Orchiectomy in San Francisco

Medically reviewed by Lin-Lin Liu, PA on July 31, 2026.

For many trans women and nonbinary individuals, orchiectomy is a meaningful step in gender affirmation — reducing gender dysphoria and eliminating the need for anti-androgens. At Gender Confirmation Center (GCC) in San Francisco, Dr. Zara Ley (she/her/they), a board-certified surgeon and trans woman specializes in bottom surgery procedures like orchiectomy. Her and her team offer personalized care from consultation through recovery. The GCC and San Francisco more generally have been some of the leading destinations for gender-affirming surgery because of our trusted providers and the resources our city has to offer the trans community.

Dr. Ley offers surgical consultations, commitment free and free of charge, to patients interested in undergoing bottom surgery with her.. You can request a consultation with her here.

What Is an Orchiectomy?

An orchiectomy is the surgical removal of one or both testicles. At the GCC in San Francisco, Dr. Ley offers orchiectomy as a form of gender-affirming care to qualified patients. For trans women and non-binary patients, an orchiectomy involves the removal of the principal organs that produce testosterone.

The following illustration demonstrates how an orchiectomy is conducted: 

Benefits of Gender-Affirming Orchiectomy

For qualified trans women and non-binary patients, an orchiectomy can reduce symptoms of gender dysphoria. Likewise, in the long-term, there are some health benefits to undergoing an orchiectomy for patients on feminizing, gender-affirming hormone therapy. Removing the testicles, the body’s main producer of testosterone, means that patients no longer have to take anti-androgen medications and can even take larger doses of estradiol to maintain their pre-operative levels. This can lower a patient’s risk for conditions like blood clots that are associated with long-term use of these medications.

How to Qualify for an Orchiectomy

To undergo bottom surgery with Dr. Ley, she requires that patients present a letter of support from a gender care health professional––such as an endocrinologist or licensed mental health professional––continuously for at least 9 months. Likewise, the Gender Confirmation Center (GCC) of San Francisco only offers surgery to adults at this time.

Important Considerations for Bottom Surgery

Some patients undergo orchiectomy with a scrotectomy, which is the surgical removal of the scrotal pouch. A scrotectomy is not recommended for patients who would like to undergo a vaginoplasty or vulvoplasty eventually, as skin grafts are taken from the scrotum to construct the vulva and the vaginal canal.

Additionally, because this procedure leaves patients irreversibly infertile, you are strongly encouraged to look into your fertility preservation options prior to your surgical consultation.

What to Expect: Procedure and Recovery

An orchiectomy is a fairly brief, out-patient procedure. It is typically performed in about 30-60 minutes, and patients can go home the same day of surgery if they are not undergoing a simultaneous vaginoplasty or vulvoplasty procedure.

Recovery for an orchiectomy is fairly straightforward and lasts usually around 3 weeks. Patients should avoid strenuous physical activity, sexual activity and immersing themselves in water for the first few weeks, until your care team clears you for these activities. Avoiding straining during your bowel movements is also important at this time. Likewise, your care team will advise you on how to keep your incisions clean as you heal.

Orchiectomy Cost and Insurance Coverage

Costs for orchiectomy vary by provider. In the US, the out-of-pocket cost can be between $2,000-$8,000. That said, this estimate does not include additional costs like anesthesia and facility fees.

Insurance providers that cover gender-affirming healthcare can help you with the cost of surgery. In order to obtain pre-approval coverage for an orchiectomy, you will likely need to provide a support letter from a licensed mental health provider, and to have been on hormone replacement therapy for at least 12 continuous months.

Orchiectomy vs. Vaginoplasty: Which Is Right for You?

Many trans, non-binary and gender expansive patients who undergo orchiectomy are on the fence about whether they would like to eventually undergo other forms of bottom surgery, such as a vulvoplasty or vaginoplasty. Undergoing an orchiectomy as a stand-alone procedure does not close the door on the possibility for you to undergo future bottom surgery procedures, so long as your surgeon maintains your scrotal skin in-tact.

Generally speaking, vaginoplasty and vulvoplasty are sought out by patients whose natal genitals (e.g., their penis) are a source of gender dysphoria, and who would like to have penetrative, receptive vaginal sex.

If you have questions about which procedure is right for you, you can consult with Dr. Ley in a commitment-free, and cost-free consultation.

FAQs

How much does an orchiectomy cost with insurance in 2026?

The cost of surgery with insurance differs greatly by provider. To get an exact quote from your insurance, you will need to apply for pre-approval.

What type of doctor performs orchiectomy?

In the United States, any of the following board-certified surgeons with the proper training and facilities can perform an orchiectomy: urologists, general surgeons and plastic surgeons.

Will an orchiectomy affect my ability to get vaginoplasty in the future?

Patients who would like to eventually undergo a vaginoplasty should have their scrotal skin remain intact when they undergo an orchiectomy. This is because skin grafts will be taken from the scrotum to construct the vulva and the vaginal canal.

How long is the recovery after an orchiectomy?

Most orchiectomy patients will recover in 2-3 weeks after surgery.

Does Medi-Cal cover orchiectomy in California?

Yes, in California, trans and non-binary patients with Medical can obtain coverage for a gender-affirming hysterectomy if they provide the proper documentation to qualify the procedure as medically necessary: namely, a support letter from a licensed mental health professional.

Schedule Your Orchiectomy Consultation in San Francisco

Gender Confirmation Center’s experienced surgical team is here to guide you through every step — from qualification and insurance verification to recovery after surgery. Contact us today to schedule a personalized, free consultation and take the next step in your gender-affirmation journey.