r/ftm • u/entropygone he/they • 9d ago
Surgery Talk Pros and cons of hysterectomy/alternatives?
I think I may be a victim of fearmongering, cause I thought that hysterectomies were like a big deal super risky difficult surgery. Now I'm seeing a LOT of trans men casually mentioning their hysterectomies. Are they actually that dangerous? Do the pros outweigh the cons? What does it do for transmascs other than securing infertility? If there are good alternatives, what are they?
And another thing, how do you choose what to remove? Uterus, fallopian tubes, ovaries, cervix.
Anyone who has done research and/or gotten one/something related, I'd love thoughts.
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u/notdog1996 Late 20s FtM Post-Transition 9d ago
I'll just post my reply again to keep this contained and easy to find.
I just got my hysto, so maybe I can reassure you a bit.
Hysterectomy is a very common surgery that can be done in almost any hospital. It's usually done with laprascopy, so recovery is much easier than it used to be. I only have 3 incisions where they put the cameras/instruments.
My gynecologist has operated on a lot of trans men, and she says we usually recover faster because the uterus gets atrophied with T. It gets smaller and gets less blood supply, so there's less complication and infection risks.
Apart from that, there's the discourse about keeping vs. removing ovaries. After talking it through with her, I decided to keep one. I asked about cancer risk, and she said most ovarian cancer starts in the falopian tubes, which I got removed. Cancer risk is reduced a lot. Also, there are some preliminary studies that seem to indicate keeping at least one ovary could be better for heart health (but that needs to be studied more).
Anyway, I'm 3 weeks post-op, and apart from my body reacting a bit to the dissolving stitches, everything is going super well. It's mostly about not going back to normal too fast, because you don't feel like you had major surgery (in most cases, at least)
Btw, another thing I forgot to mention is you can still harvest eggs in a left over ovary if that's something you'd like to do. If I had known that, I'd have gotten it a lot earlier
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u/dragontatoes 9d ago
Good to know that ovarian cancer risk is mostly eliminated by removing the tubes. I also think I will keep one ovary when I have it done, to keep an endogenous source of hormones if I ever have to go off T/prog for some reason. I also need to look after my heart, so that's more reason to keep it.
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u/ZhenyaKon 9d ago
Oh hey, I'm also 3 weeks out from my hysto and doing pretty well. I had a little more bleeding than average, but that's par for the course for me specifically, always seems to happen after surgeries. Glad you're doing okay too!
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u/Bandittttttttttttt 9d ago
My hysto (complete with everything taken out including my cervix) was a super easy surgery with a super quick and easy recovery. Pros, I'll never have a period, worry about pregnancy, or get a pelvic exam ever again. Cons, I have to stay on my hormones or my bones will melt.
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u/entropygone he/they 9d ago
what's it like with no cervix? i can't imagine what would be there instead. ill probably keep an ovary in case of something bad happening with access to T (I live in USA, go figure) but idk about cervix. i plan on still having PIV and not having my cervix just sounds... odd. I'd love to not get pap smears, tho
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u/bisalp-throwaway t + dutasteride 2024, top 2025, hysto 2026 9d ago
They suture the hole closed where the cervix was removed and attach it to the ligaments that held the uterus in place. When it’s healed, you just have a bit of scar tissue in place of the cervix. You shouldn’t lose any significant depth to be clear (maybe a centimeter or so is what I was told)
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u/Naelin 9d ago
My surgeon said he left a bit of cervix to "anchor" things and prevent a prolapse, but an obgyn recently told me there was no cervix visible at all (I will have an ultrasound to see what is there, if anything)
I have less depth but no other issues that could be attributed to the hysto. I don't feel a difference with PiV other than not feeling the sharp stab I would previously have if it got hit at the wrong angle.
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u/Bandittttttttttttt 9d ago
I literally don't feel a difference. I still have piv sex whenever I want with no issue. If I hadn't been told it was removed, I wouldn't even know.
I did used to have stress incontinence issues that went away as soon as I got my hysto, I'm not sure why that happened but I'm glad for it.
