Elective Bilateral Orchiectomy

[snippedandcalm (imported)]

From my own experience, it seems to me that the less evidence they require for castration, the higher the price for some urologists. But is this really so positive? I no longer see it necessarily as a disadvantage that such operations are performed so restrictively in Europe, unless they prevent an operation for which there is a well-founded indication. A good urologist asks for proof from a therapist before he removes something hastily. He just wants to prevent the patient from regretting the irreversible castration later.

But if you have the money, somehow that worry of your regret just melts away, lol. I guess that shows better planning and better planning leads to greater resolve and less legal liability for the healthcare provider. More like, hey I can fill a niche and make more money because some people are desperate.

[BillyBlogs (imported)]

You might think Oz was more open minded than it appears when it comes to elective orchiectomy but it seems the USA is miles ahead. I know of several surgeons who will do it with minimal if any hoops to jump through. Of course prices vary from reasonable to ridiculous but that’s American healthcare. I have seen reports here of a doctor in Atlanta who offers informed consent castration but at a price that seems outrageous.

From what I can tell, we're as much in a transitional state as anywhere else. I think it's worthy of note that my psychologist, GP, and I do believe, my surgeon-to-be are all under about 35 years old. I think there's a generational wave of change coming. Like the social revolution of the sixties, but with a bit less LSD, and a bit more genuine peace and love. (At least, I hope so.)

There are still more than enough medicos out there working under the old 'gatekeeper' paradigm. Hopefully I've given Raj a pathway to sidestepping them. I don't know why his psychiatrist isn't forthcoming with the WPATH letter, unless there are some underlying matters that haven't been divulged.

[dingoaud (imported)]

Hi, from Australia aswell the only way for myself to reach my goal of castration was to go down the alcohol injection path. Which did work for me to get both of them removed

[BillyBlogs (imported)]

Hi, from Australia aswell the only way for myself to reach my goal of castration was to go down the alcohol injection path. Which did work for me to get both of them removed

Hi there Ding,

I don't know how long ago you felt that the injections were needed, but I think times have changed a great deal since then. Under the informed consent model, once you've established that:

you know what you want,

that you understand and accept any risks associated,

and you're not considered in a mental state where a WPATH letter isn't yet suitable,

then a person *should* be through the appropriate hoops in a matter of a few months.

I think Raj is a thoughtful soul, and will follow up the leads I've given him in Melbourne. The Monash University gender clinic looks to me like a good starting place.

However, Raj also indicated that he's also working through some other issues, and it may be that he needs some room to deal with those first. That's how my therapist worked so there was no muddying of the waters, so as to speak.

[raj1tm115 (imported)]

Dear Billy,

You are a thoughtful soul indeed, especially when you sensed some of my issues without even me writing them.

I have been having a rough time indeed for more than 5 years with work and family and everything. But the last 10 months were really tested me and I thought of just ending myself. Honestly, I didn't have the courage to bring my sexuality issues till my Psychiatrist said that unless we deal with the "iceberg", the mental issues were only going to get worse.

I did come across the Monash University gender clinic, but I thought I could never be accepted there. Anyway, this week is big for me as I have an appointment with my Psychiatrist (public) mid-week. I am planning to ask the following q's

Q1) I understand that chemical castration is being recommended as a Psych. may not be able to suggest an "invasive" procedure. But as a patient why should I opt this, considering that this is life-long and a big financial burden to me (based on another Psych. in public, he said avg. $2k every year on injections)

Q2) I have had a few friends in EA forum suggest me to go the WPATH way. Isn't this an option? If so, can I approach the Monash gender clinic?

Q3) I have got a quote from a Thailand hospital of about $5k AUD (surgery and accommodation). Why should I not consider this

Note: Billy, I just got this quote from Kamol hospital today morning. I know its expensive but it was huge huge relief as I now have a plan B. (In fact I was so desperate that I was considering plan C - DIY and was scheming it, but I put them off once I got some hope after your suggestion from the other thread)

Hope the above q's are ok. I do not want to offend the Psychiatrist in any way also.

