Testicle Implants

Testicle Implants

After losing a testicle (or two), due to cancer, infection, injury or torsion, do you consider getting testicle implants?  What if you are a trans-man?  According to our documentary subjects, the opinions vary and are split down the middle.

To replace, or not to replace.  This is the question.
 
In the case of Matt Perry, who lost his testicle to testicular torsion, he has no interest in replacing the excided ball with a testicle implants.  Now in his fifties, Matt had his ball removed in his early twenties because the twisted testicle had cut off all blood supply to his left nut rendering it dead.  Not only is testicular torsion a medical emergency but it is also very difficult to diagnose.  If the diagnosis and “un-twisting” is not made within the first 8 hours, the testicle will likely be lost.  

Matt’s trauma of undergoing an orchiectomy over 25 years ago is so great, that the thought of having to undergo surgery once again to have testicle implants is even further traumatizing. Besides, he is much older now and in a long-term committed relationship with a partner who is comfortable and supportive of Matt’s body.  Matt jokes, “If you could click your fingers and have testicle implants with no effort required, I would probably do that”. Sadly, it is not that simple.
 

Siavash, on the other hand, who also lost a testicle to torsion in more recent years, is definitely considering re-balancing his body with testicle implants.  As a younger man in his late twenties, he would like his body to look more symmetrical.  At the moment, he is researching clinics and doctors.
 
For Peter Bovolaneas, who lost both testicles to cancer, it was a no brainer.  He was thankful for the modern day medical technology and elected to get 2 prosthetic testicle implants.  Peter is a remarkable human being who has such a great sense of humor and amazing coping skills.

Sometimes when he is out at the bars, he will approach acquaintances (who do not know his testicular history) and ask them to flick his balls.  If he doesn’t flinch, they buy him a drink; if Peter flinches, he buys the drink.  It’s a win-win situation for tipsy Peter, leaving the “flicker” scratching his or her head.  

It should also be noted that Peter, who presents as a VERY masculine/muscular man, can no longer produce testosterone because both testicles were removed due to cancer. Because of this fact, Peter must inject himself with testosterone every 2 weeks to maintain sex drive, bone mass, muscle mass and mental health.  He humorously accepts this shot in the buttocks as his “pain in the ass”.

Peter takes testosterone because without biologically intact testicles, as a man he needs it.  This is different than when men with functioning testicles take testosterone for purely aesthetic reasons.

The decision to get testicle implants after the required removal of one or both balls really comes down to choice and comfort.  And as Maggie Cassella jokes, “I’m not going to judge a guy for getting a fake ball any more than I’m going to judge a woman for getting a fake boob. It’s your choice and we have the technology!”

testicle implants sizingDifferent sizes of testicle implants are measured against the patient’s real testicles to get as close a match as possible.
 testicle-implants-sizing-indianapolis-dr-barry-eppley
There are different types of prosthetic testicle implants.  The ultimate goal is to match the prosthetic as much as possible to the remaining, natural testicle.  Testicular prostheses are made of silicone gel or saline (salt water) with a silicone rubber covering.  The surgeon makes a small incision in the lower groin where the prosthesis is inserted and then placed in the empty scrotum and secured with a stitch, or suture. You can usually go home the same day of the surgery.  Often testicular prosthesis surgery can be done at the same time as the orchiectomy, or during a later surgery.  It all depends on what the patient wants.

As a trans-man, Carey is not interested in getting prosthetic testicle implants.  His genitals do not define his masculinity, though he jokingly claims to have “psychic balls”.  Interestingly enough, once Carey started to take testosterone, his genitals started to change.  His clitoris and labia started to grow, so much so that he often feels as though he has a penis and balls.

Gender Reassignment

Gender Reassignment - Tiana

“My gender reassignment is not about my balls. What I wasn’t comfortable with was living as a man”.  

Tiana is fierce and speaks her mind unapologetically. Somehow, there is this assumption that trans people’s ultimate transformation is to match their gender identification with their physical genitals.  For some trans people, this might be the case. Danica is a perfect example. For her, matching her gender to her genitals was a very important part of the process. In Danica’s words, “I hate to say it, but it’s the icing on the cake!”
 
Society at large is obsessed with trans people’s genitals.  You are either male or female and nothing in-between.  Tiana, like so many other trans people, keep proving society wrong and insist that gender, biological sex and sexuality are on a spectrum.  Tiana loves her balls and penis, and quite rightly so as she considers herself a “top” (a person who engages in the penetrative role during sexual activity).  

The world is not black and white but ever-changing shades of gray.  The trans experience, is a diversity of experience.  That is why we cannot pigeon-hole Tiana OR Danica. Though they refer to themselves as trans women, their individual stories are unique, powerful and ultimately transcend convenient labelling. 
 