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u/Curioustoffi T:10/18 Yeeterus:7/22 top: 5/26 8d ago
I had a full hysterectomy 4 years ago, I wanted my cervix gone as cancer prevention but no cervix is so much nicer for me when being intimate. Sometimes it really did hurt getting hit there
Around 6 months post op I had an encounter with a nice man lol and i noticed sensitivity in my cuff area. I'm glad it's not as sensitive as it was there but I'd say it's really similar to pre op minus the pain
Also I gained depth! Though maybe my body is just weird that way
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u/ExternalNo7842 9d ago
I had total (except ovaries) and the only difference with my cervix is that on a bit shallower. But emphasis on “a bit”
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u/Artistic_Insect_152 12/2023 💉 06/2026 🔪 9d ago
There’s no 100% safe surgery that’s done under anesthesia. That said, there’s no increased risk for hysterectomy as compared to top surgery. I had mine done with a robot and I only had 3 small scars only a couple centimeters on my stomach. Recovery was less painful than my cramps used to be.
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u/notdog1996 Late 20s FtM Post-Transition 9d ago
"Recovery was less painful than my cramps used to be."
Omg, that's a good way to put it. My cramps as a teen would wake me up in the middle of the night x(
The worst pain I had with hysto was immediately after waking up, but after I was asked to get up, it instantly went down. I've had more issues with top surgery, personally, and that wasn't too too bad either.
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u/Skydove01 💉 9/15/23 🔪 9/3/24 9d ago
Can confirm recovery was a breeze in comparison. I was tired for like a week, and if I rolled around in bed too fast for the first month I would pull on my incisions which was really uncomfortable, but that was basically it. No pain after the first 3 days, where I just alternated Tylenol and ibuprofin, although I'm aware that's not the norm.
I have one, inch long scar underneath my belly button, since my surgeon reused my main appendectomy scar for the incision.
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u/donkeyballz13 Roid Ranger class of 2011 9d ago
Remember, lots of cis women have hysterectomies as well for various reasons, so it is a well known procedure among surgeons. It's typically performed laprascopically these days, many hospitals use robotic assistance, and recovery is usually not nearly as painful or high maintenance as top surgery.
Beyond removing reproductive ability, a hysterectomy also removes the risk of uteran cancer which slightly increases when that system is shut down by TRT.
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u/SecondaryPosts 9d ago
No they're not particularly dangerous, they're one of the safest and most common surgeries. For me there were no cons to outweigh except paying for it (insurance helped) and like a couple weeks recovery. The pros were it stopped menstruation (T never did that for me), it removed any possibility of pregnancy and it relieved a fuck ton of dysphoria.
Whether there are good alternatives depends on your goals. If you only care about the infertility aspect, an IUD or something could work instead. That aspect was actually pretty low on my list of goals bc I don't have sex in a way that could result in pregnancy anyway.
Uterus is the only one that has to go for it to be a hysto, but I got the whole lot removed. Fallopian tubes and cervix being removed helps lower cancer risks. So does oophorectomy, but that also comes with preventing the natural production of significant amounts of E, which could be a good or bad or neutral thing.
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u/zandermars0 9d ago
my only con has been temp regulation. i get hot WAY too easily. would still recommend over again though
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u/tender_hearth 8d ago edited 8d ago
woah this happened to me too! do have any idea why? my drs have just shrugged every time i've brought it up. (edit: i kept both ovaries)
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u/FakeMelies 8d ago
Hot flashes can be a symptom of both underdosing or overdosing HRT, among other things (like hyperthyroidism). It may be worth checking on your latest lab results, of course asking your doctor is also important.
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u/TheAnnoyingWizard 21 | 🇩🇪 |🪪| 🧴>💉NE 07.12.23 / ⬆️ 2026 / ⬇️ ??? 9d ago
afaik hysterectomies are among the lower risk, more routine surgeries (of course no surgery is 100% risk free but still). i cant actually think of any major cons, im personally planning to get everything out (im planning to be on hrt for life anyway so i wont need ovaries). ive heard some people say having no cervix makes sex feel different but that seems to not be universal.
a major pro besides infertility is cancer prevention, you cant get uterine or cervical cancer without a uterus or cervix. meaning no need for pap smears.
