Dr. Reed, Am contemplating orchiectomy as my next male to female transition step. How soon will I see change? 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
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 b Estimates represent published and unpublished clinical observations.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