Orchiectomy, sometimes called orchidectomy, is a surgical procedure that removes one or both testicles. Many transgender women and some non-binary people choose this surgery to reduce testosterone levels, ease gender dysphoria, or as part of their gender-affirming care.
Types of Orchiectomy
Bilateral orchiectomy: Both testicles removed. Common in gender-affirmation.
Unilateral orchiectomy: Only one testicle removed, usually for medical reasons (e.g. injury or disease).
Simple orchiectomy: Removes testicles but leaves surrounding tissue intact, which can help with future surgeries.
Radical orchiectomy: More extensive; removes testicles plus other structures (often for cancer treatment).
Why Consider It?
Some of the benefits and reasons people consider orchiectomy:
Lower testosterone; reduces need for anti-androgen drugs.
Relief of gender dysphoria.
It can simplify or improve outcomes of future surgeries (like vaginoplasty) if desired.
It's less complex/costly compared to some other surgeries.
What Happens Before, During, and After Surgery
| Phase | What to Expect |
|---|---|
| Preparation | Medical and mental health evaluations; informed consent; stopping certain medications; fasting before surgery. |
| Procedure | Usually 1 hour; small incision in the scrotum; testicles are removed, blood vessels cut/sealed; sutures used. Usually under general anaesthetic, though sometimes local and sedation. |
| Recovery | • Go home same day in many cases. • Pain is mild-moderate, especially early on. • Avoid heavy lifting & strenuous activity for ~2-4 weeks. • Keep surgical site clean; follow-ups needed. |
If you want a surgery referral letter from us, we'll help with the assessment. You'll also need to have a conversation with your surgeon before the surgery.
Choosing your Surgeon
We have a list of recommended surgeons here.
We always recommend thoroughly researching the best professionals for your surgery. Look up the name of the surgery you are seeking, your region, and the names of surgeons you’ve heard of. Visit their websites and gather as much information as possible. Choosing a surgeon is important, so make sure that when you have a consultation or seek second opinions, you feel completely confident in the surgeon and the services they offer.
If you feel ready, you can book a Surgery Referral session with us to help you with the next steps. You can read more about surgery referral sessions here.
Risks & Considerations
The surgery is permanent – testicles can't be reattached.
It causes fertility loss (no more natural sperm production). Sperm banking must be done before surgery if you want biological children.
Lifelong hormone replacement therapy will be needed to maintain things like bone health, cardiovascular health, etc.
As with all surgery: risks include infection, bleeding, healing delays, reactions to anaesthesia.
After the Surgery: What Changes to Expect
Hormone levels drop quickly (testosterone), often within a few days, with longer-term effects over weeks.
Physical comfort may improve; less genital dysphoria.
Hormone therapy tends to work more smoothly without testicular testosterone.
Need regular check-ups: hormones, bone health (e.g. calcium & vitamin D), heart health, mental health.
Practical Details
Eligibility: Usually includes having persistent gender dysphoria, mental health assessment, understanding of the surgery and its effects. Typically age 18+ under many providers.
Cost (UK example): Private orchiectomy can cost around £3,000-£6,000. NHS may provide it, but there may be long wait times.
Frequently Asked Questions
How long does it take?
About 1 hour.
Stay in hospital?
Usually same day discharge.
When do testosterone levels drop?
Within 24-48 hours, with very low levels in a few weeks.
Can I still have biological children?
Not without preserved sperm.
Do I still need hormones?
Yes.