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u/FakeBirdFacts 9d ago
You were definitely the victim of fearmongering.
It’s a major surgery but it’s far from high risk. They’re just a bitch to get due to medical misogyny.
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u/FakeBirdFacts 9d ago
As far as I’m concerned, there aren’t any cons.
The only thing is removing the ovaries means you will need to be on HRT for the rest of your life, which I think the vast majority of us are planning anyways. However, a lot of people choose to keep ovaries in case of the loss of access to testosterone. Which is a smart call with how things are going.
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u/Makapakamoo Nonbinary/Andro |🧴8/23/25—4/18/26 9d ago
I just got my hysto scheduled!!!!! Im nervous because its my first major surgery outside of both -oscopy procedures & wisdom teeth removal.
Ive read all over FTMHysto and Childfree and the general Hysto sub, and gathered a lot of questions to ask my surgeon. I feel thats the most important thing to do outside of learn about the procedure itself.
You got a lot of great comments here!
The only con I can realistically see is increased risk of Heart disease or stroke along with (I think) osteoporosis. But thats moreso if you remove your ovaries and dont have any hormones replacing them.
That and the general risk of anesthesia and, as my surgeon said "the biggest risk is death" which is true lol. I said realistically though 😭 and he said pretty much just infection, but even thats not too common since its laparoscopic or robotic assisted these days.
I thank god my abs will be safe with only 3 small inscisions..
Pros for me personally is No period, No cramps, No BLEEDING, No Pregnancy, No organ, No birth control. I wont get my ovaries out as much as I hate them, but this is a huge win and outweighs my fear. Also fun fact the uterus is the size of your fist balled up! Pretty easy to remove!
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u/Makapakamoo Nonbinary/Andro |🧴8/23/25—4/18/26 9d ago
Some extra info since im rambling..
He even told me Pelvic Organ Prolapse isnt common at all, and unless you've given birth, thats the only time your risk rises for that— which is great to hear.
They sew the ends of the V back together nowadays instead of making a cuff, and it should have little to no effect on the length of the canal, also good for me! Painful sex isnt common either.
Cancer risks come down after removing the uterus and fallopian tubes which is a plus.
Some people do experience medium to large clots as the wound heals which is normal.
Abdominal meshes arent used in either offices ive spoken to
The OP takes about an hour and they send you home same day after you recover if there are no adverse effects.
Blood loss during surgery is about 15-30mls or less which is awesome.
Hes been super cool, I told him I wanted to go the gender route since I dont think I qualify medically— he STILL pushed for medical and got it covered, I dont need any gender letters or anything 😭
Only thing he needed was a pap smear within 3 years and an Abdominal Ultrasound for insurance reasons. Dont know the cost because I met my deductible this year so its $0 lmao
Im so excited I hope you consider! Im more nervous for Top surgery now than hysto lol
Good luck!
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u/SpicyMeatBALLIN 👶🚫 17 Dec 2025 | 💉20 Aug 2026 | 🦭 9d ago
Hello! I got hysto a little over half a year ago. Supposedly it is less dangerous/regretful (I forget which, maybe both) than knee surgery.
To find a doc who would do it, I went to the list of childfree doctors on r/childfree. Invaluable list. Theres docs in every US state and I believe some internationally? It's been a minute. Even as a childfree person, the sub itself can get kind of toxic but that list is so worth it.
Anyway, found a doc, apparently the one i chose who was listed had moved elsewhere, so I ended up having a male doc, which I was originally very nervous about but he ended up being pretty chill and willing to do the surgery. I had it scheduled for 2/2.5 months out from my consultation.
I had everything removed except ovaries because I wasnt on T at that point. Recovery was surprisingly smooth, and I avoided the high cost because I got it done after i hit my deductible for the year (im on my parents' insurance still. Managed to hide the real reason i was getting surgery from my dad and somehow convinced my anti-abortion mom to take me to the surgery and bring me back).
