Because anatomically masculine hips and buttocks are generally smaller than those that are anatomically feminine, some MTF individuals will choose to undergo buttock augmentation . If, however, efficient hormone therapy is conducted before the patient is past puberty, the pelvis will broaden slightly, and even if the patient is past their teen years, a layer of subcutaneous fat will be distributed over the body rounding contours. Trans women usually end up with a waist to hip ratio of around , and if estrogen is administered at a young enough age "before the bone plates close", [ citation needed ] some trans women may achieve a waist to hip ratio of or lower. [ citation needed ] The pubescent pelvis will broaden under estrogen therapy even if the skeleton is anatomically masculine.
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.