Orchids symbolize elegance and beauty--wonderful beauty. Those fantastically creative ancients, the ones that brought us such useful ideas from theatre to democracy--the Greeks--believed that if you ate the orchid before conception, it would influence the gender of the child, depending on whether it was eaten by the mother or the father. So we could certainly say that the fabulous orchid has been, not only a symbol of sex and love, but also of gender. Isn't this interesting?
An orchidectomy, however, or--more commonly--ochiectomy, is the surgical removal of one or both testicles. And I had mine a little less than a week after my last post. Mm hm--Surprise! I really had meant to write about the experience much earlier than this, but then this little thing called life got in the way, and well, so many things, including this blog were put by the wayside. But, now I am back, and am prepared to slightly disgust you with all the messy details.
I had what is known as a simple bilateral orhiectomy performed by an amazing doctor in the Detroit area named Dr. Mark Arnkoff. Of course, especially to men, there is nothing "simple" about having your balls cut off. I am, of course, no man--never was--despite having the two berries hanging from a seemingly phallic symbol of masculinity, they were very much unwanted. But the "simple" simply means, instead of having the "radical" procedure--where your testicles and tubes are removed through a slit in your abdomen, mine were removed through a "simple" incision in my scrotum. And "bilateral," in basic terms, means they took both of 'em, thank you very much. And to me, the whole experience was, quite a bit more smooth and simple than I had imagined it would be, and yes, incredibly welcome.
As I mentioned, the procedure was performed by the wonderful Dr. Mark Arnkoff. If you also need to have an orchiectomy, you can go visit his site for more information. He is a board certified urologist with plenty of experience who has been performing orchiectomies since the 70s. In fact, he kindly reminded me of this and that he had performed this procedure hundreds of times just before cutting me open. He is quite a skilled surgeon, and has a calming and kindly demeanor to boot. His assistant, Sarah, was attentive and a huge help in making sure I felt at ease during and after the surgery. This was my first and only surgery so far, so I was incredibly nervous, but the two of them together provided an atmosphere of reassurance and professionalism that helped me gather myself calmly as I prepared to go under the knife.
The operation was an out-patient procedure, done right in Dr. Arnkoff's humble practice in Southfield, Michigan, in the short term not much more time consuming or painful than what I have heard described of vasectomies. With only local anaesthesia, for me it was a little unnerving to be awake during the procedure as you're innards are pulled out and snipped, even in Dr. Arnkoff's capable hands. Of course I was informed this would be the case before the procedure, and for Dr. Arnkoff's excellent work, and what he offers, to me it was worth the slight uneasiness.
What exactly does Dr. Arnkoff offer that many transsexuals, like myself, have been interested in? Dr. Arnkoff is an avid supporter of informed consent in the treatment of transsexuals. After the procedure, feeling incredibly normal--not at all like I just had surgery--while I was waiting for my taxi, the plainspoken doctor and I had a witty little conversation on the subject in which he succinctly remarked that if a person wants to cut off his testicles, its certainly not something they haven't already given a lot of thought to. What this doctors direction amounts to is relief for those transsexuals that, for whatever reason, cannot get a therapist's letter for surgery.
Therapy comes out to a big expense in addition to all the other things we transsexuals need to pay for, often out of our own pocket. And if you are like me and many other trans people, who have known this is what we wanted since we were young children, it is really unnecessary, especially when it comes to something as innocuous as an orchiectomy--Innocuous because cisgender men do get it and remain men thereafter. If there is an unlikely instance where the trans person changes his mind and wants to remain a man, that person would simply need to be prescribed testosterone for the rest of his life, instead of the estrogen that he would have been prescribed as a woman, just like a female to male transsexual and just like other cis men who have had bilateral surgery due to cancer. There is no reason to hold castration away on a pedestal like it is full gender reassignment surgery--often times requiring a year of therapy before granting a letter. The orchiectomy allows male to female transsexuals to be free of what we refer to as testosterone poisoning, without the ongoing cost, side effects, and other issues with prescribed anti-androgens. It also many times, as it did for me, provides a legal basis for changing genders on ID cards and the like. As with hormone replacement therapy itself, there is no real reason to deny orchiectomy to transsexuals if they are medically deemed healthy enough for the treatment. Complete gender reassignment surgery, on the other hand, is another debate for another time...
Ok. Rant over. As I mentioned, after the surgery I was able to change my gender on my drivers license, and I am currently working on changing my gender on both my social security information and on my birth certificate. How? Dr. Arnkoff will provide you with a notarized letter after the surgery that states plainly what has been accomplished.
I live in Florida, so I took a plane to Detroit. I found an inexpensive fare and hotel package on Priceline.com--whenever I go anywhere I always find Priceline has the best deals--gotta love James T. Kirk! Anyways, I stayed at a very nice and clean hotel that was recommended by another patient of Dr. Arnkoff--a trans woman who simply goes by the name of Ashley who has posted her own glowing review of Dr. Arnkoff on just about every transgender forum you can find--The Hawthorn Suites, which had a nice cozy and large bed, its own kitchen, a sofa, fireplace, and of course a T.V. The stay was uneventful, which is always nice, but especially when recovering from surgery. And for anyone who is considering making the trip, I'd also like to suggest Detroit Metro Airport Taxi. I used three different services while I was there, and I found this one to be the best mixture of affordable, prompt, and courteous of the three I used.
