Hey y'all, I'm Niannar. It's my Warcraft toon's name, I'm not very creative. Any who, I'm 39 years old and about 6 months ago came out to my wife as MTF. She is very supportive of my journey and has been my rock. Mainly I am here to meet new folks. I am looking to get an orchiectomy once of these days. Sooner the better. Looking for advice, recommendations, stories, etc. I'm pretty open, so if you want to know more just ask.

Welcome to the Archive!

I expect that you'll be able to get lots of advice and support on your journey and transition... It also sounds great that your spouse is supportive, tell her to feel free to log in on her own with any questions she has.... Hopefully you have been doing some homework already, so this may be redundant, but a few suggestions if you haven't done this already...

1. Go to the WPATH website, and download a copy of their Standards of Care v.8 (usually referred to as the SOC v8) - this is the guide that nearly all transgender providers will be following, and it is helpful to know what they will want and are looking for. It will give you a good idea of the process you will need to go through in order to transition.

2. Do a search online for transgender centers / clinics near you and reach out to the ones that appeal to you most, and get started on booking appointments with the appropriate medical folks... The SOC process is not a fast one, so getting started sooner is good...

3. In addition to this site, I also think highly of the TransFeminine Science website, they don't have forums, but are an excellent reference source for information about the science involved, such as drug and hormone choices, etc... Unlike a lot of sites, they base everything on published medical research and hard science, not guesswork and popular beliefs... They also do an excellent job of translating 'Medicalese' into human....

4. It is probably worth talking with the TG center folks first to see what they say (including things like what your insurance might cover) but there is some research that says there are considerable benefits to getting an orchie early in the transition process, including not needing Testosterone blockers and possibly better responses to feminizing hormones and meds... If the WPATH rules hit you with more of a delay than you'd like, Texas is close to Mexico, and there is a clinic there (Dr. Aguilar (sp?)) that many members here have used and been very happy with the results. I'm told he requires far less in the way of approvals than WPATH, basically working on an informed consent basis... It would be out-of-pocket, but the cost is relatively reasonable so may be worth considering....

WheelyFixed

Hey, great to meet you, and thanks for the response. I uave done some of what you spoke about. I have read the WPATH 8 SOC. Waiting for the audio book for the whole thing. I've been on HRT for about 5 months now with SUB-Q/IM estradiol valerate .2mL at 20mg/mL. Going through Plume for my care. Couldn't be happier. I would love to go to someone local, but as i work for the only hospital in town and they own all the PCPs in the area it's my only choice. My coworkers have access to my EMR, and since I am not out at work/public yet... I know it is against the law for them to go into a chart but I am not going to take the risk and he outed sooner than when I want to come out. I am OK paying the monthly fee to Plume.

I have been sorta looking into surgery centers/surgeons. All so far seem to follow the guidelines, requiring letters and the rest of the hoops to jump through. I do have insurance, but like the PCP problem it is also administered through and by the hospital. So I'm looking into self-pay for the orchi. I know going south of the border would be a lot cheaper, but my spouse is against the idea. I would love to find someone in the US to go off of informed concent and self funded.

Given the employment / outing concerns, it sounds like you are doing the best you can...

My only thought is that one of the things the WPATH seems to require before surgery is "Real Life" transitioning - and I'm not sure how one can do that without being out.... (I didn't have a big issue with it as I just did M->E and that doesn't show, so no need to be generally out) I have no idea how best to handle this.

Unfortunately I haven't seen any good suggestions for US based surgeons that will do 'informed consent' surgery w/o the WPATH hoops, but Plume might be able to suggest a surgeon that can do a simple orchie, as that is all you really need at this point (This is a recent post about a paper on the benefits of orchie's for M-F trans folks, seems like really relevant. http://forums.eunuch.org/showthread.php ... rchiectomy (BTW "Jesus" is one of the major forces behind the Eunuch chapter in SOC v8)) I don't know just what your end goals are for surgery, but generally it seems suggested that you want to keep the scrotum as they use that tissue later when doing vaginoplasty...

I don't know just how to convince your wife about Mexico, other than to say I've seen reports from several members here that have gone to Dr. A.'s clinic and every one of them has been very happy with the results and the care they got. According to the reports the clinic is easily comparable to anything in the US in terms of the conditions, equipment, and so on... If you need overnight accommodations, they have connections to good quality places to stay that are used to dealing with his patients, so by all reports it's a first class operation.... He has a good enough reputation that he is possibly our top suggestion for anyone that is having problems getting surgery through their local medical system.

In terms of costs - I started a thread about a year ago http://forums.eunuch.org/showthread.php ... ting+fixed where I posted the numbers I got from Medicare for my surgery at a major Boston hospital. Besides the amazing difference between what the hospital had for their 'official charges' and what Medicare paid, the balance that I would have had as a copay (if it hadn't been covered by Mass. Health) was pretty close to what I've seen posted as the amount Dr. A charged...

WheelyFixed

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Niannar1 (imported) wrote: Thu Oct 17, 2024 12:29 pm I have read the WPATH 8 SOC. Waiting for the audio book for the whole thing. I've been on HRT for about 5 months now with SUB-Q/IM estradiol valerate .2mL at 20mg/mL. Going through Plume for my care. Couldn't be happier. I would love to go to someone local, but as i work for the only hospital in town and they own all the PCPs in the area it's my only choice. My coworkers have access to my EMR, and since I am not out at work/public yet... I know it is against the law for them to go into a chart but I am not going to take the risk and he outed sooner than when I want to come out. I am OK paying the monthly fee to Plume.

I have been sorta looking into surgery centers/surgeons. All so far seem to follow the guidelines, requiring letters and the rest of the hoops to jump through. I do have insurance, but like the PCP problem it is also administered through and by the hospital. So I'm looking into self-pay for the orchi. I know going south of the border would be a lot cheaper, but my spouse is against the idea. I would love to find someone in the US to go off of informed concent and self funded.

I'm not familiar with Plume and their services but last year I found it very easy to get the orchie. Just needed one letter and a Urologist (in GA). I didn't need to do the waiting or chemical trial since I didn't want a binary transformation, just a castration (one step at a time approach). If I had paid cash, it would have been done in about two months mostly waiting for a surgical opening. But I went through insurance which required a predetermination review that took an additional amount of time. If you are in Tx contact Crane Center. They are very helpful. I should know since they are completing my nullification VERY, VERY soon.