Sometimes, it is difficult or impossible to take feminizing hormones. An endocrinologist may recommend an orchiectomy, which involves removal of the testicles, to considerably reduce the production of testosterone.
An orchiectomy prior to vaginoplasty does not compromise the results of the latter. However, because the scrotal skin may retract (shrink) after an orchiectomy, a skin graft may be necessary for the construction of the vaginal cavity. If you plan to have vaginoplasty surgery, it is recommended that you do stretching exercises with the skin of your scrotum to prevent it from retracting (shrinking) after your orchiectomy.
During an orchiectomy, the surgeon will remove one or both testicles from the scrotum. During a scrotectomy, the surgeon will remove the entire scrotum or a portion of it.
If your transition will eventually include a vaginoplasty, the scrotal tissue may be used to create the vaginal lining. A vaginoplasty is the construction of a vagina using skin grafts. In these cases, a scrotectomy may not be recommended.
If there’s no scrotal tissue available for a vaginoplasty, the next option for constructing the vaginal tissue can often include skin grafts from the upper thigh.
It’s a good idea to talk to your doctor about all of your options. Be open with them about future surgeries you may plan to have. Before the procedure, talk to your doctor about fertility preservation and impact to sexual functioning.
Dr. Aguilar is the only surgeon in Latin America who offers Nullification surgery, also well known as Male-to-Nullo.
Many Gender Non-Binary patients opt for this more conservative surgical approach than the standard SRS. This surgery is focused on providing no sexual internal and external genitalia, giving the patient an external appearance of no penis or vagina. What makes Nullification SRS different from the standard SRS in the case of Male-to-Nullo, is that it does not include the creation of a vaginal canal so there will be no functional depth for penile penetration, includes the testis removal and the highly reconstructive procedure to reroute the urethra.
For those patients seeking to preserve sensitivity and an ability to orgasm, we can preserve the part of the glans, embedded under the skin surface.