I still identify as male except when involving medical matters and then as a eunuch. It's one place to be straight.

Hello. I'm currently an intact male who has always identified as a eunuch. Until recently, gender-affirming surgery seemed like more of a dream. Too expensive + too difficult to get someone to even do it.

I'm hoping this situation changes soon.

According to WPATH's recently released Standards of Care, Version 8 (Oct 2022), "eunuch" is now an official gender identity. Plus the standards now say a eunuch isn’t just a castrated male. The designation also includes men (like me) who haven't been castrated yet but want to be in the future.

It's possible that this development will make it a little easier to get a voluntary orchiectomy and have it be covered by insurance. My wife is onboard with the orchi, but balks at spending thousands out of pocket to get it done.

I'm trying to find a doctor who is knowledgable about male-to-eunuch issues, takes Medicare, and can do the procedure quickly and with as little red tape as possible.

I'm also starting to have prostate issues. So if the gender dysphoria angle doesn't work, that's my backup plan. One way or another, these balls are coming off. I hate them and I really need to flush all testosterone out of my body!

NaturalEunuch (imported) wrote: Wed Jan 04, 2023 5:35 pm Hello. I'm currently an intact male who has always identified as a eunuch. Until recently, gender-affirming surgery seemed like more of a dream. Too expensive + too difficult to get someone to even do it.

I'm hoping this situation changes soon.

According to WPATH's recently released Standards of Care, Version 8 (Oct 2022), "eunuch" is now an official gender identity. Plus the standards now say a eunuch isn’t just a castrated male. The designation also includes men (like me) who haven't been castrated yet but want to be in the future.

It's possible that this development will make it a little easier to get a voluntary orchiectomy and have it be covered by insurance. My wife is onboard with the orchi, but balks at spending thousands out of pocket to get it done.

I'm trying to find a doctor who is knowledgable about male-to-eunuch issues, takes Medicare, and can do the procedure quickly and with as little red tape as possible.

I'm also starting to have prostate issues. So if the gender dysphoria angle doesn't work, that's my backup plan. One way or another, these balls are coming off. I hate them and I really need to flush all testosterone out of my body!

Welcome to the forums, wishing you success in your journey!

I'd suggest starting by looking for a transgender clinic in your area - I'm guessing FL from your handle, but... These are the doctors that do any sort of gender-mod surgery, which definitely includes us under SOCv8.

Unfortunately, while the new SOC should make things easier, it still calls for a good bit of red tape and hoop-jumping... From what you say, it sounds to me like you can probably get the required medical approval without much of a problem, but will probably need to spend some time on chemical castration drugs before they will talk to you about getting surgery....

The good side is that the drugs (probably Lupron in the US) will probably help w/ your prostate issues. The drugs they use on us are essentially the same as are used on guys w/ hormone sensitive prostate cancer...

FWIW, I started the journey not to long ago, at a TG center in my area, and basically started med changes on my first visit. I'm now chemically castrated, and just waiting for the SOC 8 specified time before talking surgery... I started after the 'draft' SOCv8 had been released but before the 'official' version. So at least at the center I'm working with (which is associated w/ a major hospital) it has been relatively easy, just tedious.

WheelyCurious

WheelyCurious wrote: Wed Jan 04, 2023 8:56 pm Welcome to the forums, wishing you success in your journey!

I'd suggest starting by looking for a transgender clinic in your area - I'm guessing FL from your handle, but... These are the doctors that do any sort of gender-mod surgery, which definitely includes us under SOCv8.

Unfortunately, while the new SOC should make things easier, it still calls for a good bit of red tape and hoop-jumping... From what you say, it sounds to me like you can probably get the required medical approval without much of a problem, but will probably need to spend some time on chemical castration drugs before they will talk to you about getting surgery....

The good side is that the drugs (probably Lupron in the US) will probably help w/ your prostate issues. The drugs they use on us are essentially the same as are used on guys w/ hormone sensitive prostate cancer...

