What factors make a surgeon a better choice for orchi?

Here are what I can think of

1. able to do under local anesthesia (without sedation)

2. able to do downstream surgeries such as vaginoplasty

3. FACS and/or board certified urologist

4. orchi experience mentioned in reddit/eunuch (positively)

Let me know if you know other factors or have thoughts on any of the factors above.

I haven't been castrated, but I am hoping to go that path. I am working with a therapist.

To me, the factors are location, cost, and availability.

There are a handful of doctors who openly advertise transgender procedures on their website including orchiectomy and penectomy.

My personal preference is to find one who is local or would require the least amount of travel for the procedure. If I have to fly across the country, that means extra time off from work, paying for airfare, rental car, hotel, food, and other expenses above and beyond the cost of the procedure. Honestly, I am not sure if I can have my current insurance cover any part of the procedure. They will pay for some transgender related procedures, but only after living in the desired gender for a year, and being on hormones. I honestly don't know what that would mean for an orchiectomy since there isn't exactly a gender in the way MTF or FTM transitions.

Obviously, the doctor must be willing to perform the procedure for Eunuch and gender nullification and not just for the MTF procedures. I would probably be more concerned about the qualifications of the doctor for a penectomy compared with orchiectomy. The penectomy is a more invasive procedure and probably isn't one that could be done on an outpatient basis.

An orchiectomy is actually a very simple surgery (view a video of the procedure on my personal blog) requiring only basic surgical skill. Therefore I would not consider the qualifications of the surgeon a top priority. As most insurance does not cover an elective surgery cost and location are critical as prices can vary widely and far exceed $5000 for the surgeon alone. Add a hospital OR, anesthesiologist, travel and hotel stay and that figure could double. I doubt many doctors would do it under a local anesthesia, as one slip of the scalpel because a patient moved would be problematic, so that is not to be considered. To go beyond a simple orchiectomy skill comes into play and a surgeon with SRS experience is crucial. I've seen some pretty shoddy results of MtF patients whose scrotum was excised by a less than skilled doctor.

My orchi was medically necessary so my insurance covered it. However, deciding to have my scrotum removed was elective. My urologist wanted over $6,000 but I found a great cosmetic surgeon a few hundred mile away who did it in her office with Propofol for $1,200 cash. In one morning and out just after lunch that day.