Bilateral Orchiectomy for Gender Affirmation: A Video Guide for Urogynecologists

Objectives: This educational video is intended for urogynecologists to learn indications, surgical steps, and gain exposure to bilateral orchiectomies for gender affirming care. The learning objectives for this video include: 1) describe the indications for bilateral orchiectomy for gender affirming care; 2) demonstrate the step-by-step surgical technique for bilateral orchiectomy; and 3) illustrate how urogynecologists can perform this surgery to expand access to those seeking gender affirming care.

Methods: The pre-production phase was divided into these elements: literature review, generation of learning goals and objectives, and storyboarding. After the creation of the learning objectives, a storyboard was created to achieve these objectives. The storyboard included a timeline with individual panels for each section of the video and contained video text, graphics, and audio script. After completion of the preproduction phase, video production mode was started. Adobe products were used to create the graphics, animations, and transition features, produced by the primary author. Patient consent was obtained to film the surgical procedure.

Clinical Relevance: Transgender individuals have health care needs that need to be addressed, with surgical and medical multidisciplinary teams around the country. While access to this specialized care has increased over the past decade, barriers remain to accessing gender affirming surgeries. Bilateral orchiectomy is a simple, same day surgical procedure that is a key component for many patients seeking gender affirming care. Urogynecologists have the surgical acumen to complete these pelvic surgeries and help this population immensely. Few surgical videos demonstrate step-by-step surgical technique for bilateral orchiectomy for gender affirmation surgeries, and there are not any that specifically have a urogynecology focus. This video will describe the indications for bilateral orchiectomy for gender affirming care, demonstrate systematically the surgical technique for this procedure, and show how these techniques are very similar to those used in urogynecologic surgeries. Exposure to this surgery could potentially allow urogynecologist to recognize that this surgical procedure is possible to add to their privileges with minimal additional training.