First Time Poster - Aspiring Eunuch/Nullo - Help!

[Swim1650]

Hello,

I’m a male, 28 years old, who has been interested in gender nullification since early college- I’ve just never been comfortable having male anatomy between my legs or had the sexual masculinity of other men despite otherwise being masculine. I’ve come to point where I’m looking to finally try to get an orchiectomy and ideally a penectomy with sensation preservation + TRT.

It’s my understanding WPATH now recognizes eunuchs and surgical interventions as treatment. I’m just not confident there’s many providers who are comfortable dealing with this.

If anyone has been through this, please DM me. I have a lot of questions about the best way to go about this and your experience with the changes.

I appreciate the help!

- Jack

[WheelyFixed]

Welcome to the forums, glad to see you here.

I'm actually one of the first people to go through the WPATH SOCv8 process to get an orchiectomy and scrotectomy, so I'm quite familiar with the process...

One of the first things I'd do is go to the WPATH website and download a copy of the SOCv8 https://wpath.org/publications/soc8/ It is available in other languages, not sure if Hebrew is on the list or not. I recommend reading all of it, paying particular attention to the chapters on Eunuchs and Mental Health. One of the things the process requires is convincing the doctors and shrinks that you are sincere in your desire, and fully and totally understand all of the risks and consequences involved.

In many ways I'd compare it to a job interview, where HOW you answer is almost more important than what you say, and knowing the SOC helps you know what sorts of things they are going to ask, and the sorts of things they will be looking for in the way of answers.... When you start talking and quoting the SOC It also tells them that you have "done your homework" I'd also get very good understanding of all the effects of surgery and be able to discuss them in detail....

What I'm not sure about is what the options are in Israel for any sort of trans-gender care, I'd try a search for clinics and reach out to them. I just did a quick one and most of the references were in Hebrew, but they mentioned https://eng.sheba.co.il/Gender-Reassignment-Clinic multiple times and at least one said they did all sorts of top and bottom surgery.... I'd suggest starting there unless you find a better choice. I will say that I was very pleasantly surprised at how open and accepting the clinic I went to in the US was, so don't be afraid to call them.

WheelyFixed

[NaturalEunuch]

The other option is to save up some money, fly to San Diego, hop across the border to Dr. Aguilar's clinic in Tijuana, and get whatever procedure you desire. Prices are reasonable and you can bypass the lengthy SOC-8 process altogether. Good luck!

[Swim1650]

Welcome to the forums, glad to see you here.

I'm actually one of the first people to go through the WPATH SOCv8 process to get an orchiectomy and scrotectomy, so I'm quite familiar with the process...

One of the first things I'd do is go to the WPATH website and download a copy of the SOCv8 https://wpath.org/publications/soc8/ It is available in other languages, not sure if Hebrew is on the list or not. I recommend reading all of it, paying particular attention to the chapters on Eunuchs and Mental Health. One of the things the process requires is convincing the doctors and shrinks that you are sincere in your desire, and fully and totally understand all of the risks and consequences involved.

In many ways I'd compare it to a job interview, where HOW you answer is almost more important than what you say, and knowing the SOC helps you know what sorts of things they are going to ask, and the sorts of things they will be looking for in the way of answers.... When you start talking and quoting the SOC It also tells them that you have "done your homework" I'd also get very good understanding of all the effects of surgery and be able to discuss them in detail....

What I'm not sure about is what the options are in Israel for any sort of trans-gender care, I'd try a search for clinics and reach out to them. I just did a quick one and most of the references were in Hebrew, but they mentioned https://eng.sheba.co.il/Gender-Reassignment-Clinic multiple times and at least one said they did all sorts of top and bottom surgery.... I'd suggest starting there unless you find a better choice. I will say that I was very pleasantly surprised at how open and accepting the clinic I went to in the US was, so don't be afraid to call them.

WheelyFixed

Thank you for taking the time for such a detailed response. I actually live in the US but did spend a lot of time in Israel when I was younger.

I understand the need for me to demonstrate I understand the procedure, how it will affect me, the risks involved, and that I’m pursuing this for the right reasons. As I read the document (about a week ago), as I recall, WPATH said a Eunuch is assigned male at birth who desires to remove or inactivate their reproductive organs. I guess the question by that definition is identifying as a Eunuch body dysmorphia or actual gender dysphoria? I still feel and desire to be otherwise masculine. Is body dysphoria enough to warrant intervention? In other contexts, I’ve seen people discuss being a Eunuch or Nullo as non-binary, which in some ways resonates less with me. On the other hand, my sincere desire to get rid of my penis is not typical of most men.