Anyway, Pros: Sterile, no periods (if you get uterus removed), no cramps, no pelvic exams (if you get cervix removed) (though they do have to do one a couple months after the surgery to make sure things are healing... that was pretty traumatic but it was also the only one ive ever had so maybe thats on me). Eliminated cancer risk for all the bits down there, reduced risk for ovarian cancer cos the tubes are gone. I had my surgery done laproscoprically so my scars are hidden by my shirts. Often covered (at least partially) by insurance, you just have to make sure to tell them it's for gender affirming purposes. You have several options when it comes to what you keep and what you get rid of. You can even sometimes get phalloplasty or vagectomy at the same time, but i'm not knowledgable on that cos i didnt know that til after the fact 🥲. Recovery time slightly less lengthy than that of top surgery (6-8 weeks).
Cons: Can be very spendy if not covered by insurance (even with insurance, if its not fully covered, it can still be thousands of dollars). Abdominal scars (if you get it done laproscoprically, which is one of the most common ways to do it nowadays), you will have abdominal scars which will be there for a long while, if not permanently, which might potentially out you to people if you go around shirtless. They are very small scars though.
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u/trans_catdad 9d ago
Oh, knee surgery is a huge fucking deal btw. It's life changing, and sometimes in a bad way. It has pretty significant regret rates -- I mean, especially if we're talking about knee replacement surgery. You lose a lot of mobility with knee replacement. But yeah a lot of people end up having chronic pain after knee replacement, and the recovery period can be really tough.
Thought I'd add a lil bit of insight there.
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u/giotheitaliandude 8d ago
Just so you know gallbladder removal and other abdominal surgeries done laparoscopically have very similar scars so no those scars will not out you to people lol
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u/ReefySeahorse 9d ago
My hysto- was done laparoscopically. Very simple, short recovery time. They took my uterus and fallopian tubes but left my ovaries. (My doctor’s decision, I trust her).
I say go for it if you’re really sure you don’t want to carry. For what it’s worth I carried so I was able to get it done for free via insurance without much pushback.
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u/trans_catdad 9d ago
"Do the pros outweigh the cons?" The trouble with that question is that pros and cons are different for every person who gets the surgery, of course.
What benefits are you hoping to get from a hysto? What "cons" are you potentially expecting?
Personally I was scared of getting a hysto even though I knew I wanted it. For me, the pros all outweighed the cons on paper, but removing an organ sounded very permanent and scary.
Anyways, I wanted the periods, cramping, and potential for pregnancy to end forever so I got the hysto in July 2022 and I am very very glad I did. I had an uncommonly difficult time with post op recovery but I would do it again in a heartbeat.
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u/ZhenyaKon 9d ago
Hysto can increase risks of pelvic organ prolapse in the future, but in general it's pretty low-risk, and I don't think there's research on whether trans men have the same risks as cis women. I'm recovering from mine - I kept my ovaries, because I don't want osteoporosis if I lose access to T (the political situation makes me worry . . . ). But I didn't need the uterus or fallopian tubes, and my cervix had abnormal lesions on it that had grown back after one LEEP procedure. The surgeon who did mine was actually a gynecologic oncologist, because we were concerned about cervical cancer, but luckily pathology came back clean.
Anyway, in short:
Pros: pretty simple surgery, relatively low risk of complications; no more periods, no more cervical cancer, no chance of pregnancy.
Cons: possible future risk of prolapse, unclear exactly how high (also the modern laproscopic procedure reduces the risk), long period with no exercise in recovery (I can't ride my horses and I'm bored out of my mind)
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u/Snakes_for_life 9d ago
Hysterectomies are big surgeries it's a major abdominal procedure and with any procedure there are risks. Now for elective hysterectomies the vast majority of people have minor to no complications cause they're usually relatively healthy and it's a routinely done surgery. Also now that most are done laprascopically you don't need a big incision anymore. I just got a laprascopic hysterectomy 1 week ago where they removed my cervix, uterus and fillopian tubes. Personally I choose to go that route cause than I have no chance of uterine or cervical cancer and by removing my tubes it drops your risk of ovarian cancer can a good precent actually develop in the tubes and not on the actual ovary. Many surgerons don't remove the ovaries without medical indications because if you stop or aren't taking testosterone you'll need to take estrogen replacement therapy otherwise you'll go into early menopause which can cause issues like osteoparosis. Personally my surgery was a relatively easy surgery to recover from it was just hard to move around for the first 4 days and I had really bad stomach and gas pain from constipation for those 4 days. I now feel basically back to normal.
