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location:  Transition  >  Frequently Asked Questions (FAQ)  >  Transitioning Process  >  Hysterectomy Questions


1. Do you need to get a hysterectomy after starting testosterone?
2. How did you get the diagnosis for endometriosis and then get insurance to pay for your hysterectomy?
3. After your hysterectomy, did you masculinize more/faster?



1. Do you need to get a hysterectomy after starting testosterone?
This is a highly-debated topic within the trans community. To my knowledge, there hasnít been a scientifically-reported increased risk of uterine/ovarian/cervical cancer in female-born people on testosterone; however, there also havenít been that many long-term studies to fully assess the true risk. As it stands, itís mostly a matter of personal choice. I felt that since a.) they are organs that are not present in men-born-male (who have similar testosterone levels as me), b.) the long-term effects of testosterone on those organs arenít currently known, and c.) I wasnít planning on using them - then I might as well get rid of them. My female reproductive organs werenít serving me any purpose, and since they may serve as a source of future problems/cancer, then I would be better off without them. Some transmen choose to keep their reproductive organs so they can stop testosterone therapy in the future and bear a child.


2. How did you get the diagnosis for endometriosis and then get insurance to pay for your hysterectomy?
As a teenager, I had a history of very heavy and painful menstruation that did not improve on birth control and resulted in chronic anemia. I went to a trans-friendly gynecological surgeon, who said that might be due to endometriosis, and in fact, if I did have endometriosis, then my health insurance would most likely pay for a hysterectomy. She preformed a laparoscopic surgery to look for endometriosis, and to my luck, she found a couple spots of it! My surgeon subsequently put in a request for a hysterectomy approval, and my health insurance approved it.


3. After your hysterectomy, did you masculinize more/faster?
I was only on testosterone for about a month before having my hysterectomy so I canít accurately answer this question. I was also on a fairly low dose (60 mg/week) from the start so I didnít see the changes as fast as other people on a higher dose (who hadnít had a hysterectomy) might see. My endocrinologist said that the only reason to start someone on ďfull doseĒ (traditionally 100 mg/week) is to suppress estrogen production by the ovaries and thus stop menses (periods). Since I was having my hysterectomy within a month after starting testosterone, my doctor saw no reason to start me at this high of a dose, considering it often ends up being too high for people in the long run and wind up having to drop it down to 60 or 80 mg/week anyway. I have known some people who were on ďfull doseĒ for a year or two before their hysterectomy, then after their hysterectomy said they saw some additional masculinization and/or had to decrease their dose. This is anectodal information only, and I did not experience this for the reasons just stated.