Orchiectomy in the North East USA

[Losethem (imported)]

I just got back from my doctor.

She's fine with me self medding cypro until I get an orchi. She put it in her records she advises against it. Orchi will have to be out of pocket. $6000 locally (yikes) so it's Arnkoff for sure. Just gotta save up or find other ways to pay. Being trans is officially in my medical record now.

So Losethem, it turns out some doctors are totally accepting and willing to work with me knowing everything. Pretty good news I think. None of this existed when I began self medding years ago.

You do understand my objection was self-medication without doctors knowledge. In your case, you've notified the physician, and they can take it into account in the care plan. The idea being that if you are self medicating with whatever chemical/drug, they need to know. That way they do not prescribe you something for this condition or another, that would potentially cause you serious illness or death. It's quite easy to get a cross-conflict in drugs/chemicals/medications, if you're not up front and honest with them, which can do you serious harm.

Frankly in your case, since the doctor knows, so long as you continue to notify them of any changes in what you're doing, i'm not going to have a lot of disagreement with it. It's the self medication without knowledge of the physician I find problematic.

So on this point, good on you. It's the right thing.

[Zebedeee (imported)]

Question for Losethem,

I’ve just spent a few hours reading through older posts on the forum. At every stage of your transition to nullo has it been fully medically supervised and through ‘regular’ medical channels? No DIY meds or docs that don’t require letters?

I didn’t know that was even possible.

It would explain why I’ve received a more positive reaction from my GP and therapist than I was expecting.

[Tibergrace (imported)]

You do understand my objection was self-medication without doctors knowledge. In your case, you've notified the physician, and they can take it into account in the care plan. The idea being that if you are self medicating with whatever chemical/drug, they need to know. That way they do not prescribe you something for this condition or another, that would potentially cause you serious illness or death. It's quite easy to get a cross-conflict in drugs/chemicals/medications, if you're not up front and honest with them, which can do you serious harm.

Frankly in your case, since the doctor knows, so long as you continue to notify them of any changes in what you're doing, i'm not going to have a lot of disagreement with it. It's the self medication without knowledge of the physician I find problematic.

So on this point, good on you. It's the right thing.

You seem to have misread my posts. I explicitly stated I inform doctors of my self medication. If they didn't want to help with hormones I moved on to the next doctor. If I'm not seeing them for trans related things, I tell them what medications I take and if they ask I say I am self medding. If they tell me not to, I tell them "I don't care lol" and "let's move on and treat me for whatever medical concern I'm actually here for." They then treat me for whatever I'm there for because they had their opportunity to record it. What I don't do is tell them I am transgender, as that is none of their concern.

Maybe I could have been more clear, I thought I was pretty clear about things. I'll say it again: I inform all doctors of my self medication.

It should have been clear from my previous posts.

Not a single doctor goes without knowing I take 12.5mg cyproterone acetate every other day and 2mg estradiol validate every 12 hours.

I don't want drug interactions.

I don't tell them I am trans unless I am there for trans related things, since that is not important info.

[nutless1 (imported)]

In the U.S. the cost of SRS is now being covered by the U.S. military and the Medicare program for senior citizens and persons who can no longer be employed because of a disability. This social advancement is driving some people nuts, no pun intended.

[Zebedeee (imported)]

Good evening. I have seen references to Dr. Ankoff . on many posts on this site but am wondering if anyone knows of a doctor in the North East of the USA who is well regarded for performing bilateral orchiectomy in or near New England. Thank you very much for any input.

Going back to your original question. Being from the UK I’m not in a position to know what’s available in your part of the world, but I get the impression that if you’re not going to seek professional help then Dr Ankoff is probably your best option. Have you considered talking to your GP about this? If you’re referred to a gender therapist and can get the necessary letters then I think you’ll find you have a lot more options.

I totally understand why you might be nervous about doing this, it’s taken me until I’m 46 to start dealing with my gender identity issues, frankly because I’ve been too scared to seek help. It’s a big thing to do. It was only when I reached crisis point (drinking a bottle of vodka a day) and my doctor asked me what the problem was, that I finally talked to her about it. It’s beginning to look like it’s the best thing I’ve ever done, and my only regret is that I didn’t have the courage to speak up years ago.

[lightening (imported)]

You do understand my objection was self-medication without doctors knowledge. In your case, you've notified the physician, and they can take it into account in the care plan. The idea being that if you are self medicating with whatever chemical/drug, they need to know. That way they do not prescribe you something for this condition or another, that would potentially cause you serious illness or death. It's quite easy to get a cross-conflict in drugs/chemicals/medications, if you're not up front and honest with them, which can do you serious harm.

Frankly in your case, since the doctor knows, so long as you continue to notify them of any changes in what you're doing, i'm not going to have a lot of disagreement with it. It's the self medication without knowledge of the physician I find problematic.

So on this point, good on you. It's the right thing.