The next question I have is regarding the typical requirement to socially transition for a year and trial hormones. I’m not sure how I really socially transition to being a Eunuch. My intention if castrated would be to take testosterone to maintain my masculine physique elsewhere. WPATH mentions androgen suppression prior to castration as an option to reduce sexual function… maybe that’s worth trying but I feel like reducing T comes with a lot of undesirable issues for me like muscle loss, weight gain, depressed mood, etc. The only reason I might consider that was if maintaining lower T-levels (before and after castration) would atrophy my penis enough so that I didn’t feel the need to have a penectomy. I’m not sure that’s realistic especially without affecting my body in other un wanted ways.

I am confident to let my scrotum and testicles go. I also know I’d prefer not to have a penis, but that’s admittedly a much bigger decision to make. Is it typical that they would do the castration first and then the penectomy at a later date, or would I have to get it all done at once? (Two surgeries also means a lot more recovery.

I’m know I’m overthinking this but I’d just hate to invest a lot of time and emotional energy discussing a deep part of me only for this not to work out.

I know I just need to take that first step.

[WheelyFixed]

Excellent set of questions Swim, I will do what I can to answer them from my experience, anyone else feel free to chime in as well...

Thank you for taking the time for such a detailed response. I actually live in the US but did spend a lot of time in Israel when I was younger.

I understand the need for me to demonstrate I understand the procedure, how it will affect me, the risks involved, and that I’m pursuing this for the right reasons. As I read the document (about a week ago), as I recall, WPATH said a Eunuch is assigned male at birth who desires to remove or inactivate their reproductive organs. I guess the question by that definition is identifying as a Eunuch body dysmorphia or actual gender dysphoria? I still feel and desire to be otherwise masculine. Is body dysphoria enough to warrant intervention? In other contexts, I’ve seen people discuss being a Eunuch or Nullo as non-binary, which in some ways resonates less with me. On the other hand, my sincere desire to get rid of my penis is not typical of most men.

The impression I got from my docs (including the shrinks) is they really didn't care all that much about the psych definitions and labels, but that I was well informed and definite in my desires and goals. They did a fair bit of "have you considered <option>?" and expected you to be coming back with something on the order of "I have considered <option> and don't want that because <reason>"


On my first visit the doc asked my permission to put a 'gender disphoria' diagnosis on my record, with the explanation that it really didn't mean much but would make life easier in terms of convincing my insurance to pay for further care... Ditto the whole binary / non-binary question, and being "transsexual" - those are labels and descriptions, they aren't "YOU", and mostly it is up to you whether you want to apply them to yourself in anything other than a technical sense. (other people may use them, but that's their problem, not yours....)

The next question I have is regarding the typical requirement to socially transition for a year and trial hormones. I’m not sure how I really socially transition to being a Eunuch. My intention if castrated would be to take testosterone to maintain my masculine physique elsewhere. WPATH mentions androgen suppression prior to castration as an option to reduce sexual function… maybe that’s worth trying but I feel like reducing T comes with a lot of undesirable issues for me like muscle loss, weight gain, depressed mood, etc. The only reason I might consider that was if maintaining lower T-levels (before and after castration) would atrophy my penis enough so that I didn’t feel the need to have a penectomy. I’m not sure that’s realistic especially without affecting my body in other un wanted ways.

The question of "transitioning" and what constitutes "presenting as a eunuch" has been a frequent topic of amusement among us, as we have yet to figure out what it is we are supposed to be transitioning INTO... It seems this is mostly a carryover from the binary M<->F guidelines and doesn't mean much. I know that I asked the question in my psych evals, and the therapist didn't have an answer so said he assumed I was...

I did do a year+ of chemical castration before surgery, but it wasn't a big issue for me as I wasn't planning to do T, and was actually on E for most of the time. I'm not sure what the answer is if you are not wanting to get rid of the effects of T. It is possibly relevant that the SOCv8 does say that it's a recommendation, not a requirement.

I am confident to let my scrotum and testicles go. I also know I’d prefer not to have a penis, but that’s admittedly a much bigger decision to make. Is it typical that they would do the castration first and then the penectomy at a later date, or would I have to get it all done at once? (Two surgeries also means a lot more recovery.

I’m know I’m overthinking this but I’d just hate to invest a lot of time and emotional energy discussing a deep part of me only for this not to work out.

I know I just need to take that first step.

