(New account to post this)

It's been about a year since I had my orchiectomy with Dr. Bobby Najari at NYU Langone, and I love the results. I wanted to give an update and share some of the unexpected changes that happened for me.

I'm not particularly dysphoric about my genitals, and I enjoyed the default setup for many years. This lack of dysphoria was part of why it took me so long to figure out that I was in fact trans. Once I finally came out as trans and started tucking, I realized that I did have intense dysphoria around my testicles, but not around my penis. I considered options like vaginoplasty, but decided to go for an orchiectomy first, and reconsider if I actually wanted a vaginoplasty down the line.

I initially wanted my surgeon to also perform a scrotectomy, which would have given a result that I liked visually. But I changed my mind on this a few days before surgery, since I wasn't entirely sure that I didn't want a vaginoplasty later. Leaving the material kept my options open for either a scrotectomy as a revision, or extra material for vaginoplasty. I'm very glad I chose to keep the scrotum, because these days I am actively reconsidering whether or not I want a vaginoplasty.

The healing process took a total of about three months, with discomfort fading slowly over time. At about the three month point, I was able to comfortably pat the area with my hand. These days, I can manipulate the area however I want without pain. (Lightly hitting the area just feels pleasurable, much like hitting the penis does.) Everything is fully healed, and I can't see a scar even if I look for it. Visually, the results are quite impressive.

I do have some discomfort in the inguinal canals. This is from the remaining material that was left, and I've been told it can be treated with pelvic floor therapy. The sensation is still that particular testicular discomfort kind of pain, which does bring on some dysphoria for me, but it's so minimal I've just been putting off finding a therapist to treat it. But, it does exist. The feeling is the same as if the testicles were pushed up into the canals, but extremely faint, like the testicles are 5% of their original size. My surgeon said if it doesn't go away with the physical therapy, that we could do a follow-up revision to ablate the nerves. If I have a vaginoplasty, I plan on asking my surgeon to ablate the nerves during the procedure.

Tucking is easy. This is the biggest part for me - the dysphoria that came from the pain of daily tucking was really affecting my quality of life, and that has been completely eliminated. If I want, I can tuck aggressively all day. I usually don't want to, because I still get all the usual issues like moisture, skin irritation, etc. But the testicular pain is completely gone. I just wear the Tomboy X tucking underwear, which is enough to give me the flatness I feel I need. I often forget that I'm wearing tucking underwear.

Erections are rare. Even when I try my hardest, I can usually only get to about 75% of a full erection. This change feels neutral for me personally, because on the one hand, I do enjoy the function of my penis and would like to top occasionally. But on the other hand, erections do feel somewhat dysphoric, and it feels validating to have small genitals. I almost always bottom, and when I do top I use a strap, which I enjoy quite a lot. I've tried anal penetration with my penis, but it no longer has enough rigidity to have this be satisfying for either party. It's mildly frustrating when I do feel in a toppy mood, and am unable to have sex in the way that I used to, but I'm happy to make this trade-off for all the other benefits.

Sterility is huge peace of mind. I personally made the decision that I never wanted children, and the thought that I could accidentally impregnate someone was dysphoric. Knowing with certainty that this won't happen has been a big relief. It's allowed me to feel much more comfortable in exploring my sexuality. The idea that I could have an orgasm inside a natal vagina without worrying about impregnation is very appealing.

Orgasms are extremely rare. I wasn't expecting this to be as big a change as it's been. The drop in testosterone levels have really reduced my ability to orgasm. This is not a bad thing, just very different. Instead of reaching the satisfaction of an orgasm and feeling done, I just edge up to 90-95% and stay there. This can go on for hours, which I personally find much better than the intense 100% orgasms of my past. I've not been able to reach that 100% orgasm with a partner, and by myself I've only been able to do it maybe 15-20 times since surgery.

When I do orgasm, there's either a very small amount of clear ejaculate, or it's completely dry. When I do have ejaculate, it's a nice sticky texture with little taste. The amount is at most the size of a quarter. Before I could produce enough to cover a two inch circle or so. Not exactly sure how to describe this better, but the amount I produce is very significantly reduced, if not completely eliminated. More often than not, there's only the slightest amount of wetness produced.

I'm glad I kept my scrotum. Now that everything is healed, I can explore sensations I was never able to before. Touching my testicles brought on such intense dysphoria I couldn't handle that area directly, but now that it's gone, I'm finding the skin to be quite pleasing. It feels like a labia does on a natal vagina, which has helped me think through whether or not I want vaginoplasty.

There's a lot less sensitivity in my penis. I think this is mostly because of the lack of testosterone, more than anything else, but it's been a big change. Again, not a bad thing, but it does significantly contribute to orgasms being very challenging. Instead, I find penetration to be much more satisfying, which I didn't particularly enjoy / explore before surgery. The sensation in my penis was significant enough that I was able to just kind of ignore the prostate. Interestingly, this change in sensitivity sounds very similar to the changes that I've read about with vaginoplasty.

Because my genitals have changed sensation so much, I'm actually now much more open to vaginoplasty than I was before my orchiectomy. I feel like I've gotten all the sensation changes that I would have expected with vaginoplasty, but it's just that the physical parts haven't been reconfigured. Masturbating, I need to use a vibrator just like how I would if I had gotten a vaginoplasty, except things are in a bit of an awkward configuration to accommodate the toys. Combined with penetrative exploration, I now find myself wishing I had a vagina where my scrotum is. I now find myself wanting to put my fingers inside, and being frustrated that they don't go in.

I'm still very undecided on whether or not I want to have a vaginoplasty, because I do actively enjoy my penis. I've not had an opportunity to have penis in vagina sex since my surgery, and I imagine I would still very much enjoy that. But the day-to-day frustration of worrying about things like bulge and not having my genitals visually match the rest of my body may push me toward vaginoplasty regardless. It's a trade-off I think I may be willing to make, but I'm still considering it.