The two main human castration procedures are bilateral orchiectomy and bilateral oophorectomy, states the Encyclopedia of Surgery. These procedures involve the complete removal of the gonads, often as a treatment for cancer, or as part of medical transition for transgender people.
Castration is defined as any procedure that removes or destroys the gonads, states the Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health. The technical term for surgery that removes the testes is orchiectomy. The corresponding procedure for ovaries is called oophorectomy.
In the past, orchiectomies were often performed with external cuts that sliced off both the testes and penis, reports the Endocrine Society. For example, in 19th century China, castration was performed with a single cut that removed the testes, penis and scrotum.
As of 2016, orchiectomy usually involves a small incision to the scrotum, states the Encyclopedia of Surgery. The testes are removed through the incision, which is then stitched. In modern oophorectomies, the ovaries are usually removed through the abdomen, but sometimes a small incision to the genitals is used instead, as that method has less risk of complications. Modern castration procedures are chiefly performed to treat cancer or lower hormone levels.
However, both castration procedures are also frequently performed on transgender people, states the University of California. They may be performed alone, or as part of a suite of surgeries that alter the patient's genitalia. The removal of the testes allows trans women to take a lower dose of estrogen over the course of hormone therapy.
Oophorectomy in transgender men is generally performed to reduce cancer risk due to the use of testosterone, states the International Journal of Transgenderism. Transgender men who are castrated tend to have shorter operating times and less bleeding than the general population.