overview

Bilateral Orchiectomy (BO) for Transgender Women and Non-Binary Individuals

What is Bilateral Orchiectomy?

Bilateral Orchiectomy (BO), also known as orchiectomy surgery, is a procedure that involves the surgical removal of the testes. This surgery is often chosen by transgender women and non-binary individuals who wish to reduce testosterone production but are not planning full male-to-female (MTF) gender reassignment surgery in the near future.

Who is Bilateral Orchiectomy For?

Orchiectomy is typically sought by trans women and non-binary people assigned male at birth as a way to stop the production of testosterone and sperm. This procedure can help affirm gender identity and reduce the need for high doses of hormone therapy.

Is Bilateral Orchiectomy Right for You?

Bilateral orchiectomy is a valuable option for those who are not yet ready—or do not plan—to have full male-to-female gender confirmation surgery. It can be an empowering choice that aligns with your gender identity and personal goals.

Important Considerations for Orchiectomy and Gender Reassignment Surgery

After undergoing an orchiectomy (removal of the testes), patients typically require anti-androgen therapy or may follow a reduced hormone medication regimen.

If you plan to have full gender reassignment surgery (GRS) in the near future—such as Penile Skin Inversion, Penile Skin Inversion with Scrotal Skin Graft, or Sigmoid Colon with Penile Skin Inversion Vaginoplasty—our specialists do not recommend having an orchiectomy beforehand.

This is because orchiectomy involves removing the testes and the scrotal skin, which can cause the skin in that area to tighten. Since scrotal skin is often used in reconstructive surgery to create the neo-vagina, removing it too early may limit the available tissue for important aspects of the surgery, including the formation of the labia majora and the vaginal canal depth.

About Bilateral Orchiectomy at Preecha Aesthetic Institute

At Preecha Aesthetic Institute, bilateral orchiectomy (BO) is performed by highly experienced surgeons:

All are Board-Certified Plastic & Reconstructive Surgeons.

The procedure is performed under General Anesthesia with patient safety and comfort as top priorities. Before surgery, the surgeons will thoroughly discuss realistic expectations and potential outcomes of both the orchiectomy and any future reconstructive surgeries.

If you have questions about the timing of orchiectomy and gender reassignment surgery, please contact us for a direct personalized or online consultation.

visit more gender affirming surgery (MtF surgery), body contouring cosmetic surgery and facial feminization surgery

Bilateral Orchiectomy candidate

At Preecha Aesthetic Institute (PAI), Dr. Preecha Tiewtranon, MD, Dr. Sutin Khobunsongserm, MD, and Dr. Burin Wangjiraniran, MD, FRCST, proudly follow internationally recognized standards for transgender healthcare.

We adhere to the Standards of Care (SOC) established by the World Professional Association for Transgender Health (WPATH) and other respected guidelines such as HBIGDA and Asia PATH protocols. These guidelines are designed to support individuals with gender identity disorders by promoting “lasting personal comfort with the gendered self to maximize overall psychological well-being and self-fulfillment.”

While WPATH’s Standards of Care remain the most widely recognized clinical guidelines worldwide, we also incorporate regional protocols like Asia PATH to provide culturally sensitive and up-to-date care tailored to our patients’ needs.

  • Specific minimum requirements as prerequisites to HRT at least 12 months 
  • Much of the criticism surrounding the WPATH/HBIGDA/Asia PATH 
  • Psychological evaluation with 2 letters by qualified mental health professional
  • Highly controversial and often maligned document among patients seeking medical intervention (Hormones) unless there is contraindication or the patient is unwilling to
  • Understands alternatives
  • Retains information - and recalls the advantages and disadvantages
  • Understands concepts of permanence and irreversibility
  • Good health conditions
  • Must be over 18 year old

Package is include Bilateral Orchiectomy

Package is include for Bilateral Orchiectomy

  • Accommodation for 1 night in hospital private room after surgery (JCI accredited)
  • Operating room charges: OR room use, recovery room, scrub & circulate nurses
  • Regular menu food charges
  • Laboratory testing: necessary for the procedure as CBC, EKG, UA, Anti HIV, Chest X-Ray. (An extra charge is 100 US Dollars + -, if age is over 45 years for cardiologist exams)
  • Medical equipment’s and Medical supplies
  • General anesthesia - Pre Anesthetic Drugs, Anesthesia and Medical Gas (Oxygen, Nitrous Oxide)
  • Medical treatments
  • Doctor fees
  • Anesthesia fees
  • Nursing services
  • Take home medication and supplies
  • Post op cares
  • Transportation pick up (optional)

An extra charge is 50 %, if HIV+ from surgery fee. CD 4 must be > 500 + and Viral load must undetectable. 