FWIW, I started the journey not to long ago, at a TG center in my area, and basically started med changes on my first visit. I'm now chemically castrated, and just waiting for the SOC 8 specified time before talking surgery... I started after the 'draft' SOCv8 had been released but before the 'official' version. So at least at the center I'm working with (which is associated w/ a major hospital) it has been relatively easy, just tedious.

WheelyCurious

Thank you for the nice response. Getting started is indeed the tricky part. I was hoping to avoid putting chemicals in my body. Oh well, I'll do whatever it takes. It's awesome that they got you started right away. Did you have to do the two letters?

NaturalEunuch (imported) wrote: Wed Jan 04, 2023 11:35 pm Thank you for the nice response. Getting started is indeed the tricky part. I was hoping to avoid putting chemicals in my body. Oh well, I'll do whatever it takes. It's awesome that they got you started right away. Did you have to do the two letters?

SOC v8 has reduced it to only one letter, and specifically says that psychological / psychiatric care is recommended but NOT required... The letter is basically the TG center doc agreeing that you have a geneuaine desire and are aware of the risks and consequences and have done a really FULLY informed consent. Once you've convinced the doc, the drugs are just a question of writing a prescription...

At least so far, I don't have a written letter as such, but I get all my care through the major hospital that the TG center is part of, so all of her notes are in my electronic health record which is shared between all my many doctors... Whether I'd actually need a written letter before surgery I don't know, but I'd expect that if the surgery is done at the hospital, my record would probably meet the requirement....

WheelyCurious

WheelyCurious wrote: Thu Jan 05, 2023 3:48 pm SOC v8 has reduced it to only one letter, and specifically says that psychological / psychiatric care is recommended but NOT required... The letter is basically the TG center doc agreeing that you have a geneuaine desire and are aware of the risks and consequences and have done a really FULLY informed consent. Once you've convinced the doc, the drugs are just a question of writing a prescription...

Just for clarity, the SOC8 has recommended that only one letter is necessary. That does not mean a surgeon or other care provider cannot require more, and the SOC specifically states more than one letter may be necessary depending on the facts of an individuals case.

Losethem (imported) wrote: Sat Jun 02, 2018 5:08 pm How do you identify your gender? Using myself as an example, I am nullified, but if I gender identify myself I would say male.

To answer the initial question, at the moment I am still an intact male and also identify as a male.

Losethem (imported) wrote: Thu Jan 05, 2023 9:17 pm Just for clarity, the SOC8 has recommended that only one letter is necessary. That does not mean a surgeon or other care provider cannot require more, and the SOC specifically states more than one letter may be necessary depending on the facts of an individuals case.

Thanks for the clarification LT, I agree that docs can add whatever requirements they want to... However at the same time the SOC8 does at least provide grounds to push back against excessive hoop jumping requirements. While pissing off the doc that you want going after you for a is probably not the best idea, at least if you point at the SOC, you can ask about why the extra...

WheelyCurious

WheelyCurious wrote: Fri Jan 06, 2023 8:04 pm However at the same time the SOC8 does at least provide grounds to push back against excessive hoop jumping requirements.

Sorry, but what is the point? The doctor must be able to agree with his conscience whether he can justify the operation. If he is not convinced that it will help the patient more than harm him, the reference to SOC8 is of little help in my view.

Castor (imported) wrote: Sat Jan 07, 2023 4:37 pm Sorry, but what is the point? The doctor must be able to agree with his conscience whether he can justify the operation. If he is not convinced that it will help the patient more than harm him, the reference to SOC8 is of little help in my view.

SOC8 is a major part of the case I'm formulating. WPATH is viewed as the authority and they 1) include eunuch as a legitimate gender identity, 2) advocate that eunuchs should be entitled to 'gender affirming care.'

Picking the right physician is critical. I believe SOC8 will have influence with doctors who work with trans patients.

Well, I guess I'll find out.