For many transfeminine individuals, orchiectomy is a meaningful step that eliminates the body's primary source of testosterone. Whether pursued as a standalone procedure or as preparation for future vaginoplasty, it can reduce or eliminate the need for anti-androgen medications, simplify your hormone regimen, and provide significant relief from dysphoria, all through a relatively straightforward surgery with a short recovery.
What Is Orchiectomy?
Bilateral orchiectomy is the surgical removal of both testes. For transfeminine patients, this eliminates the body's primary source of endogenous testosterone, which means anti-androgen medications (such as spironolactone or cyproterone acetate) are typically no longer needed. Oestrogen doses may also be reduced under the guidance of your endocrinologist. The procedure is performed through a small incision in the scrotal midline or inguinal region and is one of the shortest and most straightforward gender-affirming surgeries available.
Many patients choose orchiectomy as a first surgical step in their transition, particularly if they are uncertain about or not yet ready for vaginoplasty. Others pursue it as a definitive standalone procedure. If you are considering vaginoplasty in the future, it is important to discuss this with your surgeon, as orchiectomy can affect the amount of available scrotal skin. Under WPATH Standards of Care (SOC 8), orchiectomy requires documentation of persistent gender incongruence, a period of hormone therapy, and one referral letter from a qualified mental health professional.
Common Concerns Orchiectomy Can Address
- Ongoing need for anti-androgen medications and their side effects
- Discomfort or dysphoria caused by the presence of testes
- Desire to simplify hormone therapy and reduce medication burden
- Considering a preliminary step before potential future vaginoplasty
Are You a Good Candidate?
- Persistent gender dysphoria with at least one referral letter per WPATH SOC 8
- A period of continuous hormone therapy (unless medically contraindicated)
- Good overall health with no active infections or uncontrolled bleeding disorders
- Clear understanding of the irreversible nature of the procedure
Techniques & Options
Orchiectomy for gender affirmation is a relatively straightforward surgical procedure, but the approach and incision placement should be chosen carefully, especially if future vaginoplasty is a possibility. The best technique is determined by your anatomy and long-term surgical plans.
Two primary approaches are used:
Scrotal Approach (Simple Orchiectomy)
A single midline incision is made in the scrotum, through which both testes, epididymides, and a portion of each spermatic cord are removed. The incision is closed with absorbable sutures. This is the most common approach for gender-affirming orchiectomy and provides a quick, minimally invasive procedure with a short recovery.
- Minimal incision with rapid operative time (30–45 minutes)
- Performed as a day case or with a single overnight stay
- Well-suited for patients seeking orchiectomy as a standalone procedure
Inguinal Approach
An incision is made in the inguinal (groin) crease, and the testes are delivered through this higher approach. The inguinal method allows the spermatic cord to be divided at a higher level, which may be preferred for certain medical indications. This approach preserves more of the scrotal skin intact, which can be advantageous if vaginoplasty is planned in the future.
- Preserves scrotal skin for potential future vaginoplasty
- Higher cord ligation may be preferred for specific anatomical reasons
- Incision hidden in the natural groin crease
Recovery Timeline
Day 1
You may return to your hotel the same day or stay one night in the clinic depending on the anaesthesia used. Mild to moderate discomfort, swelling, and bruising are typical in the first 24 hours. Ice packs and prescribed pain medication keep you comfortable. Rest with the scrotum elevated.
Days 2–5
Swelling peaks around day 2–3 and then steadily improves. You can walk gently and manage daily self-care activities. Keep the incision clean and dry as instructed. A follow-up appointment checks your wound and progress.
Weeks 1–2
Bruising fades and discomfort decreases significantly. You can resume light activities and short outings. Avoid strenuous exercise, heavy lifting, and sexual activity. Your surgeon confirms healing at a follow-up visit before you travel home.
Weeks 2–4
Most patients feel fully recovered by week 3–4. You can resume exercise, work, and all normal activities. Your endocrinologist should review your hormone regimen, as anti-androgen doses are typically reduced or discontinued following orchiectomy.
What to Expect
Safety & Risks
Orchiectomy is a low-risk procedure with a well-established safety profile, but as with any surgery there are potential complications to be aware of.
- Haematoma or bleeding at the surgical site
- Infection of the wound (uncommon)
- Chronic scrotal pain or sensitivity
- Adverse reaction to anaesthesia
- Reduced scrotal tissue for future vaginoplasty (if scrotal approach is used)
- Hormonal adjustment required post-operatively
Serious complications from orchiectomy are rare, particularly when performed by experienced surgeons in a clean clinical environment. The most important long-term consideration is coordination with your endocrinologist to adjust hormone therapy following the procedure, and informing any future surgical team if you plan to pursue vaginoplasty.
How Much Does Orchiectomy Cost in Thailand?
Our pricing is transparent and all-inclusive, and your quote covers everything from surgeon fees to hospital stay.
Orchiectomy
All-inclusive surgical package- Board-certified surgeon fee
- Anaesthesia & operating theatre
- Hospital stay & nursing care
- Post-operative medications
- Follow-up appointments
- Dedicated care coordinator
Common Questions About Orchiectomy
Everything you need to know before your procedure
Dr. Kanokwan Pattanaporn
MEDICALLY REVIEWEDDr. Kanokwan Pattanaporn
MEDICALLY REVIEWEDGender Affirmation Surgeon · Bangkok
Last reviewed: February 24, 2026
Medical References
- WPATH Standards of Care for the Health of Transgender and Gender Diverse People, Version 8 (2022)
- Nikkels C et al."; Beyond Genital Reconstruction: A Review of Genital-Related Procedures for Transgender Patients — Transgender Health (2020)
- Endocrine Society — Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons (2017)
- American Urological Association — Transgender Surgical Care
Medical disclaimer: Content on this site is provided for informational purposes and should not be treated as medical advice. Outcomes, timelines, and eligibility differ from person to person. Speak with an experienced gender-affirming surgeon before proceeding with any procedure.
What's Included
- Board-certified surgeon fee
- Anaesthesia & operating theatre
- Hospital stay & nursing care
- Post-operative medications
- Follow-up appointments
- Dedicated care coordinator
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