I've heard of people going several different ways on the surgery. Some just get an orchie, and do the scrotectomy later, others (including myself) did both at the same time to avoid extra surgery and recovery. I've seen discussion of people that did testicles and penis as separate surgeries and others that had everything done at once... There are arguments in favor of both separate and one at a time approaches.

Whatever you do, the first step is reaching out to your local TG clinic for an initial consult, and that doesn't commit you to any set course of action until much later, but that will at least get things moving and get you more definite answers about things like your options for hormones and chemical castration...

WheelyFixed

[Aunuch]

I've heard of people going several different ways on the surgery. Some just get an orchie, and do the scrotectomy later, others (including myself) did both at the same time to avoid extra surgery and recovery. I've seen discussion of people that did testicles and penis as separate surgeries and others that had everything done at once... There are arguments in favor of both separate and one at a time approaches.

WheelyFixed

I am one of those who had gotten rid of all the offending bits and bobs (penis and testicles in my case) in one surgery, rather than having done it later, and honestly, I feel like it is a better idea financially, but mainly in the way of recovery, just one big surgery, instead of eventually getting another surgery.

But I was also sure of myself, so I didn't want to do them separately...

[Swim1650]

I've heard of people going several different ways on the surgery. Some just get an orchie, and do the scrotectomy later, others (including myself) did both at the same time to avoid extra surgery and recovery. I've seen discussion of people that did testicles and penis as separate surgeries and others that had everything done at once... There are arguments in favor of both separate and one at a time approaches.

WheelyFixed

I am one of those who had gotten rid of all the offending bits and bobs (penis and testicles in my case) in one surgery, rather than having done it later, and honestly, I feel like it is a better idea financially, but mainly in the way of recovery, just one big surgery, instead of eventually getting another surgery.

But I was also sure of myself, so I didn't want to do them separately...

I have many questions for you then…

You are correct. It’s not just the cost of the procedures, it’s the cost of a second recovery. If I opted for the castration, I’d really want the scrotum removed at the same time. But the scrotum job makes the recovery a lot longer and I’m not sure if having that extra skin might have some potential use for the reconstruction after the penectomy. So again probably just better to get all the work done at the same time.

What was the surgery and recovery like for you? Were there any complications (then or since) or changes to your body you were not expecting? Is there anything you would have done differently?

I guess my other worry is how people will react if they found out I’ve been voluntarily emasculated. Like I wouldn’t tell my parents or siblings. I assume the therapist will expect me to have at least one person to talk to about this. Does part of “living in the real world for a year with my preferred gender identity” include me telling everyone I’m actually a Eunuch now? I would hope not. No one would believe me either.

Thanks for the chat

[Swim1650]

Excellent set of questions Swim, I will do what I can to answer them from my experience, anyone else feel free to chime in as well...

Thank you for taking the time for such a detailed response. I actually live in the US but did spend a lot of time in Israel when I was younger.

I understand the need for me to demonstrate I understand the procedure, how it will affect me, the risks involved, and that I’m pursuing this for the right reasons. As I read the document (about a week ago), as I recall, WPATH said a Eunuch is assigned male at birth who desires to remove or inactivate their reproductive organs. I guess the question by that definition is identifying as a Eunuch body dysmorphia or actual gender dysphoria? I still feel and desire to be otherwise masculine. Is body dysphoria enough to warrant intervention? In other contexts, I’ve seen people discuss being a Eunuch or Nullo as non-binary, which in some ways resonates less with me. On the other hand, my sincere desire to get rid of my penis is not typical of most men.

The impression I got from my docs (including the shrinks) is they really didn't care all that much about the psych definitions and labels, but that I was well informed and definite in my desires and goals. They did a fair bit of "have you considered <option>?" and expected you to be coming back with something on the order of "I have considered <option> and don't want that because <reason>"


On my first visit the doc asked my permission to put a 'gender disphoria' diagnosis on my record, with the explanation that it really didn't mean much but would make life easier in terms of convincing my insurance to pay for further care... Ditto the whole binary / non-binary question, and being "transsexual" - those are labels and descriptions, they aren't "YOU", and mostly it is up to you whether you want to apply them to yourself in anything other than a technical sense. (other people may use them, but that's their problem, not yours....)

The next question I have is regarding the typical requirement to socially transition for a year and trial hormones. I’m not sure how I really socially transition to being a Eunuch. My intention if castrated would be to take testosterone to maintain my masculine physique elsewhere. WPATH mentions androgen suppression prior to castration as an option to reduce sexual function… maybe that’s worth trying but I feel like reducing T comes with a lot of undesirable issues for me like muscle loss, weight gain, depressed mood, etc. The only reason I might consider that was if maintaining lower T-levels (before and after castration) would atrophy my penis enough so that I didn’t feel the need to have a penectomy. I’m not sure that’s realistic especially without affecting my body in other un wanted ways.

