Most trans men will have one surgical procedure in his lifetime related to his transition, if not several of them. The question a lot of trans guys ask is whether having a hysterectomy is one of them. Some doctors recommend having a full hysterectomy within 5 years of starting testosterone. There are two main reasons why doctors believe this should occur. The first one is the concern that long-term testosterone therapy may cause ovarian cancer or endometrial hyperplasia. The other reason is because after having a full hysterectomy your testosterone can be decreased due to having no estrogen to combat.
There is no research to prove whether the risk of such cancers increases due to long-term testosterone therapy. Trans men are a small population and typically undergo a full hysterectomy early in their transition if they plan on having one. The ability to research the long-term effects of testosterone is minimal. Due to the lack of knowledge between long-term testosterone use and gynecological health, and because a lot of trans men experience embarrassment and/or unable to access care, some feel it is necessary to undergo a full hysterectomy as a safety precaution. If a trans man chooses not to have a full hysterectomy they should continue to have regular pap smears and should seek care in the case of abnormalities in that region.
For me personally I have had a partial hysterectomy, so they have removed my uterus and fallopian tubes. Due to the fact that I still have my cervix and ovaries I am still required to undergo regular pap smears to check for cancer. I underwent a partial hysterectomy due to years of endometriosis growth and was unable to continue with the pain I encountered every month. Currently I am debating whether or not I want to have the rest of those reproductive organs removed. The reason I didn’t have a full hysterectomy at the time was because I was unsure of going on hormones and did not want to be placed on artificial estrogen, plus the parts that were left were fairly healthy at the time.
There are different methods of having a hysterectomy. They can perform laparoscopic which is the most used method or can cut you under the belly in order to get to the proper organs. My doctor performed my surgery laparoscopically with 4 small incisions using a camera and small instruments in order to remove my uterus and fallopian tubes. This method has fewer complications and a faster recovery time. I would recommend this method to anyone undergoing this type of surgery.
Of course with any type of surgery there are always risk and complications that can happen. These can include bleeding, infection, problems from anesthesia, blood clots, or death (rare). Some other problems that have been reported after hysterectomy include irritable bowel syndrome, incontinence, damage to the urethra or bowel, prolapse of the vagina, back pain, or loss of sexual feeling or function. Depending on the type of procedure you undergo, these risks may be more or less common.
Most insurance companies will pay to have a hysterectomy so fortunately this is one of the few surgeries that has the possibility of being covered through a trans guys transition. Check your plan though because every plan is different even if its the same insurance company. Mine was covered by my insurance all I had to pay was my 20 percent coinsurance portion.
If you decide to undergo any type of surgery just be prepared and know what you are getting yourself into. No surgery is a minor surgery even though it may seem like it. There are always risks and complications that can occur so be prepared and ask questions.