I think most people on here if they are at the self medication phase are bright enough to realise that certain drugs don't mix well with others, by the time most take some sort of hormone or anti -hormone drug they have read everything there is to know and in my case i would certainly have been more knowledgeable than my own doctor, the assumption that people in the medical field know everything about everything is quite frankly wrong.

You may know about it because it is of particular interest to you but my own GP has far less knowledge than me as he is a general practitioner and i am the only patient he has ever had without both testicles even in a city as large as London, it is rare even amongst those with testicular cancer, most get it in one testicle not both, I know as he told me that i am the only one and he has been practising as a doctor for forty years. Self medication is the only way a lot of men who are not changing gender can trial androcur etc, not all of us want things on our medical records forever. Also the assumption you put across is that we take this step lightly without investigating it before we do, wrong on both counts with me.

[Jorge2008 (imported)]

It's easier here in the more conservative (sic!) part of Europe, i.e. Baltics. I've found a couple of doctors willing to prescribe me antiandrogens. Thus, I think it is not so much an ignorance of the trans matter, but rather the stupidity prevalent in the West nowadays, that high sex drive and lots of sex are somehow the ultimate good thing.

I think most people on here if they are at the self medication phase are bright enough to realise that certain drugs don't mix well with others, by the time most take some sort of hormone or anti -hormone drug they have read everything there is to know and in my case i would certainly have been more knowledgeable than my own doctor, the assumption that people in the medical field know everything about everything is quite frankly wrong.

You may know about it because it is of particular interest to you but my own GP has far less knowledge than me as he is a general practitioner and i am the only patient he has ever had without both testicles even in a city as large as London, it is rare even amongst those with testicular cancer, most get it in one testicle not both, I know as he told me that i am the only one and he has been practising as a doctor for forty years. Self medication is the only way a lot of men who are not changing gender can trial androcur etc, not all of us want things on our medical records forever. Also the assumption you put across is that we take this step lightly without investigating it before we do, wrong on both counts with me.

[Zebedeee (imported)]

I guess that if you think that castration is right for you, then you have to be prepared for resistance and lack of understanding from some members of the medical profession. It never does any harm to get a second opinion (or third, fourth, etc..!), and if you can find doctors who are prepared to work with you, then it can’t be a bad thing. Though of course for some this can prove to be very difficult.

But I think you have to be pragmatic and keep an open mind. If every doctor you see tells you that you shouldn’t be doing this because you have say a heart condition, or whatever, then it’s most likely in your best interests to listen to them. If on the other hand they simply have a moral objection, or think that they know the best way for you to live your life, then it makes sense to either keep looking or take matters into your own hands. Just be very careful, and if you f**k things up then you’ve only got yourself to blame..!

Anyway, I saw this quote somewhere and I rather like it

“Sometimes the people around you won’t understand your journey. They don’t need to, it’s not for them.”

[Hyperion92 (imported)]

Thank you to all. Zebedee, I think you are right. Having another opinion may not hurt. I think if i am to make any progress, then at least consulting my doctor would be constructive. I get the sense he would not immediately brush aside my case as he is a very reasonable person. I guess what I am saying is that I should start by using the resources available to me and see where I get from there.

[Zebedeee (imported)]

Have you considered chemical castration first? You make no mention of it, and going straight for surgical castration without a ‘trial run’ is risky to say the least. You may like not having balls and no sex drive, but what other side effects will you have to cope with? People’s experiences seem to vary a lot. If you’re unlucky you may find that you put on weight, have unbearable hot flashes, barely have the energy to get out of bed, and develop an overwhelming urge to watch every movie ever made starring Jennifer Aniston… This is serious stuff, could you cope with it? She’s been in some terrible films!

Also, don’t forget that those still posting on here who went straight for the surgical option, are most likely the ones who it worked out for. Although I only recently joined the forum I’ve been lurking around here for years, and there seems to have been quite a few members who not long after castration disappear, never to be heard from again. Hopefully it worked out for them and they are living happy lives, and they haven’t gone on to develop an unhealthy interest in lengths of rope and wobbly chairs.

I do understand where you’re coming from, a few years ago I was seriously considering the surgical option. At the time I think a Dr Spector in Philadelphia (or something like that) was offering the service. I had the money and a friend lined up who was prepared to come with me, but in the end I was crippled by indecision. It could have been the best thing I ever did, or the worst decision of my life. I don’t know why I didn’t consider trying chemical castration at the time, I guess that I just didn’t know much about it or how effective it can be. Anyway, I’ve now decided that I’m going to give it a go and if it’s right for me I will consider surgery, but only after a year or two of full time chemical castration. It may be that it’s enough and I don’t need to take things any further. If it’s not for me then at least I didn’t do something which is irreversible. Of course long term chemical castration can cause damage to testicles, but I’m not going to be staying on it if I don’t like its effects.