Hysterectomy

Hysterectomy with bilateral salpingo-oophorectomy (removal of the uterus, both fallopian tubes, and ovaries) is often among the first gender-affirming procedures for trans men, frequently planned together with bilateral mastectomy. It entails complete removal of the internal reproductive organs that are typically categorized as female—uterus, tubes, and ovaries—so that anatomy matches surgical goals and, where relevant, endocrine management can be simplified after oophorectomy.

In our practice, hysterectomy is usually performed in the same stage as mastectomy, which limits the number of anesthetics and recovery periods. When clinically appropriate, it can also be combined with phalloplasty (or staged according to your overall plan). Timing is individualized after consultation, review of health status, and discussion of priorities—consistent with international standards for gender-affirming care.

Leading clinical guidelines recognize hysterectomy and oophorectomy as established options for trans masculine and non-binary people who seek relief from pelvic anatomy, wish to stop cyclic bleeding (when present), or remove hormone-producing ovarian tissue as part of a long-term plan—often alongside testosterone therapy prescribed by an endocrinologist. Removing the ovaries ends the body's main source of estrogen production; testosterone dosing and monitoring may be adjusted afterward, which is coordinated with your hormone provider.

For many patients, the procedure also supports psychological well-being and reduces the need for future gynecologic examinations tied to organs that are no longer present. It may simplify planning for certain bottom surgeries (for example, some phalloplasty pathways). Risks, benefits, and alternatives are discussed in depth before consent—there is no one-size-fits-all sequence; your goals and medical history guide the plan.

In trans men we perform hysterectomy using a transvaginal or laparoscopic (minimally invasive) approach, depending on indications, anatomy, prior surgery, and patient preference. Both approaches, in experienced hands, are associated with a very low rate of serious complications when patients are appropriately selected and prepared.

Laparoscopy uses small abdominal incisions and a camera; it often allows precise visualization of the pelvis and may be preferred when adhesions or other factors are expected. Transvaginal access can reduce visible abdominal scars in suitable candidates. The choice is made after examination and imaging when needed— not by a generic rule.

This is a routine component of our gender-affirming program; we frequently combine it with mastectomy or phalloplasty and aim for smooth coordination of nursing, anesthesia, and follow-up so recovery is as predictable as possible.

Mastectomy + hysterectomy in one stage is common in our center: one hospital stay, one recovery trajectory, and a single coordinated team plan. Combining procedures must balance operative time, blood loss, and overall fitness—your surgeon will confirm whether a one-stage plan is safe for you.

Phalloplasty (or other genital surgery) may sometimes include or follow hysterectomy depending on technique and staging. Some bottom-surgery pathways require prior or concurrent removal of the uterus and ovaries; we align with your urology/gynecology and reconstructive plan so stages are clear and expectations are realistic.

Recovery varies by approach (laparoscopic vs transvaginal), whether surgery was combined with mastectomy or other procedures, and individual healing. Typically, patients receive clear instructions on pain control, activity limits, wound or vaginal care when relevant, and warning signs that should prompt contact with the team. Return to desk work is often sooner than return to heavy lifting or sport; your discharge summary will personalize timelines.

Testosterone therapy is not automatically stopped—changes in dosing or monitoring after oophorectomy are coordinated with your prescribing clinician. Long-term follow-up for bone health and overall wellness remains important and is part of holistic care after gender-affirming surgery.