PREECHA AESTHETIC INSTITUTE AND AFFILIATED HOSPITALS - JCI-ACCREDITED INTERNATIONAL HOSPITALS

About Preecha Aesthetic Institute (PAI)

Preecha Aesthetic Institute (PAI) is Thailand’s first multidisciplinary aesthetic and reconstructive center and a pioneering leader in Sex Reassignment Surgery (Male to Female and Female to Male) since 1980.

Our state-of-the-art facility features:

  • 10 advanced consultation rooms
  • 6 operation rooms equipped for procedures under local anesthesia
  • The latest surgical equipment used in leading aesthetic plastic surgeries
  • Comfortable recovery rooms designed for patient safety and comfort
  • An internationally accredited hygienic system ensuring the highest standards of cleanliness and safety

At PAI, we are committed to providing world-class care and support throughout your gender affirmation journey.

  • Bilateral Orchiectomy (BO) is performed under General Anesthesia. This is required one night in hospital.

World-Class Surgical Care at Preecha Aesthetic Institute

All surgical procedures at Preecha Aesthetic Institute (PAI) are performed under general anesthesia in partnership with two leading private international hospitals in Bangkok, both JCI-accredited for healthcare excellence.

Our affiliated hospitals offer:

  • Between 230 and 500 private patient rooms
  • Modern, state-of-the-art medical equipment
  • 24-hour emergency services
  • Accreditation for the highest standards of quality and patient safety

Operating under the philosophy of “World-class quality with Thai hospitality,” these hospitals ensure a comfortable, safe, and supportive environment for every patient.

All direct consultations and follow-up appointments take place at Preecha Aesthetic Institute, where our expert team provides personalized care throughout your journey.

  • Consultation, medical health checks, preparation and follow up are appoints within Preecha Aesthetic Institute.
  • Two international standard hospitals - JCI accredited International Hospitals 
  • Surgical will perform an affiliated hospital ⇒ General Anesthesia ⇒ International Standard Hospital.
preecha aesthetic institute (PAI)

Preecha Aesthetic Institute (main's clinic)

Affiliated hospital

International Standard Hospital (JCI accredited)

Affiliated hospital

SERVICE ACCOMMODATION

  • Transportation pick up from airport –hotel-hospital-clinic-airport as well as follow up period (optional)
  • Hotel reservation within 2 KM from PAI's clinic
  • Interpreter services with any language

Risk of Bilateral Orchiectomy

All surgery carries risks – Infection and extensive bruising but can minimize by closely following your surgeon’s advice on follow up care during the healing process.

Health Concern

An extra charge is 50% from surgery fee, if HIV +

  • CD4 must be 500 +
  • Viral load must undetectable

QUESTIONS & SCHEDULE

Expert Surgeons Performing Bilateral Orchiectomy (BO)

Bilateral Orchiectomy (BO) at Preecha Aesthetic Institute is performed by our highly skilled surgeons:

  • Dr. Preecha Tiewtranon, MD
  • Dr. Burin Wangjiraniran, MD, FRCST
  • Dr. Sutin Khobunsongserm, MD

All are Board-Certified Plastic & Reconstructive Surgeons in Thailand, dedicated to providing safe and compassionate care.

Thailand’s Pioneer in Sex Affirmation Surgery

Over the past 40+ years, our team has continuously refined and advanced surgical techniques for male-to-female vaginoplasty, achieving outstanding functional and aesthetic results.

We specialize in a range of MTF vaginoplasty procedures, including:

  • Penile Skin Inversion
  • Penile Skin Inversion with Scrotal Skin Graft
  • Sigmoid Colon Vaginoplasty

With over 6,000 successful SRS procedures performed, PAI has earned a reputation for clinical excellence, innovation, and compassionate care.