Blessings to everyone

I am a bit happy today .... yay

raj

[BillyBlogs (imported)]

Dear Billy,

You are a thoughtful soul indeed, especially when you sensed some of my issues without even me writing them.

Aw, shux. (Paws the floor)

I have been having a rough time indeed for more than 5 years with work and family and everything. But the last 10 months were really tested me and I thought of just ending myself. Honestly, I didn't have the courage to bring my sexuality issues till my Psychiatrist said that unless we deal with the "iceberg", the mental issues were only going to get worse.

This is the crux of the matter, as far as I can see. Once you are inside that consultation room, you have to be incredibly brave and trusting. But it's like sex, it only hurts the first time

When I told my counsellor I was not a man and I wanted to be surgically altered to express how I did see myself, I nearly threw up on the way home, the physical shock was so great. It was so hard to do. I just blurted it all out in a rush so the fear couldn't silence me once I started.

Once I did though, I could feel the healing starting straight away. Since then, the fear has subsided a lot, and I'm much more comfortable in this "new skin". I think you will find much peace too, once you lift the lid on your own your own can of worms.

Sunshine and fresh air seem to be not so good for worms.

I did come across the Monash University gender clinic, but I thought I could never be accepted there. Anyway, this week is big for me as I have an appointment with my Psychiatrist (public) mid-week. I am planning to ask the following q's

Monash will indeed accept you, but there is a very long waiting list to get to see their in-house specialists. Presently about 12 months.

Q1) I understand that chemical castration is being recommended as a Psych. may not be able to suggest an "invasive" procedure. But as a patient why should I opt this, considering that this is life-long and a big financial burden to me (based on another Psych. in public, he said avg. $2k every year on injections)

My GP has given me the names of four counsellors that can supply me with the required WPATH letter. Three of them are psychologists, and one is a psychiatrist. Both are considered qualified to supply WPATH documents.

I would suggest you ask whether your psychiatrist thinks you need to negotiate your "iceberg" before you make a decision about being permanently altered, or, is that decision, whether by chemical or surgical means, the iceberg. Another way perhaps to ask the question would be, "What would satisfy you that orchidectomy is the right way for me?"

Q2) I have had a few friends in EA forum suggest me to go the WPATH way. Isn't this an option? If so, can I approach the Monash gender clinic?

If you need to go public completely, the Monash might be the option.

For myself, as soon as I have my WPATH letter I am employing the services of a urological surgeon, and paying the medicare gap. This is a very much faster path, but there are some dollars to be found.

Q3) I have got a quote from a Thailand hospital of about $5k AUD (surgery and accommodation). Why should I not consider this

I thought about this way too. The biggest drawback I could see was getting my GP etc. up to speed once I came back.

Surgeons here can go ooggedy-boogedy and wave their hands as if conjuring up the white-man medical spirits, while trying to not sound racist as they imply that Thailand and India are a bit third world and would you trust them with this sort of thing? (It's called professional etiquette, and is why sharks don't eat lawyers, too.)

Note: Billy, I just got this quote from Kamol hospital today morning. I know its expensive but it was huge huge relief as I now have a plan B. (In fact I was so desperate that I was considering plan C - DIY and was scheming it, but I put them off once I got some hope after your suggestion from the other thread)

Personally, Raj, I think you're off to a good new beginning. I would agree with you that you put the medico-holiday aside as a back-up plan. You should have no need to cause yourself pain and harm to become a eunuch today, so long as your mental state allows of it.

One little thing that's helped me along is turning up at my counselling sessions with a little notepad. I open it, and will say something like- "I've noticed that when blah, then, I something-or-other". This helps me because I have what I want to deal with clearer, and it helps to keep the conversation on topic when I have the matter in front of me in writing.

Hope the above q's are ok. I do not want to offend the Psychiatrist in any way also.

Your counsellor will have a pretty thick skin. That's not to say you should come out swinging punches, but you are entitled to some concrete answers to the questions around you getting yourself to where you need to be.

