Hysterectomy/Oophorectomy
What is Hysterectomy/Oophorectomy?
A hysterectomy is a surgical procedure that involves the removal of the uterus (womb), while an oophorectomy is the removal of one or both ovaries. These procedures are commonly performed as part of gender-affirming surgery for transgender men and non-binary individuals who wish to stop menstruation and reduce oestrogen production.
Hysterectomy can be performed with or without oophorectomy, depending on the individual’s goals and medical considerations. When both the ovaries and fallopian tubes are removed, it is called a bilateral salpingo-oophorectomy (BSO).
Why Choose Hysterectomy/Oophorectomy?
- Eliminates menstrual cycles
- Reduces gender dysphoria related to reproductive organs
- Stops the production of oestrogen (if ovaries are removed)
- Reduces the risk of certain cancers (uterine, ovarian, cervical)
- May be a required step before phalloplasty or metoidioplasty
Am I Ready for Hysterectomy/Oophorectomy?
- You are in overall good health with no uncontrolled medical conditions
- You have been on testosterone therapy (if applicable) or discussed its impact with your doctor
- You understand the permanent effects of removing reproductive organs
- You have realistic expectations about the surgical process and recovery
- You feel confident that this step aligns with your gender-affirming journey
- You have considered the impact of potential infertility
- You have a support system to assist with recovery
- You have discussed the mental and emotional aspects of the procedure with a healthcare provider if needed
What Happens During Hysterectomy/Oophorectomy?
During your consultation, the surgeon will:
- Assess your medical history and discuss your transition goals
- Explain the different surgical options (total vs. partial hysterectomy, with or without oophorectomy)
- Discuss potential risks, benefits, and long-term effects
- Ensure you meet any medical or insurance requirements
The surgery is performed under general anaesthesia, meaning you will be asleep throughout the procedure.
There are different techniques for hysterectomy/oophorectomy:
Laparoscopic (Minimally Invasive) Hysterectomy
- Small incisions are made in the abdomen
- A small camera and surgical instruments are implanted.
- The uterus and/or ovaries are carefully removed
- This method leads to quicker recovery and less visible scarring
Vaginal Hysterectomy
- The uterus is removed through the vaginal canal, leaving no visible scars
- Recovery is usually faster than open surgery
Abdominal (Open) Hysterectomy
- A bigger incision is made in the lower abdomen.
- This is usually done if the uterus is very large or if there are complications
- Recovery time is longer compared to minimally invasive methods
- The procedure typically takes 1 to 3 hours, depending on the technique used.
Recovery Timeline
- Expect mild to moderate pain, managed with prescribed medication
- Rest is essential—avoid heavy lifting and strenuous activities
- You may experience fatigue and light vaginal bleeding
- Walking is encouraged to prevent blood clots
- Stitches (if any) start dissolving, and incisions begin healing
- Most people can return to light work within 2-4 weeks
- Avoid intense exercise or sexual activity until cleared by your surgeon
- Swelling and tenderness gradually subside
- Hormonal changes (if ovaries are removed) may require hormone therapy adjustments
- Full internal healing may take several months
Benefits of Hysterectomy/Oophorectomy
- Stops menstruation permanently
- Reduces gender dysphoria related to reproductive organs
- Eliminates the need for pap smears (if the cervix is removed)
- Can lower the risk of certain reproductive cancers
- May be required before phalloplasty/metoidioplasty for optimal results
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Frequently Asked Questions
Will this surgery affect my hormone therapy?
If both ovaries are removed, your body will no longer produce oestrogen, which may require adjustments to your testosterone dosage.
Can I still get pregnant after a hysterectomy?
No, a hysterectomy removes the uterus permanently, preventing conception. If you may want biological children, consider fertility preservation before surgery.
Will I go into menopause if my ovaries are removed?
Yes, removing the ovaries causes surgical menopause, which can lead to symptoms like hot flashes and mood changes. Testosterone therapy may help manage these effects.
When can I resume normal activities?
Most people can return to light activities within 2-4 weeks but should avoid heavy exercise or lifting for at least 6 weeks.
Does hysterectomy improve gender dysphoria?
For many transgender men and non-binary individuals, hysterectomy significantly reduces dysphoria by eliminating menstruation and reproductive organ concerns.