Source: "Male-to-female vaginoplasty: Preecha’s surgical technique", NCBI Literature Resources, October 30, 2022

Dr.Preecha Tiewtranon MD, Dr.Burin Wangjiraniran MD FRCST and Dr.Sutin Khobunsongserm MD, all Board of Plastic and Reconstructive surgery Thailand.All your questions will be direct answers from PAI's doctors.

  1. Write your question, interest
  2. List your expectations or procedure that you are interest and give us your detail as possible
  3. Email to us at consult@pai.co.th
  4. We will get back to you shortly after receive your question

Once all are confirmed. To set up direct consultation and schedule surgery date.

  • Plan your available date to be surgery and departure from Bangkok
  • We will confirm you for surgery date
  • You may start to book your airline ticket
  • We will confirm you all detail and hotel booking, if require
  • For transportation to be pick up from the airport, we need you to confirm your airline flight itinerary
Set up an appointment with us

1. Write your question, interest at consult us in program form

enquiry

2. Via email consult@pai.co.th

2.1 list your expectations or procedure that you are interest and give us your detail as possible
2.2 email to us
2.3 We will get back to you shortly after receive your question with recommendation from specialize surgeon

Once you know your planning date for surgery. Here is the next step:

1. Consultation with us via email for details and procedure
2. Plan your available date to be surgery and departure from Bangkok
3. We will confirm you for surgery date
4. You may start to book your airline ticket
5. We will confirm you all detail and hotel booking, if require
6. For transportation to be pick up from the airport, we can do for you as optional

surgical details:

At your consultation with our surgeons — Dr. Preecha Tiewtranon, Dr. Sutin Khobunsongserm, and Dr. Burin Wangjiraniran - We’ll take time to carefully assess your overall health and talk about any existing medical conditions or concerns. We’ll also do a physical exam, take some measurements and photos (with your permission), and go over your options. We’ll explain the recommended treatment plan and help you understand what to expect from bilateral orchiectomy (BO), including any possible risks or side effects.


  • Inform us about any allergies, any serious medical condition(s), and all medications you are
    taking (both prescription and non-prescription)
  • Qualify letter from Psychiatrist doctor or Hormone Therapist
  • No Aspirin 2 days before surgery
  • Stop vitamin E Oil 1 day before surgery
  • Stop smoking 2 days and a month after surgery
  • Stop Hormone, if taken 2 weeks before surgery date
  • Tell doctor if you have any serious medical condition(s)
  • Stop meal and water starting from midnight before surgery
  • Plan to be in Bangkok at least 9 days. Stitches will remove day 5 to 7 after surgery date

Bilateral Orchiectomy Dates :

Day 0 - Arrival date (check in hotel)

Day 1 - Consultation and Prepare for Laboratory Testing

Day 2 - Check out (if necessary)

Day 2 - Surgery date with 1 night in hospital

Day 3 - Discharge from Hospital

Day 3 - Check in hotel

Day 3 to 8 – Stiches removal and final check ups

Day 9 – Departure date


 

Things should bring from home for Bilateral Orchiectomy (BO).

  • Button-up shirts in large sizes
  • Skirts (not too tight)
  • joggers or loose pants
  • Slip-on shoes or slippers
  • Phone charger, long phone charger
  • Books, magazines
  • Travel neck pillow
  • Personal medicines / HRT
  • Regular sanitary napkins, if prefer specific brand
  • Underpads

 

A bilateral orchiectomy is a surgical procedure involving the removal of both testicles. It's most commonly performed as a treatment for conditions like gender-affirming surgery for transgender women.

A single inguinal incision approximately 1–2 inches in length was made in the groin region. Through this incision, both testicles were mobilized and delivered. The spermatic cords were individually clamped, ligated, and transected. Hemostasis was achieved. The testicles were then removed through the incision. The incision site was irrigated, and the wound was closed in layers using absorbable sutures for deep tissue and non-absorbable or absorbable sutures or skin adhesive for the skin, depending on surgeon preference.

The patient will have a minimal amount of discomfort at the incision site for couple of days.

Postoperative Recovery: Bilateral Orchiectomy

  • The patient is required to stay one night in the hospital following the orchiectomy procedure for observation and initial recovery.
  • Recovery in Bangkok typically takes approximately one week. During this time, patients are advised to rest, limit physical activity, and follow all postoperative care instructions closely.
  • Stitch removal is generally scheduled for 5 days after the date of surgery, unless dissolvable sutures are used.
  • Individual recovery instructions may vary depending on the specific surgical technique used, the patient’s overall health, and the surgeon’s preference. It's important to follow the personalized guidance provided by your surgical team.

