orchiectomy, what should therapy clearance letter say?

Dear Diana,

WPATH standards are guidelines from which reasonable doctors and therapists may  make reasonable exceptions. Some surgeons will always be more permissive than
others, regardless. Same for some licensed therapists.

Please confer with your prospective therapists and surgeon on a one to one basis.

Personally I have no requirement that exogenous hormones are necessary for a real life test for many reasons. I do know this is irreversible surgery and
there may be some incidence of remorse.  At any rate, we hope you come to us for your orchiectomy and yes we’re going to fuss over you.

Harold M. Reed, M.D.

Sheryl

Dear Sheryl.

Easier to talk about the standards than about exceptions.

Yes, the standards are just guidelines, and if your therapists recommend that an orchiectomy is appropriate for you, even though you are not 24/7 and one of the two licensed therapists has a doctoral degree,  I am good with that.

Hope this is of help,

Harold M. Reed, M.D.