Category Archives: Transgender hormones

Male to female orchiectomy preparation

Dr. Reed,  How do I prepare for transgender (male to female) orchiectomy?  Darlene

Dear Darlene,

Yes, we do orchiectomy for women such as yourself and also removal
of the scrotum if you so wish. The advantages are reduction of estrogens
by about 1/3rd and avoidance of testosterone blockers such as Spironolactone,

Yes, we do high ligation of the cord (no tootsie roll). Prior to orchiectomy you
may wish to consider cryo-preservation of your sperm.

Please see
for some photographic examples.

Mention should be made that there are medical (non-surgical) ways to achieve
the same effect with hormones or testosterone blockers. 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. You will also need
2 letters of therapy clearance, both written by licensed therapists, one of which has a doctoral degree
(could be a PhD or an MD if a psychiatrist) saying your are mentally stable, that the likelihood
of remorse is low, and that you will be a happier and more productive person as a result
of your orchiectomy, or at this time in your transition that the procedure is “medically necessary.”

Fees are consultation: $250, orchiectomy to include high removal of cord under local with
IV sedation, use of the operating room and any followup aftercare I provide: $2,500.

If you wish for simultaneous removal of the scrotum please add an additional $1500.

If you are 40 years or older, you may also need a letter of medical clearance
with reference to a recent EKG, and routine lab tests. a CBC, PT, PTT and platelet count.

Candidates who wish to secure their reservations are required to have minimally
a letter of clearance if needed and a phone consultation with a favorable response
to questions of concern. Assuming this, you will be given the nod to send
in a 50% deposit which is non-refundable.

If there is further interest please call and ask for Anne our amiable office
manager who will assist with arrangements.

You will need to stay overnight, ideally 2 days after surgery, at a nearby motel.  Please discontinue estrogen for 1 month before surgery to avoid adverse reactions related to hyper-coagulation.

We recommend Daddy O Hotel, 9660 East Bay Harbor Drive,
one block from our office (305-868-4141) somewhat more posh,
or the Baltic Hotel (305-861 8845) where Cristina (owner manager)
takes excellent care of her guests.

Please no aspirin or aspirin products, no anti-inflammatory drugs
such as Motrin, Advil, Alleve, or Cox 2 inhibitors such as Celebrex
or Vioxx 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 for “pennies” and we do notice
a difference. You will need 2 vials.

Please discontinue estrogen for 1 month before surgery to minimize adverse reactions related to hyper-coagulation.

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

With kindest regards,

Harold M. Reed, M.D.
The Reed Centre for Transgender Surgery | Dr. Harold Reed | Miami


For orchiectomy or feminizing vaginoplasty which is irreversible surgery, we need 2 letters of therapy clearance.

1. The letter should be written on a professional letterhead.

2. In the first paragraph, the therapist should introduce himself/herself and provide some background about his/her training, etc.

3. That the likelihood of patient remorse or regret having had surgery is extremely low or remote.

4. That the patient is mentally/emotionally stable

5. Towards the end of the letter the therapist has to say (words to this effect) I recommend, I endorse, I approve, Katelyn would be
an excellent candidate for feminzing vaginoplasty or orchiectomy. (not intersex surgery) . Not Katelyn has a good head on her shoulders, she knows
what to do. That the procedure is medically necessary.

6. At least one letter has to be written by a therapist with a doctoral degree.

7. One letter is a comprehensive letter which details your psychological background, pertinent medical history , any adjustment problems, etc.

8. The second letter is a letter of concurrence (more simple).

9. Lastly, the therapist or psychiatrist has to say, “I would welcome a call from Dr. Reed, if there are any questions or concerns.”

If you have difficulty obtaining such letters we have a list of therapists in Florida all with doctoral degrees, and you can confer with them and check out fees, etc. They do the evaluation and write such letters routinely.

Hoping this is of help. Please feel free to call me at any time if I may be of more service.



Harold M. Reed, M.D.
The Reed Centre for Transgender Surgery | Miami


Male to female vaginoplasty picture (patient of Dr. Reed)

MTF bottom surgery, what may I expect

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Vaginoplasty surgery on minors

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How long do I have to be on female hormones to have a MTF vaginoplasty?

Dr. Reed,  I have been a transgender woman for 7 years and my therapist says I may need to be on female hormones for a year before I can have sex change vaginoplasty.  Thus far I have not taken hormones because I pass very well, and to be perfectly honest they’re costly.   Lolita Dear Lolita,…Continue Reading