How soon can I expect changes with transgender bilateral orchiectomy?

How soon can I expect feminizing changes after bilateral orchiectomy?  Brittani

Dear Brittani,

The changes which occur assuming proper doses of estrogens (serum estrogen of about 125 to 150 pg/ml) are known and reported in WPATH version VII based on work by endocrinologist Dr. Hembree. Usually patients who schedule in with us for orchiectomy should have a history of living as a woman for 2 years assisted by intake of estrogens for that time. The value of orchiectomy is to reduce scrotal mass, reduce estrogen intake and discontinue spironolactone or cyproterone acetate both having adverse side effects.  For spironolactone that could include dehydration and for cyproterone acetate, liver dysfunction.

We performed bilateral transgender orchiectomy via a midline scrotal incision  under local anesthesia with IV sedation.  To reduce scrotal size and avoid the palpable “tootsie roll” effect of a retained spermatic cord, the testis and cord are removed.   Allow 3 days to a week of convalescence before returning to an office environment.

Please visit for before and after pictures of male to female surgery

Cordially, and Happy and Healthy New Year,

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


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