The entire trip, including surgery, cost me just under $3500. Dr. Arnkoff's fee was $2500 at the time, but while I was there, he did talk of charging a little more sometime in the future. I was there in Southfield, Michigan from March 11 to 16. As he had requested, I called Dr. Arnkoff upon arriving at my hotel. My surgery was supposed to be the next day, but Dr. Arnkoff asked me if I wanted to have my surgery that day, since he had a patient cancellation. I was surprised, and eager to have it done, but I decided to wait and use the day to get everything prepared for my stay after surgery, as I had no idea how functional I'd actually be afterwards. I had my surgery the next day, Tuesday in the afternoon, and I stayed four days, until Saturday, after the surgery to recover a bit before my somewhat lengthy plane ride home.
I felt that by that fourth day I was doing pretty well. I walked just normally with very little pain to the terminal at the airport--no problem. Recovery, in all, was not all that bad. Just after the surgery, as I mentioned, I felt incredibly normal. Dr. Arnkoff--since he was on his way out--was nice enough to drive me to the Walgreens which is just across the street from his office, so I could fill my prescriptions. Really I felt I could have walked, as I have heard from a few others that they did, and I did walk just fine through the pharmacy to order my prescriptions. The anaesthetics take a few hours to wear off, so I had no pain until later in the evening, safely back at my hotel. I was prescribed vicodin and an antiboitic. I took very little of the vicodin, instead mostly using Tylenol after about the second day after surgery. The antibiotic made me feel dizzy, dehydrated, and very sleepy, but I managed through it with Dr. Arnkoff's help, who--making full use of modern communication--responded to my text messages right away and asked me to text him a picture of the incision when I was concerned at one point--overly concerned as I tend to be. Two things I found helpful: LOTS of ice (there is a freezer with an ice maker in the room at Hawthorne Suites so that was easy), and drinking LOTS of water.
I took it pretty easy for another week after I returned home--basically until I was finished with the horrid antibiotics! The incision was completely closed within three weeks, and by the beginning of May, everything "down there" felt the same as it always was, minus two berries.
It has been a little more than two months since surgery now. I don't have much of a scar from the surgery, and I am feeling wonderful. My serum testosterone level is down to 27 units without spironolactone, and I was even able to go down to 2 mg of estradiol per day as opposed to the 4 mg plus estradiol gel I was on before.
In all, as others before me, I HIGHLY recommend Dr. Arnkoff to anyone that is seeking a simple orchiectomy because of his technique, his price, and, above all, his professionalism, as well as that of his staff. I couldn't be happier with the experience or the results.
One thing to please keep in mind, however: If you are planning to have full gender reassignment surgery in the future, please keep in mind most surgeons want you to have a RADICAL orchiectomy so that the scrotal tissue is not damaged--they often use the scrotum to build the vagina. Ask your GRS surgeon of choice if they will perform the operation if you have had a simple orchiectomy with the incision in the middle of the scrotum, which is how Dr. Arnkoff does it. And keep in mind, if you are planning to have GRS in a few years, it may not be worth having the orchiectomy. I recommend Dr. Arnkoff mostly to those who are not interested having full GRS surgery, as well as to those who discuss Dr. Arnkoff's technique with their future GRS surgeon, and find it acceptable. For those individuals, I haven't heard of anyone better than Dr. Mark Arnkoff.
I did have one terrible experience during my stay in Detroit. But it was something that was brought on, not by a bad flight, not by the hotel room or their service, not by Dr. Arnkoff or his staff, but by my own mischievous mind. Just after my surgery, the night afterwards, I had a very bizarre and emotional nightmare. In my deep slumber, my head concocted a replay of my life, but it was not quite an exact recreation. Instead of growing up as a biological male, I had been born female in my dream. Although this should have been welcome, instead of replaying my ENTIRE life as a woman before my eyes, instead of just the good, or even a selection of good and bad memories, my brain chose to make me relive the worst parts of my life over again, but as a woman. I won't go into the details, but it was intolerably restless sleep to say the least. And the final part of my dream, the last major hapless event in my life--my best friend of seventeen years, nearly a brother to me, rejecting me as I left the Jehovah's Witness cult--was warped into something deeply troubling, and utterly depressing.
The sick, twisted nightmare, apparently getting its jollies from reviving the torturous events of my life, decided to replay this memory with a further twist: My best friend of 17 years was not my best friend in this version, but instead he was my boyfried. In this version of my life I was his girlfriend of 17 years, with all the hormotional attachment and love this role would entail. In this version of my life he again leaves me, and I am crushed further than I had been in real life. In this version of my life, I run to my father for comfort, who simply says, "You wanted to be a woman didn't you?" And then I am startled awake, crying desperately and inexplicably depressed for hours afterwards.
As you can imagine, I was utterly confused as to why my mind was going through such upheaval. This is who I was... This is what I wanted... There was no doubt in my mind of that... and yet... This nightmare? It has been some time since then, of course, and what I have come to realize is that this too, this nightmare, was part of my transition. My mind was re-syncing itself to who I had become. It was a rebirth, a messy one at that. Those things that troubled me at one time in the body of a man, would have been just as troubling, if not more so, in the body of a woman. And the answer to my father's question is, "Yes"--and unlike so many other things, that hasn't changed.