General Recovery Guidelines May Include:

  • Keep the incision site clean and dry.
  • Avoid strenuous activity, heavy lifting, or vigorous exercise for at least 2 weeks.
  • Take prescribed medications as directed, including antibiotics and pain relievers.
  • Monitor for signs of infection (redness, swelling, fever, drainage from the incision).
  • Attend all follow-up appointments, including for stitch removal on day 5.

Recovery Timeline for Bilateral Orchiectomy by Preecha Aesthetic Institute.

Day 0 - Arrival date (check in hotel)

Day 1 - Consultation and Prepare for Laboratory Testing

Day 2 - Check out (if necessary)

Day 2 - Surgery date with 1 night in hospital

Day 3 - Discharge from Hospital

Day 3 - Check in hotel

Day 3 to 8 – Stitches removal and final check ups

Day 9 – Departure date


For local’s patient - You may resume to work after five days surgery but must avoid heavy lifting object over the head or fast movement during 3 to 8 weeks after surgery date.

For international patient - Please plan to be in Bangkok at least nine days all together. Stitches will remove day 5 to day 7 after surgery date. You may resume to work within a few days after depart from Bangkok but must avoid heavy lifting object over the head or fast movement during 3 to 8 weeks after surgery date.

◊ Any bruising and swelling will usually dissipate within 2 to 3 months after Bilateral Orchiectomy.

Recovery Timeline – Bilateral Orchiectomy (for Trans Women)

Total recovery time: Approximately 1 to 2 weeks, depending on individual healing and surgical technique. Most patients feel significantly better within 7 days.

  • Hospital stay: Most patients stay overnight for monitoring.
  • Anesthesia recovery: You may feel groggy, tired, or slightly nauseous.
  • Discomfort: Mild to moderate pain or pressure in the groin/scrotum area.
  • Mobility: Walking is encouraged the same day or next morning, but movement should be limited.

Days 1–3: Initial Healing Phase

  • Pain/discomfort: Usually well managed with oral pain medications.
  • Swelling and bruising: Common around the incision and scrotum.
  • Wound care: Keep incision clean and dry; follow instructions for dressing changes if needed.
  • Activity: Short walks are encouraged; avoid stairs and strenuous movement.
  • Showering: Usually allowed after 48 hours (check with your surgeon).

Day 5: Stitches Removal

  • Stitches will be removed at PAI’s clinic.

Days 5 - 7: Return to Light Activity

  • Most patients can resume light daily activities (walking, desk work).
  • Avoid: Lifting more than 5–10 lbs, bending, squatting, or sexual activity.
  • Discomfort: Usually much improved; over-the-counter pain relief may be sufficient.
  • Emotional well-being may improve as hormone levels begin to stabilize.

Week 2: Return to Work / Routine (if non-strenuous)

  • Return to non-physical work or study is often possible within 7 - 10 days.
  • Swelling and bruising should mostly resolve.
  • Incision should be healing well; scabs may begin to fall off.

Week 3–4 and Beyond

  • Most physical restrictions lifted by the end of week 2–3.
  • Sexual activity can typically resume after 3 - 4 weeks or should wait until the surgery has fully healed before having sexual intercourse (confirm with your surgeon).
  • Final cosmetic healing may continue over several weeks.
  • If not already on hormone therapy, your provider may begin or adjust estrogen and anti-androgens.

 

 

The pioneer Sex Reassignment Surgery and The first multidisciplinary plastic surgery center Thailand.

Preecha Aesthetic Institute award


 

surgery info:

services icon 1 150x150 1
TIME REQUIRED

1 - 1.30 Hours

services icon 2 150x150Anesthesia
Anesthesia

General Anesthesia

Back to work

8 days

services icon 4 150x150 Strenous Activity
Strenuous Activity

1 month

Fading of scars

Several months

Surgery Schedule

Schedule Appointment Consultation / Surgery / Question Bilateral Orchiectomy at Preecha Aesthetic Institute.