I think you're a bit smarter than the captain of the Titanic, and you will deal with your own iceberg in a better way than "full speed ahead".

Blessings to everyone

I am a bit happy today .... yay

raj

My comments are in line. If you scroll through the quote, you'll find my notes.

Billy.

[WheelyCurious]

I think Billy is giving you some really great advice and support, big thanks to him for joining the thread...

To add to a couple of questions you asked - One of the reasons they are probably going to be insistent on at least some length of time doing chemical castration is that they want you to be REALLY REALLY sure that you are doing the right thing for you - castration is more forever than diamonds, once you've been cut there is no gluing them back on...

With a few exceptions, a chemical castration test drive is part of the WPATH protocol. I'd expect that any clinic you would want to deal with is going to be doing the WPATH approach, so that is pretty much what you will get if you go the medical route.

I don't know how your medical system works in AU, but in many cases once you have an 'official diagnosis' of gender disphoria, which your therapist should be able to provide, the chemical castration drugs will be covered by your health insurance. At least my Lupron shots are being covered 100%

I would at least reach out to the Monash clinic that you and Billy mentioned, it seems possible that they might be able to get you in sooner since at least as I understand it we need less in the way of care than a person doing the full reassignment route. Purely speculating, but if you are already seeing a therapist, it might be possible to have Monash handle the medical side while your existing person handles the mental health side...

I have seen some reports here on EA and a couple of other TG sites from folks that have done the Thailand trip and seemed to have had a positive experience, but I'd agree with Billy that it is probably best to keep that as 'plan B' for now.

WheelyCurious

[raj1tm115 (imported)]

Billy, you did once again with a lot of great info - thanks a lot my friend.

Yes, I am keeping up a notepad this time. I may stutter but at least considering my sleepless anxious nights, I am going to unashamedly ask the queries from the notepad

Looking back at the last 10 months, each visit to my Psychiatrist drains me completely. That's why I overseas surgery (Thailand & US) started to get attractive to me... so that I can get on with life. Nevertheless, Wheely and Billy, I will currently keep it as plan B.

Billy, quick thing. Would you be able to share roughly how much $ you would have spend as gap?

Kind Regards, raj

[BillyBlogs (imported)]

Billy, you did once again with a lot of great info - thanks a lot my friend.

Yes, I am keeping up a notepad this time. I may stutter but at least considering my sleepless anxious nights, I am going to unashamedly ask the queries from the notepad

Looking back at the last 10 months, each visit to my Psychiatrist drains me completely. That's why I overseas surgery (Thailand & US) started to get attractive to me... so that I can get on with life. Nevertheless, Wheely and Billy, I will currently keep it as plan B.

Billy, quick thing. Would you be able to share roughly how much $ you would have spend as gap?

Kind Regards, raj

You'll be fine Raj, your psychiatrist is there for your benefit. He's not going to judge you, other than to determine how to help you.

I think you'll find the pad useful. You can look at it and know if you have your answers, rather than the session ending after being a bit of a ramble. Your therapist will also be a bit more sharp. I've noticed a small body language change when I take the pad.

About the gap, I'm not sure. I went to the medicare site and looked up the rebate for orchidectomy.

I don't know how to look up a preliminary consultation, so I'll use the fee I have been quoted as an example.

Preliminary consultation fee, $280.00, rebate $76

For a simple orchidectomy, unilateral (one side) the recommended fee is AU$424.00, rebate $318.00. (You'll need to double these numbers as you have two balls.)

Bear in mind here that magic word "recommended" means this is the minimum possible you will be charged. It's entirely likely that the actual fee will be greater than the recommended. I haven't been quoted for the surgery yet, but I'm expecting it to be somewhere in the region of $150 to $300 or so more than the recommended fee.

I suspect you will soon enough have a much better idea of where you're going.

Billy.

[WheelyCurious]

I just found this - might be useful....

https://www1.racgp.org.au/ajgp/2020/jul ... erse-patie

It is an article from an Australian medical journal about having GP's doing some hormone therapy... It can be useful to see what they are telling the guys in the white coats...

WheelyCurious