The Transgender Dictionary

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Hysterectomy

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Introduction

A hysterectomy is the removal of the uterus. Hysterectomies are performed for a multitude of reasons, such as; treatment for various ailments such as uterine fibroids, pelvic support problems, chronic pelvic pain, gynecologic cancer, abnormal uterine bleeding, and abnormal uterine bleeding. This surgery can also be performed due to personal preference, or gender dysphoria.

The primary target audience of this page is transgender men who have gender dysphoria regarding experiencing menstruation, the possibility of getting pregnant, and simply having an organ so heavily associated with femininity. Hysterectomies are considered to be one of many gender-affirming surgeries for transgender men.

Hysterectomies are required to be performed for those who seek the nullification procedure known as a vaginectomy. It is important to note that most people who seek vaginectomies do so alongside metoidioplasty, or phalloplasty.

If you are considering a hysterectomy, please do not treat this page as your only or primary source. The Transgender Dictionary is not a medical text. Please seek out as many sources as possible prior to undergoing surgery. Consult a doctor. This is simply general information for those who are curious. Please see the bottom of this page for external resources.

This page contains both information on hysterectomies, as well as information regarding the anatomy of the uterus, variations, and surrounding internal body parts. If you experience confusion regarding certain terms, click on the underlined words to be led to other pages explaining the relevant concepts in further detail. You may also navigate this site using the alphabet menu buttons at the top of the page.

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General Information

A hysterectomy is the surgical removal of the uterus. This is a surgery that is performed by a gynecological surgeon while the patient is under general anesthesia. Though less common, some patients will be given regional anesthesia for a hysterectomy.

Hysterectomies are safe, but come with the same risks as any other surgical procedure done under general anesthesia such as; heavy bleeding during or after surgery, blood clots in the leg that can travel to the lungs, fever and infection, injury to the urinary tract or nearby organs, and breathing or heart problems related to anesthesia.

After having a hysterectomy, the patient will no longer be able to get pregnant or menustrate, making this surgery appealing to many transgender men who experience gender dysphoria regarding pregnancy and menustration.

Hysterectomies typically take 2-3 hours to perform. Pain medications are typically prescribed after a hysterectomy.

The most common side effects after a hysterectomy are; difficulty peeing or pooping in the days following surgery, fatigue and tiredness from surgery, soreness or irritation at the incision sites, and vaginal bleeding and drainage (can last up to six weeks).

If your ovaries are removed, you may experience symptoms of menopause such as loss of libido, insomnia, vaginal dryness, and hot flashes.

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Types of Surgery

Abdominal Hysterectomy

The uterus is removed through a 6 to 8 inch long incision made in the lower abdomen - from belly button to your pubic bone or across the top of the pubic hairline. Stitches or staples are used to close the incision. Abdominal hysterectomies can be performed even if the uterus is large, or if there are adhesions present from a previous surgery. Abdominal hysterectomies are typically inpatient procedures. Typically the patient will stay in the hospital for 2-3 days after the procedure.

Abdominal hysterectomies are associated with a greater risk of the following potential complications (as opposed to other types of hysterectomies); such as wound infection, bleeding, blood clots, and nerve and tissue damage.

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Laparoscopic Hysterectomy

A Laparscope is a thin tube with a video camera on the end of it. During a robot-assited laparoscopic hysterectomy, the surgeon controls a robotic machine that performs the surgery. Not all laparoscopic hysterectomies are robot-assisted. Robot-assisted hysterectomies take longer to perform than non-robot-assisted hyterectomies.

Laparoscopic hysterectomies typically result in a lower risk of infection, less pain, and a shorter hospital stay than abdominal hysterectomies. Laparoscopic hysterectomies are typically outpatient procedures.

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Abdominal Laparoscopic Hysterectomy

Similar to an abdominal hysterectomy, a few small incisions are made in the abdomen. A laparoscope is inserted through one of the incisions near the bellybutton to allow the gynocological surgeon to see the pelvic organs. The uterus is then removed in small pieces, through the small incisions, or through a larger incision made in the abdomen.

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Vaginal Laparoscopic Hysterectomy

A laparascope is inserted into the abdomen through a vaginally made incision to allow improved visualization of the pelvic structures. The uterus is removed through the vagina.

Recovery is typcially shorter and less painful than with an abdominal laparoscopic hysterectomy.

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Vaginal Hysterectomy

During a vaginal hysterectomy, a small incision is made at the top of the vagina. Through this incision, the uterus is removed. Dissolvable stitches are used to stitch up the incision made. No abdomninal incisions are made.

Vaginal hysterectomies typically have fewer complications and shorter healing times than other types of hysterectomies. Recovery for a vaginal hysterectomy is typically around 4 weeks. If you are looking to get a hysterectomy, a vaginal one is recommended before other types. Someone with adhesions from a previous surgery, or has a large uterus may not be able to have a vaginal hysterectomy. Vaginal hysterectomies are typically outpatient procedures.

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Glossary

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Anatomy of Uterus/Womb

This page has been discussing the removal of the uterus, but what is the uterus, anyway? This section will be discussing the anatomy of the uterus (and nearby internal areas). For further information regarding relating aspects of this reproductive organ, see the vulva and the menstrual cycle.

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Cervix

The lowest part of the uterus which opens down into the top of the vagina.

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Corpus

The main body of the uterus. This is where a fertilized egg can implant during pregnancy.

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Fallopian Tubes

Hollow, muscular ducts located between the uterus and the ovaries. This is where fertilization occurs.

Note: Not part of the uterus.

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Fundus

The uppermost and widest part of the uterus which connects to the fallopian tubes.

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Isthmus

The narrow part of the uterus located between the cervix and the corpus.

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Ovaries

Small, oval-shaped glands on either side of the uterus that produce and store eggs. The ovaries release an egg once each menstural cycle. The ovaries stop releasing eggs during and after menopause. Ovaries are an average of 4cm in length, but can be as big as 6cm in length. After menopause, the overies can shrink to as small as 2cm. The size of the ovaries shrinks every decade after age 30.

The ovaries produce estrogen and progesterone.

Note: Not part of the uterus.

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Small Uterus/Hypoplastic Uterus/Uterine Hypoplasia/Underdeveloped Uterus

A small uterus is when a uterus is, well, small. Simple uterine hypoplasia is when a uterus still has a "normal" shape while being small. Malformative uterine hypoplasia is when a uterus is small, but with an unusual shape. An extended uterus with a normal fundus is known as elongated uterine hypoplasia.

This intersex variation is associated with Estrogen Insensitivity Syndrome.

Click to jump to external resources regarding uterine hypoplasia.

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Bicornuate Uterus

This is when the uterus is shaped like a heart.

Click to jump to external resources regarding bicornuate uteruses.

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Septate Uterus

This is when the uterus is split in half.

Click to jump to external resources regarding septate uteruses.

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None of these links are sponsored or explicitly endorsed. Not all of the thoughts, feelings, nor ideas conveyed in the below links inherently reflect that of The Transgender Dictionary. These links are provided as sources for information and as further reading material on relevant topics for those who seek it.

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See also the pages for; mastectomy, nullification, and phalloplasty.

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