Will Orchiectomy limit my ability to have MTF vaginoplasty depth

Dr. Reed,  I cannot afford a vaginoplasty now but would like an orchiectomy.  I am a 24 year old transgendered woman.  Been living 24/7 as a woman for 5 years.  Have 2 letters of therapy clearance, so I’m ready to go. Sarah

Dear Sarah,

We do about 3 orchiectomies a week along with several vaginoplasties every month.  While there may be some shrinkage of your scrotum, in that most likely your testicles are somewhat atrophic from estrogens, be assured there will be plenty of scrotum to provide additional vaginal depth if needed.  As a rule your potential depth is your height in feet which translate into inches and your height in inches above that which translates into a fraction over 12.  So if you are 5 feet 6 inches tall, anticipate a depth of 5″ plus 6/12 or 5 1/2 inches.

Determining how much skin is available from your penile shaft must take into account whether or not you are circumcised as we use foreskin as well.  Your total penile shaft skin length minus 2 inches (to wrap around the pubic bone) will suggest whether or not we need to do a scrotal graft add-on.

In Thailand they may use scrotal skin entirely for the vaginal vault, but most doctors in the US and Europe do use penile skin.  As you know this skin is erogenously sensate which is a good thing.


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

Scrotal graft extension adding an additional 3 3/4″ of length to inverted penile skin


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