Blood Testing After Bottom Surgery

Blood Testing After Bottom Surgery

Bottom surgery

Bottom surgery refers to a gender-affirming surgical procedure which reconstructs the external genitalia. Usually, bottom surgery involves removing the gonads. In transfeminine people, removal of the testes is called orchidectomy. In transmasculine people, removal of the ovaries is called oopherectomy.

Hormone production after bottom surgery

Given that testosterone is usually produced by the testes and oestrogen is usually produced by the ovaries, bottom surgery that involves removal of the gonads can have significant consequences on hormone production. Orchidectomy results in a significant decrease in testosterone production, while oopherectomy results in a significant decrease in oestrogen production. Nonetheless, it is important to note that small amounts of testosterone and oestrogen continue to be produced by the adrenal glands, and so hormone production does not stop entirely.

The decrease in hormone production has implications for gender affirming medical treatment. Specifically, if you were previously taking an antiandrogen or a hormone blocker as part of your gender affirming medical treatment, then it is likely that you will no longer require an antiandrogen or a hormone blocker after bottom surgery that involves removal of the gonads. This is because the body is no longer producing any endogenous sex hormones to suppress.

Blood testing after bottom surgery

Although antiandrogens or hormone blockers may no longer be required after bottom surgery, you will still need to take exogenous testosterone or oestrogen to maintain masculinisation or feminisation. Therefore, it is recommended that you continue to have blood tests to check your hormone levels. This is to ensure that your testosterone or oestrogen dose is sufficient to maintain your hormone levels within the target ranges.

If you are taking oestrogen for feminising hormone treatment, then it is recommended that you have a blood test for oestrogen every three months for the first year, then annually or as advised by your healthcare provider.

If you are taking testosterone for feminising hormone treatment, then it is recommended that you have a blood test for testosterone every three months for the first year, then annually or as advised by your healthcare provider.

References

Unger, C. A. (2016), "Hormone therapy for transgender patients". Translational Andrology and Urology, 5(6): 877-884.



Order Your At-Home Finger Prick Test Through the GenderGP Blood Test Portal Now (Available for Members and Non-Members)
Note: To use the finger prick test, you need to be 16 or older and not taking spironolactone. Vitall, the service provider, will send your blood test results directly to your email address.

If you're taking spironolactone, you'll need an intravenous blood sample. You can get this through an online blood test service of your choosing, through your GP if they're willing to help, or at a private clinic/hospital.

If you need a Blood Test Referral Letter to advise your GP or healthcare provider, you can purchase one through the Treatment Recommendation form for £20. The letter explains why you need blood tests and which ones you'll need to get (read more here: Obtaining Letters and Reports).

When you have your results, please submit them in the Treatment Recommendation form for analysis.

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