Considering surgery

What is testes removal (orchiectomy)?

Orchiectomy A gender-affirming lower surgery to remove the testicles. removes the gonads (testes) and spermatic cord. It can be done with or without scrotectomy (removal of scrotal sac).

This surgery may allow you to lower your dose of estrogen and eliminate the need for testosterone blockers (which may reduce unwanted side effects and risks). This surgery is done by a urologist.

Orchiectomy can be performed as a standalone surgery or as a part of either vulvoplasty A gender-affirming genital surgery to create a vulva (including mons, labia, clitoris and urethral opening) and remove the penis, scrotum and testes. Vulvoplasty creates the external aspects of a vulva without creation of a vaginal canal. or vaginoplasty A gender-affirming genital surgery to create a vulva (including mons, labia, clitoris and urethral opening) and vagina. surgery. Visit our Vulva & Vagina Construction Guide for more information. 

Visit Understanding the Procedure for detailed information on the procedure, your options and the potential risks.

Making a decision about surgery

A wide range of people choose to have gender-affirming surgery, including people who are transgender, Two-Spirit A term used within some Indigenous communities to reflect complex Indigenous understandings of gender and sexuality and the long history of sexual and gender diversity in Indigenous cultures. Two-Spirit encompasses sexual, gender, cultural and spiritual identity. It may refer to cross-gender, multi-gender or non-binary gender roles, non-heterosexual identities, and a range of cultural identities, roles and practices embodied by Two-Spirit peoples. Some people also use "2-Spirit" or "2S." (Source: Battered Women’s Support Services) or non-binary Umbrella term referring to people whose gender does not fall within the binary gender system of woman/girl or man/boy. Some individuals identify as non-binary while others may use terms such as gender non-conforming, genderqueer, or agender. Non-binary people may or may not conform to societal expectations for their gender expression and gender role, and they may or may not seek gender-affirming medical or surgical care. . While having surgery does not make anyone more or less trans, it can help some people feel more comfortable in their body.

Questions to ask yourself

As you consider whether surgery is right for you, it may be helpful to start by asking yourself the following questions:

• Do you plan to stop taking hormone therapy in the future?
• What is important to you regarding fertility?
• Do you have any health issues that may restrict your options?
• What can you afford to do (in terms of travel, aftercare costs, time off work, etc.)?

Setting realistic expectations

Like with any other surgical intervention, there are risks associated with testes removal. Many people are very happy with the outcomes of their surgery, but some also experience complications or results that don’t meet their expectations. Being prepared for the outcomes of this surgery and the possibility of disappointment are part of ensuring you have realistic expectations. 

Outcomes of testes removal

• Results in permanent inability to produce sperm
• Requires lifelong hormone therapy 
• May allow a person to lower their dose of estrogen and eliminate their need to take testosterone blockers, reducing unwanted side effects and risks
• Allows for vaginoplasty and vulvoplasty, which can be done as a later procedure or at the same time as removal of testes

We recommend familiarizing yourself with the risks and complications associated with testes removal. 

When to have surgery 

Timing is also an important consideration for surgery. You may be heading off to school, starting a new job or have other important life events. Commitments like these make it difficult to accommodate the down time needed to recover from surgery. Picking the right time for surgery is as important to your recovery as any other pre or postop activity your primary care provider A person’s main health care provider in non-emergency situations such as check-ups and referrals. Family doctors, general practitioners (GPs) and nurse practitioners (NPs) are all primary care providers. recommends. 

This guide is meant to help you decide

There are many emotional, spiritual, physical, social and financial considerations that may impact your decision to have surgery. This guide was prepared to help you understand the costs, the procedure, the risks and the recovery associated with testes removal. 

Surgical costs — who pays for these?

Public funding

The B.C. Medical Services Plan (MSP The Medical Services Plan (MSP) is a B.C. government health plan that pays for physician services and referred services that are considered medically necessary, such as specialists (surgeon, psychiatrist, etc.), diagnostic x-rays, or laboratory services, for all BC residents. Some residents qualify for premium assistance for physiotherapy, chiropractic, naturopathy, massage therapy and acupuncture. ) will pay for the cost of testes removal.

Other surgery-related costs

While MSP pays for most of the costs associated with testes removal, there are other costs you should consider, including:

• Time off from work — You will need time off for both your surgery and recovery period. Recovery times are unique to each person, but it usually takes 2–3 weeks for most people to return to work. If your work is physically demanding, you may need more time.  
• Medical supplies & other post-surgery items — These include wound care supplies and medications. You can find a full list of recommended post-surgery items here.
• Travel and accommodation — If you don’t live near your surgical centre, you will need to cover the costs of travel. You may want to arrive a day ahead of your surgery and may need to stay for several days after. Ensure that you budget for accommodations, meals and parking.
• Costs for your support person — If someone is coming with you to help with your care before and after surgery, you may need to account for their travel and accommodation costs as well.

Financial support available

There may be some financial help available depending on your employer and your income bracket. 

• Paid leave — Speak with your employer or Human Resources department about any short-term disability, sick leave or vacation time you can use during your time off. 
• Extended benefits — If you have extended benefits, check your program to see what is covered.
• Disability assistance — If you are on provincial disability assistance, you can contact the Ministry of Social Development and Poverty Reduction to discuss funding for travel, support garments and other medically necessary Treatments, procedures or services that health care professionals determine are essential for diagnosing or treating a medical condition based on established medical guidelines and individual patient needs. supplies. Your primary care provider can write you a letter of support to access these funds.
• EI Sickness Benefits — EI Sickness Benefits can be an option for individuals who are working and meet the eligibility criteria.
• First Nations Health Authority (FNHA) Benefits Program — Individuals who are Indigenous, have status and live in B.C. are able to access FNHA benefits. These benefits can provide coverage for gender-affirming resources and postoperative supplies, like compression garments.
• Fundraising — Consider organizing online or in-person fundraisers.

There are also several programs that can help you cover transportation costs, including:

• Hope Air — A Canadian charity that arranges free flights for low-income Canadians who must fly to get health care.
• Travel Assistance Program (TAP) — If travel costs are a barrier for you, you may qualify for this program. You can apply for the program through your primary care provider. Visit the TAP website to learn about the application process.
• First Nations Health Authority (FNHA) Medical Transportation Benefit — FNHA benefits can also cover the costs of travel, accommodation and meals when you need to travel for medically necessary care.