Trans Men and Hysterectomy
Ryan one month after undergoing a Total Laparoscopic Hysterectomy (TLH). The two pink lines on his abdomen are scars from the surgery (which are now unnoticeable). There was one more incision made in his belly button (which cannot be seen).

With all the different gender-affirming procedures, it seems that a topic that is often left off the blogs are trans men and hysterectomy. Below, I share my experience and also interview Dr. Jean Amoura to help dispel myths around this procedure, and provide information around options trans men have when deciding if they would like to move forward with a hysterectomy.

I had a hysterectomy (removal of the uterus) and salpingo-oophorectomy (removal of the ovaries and fallopian tubes), as well as removal of the cervix on August 14th, 2006. This procedure took place a year after being on hormone therapy.

By nine months of being on testosterone, I started experiencing extreme cramping that lasted throughout the day and night, for up to three weeks a month. I went into a healthcare provider and described what I was experiencing. I wasn’t interested in exploring options for ways to control the cramping (there aren’t really any good options at this time), I wanted to have a hysterectomy completed. The doctor felt that with my symptoms, and my family history surrounding reproductive organs, that I would be a good candidate for the procedure.

After receiving the pre-certification notice from my health insurance company, we moved forward with the procedure. My doctor performed a Total Laparoscopic Hysterectomy (TLH), in which she inserted laparoscopic instruments into my abdomen to make the incisions and then removed the uterus and cervix via the vaginal canal. I was in the hospital for two or three days (I can’t remember exactly) before being released.

Recovery required me to take it easy and not physically exert myself for six weeks. I had very little, if any, pain during the recovery process. The main thing I noticed was that I was very, very, very tired.

Due to the fact that my insurance card had “M” for the gender marker, four months after this procedure my insurance company conducted a post-payment audit and sent me a notice that my surgery did not match my gender. They requested a refund from the hospital, and I was then sent the bill. Through the use of a lawyer, I filed an appeal and was granted approval.

Do trans men absolutely have to have a hysterectomy? 

If they do, do they have to have their ovaries removed as well?

Are there different options regarding procedures?

These are some of the questions asked/answered in the video below where Ryan interviews Dr. Jean Amoura at Nebraska Medicine’s Specialty Care Center. Dr. Amoura is the director of the transgender care clinic that is part of Nebraska Medicine.

Dispelling Myths Around Transgender Men and Hysterectomies