Though Tiana has had some plastic surgery, she is not currently on (nor has she ever been on) hormone therapy. Unlike Danica, Tiana is unwilling to take large doses of estrogen and change the chemical makeup of her body.  In her own words, “I want to save my liver.”  There are many side effects to being on estrogen hormone therapy.  These might include: deep vein thrombosis, the formation of a blood clot within a deep vein, pulmonary embolism, the blockage of an artery in the lungs, gallbladder disease and some forms of cancer.

Tiana’s natural body type (even before transitioning) is long and lean.  For Tiana, being an ectomorph was a blessing in disguise. Through plastic surgery, she was interested in “feminizing” her face, but not her body.  She continues to visit a  cosmetic clinic for general upkeep with botox and facial fillers.
 
“I view my body as feminine, even though I have balls.  My balls are not on public display.  Unless you are going to sleep with me, you really don’t know what’s going on down there”.

I am so impressed with Tiana’s honesty.  It’s refreshing and inspiring.  She is living her life the exact way she wants to live it.  Who could ask for anything more than a life lived to its fullest? 

Gender Reassignment vs Gender Confirmation

I recently had a conversation with my producing partner, Charlie David, about the use of words to empower minorities, particularly in the case of trans people.  We discussed the importance of using a vocabulary that is positive, helpful and more accurate. Instead of saying gender reassignment surgery, perhaps we should instead say gender “confirmation” surgery.  It is important to consider this etymology as it validates a person in gender transition.  “Gender Reassignment” suggests that a person is making a choice to switch genders. It’s not about choice; it’s about using surgery as a therapeutic tool to help trans people to be more comfortable with their gendered, chosen self; to reaffirm and confirm their true self.

 ~Nico Stagias, director Balls documentary

Drag Queens teach the art of Tucking

Donnarama

Tucking is the art of making your testicles “miraculously” disappear.  But just how does a drag queen make that happen?  Where do they go?

Drag queens and butch lesbians were at the forefront of the gay liberation movement at Stonewall.  Their queer visibility made them conscripted soldiers for a movement in which the majority of its citizenry were invisible/voiceless gay men and women who were mostly in the closet.  Who would have thought that sissies and bull dykes would come to our community’s rescue?  Our militant forefathers and foremothers had serious balls.  And quite frankly, it’s the visible and vocal queers of today that continue to challenge gender, sexuality and sex as our modern day queer warriors.

And that’s exactly what drag artist Barbie Jo Bontemps says in our documentary Balls, ”It takes a lot of balls to be a drag queen!” In the bigger picture, she is certainly echoing our queer herstory, but at that very moment she is specifically referring to the physical, testicular pains that drag queens must undergo to realize their gender illusion.  Tucking your balls is common practice for many a modern drag artist. Whether you are using tight underwear, a gaffe (pulling all your junk back with a sock) or duck tape for tucking, the end result is the same; your testicles “miraculously” disappear.  
 ucking BarbieJoBontemps
To make one’s testicles disappear, you are essentially pushing your balls back into your body’s natural cavities.  It’s kinda uncomfortable, but not overly painful.  Unlike Barbie, Donnarama is not overly enthusiastic about tucking, “I hate 3 things.  I hate shaving my face, shaving my back and TUCKING”!  It’s not easy being gorgeous, but sometimes a girl’s got to do, what a girl’s got to do. Interestingly, this idea of tucking, like wearing high heels or make-up, speaks to the discomfort that many women often endure to also realize the illusion of gender that has been imposed on them by the heterosexual cis-male gaze.
 Tucking 1
Back in my salad days, I used to do a lot of what I would call “clown” drag.  My goal was to look fun and vaguely girly.  For me, drag was a multi-layered tool to play with gender and gender expectations.  That said, I never tucked or gaffed, in fact, sometimes I wouldn’t even shave.  I liked to both shock and amuse my immediate audience. I was never trying to “pass” as a “real” woman.  Some drag queens refer to this as “fishy”, a term that I’m not particularly comfortable with. Part of this discomfort stems from an inherent misogyny of cis-men playing with female gender without any real ownership or consequence.  If things get too “real”, the drag queen can assume the privilege of being a cis-male, whereas women are systematically compromised without any escape.  They suffer physically, emotionally and economically because of their gender.  Perhaps it is women who have the “real” balls after all.
 Tucking Donnarama
Barbie and Donnarama offer a great counterpoint and levity in our documentary Balls.  Their playful, off-the-cuff banter help bridge the conversations around testicular health and men’s health in general, both physical and emotional. Because of how men are generally socialized, they are not having open, honest and vulnerable discussions about their own personal health and how to ask for help.  In its own small ways I hope Balls, with the help of Barbie and Donnarama, opens that door.

~ Nico Stagias, Director of Photography at Border2Border Entertainment

Grab your Balls and hold on!  Let’s discover everything you never knew about your nuts.

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