Orchiectomy

On this page
Standards of care
Recovery
Costs
Locations
Risks
Downloads

An orchiectomy (also called ‘orchidectomy’), or bilateral orchiectomy, is a procedure that surgically removes the testes.

Orchiectomies are typically sought by trans people who were presumed male at birth (PMAB), including trans women and non-binary people to stop the production of testosterone and sperm, or to affirm their gender. Having an orchiectomy also removes the need to take an anti-androgen, and some people like a reduced medication regimen.

There’s no right or wrong way to be or embody your gender, regardless of your surgical status. Not all trans people want, seek or can have surgery, and being trans doesn’t necessitate surgery either. Find out more about that on our ‘Am I trans enough?’ page.

Information and resources to assist clinicians learn more about orchiectomies can be found our page for clinicians.

WPATH Standards of Care

The Standards of Care – 8th edition (SoC8) is published by the World Professional Association for Transgender Health (WPATH) and offers guidance to clinicians working with trans patients all over the world, including criteria and recommended referral pathways for those seeking particular medical and surgical interventions.

The SoC8 do not specify an order by which surgeries should occur, if sought at all, and are guidelines, not legislated requirements.

Criteria for orchiectomy in MtF patients:

Having discussed reproductive options;
Capacity to make a fully informed decision and to consent for treatment;
Having discussed aftercare and follow-ups;
6 continuous months of hormone therapy as appropriate to the patient’s gender goals (unless hormones are not clinically indicated for the individual).

The aim of hormone therapy prior to gonadectomy is primarily to introduce a period of reversible oestrogen or testosterone suppression, before the patient undergoes irreversible surgical intervention. These criteria do not apply to patients who are having these procedures for medical indications other than gender dysphoria.

Recovery

You will be required to either stay overnight after an orchiectomy, or you will be discharged a few hours after the surgery and be required to return the next day for a check up.

Recovery can take from 2 to 8 weeks. You won’t be able to do any strenuous activity, lift heavy objects or drive for at least a few weeks after the procedure. You will also need to wait until the surgery site has fully healed before having sex.

The specific instructions for your recovery will vary from surgeon to surgeon, and depending on where and what specific surgical techniques are used.

Costs

An orchiectomy can cost between $3,000 and $10,000 in Australia, depending on the surgeon and technique used. If your surgery is in Australia, some of this may be covered by Medicare or private health insurance.

Locations

This procedure is done in Australia. They are also performed in many countries, including in Asia and in the U.S.

The Australian Professional Association for Trans Health hosts a provider list of their members. It includes surgeons in Australia and is available here.

Risks

All surgeries carry some risk, including complications, infection, blood clots, and rarely death. It’s important to ask your surgeon about possible risks and how to avoid them.