Trans-masculine people have several options when it comes to having a hysterectomy, and their reasons for having this procedure vary.
Some people choose to have a hysterectomy as a gender-affirming procedure, whereas other people may have medical reasons for doing so. Unfortunately, access to this procedure isn’t simple for everyone, and it can be difficult to obtain if you aren’t referred by a gender identity clinic.
My Experience of Having a Hysterectomy
My process to finally having a hysterectomy was a long one. I originally planned to do this alongside stage two of metoidioplasty in 2019 but decided that recovering from both procedures would have been too much.
Recovering from this metoidioplasty surgery was quite intense, so I’m glad I made this decision at the time. However, when I did reach out to my surgery provider to get on the list for a hysterectomy, I was advised this was no longer possible through them, and my referral had been passed on to Chelsea and Westminster Hospital.
As I hadn’t heard from Chelsea and Westminster Hospital, I wasn’t confident that this was the case. After speaking to my GP about this, he gave me a referral to get on an NHS waiting list for this procedure. However, eventually, C&W Hospital did call me and let me know I’d been transferred into their care.
Hysterectomy Consultation
A few months after I was informed of my transfer, I was contacted again and offered a hysterectomy consultation on the 9th of July, 2024.
I’m always anxious about medical appointments because there’s so much potential for nonsense, such as being misgendered, assumptions being made about my body, invasive and inappropriate questions, etc, so I didn’t have high expectations. But I was pleasantly surprised by this appointment.
The doctor asked me about my pronouns, what my goals were for the surgery and how I would like to proceed.
We decided that I would keep both of my ovaries. I was told that if I was unable to access testosterone in the future or voluntarily decided to stop taking it, my ovaries still had the potential to produce oestrogen. This would mean I wouldn’t be without hormones entirely, which are naturally essential for the body.
Additionally, I initially thought a good reason for removing the ovaries was to protect against the possibility of ovarian cancer. However, the doctor told me that 99% of the time, ovarian cancer begins in the fallopian tubes. So, removing them essentially eliminates the chance of ovarian cancer anyway.
The doctor also asked me if I wanted to store my eggs for future fertility potential, which I don’t, but it’s great that more consideration is being given to this when it comes to trans-masculine people.
I was told that because this is a laparoscopic robot-assisted procedure, the scarring is very minimal, and the recovery is quick. This also meant it would be a day procedure, so I wouldn’t have to sleep over in the hospital.
When I asked about the waiting list, he told me that it’s about three to four months, so I should definitely be called for surgery by the end of the year.
Waiting for a Call
On August 7th, someone from the admin team at the hospital called me and asked if I could come in for surgery on August 9th, just two days later. This wasn’t super convenient for me as I had tickets to a festival, and I was working an in-person job without sick/holiday pay, but it also felt like the best idea to just get it out of the way.
Years of waiting between previous surgeries left me feeling like turning down a surgery date is impossible, as though I would be dropped right back down to the bottom of the list for saying no.
So, I said I would take it, and the caller booked me in for a pre-op check-up at 9 a.m. the following morning.
Pre-Op – August 8th
I went to Chelsea and Westminster Hospital first thing in the morning for a blood test, an MRSA swab and a quick chat with the surgeon. She told me that after the surgery, I’d just have to take it easy for two weeks, and then I’d be pretty much fine to ease back into normal everyday activities. However, she did advise that sex isn’t possible for the first ten weeks because of internal stitches.
After my pre-op checks, I went to work and tried to do some life admin/surgery prep shopping afterwards to organise the next couple of weeks.
Surgery Day – August 9th
Today I had to be at the hospital for 7:30 in the morning, without breakfast and to only drink water.
When I arrived, I was told I’d be first, so I’d be able to go home by the evening. However, a little bit later, someone came to tell me that my MRSA swab hadn’t come back yet, so I would have to wait until 2 – 3 pm. This also meant I wouldn’t be able to go home the same day as the anaesthetic likely wouldn’t have worn off in time.
I was left to wait in a small room for six hours with not much to do, so I tried to get comfy and listened to podcasts until they came to get me.
After the surgery, I spent about an hour in the recovery room, and then they moved me onto the men’s ward. This was my first experience of being on the male ward, and I hadn’t been told about this.
For all of my previous surgeries, I’ve been put in a private room, and given the nature of the surgery, I’m surprised they decided to do this. It’s clear from my documents that I don’t identify as male, and I would have requested for this not to have happened if I’d been asked or told about it in advance.
My partner came to meet me on the ward, and when the surgeon came to check on me, I asked if I could be discharged to go home. By this point, she said it was too late, and I’d have to stay the night. She also casually told me that they’d found endometriosis during the procedure, which isn’t something I was aware that I had. She said they’d managed to remove some of it but had to leave some behind because it was too complicated to remove.
I have a couple of friends who really struggle with endo pain, so this felt very stressful at the time, but I also knew that taking testosterone and having a hysterectomy could lessen the impact of the condition, so I tried to reassure myself and not dwell on it for now.
Day Two – August 10th
We left in an Uber as soon as possible the next day with a box of codeine and a bottle of laxatives. I hadn’t slept because the old guy in the bay next to me was snoring and shouting during the night, so I wasn’t in a great mood.
Although there wasn’t much pain from the incisions on either side of my belly and inside the belly button, I had pain in my shoulder, which I’m told has something to do with the stomach being filled with gas during the surgery. I also had quite intense gas pain throughout the day and incorrectly felt like the solution to this was to take more laxatives.
Once this had resolved itself after a few hours, I more or less didn’t experience any more pain and discomfort.
I had anticipated the hysterectomy to be the biggest of all of my gender-affirming surgeries, but it was by far the easiest recovery already.
Day Six – August 14th
The last few days were mostly spent in bed and pottering around the house. I was able to do a bit of work from home and got way too invested in Grey’s Anatomy.
Today was the first day that I felt able to leave the house, so we had a short walk to the dog park and sat down for a while. The dogs in the park can be chaotic, so I was a bit stressed about being bumped into, but it was fine.
For me, the first time leaving the house after surgery always feels like a big step towards getting back to normal, but it was also exhausting, and I went straight back to bed after.
Day Eight – August 16th
Today was my boyfriend’s birthday, so we took a longer walk to Pipoca in Brixton for tasty treats. This was about 20 minutes of walking in each direction, and it felt more or less manageable.
My energy was almost back to normal, and since I had a desk job, I probably could have gone back to work already.
Day Fourteen – August 19th
Today, I went back to work and had no problems at all. It’s a 30-minute walk to get there but it took a little longer than usual. I felt fine going for a walk by myself at lunch and walking home with no issues.
I’m really surprised at how quickly I felt back to normal after this surgery and I’m really glad this is the last gender-affirming surgery that I’ll have.
This is the sixth gender-affirming surgery I’ve had, starting with my top surgery in 2014. So much of the last ten years has centred around planning, waiting for, and recovering from surgery. It’s impacted where I’ve spent my time, the opportunities I’ve pursued and how I’ve felt about my body.
I’ve listed my experiences of lower surgery below for those who are interested to learn more about metoidioplasty: