(FAQ) How soon will I see feminization after orchiectomy | The Reed Centre for Transgender Surgery | Miami

Dr. Reed,  Am contemplating orchiectomy as my next male to female transition step.  How soon will I see change?  Fanny

Dear Fanny,

The feminizing changes after orchiectomy are a continuation of female hormone therapy.  You should be on hormones (ideally) for a year before you have an orchiectomy, as a safeguard to be sure this irreversible surgery is right for you.  Also as you know, you need 2 letters of therapy clearance.

The main effects of hormone replacement therapy HRT of the male to female MTF type are as follows:

  • Breast development and enlargement
  • Softening and thinning of the skin
  • Decreased body hair growth and density
  • Redistribution of body fat in a feminine pattern
  • Decreased muscle mass and strength
  • Widening of the hips (if epiphyseal closure has not yet occurred)
  • Decreased acne, skin oiliness, scalp hair loss, and body odor
  • Decreased size of the penis, scrotum, testicles, and prostate
  • Suppressed or abolished spermatogenesis and fertility
  • Decreased semen production/ejaculate volume
  • Changes in mood, emotionality, and behavior
  • Decreased sex drive and incidence of spontaneous erections

estrogen effects

Table 1b: Effects and Expected Time Course of Feminizing Hormones a Effect Expected Onset Expected Maximum Effect Body fat redistribution 3-6 months 2-5 years Decreased muscle mass/ strength 3-6 months 1-2 years Softening of skin/decreased oiliness 3-6 months unknown Decreased libido 1-3 months 1-2 years Decreased spontaneous erections 1-3 months 3-6 months Male sexual dysfunction variable variable Breast growth 3-6 months 2-3 years Decreased testicular volume 3-6 months 2-3 years Decreased sperm production variable variable Thinning and slowed growth of body and facial hair 6-12 months > 3 yearsd Male pattern baldness No regrowth, loss stops 1-3 months 1-2 years a Adapted with permission from Hembree et al. (2009). Copyright 2009, The Endocrine Society. b Estimates represent published and unpublished clinical observations. c Significantly dependent on amount of exercise. d Complete removal of male facial and body hair requires electrolysis, laser treatment, or both.

Hoping this is of help,

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

Photo of Breast development in Male to Female trans-gendered women (taken from Wikipedia)


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