I can’t help but quote Kate Bornstein in the title of this column. When asked by a talk show host if she was post-operatively orgasmic, that’s how she replied: “Yeah, the plumbing works, and so does the electricity.”
Since the last issue of Trans Health came out I had an orchidectomy, which is most likely the last surgery I’ll have. An orchidectomy (also spelled “orchiectomy,” or other variations thereupon) is the surgical removal of the testicles.
It took me a while to come to the decision to do it. I started by contacting my GP and speaking with an endocrinologist, both of whom told me that I should be concerned about losing my sex drive and my ability to orgasm. They said that, since the testes were the organ in which most of the body’s testosterone is produced, eliminating the testosterone could eliminate my ability to orgasm.
As you might imagine, I was extremely upset at the possibility. At the same time the little warning bell went off in my head: ding ding ding!!
My GP said, “You can’t orgasm if you can’t get an erection.”
It took all of my resolve to not fall off of the table and writhe around on the floor in apoplectic fits of laughter. Come on. What do orgasms have to do with erections? That’s like saying that you can’t eat ice cream without a cone. Sure, it can be more fun with a cone, but when life gives you a cup of ice cream, whip out a spoon.
So I checked with the endocrinologist. She said something similar: no testosterone equals no orgasm.
“Do you have a sex drive?” I asked my endocrinologist, a genetic female.
“Well yes, of course,” she replied.
“Then maybe I’m missing something,” I continued, “but are your testosterone levels normal for a genetic woman?”
“Good point,” she said.
See, genetic females (XX) have a much lower normal level of androgens than genetic males (XY): 5-85 ng/dl for XX persons, and anywhere between 300-1000 ng/dl (or more) for XY persons.
There is a common assumption that sexual arousal is tied to testosterone, an androgen, since increases in androgen levels have been linked to increased sexual arousal. My belief, to which I hold steadfastly, is that for most people arousal has a little to do with their biology and a lot to do with where their head is. Being a specialist in hormonal functioning in human beings, an endocrinologist, of course, will be biased towards thinking that everything is related to hormones. Which I think is total bunk.
Anyway, the next step was to see a urologist, who would perform the surgery. I got a referral from my endocrinologist, booked an appointment with the urologist, and a month or so later I went in to see him.
I asked my urologist the question about arousal, playing dumb because I didn’t want him to bias his answer. “The endocrinologist told me that I might lose the ability to orgasm after I have an orchidectomy,” I said. “Is that true?”
He laughed. “Of course not!” he said.
So that was my cue. “That’s what I thought,” I replied. “It seems to me that many trans women who have surgery and report decreased sexual function feel a discomfort with their bodies and their genitalia. I felt it myself the first time I transitioned, and the same day I started hormones I lost all interest in sex. During this most recent transition I felt no such discomfort. So, even after being on hormones for a year, my sex drive is exactly the same.”
“That makes perfect sense,” he said, “and it matches what I have seen in male-to-female transsexuals.”
I had the orchidectomy in late July, 2001. It’s been two months, and I can state conclusively that my sex drive hasn’t been affected in the least. In fact, if anything, it’s higher now than it was two months ago. I mean, still bandaged, I masturbated to orgasm less than 60 hours after I came out of surgery. And I haven’t slowed down since. (Even I was impressed.) We’re talking once a day, minimum. I even get laid with partners!
So what are the differences? My orgasms feel very different now. It takes longer to climax than it used to, for sure. The orgasm itself comes on slower, lasts longer, and is more diffuse than it used to be. Now, I have no idea whether this is physiological or psychological, but who cares? They’re more fun and that’s all that matters to me.
And yes, like Kate, my electricity still works. Does it ever. No matter what the doctors said.