The question of "transitioning" and what constitutes "presenting as a eunuch" has been a frequent topic of amusement among us, as we have yet to figure out what it is we are supposed to be transitioning INTO... It seems this is mostly a carryover from the binary M<->F guidelines and doesn't mean much. I know that I asked the question in my psych evals, and the therapist didn't have an answer so said he assumed I was...

I did do a year+ of chemical castration before surgery, but it wasn't a big issue for me as I wasn't planning to do T, and was actually on E for most of the time. I'm not sure what the answer is if you are not wanting to get rid of the effects of T. It is possibly relevant that the SOCv8 does say that it's a recommendation, not a requirement.

I am confident to let my scrotum and testicles go. I also know I’d prefer not to have a penis, but that’s admittedly a much bigger decision to make. Is it typical that they would do the castration first and then the penectomy at a later date, or would I have to get it all done at once? (Two surgeries also means a lot more recovery.

I’m know I’m overthinking this but I’d just hate to invest a lot of time and emotional energy discussing a deep part of me only for this not to work out.

I know I just need to take that first step.

I've heard of people going several different ways on the surgery. Some just get an orchie, and do the scrotectomy later, others (including myself) did both at the same time to avoid extra surgery and recovery. I've seen discussion of people that did testicles and penis as separate surgeries and others that had everything done at once... There are arguments in favor of both separate and one at a time approaches.

Whatever you do, the first step is reaching out to your local TG clinic for an initial consult, and that doesn't commit you to any set course of action until much later, but that will at least get things moving and get you more definite answers about things like your options for hormones and chemical castration...

WheelyFixed

That’s good to hear. Some of this jargon is a bit contradictory. I’ll just tell them about me and they can decide to call me whatever they think I am.

One thing I’ve seen SOC8 I believe and other similar documents is that Eunuchs that are at risk of self mutilation, obtaining drugs illegally, back-alley surgery should be recommended pharma and/or surgical intervention. Does that mean that’s the threshold for intervention, or are they just saying don’t withhold it from people just because they’re willing to take risky actions.

Yeah, I’m not sure theirs is a pharmacological solution for my goals. Spironolactone and Cyproterone are used to treat many other conditions other than GD- so maybe a lower dose? There’s some drugs shown to reduce the gyno risk in studies but it’s not something to do for a long time.

You’re absolutely right the I have to take the initiative and of course I know that. I just have a lot of fear revealing this part of me. Does this count of coming out of the closet?

[waj1993]

Communicating to others about this aspect of our lives can be a bit daunting- coming out of the closet to ourselves is a big enough step sometimes, much more coming out to others.
I find it comforting to know that there is a eunuch support community that is a mix of those who have, those who are planning, and those just kinda of figuring things out.

Society and the medical community in alot of aspects have some catching up to do still.

[WheelyFixed]

I am not a surgeon, but my understanding is that if you are doing a full M->F transition, and want to have a "full-depth" vaginoplasty then they will use the scrotum tissue for part of that reconstruction, and also to make the labia... Thus while there are several advantages for getting an orchiectomy early in the process, you don't want a scrotectomy.

However the scrotum tissue is not used or needed in a straight penectomy, it might or might not be used if doing a penectomy w a/zero depth vaginoplasty.

If you aren't interested in doing the full transition, then many have reported after an orchiectomy, finding the empty scrotum to be an annoyance - sweaty, sticks to leg skin, gets pinched by clothing, etc.

I had orchie and scrotectomy done at the same time, and didn't really notice any recovery from the orchie. The scrotectomy kept me home for 3-4 days, and I definitely took it easy for a couple of weeks, but really wasn't that bad. Of course I wasn't walking around either, which may have made a difference, but I'm still not hearing reports of recovery taking much more than a week to get back to 'light activity', assuming no complications... Full 'heavy' activity or things like bicycling take more like month to 6 weeks or possibly a bit longer, not so much for healing, as to have all the soreness go away.

I had extra problems because I have to catheterize, and between the shrinkage I'd already had and the swelling, I couldn't get to my urethra, which caused me to have to make a trip to the ER cause I couldn't pee. They put in a Foley (indwelling catheter) and I had to drag the bag around for about a week before the swelling went down enough that I could go back to my normal intermittent cath routine.

WheelyFixed