Once you know your planning date for surgery

Bilateral Orchiectomy's planning trip :

Day 0 - Arrival date (check in hotel)

Day 1 - Consultation and Prepare for Laboratory Testing

Day 2 - Check out (if necessary)

Day 2 - Surgery date with 1 night in hospital

Day 3 - Discharge from Hospital

Day 3 - Check in hotel

Day 3 to 8 - Stitches removal and final check ups

Day 9 - Departure date

testimonials

useful information

ADDRESS

PAI (Preecha Aesthetic Institute)
898/1 Sukumvit 55 Wattana, Bangkok
10110 Thailand

Tel: +662-715-0111

Fax: +662-715-0113

Email: consult@pai.co.th

MEETING POINT (AIRPORT)

The driver will be waiting for you at door number 4 (Meeting point) after exit from customs. The driver will stand by with your name and PAI  logo. [Suvarnabhumi International Airport (BKK)]

HOTEL

Hotels are under cooperate and nearby PAI, starting from 50 USD to 100 USD. Rates are quoted in THB, USD/net/included of taxes and service charges. All non-commissionable rate. VISA/Master card is accepted.

  • Special apartment 68 sq.m-131 sq.m with one to two bedroom/1 queen/master size bed, 1 bathroom (shower and bathtub), pantry and dining area, 2 Bottled water – complimentary for daily contract, bathroom (separated shower & bath tub), cable / Satellite TV, free wifi, dining Table/Chairs, Internet Access (wireless), kettle, LCD TV, refrigerator, slipper, toaster, air Conditioner, bath amenities - complimentary for daily, electronic Door Lock, iron & Ironing Board (on request), kitchenette - Full Equipment, microwave, safety box.

 

  • Hotel - studio room 46 - 58 sq.m - Features & Amenities: 40-in LED, sofa, in-room safe, minibar refrigerator, refillable tea/coffee/water, blackout curtain, free wifi, slippers, bathroom with rain shower, 100% natural therapeutic spa toiletries Mt. Sapola, hair Dryer, toothbrush and toothpaste, shower cap as well as a washing machine.

LANGUAGE

Thai, Chinese, Japanese, Italian, Spanish, French, German, Turkish and other languages upon request.

PASSPORT AND VISA

PAI can issue the letter to clarify with your local Embassy or Passport.

COST OF MEAL

Cost of living meal per day is 15-20 USD.

PAYMENT

The payment can be prepared in Cash by US dollar, Euro, Japanese Yen, Hong Kong Dollar, Singapore Dollar, Australia dollar. If using credit cards (VISA/Master card), the hospital will charged 3% for international transaction fee. This is only for surgery fees. Hotels are not charged for international transaction fee. An extra charged for HIV is 50% from total cost.

TOURIST VISA EXEMPTION (30 DAYS WITHOUT VISA)

Australia, Austria, Belgium ,Brazil ,Bahrain , Brunei Darussalam ,Canada, Denmark ,Finland ,France, Germany ,Greece ,Hong Kong ,Iceland ,Indonesia ,Ireland ,Israel ,Italy ,Japan ,South Korea ,Kuwait ,Luxembourg , Malaysia ,Monaco ,Netherlands ,New Zealand ,Norway ,Oman ,Peru ,Philippines ,Portugal , Qatar , Singapore ,Spain ,South Africa ,Sweden ,Switzerland ,Turkey ,United Arab Emirates, United Kingdom ,United States of America ,Vietnam.

AIRPORT IMMIGRATION AND CUSTOMS

Please present the supporting documents confirming the scheduled operation upon request. Please do not carry any unnecessary drugs or dangerous objects in your luggage.

Frequently Asked Questions (FAQs)

Q: I have diabetes that’s why I can’t take hormones it’s ok to do orchiectomy?

A: Must update labs for pre-screen before accept surgery at least 4 weeks.

Q: I would like to have my SRS at PAI but I don't want to be turned down because the BO surgery in England/Europe has cause problems for PAI to continue with SRS.

A: The doctor does not want you to do BO before SRS, if you have plan to come for SRS in nearby. Because skin from scrotum area will get very shorter, which is the case (problem) for SRS. Without BO surgery, he can use more skin around those area to create neo-vagina canal more beautiful. SRS is also combine with BO at the same time. You don’t need to pay BO surgery in UK.

?

Set up an appointment with us.

Write your question, interest at consult us in program form

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