What It's Like to Get a Hysterectomy as a Transgender Man
My wife and I rolled up to the surgical center before the sun had even risen on a Wednesday morning in September. It was years in the making, but I was finally getting the hysterectomy I so desperately needed. I was decked out in my best pair of sweatpants and ready to get those baby makers out of me, but I probably should have shaved my face first — because, yup, I'm a transgender man.
Why I Decided Surgery Was Right For Me
I've been dealing with ovarian cysts since I was 13 — and, as I mentioned, I'm not a woman — so I figured it was finally time to get these excess bits out of me. There was something unsettling about having multiple organs inside of my body that were literally doing more harm than good. When doctors find a tumor or cancerous mass inside someone's body, they'll remove it without question. That's how I began to see my ovaries. Each month brought more pain, but it was a pain I didn't feel comfortable discussing with my friends or coworkers. It was another reminder that, despite feeling comfortable with my outward appearance and passing as male, my internal anatomy was still fighting against me.
The ovarian cysts popped up every month, and the estradiol produced by my female organs was waging war with the testosterone I injected each week, which led to a lot of distress. I dealt with mood swings, digestive issues, depression, and just about everything else associated with both PMS and the typical male puberty. My body had no idea what to do with itself, and it was finally time to fix that.
After experiencing yet another cyst rupture at age 29, I made an appointment with the ob-gyn team at my medical center, and we scheduled a total laparoscopic hysterectomy for a few months later. I realized the one thing that made this entire surgery so uncomfortable was the same thing that made the surgery possible through my insurance: being a transgender male. I was told by the surgical coordinator that because my surgeon stated that this was a transition-related surgery, instead of a surgery to prevent ovarian cysts, my insurance covered it. If he were to say that this was a preventative surgery, my insurance likely would have denied the coverage and I would have been left paying almost $20,000 out of pocket for a surgery that will eradicate a lifetime of pain.
It's strange to think that if my wife were to go to her ob-gyn and request a hysterectomy due to ovarian cysts, her request would likely be declined in favor of "less extreme options" — cheaper and often less effective options, to be clear — like birth control.
So I dealt with being a lone male in an ob-gyn office. I brushed off the stares, the marker on all of my medical records that said "female-to-male transgender individual," and the cover-up stories about what surgery I was getting ("Oh, it's a mass removal"), because I was getting this surgery.
The morning of the surgery was less anxiety-inducing than I'd anticipated. The only thing I was actually concerned about was being nauseated after waking up from the anesthesia, but I was given a bunch of medication and a seasick patch to prevent that. The med students and residents explained what was going to go down to my wife and me, and then I was wheeled back and relieved of my female reproductive organs. No one questioned why this scrawny little man was here for a typically "female" surgery, and I was treated like every other patient who ever got their ovaries removed. The surgery was done via the da Vinci robot, which is as awesome as it sounds. My surgeon removed the organs by operating a robot through special controls that look kind of like a virtual reality setup. My abdomen was filled with gas, and there were four one-inch incisions made: two on my right side, one on my left side, and one in my bellybutton.
They took it all: both ovaries, the fallopian tubes, the cervix, and the uterus. Due to over five years of testosterone therapy and fluctuating hormones, my uterus had atrophied quite a bit. In fact, one of the residents referred to it as a "cute-erus" since it was so tiny. I went home that same day with a pair of mesh underwear and a bag full of pain medications.
The Recovery Process
By the second day, I was beginning to regret the surgery. The last surgery I went through was my top surgery (double mastectomy), which had a pretty easy recovery. I couldn't move my arms too much, but the pain was manageable and mainly came from the binder I had to wear for a couple of weeks.
A hysterectomy recovery is totally different. With my top surgery, I had a physical "trophy" of what I had gone through every time I looked in the mirror: my breasts were gone, and my chest was finally flat. Every day post-op was one more day closer to being able to remove that binder and see my chest. It was a huge step in my transition and one that I don't think I'll ever get over. Even though my chest isn't perfect (I'm still scrawny, and my farmer's tan is atrocious), it's still a masculinized chest.
With a hysterectomy, it's a distinctly female recovery. I had my last period about a month after I began taking testosterone at age 24, and I hadn't experienced menstrual cramps since then. The first month and a half of my hysterectomy recovery was essentially a month-and-a-half-long period, which caused some discomfort. I was spotting (not enough to warrant wearing a pad, thank God), cramping, and bloated. I couldn't wear anything that didn't have an elastic waistband for almost two months, I ate way too many Hostess Cupcakes, and I found myself relying on one of those husband pillows. Since it had been over five years since my last period, having to deal with these physical reminders was jarring and frustrating. I remember sitting in the bathroom and staring at the blood that had leaked into my underwear with angry tears in my eyes, a forcible reminder that my body was still clashing with my mind and soul.
But isn't that what this surgery was for? Aside from external genitalia, my body no longer thinks of itself as female. If a doctor were to check my hormone levels, they would finally be within the normal male range. If I had an X-ray or ultrasound done, no one would find any ovaries or a cervix or anything that would point to being female.
2 Months Later, I Know I Made the Right Choice
Eight weeks after my hysterectomy, my body and emotions are no longer riding the roller coaster of testosterone vs. estrogen, and I'm finally stable in a male's body.
Other than relearning how to feel and coming to terms with my new body, I had a few tiny complications that occurred throughout my recovery. These were mainly due to human error and not really related to the surgery, but it led to a longer recovery than I had planned. I went back to work part time after about three weeks and then hit full time at five weeks post-op.
For the first time in my life, my body is finally aligned with how I've always felt inside. There are no conflicting hormones wreaking havoc on my body or monthly cysts popping up to remind me of the things I cannot — or thought I could not — change. A hysterectomy is a huge step in my transition, so I'll be holding off on any additional surgeries until the practice of "bottom surgery" is a bit more refined.
I'm eight weeks out from my surgery and I still don't feel "normal," and I don't think I'll ever truly feel "normal" again. Regardless of whether you're a biological female getting your ovaries removed as a cancer prevention or you're a transgender male getting ready for your next surgical step, a hysterectomy is a life-changing surgery.
Is it weird knowing that a handful of organs have been removed from my body? A little bit. Is it a huge relief not dealing with ovarian cysts every month? You bet. Is it something I would recommend? It's hard to say. After all, I can only speak to one person's unique experience: my own. But I hope by sharing my story, someone else can make the right decision for themselves.