There was definitely pain, but part of that was due to a complication I had. Meds were helpful.

Dilation is annoying and time consuming. That will reduce with time, but if you will never want penetration, then zero depth might be easier and less risky.

As for cost, it was covered by insurance after deductible and coinsurance, and that was a lot considering the total costs were somewhere in the $200,000 range. Plus I had to travel and stay for a month in an AirBnB in San Francisco, which was quite expensive, because the local provider has a many year waiting list. Definitely wish we had a better and less ridiculously expensive healthcare system like some EU countries.

Also, vaginoplasty does require about 3 months off of work. I had medical leave coverage through my employer which gave me 75% of my salary minus waiting periods and all that nonsense. Otherwise, I wouldn’t have been able to take that much time off. FMLA in the US means your employer has to give you the time off and let you come back afterwards, but not pay you. Another thing that some EU countries do way better.

The orchiectomy is definitely lower risk than the zero depth vulvoplasty or nullification, and heals much more quickly. And there are a lot more surgeons available that can do it without the long wait lists most have for the other surgeries. But it doesn’t solve the having a penis issue.

Just have to decide what’s most going to help your issues, you have access to, and you can afford in both money and time off of work.