I understand your predicament. I am 68, and similar concerns were presented to me. I am lucky in that my health seems to be adequate. I still have to meet with the surgeon for a face-to-face sometime this summer in NY, so the final word will be determined then. I am optimist that I can receive the surgery, but I am not counting that surgical chicken until it is hatched.
I have been on hormone replacement therapy for only 8 months, much shorter a time period then many others in transition. I never want to go back to being a male, I didn’t like being a male; and because I spent 67 years doing male, I have a hard time liking males. Basically, I am a female now and nothing is going to change that: surgery or no surgery.
I have contact my primary and request an orchiectomy, I never liked them and want them gone. I will not miss them even a little bit. Research indicates that following orchiectomy the testosterone levels drop significantly to that lower then a cis-woman’s level. This allows the discontinuance of the spironolactone and the Finistride. I am going to do this soon.
You may want to consider this as a step in the right direction. You are already a woman, so be done with the little guys. I wish you the best in your transition.