So I think, given everything, if you’re not happy with how the finasteride is working for you your best bet is an orchie if that fits within your long-term goals. If you wanted to keep your gonads that’d be something else…. but if you want them to go, why not now? Definitely realistic, and your doctor can probably make a very good case with your insurance if the company is reluctant (., this is the *only* option left for suppressing your T effectively now, and suppression is necessary for treatment of your dysphoria which is a medical condition). Since you’re in California your insurance canNOT have a transgender exclusion clause in their policy. They can’t deny you surgery just because you’re trans — if they cover orchies for some, they have to cover them for all. CA is pretty awesome that way.
Finally, there are instances when a progesterone-based hormone therapy might be used in the treatment of trans men. Progesterone may be used in some instances to help stop menstrual flow if testosterone therapy alone does not adequately stop the cycle after a reasonable period of treatment. A short course of progesterone may also be prescribed to induce a shedding of the uterine lining after testosterone therapy has progressed, in the event that there is any unusual buildup of the endometrium. This may help prevent spot bleeding as well as potentially decreasing the risk of uterine cancer. To learn more specifics about FTM testosterone therapy, please read the sections " FTM Testosterone Therapy Basics " and " FTM Testosterone Therapy and General Health ."