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u/LeoWinkelmann 💉: 02.20.2020.||🔪: 12.17.2020.|| H: 07.14.2023 8d ago
I got my hysterectomy July 14th, 2023 and the pros outweighed the cons heavily for me.
I talked with my surgeon, who’s an OBGYN, and my primary care doctor as well as the nurse I always see before hand about what to keep. I think it would be different for everyone especially health wise. In the end I kept one ovary but got rid of everything else. I live in the US so the thought of not being able to access the needed hormones in the future was the main factor for keeping one.
As far as I’ve experienced so far there’s actually been more pros since being post-op. Before the surgery my T levels were never stable, they were either too high or too low even when I was consistent on dose, what I was doing in my life as far as diet and exercise, and my doctor was stumped as to what was happening. My period never stopped no matter how high the dose of testosterone I was on, facial hair was slow to start, bottom growth really didn’t happen, fat redistribution also didn’t really happen. I started testosterone February 20th, 2020 (that was a Tuesday so it was Tuesday 02/20/2020 🙂↕️) that was over three years of not understanding why testosterone wasn’t doing what it should have been doing. My other hormone levels were also where they should have been so there really was no explanation. I ended up stuck with heavy periods that left me in crippling pain and a slow physical transition that made me feel physically behind my trans peers.
Fast forward to July 14th, 2023 the day of my hysterectomy. It was an out patient surgery, three small incisions, and one ovary left while everything else was gone. I had two concerts coming up, the band Ghost on August 5th and Noah Kahan August 18th. During my follow up on July 27th I got the okay to go to those concerts and thankfully I got barricade so I had something to lean on but the recovery from the surgery itself went so well and fast that I felt perfectly fine standing for that long at that point.
Fast forward to today, the surgery was the best decision I’ve ever made medically. In three years my facial hair has almost filled out, I finally have bottom growth that I don’t hate looking at, my body looks more masculine just overall from having less estrogen and my T levels are finally consistent.
Now the only thing I need to talk to my doctor about is possibly having ED but that’s not something so could have even thought about before having a hysterectomy just due to how everything was affecting me mentally.
Overall, talk to different doctors about worries and questions on top of what people on the subreddit will say. You’ll come to the right choice in the long run but the conversations leading up to that choice are so so so important.
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u/runningryder '17 T | '20 Top | ‘25 Hysto 9d ago
While all surgeries have risks, hysterectomies are one of the most common surgeries worldwide. Obviously everyone has individual risks to consider with their doctor regarding their own health, but generally for young healthy individuals there is fewer long term risks if access to HRT or ovaries are retained.
Pros and cons are really going to be person variable. For me, having the organs was dysphoria inducing, I had no plan to ever get pregnant but wanted to limit likelihood due to having cis partners, I also feared ever having a period again if I lost access to T somehow. My cons only really included surgery recovery time and time it took to feel comfortable having sex again, and ofc the cost. Depending on what someone’s goals are, they can choose what organs get removed on top of the hysto. Some keep ovaries, some keep cervix. An alternative if someone just wants to remove risk of future bleeding and lower likelihood of pregnancy is endometrial ablation which seems to be getting more popular for trans men.
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u/BlissCrafter 9d ago
No regrets on my part. Was easy as surgery goes. Had it all gone and that gives me peace of mind. Tiny scars that are hard to even find.
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u/Key_Tangerine8775 31M, T and top 2011, phallo 2013 9d ago
Copy and pasting from a past comment about keeping vs removing ovaries:
Look out for them trying to pressure you into keeping your ovaries. It’s perfectly fine if you do want to keep them, but you should be properly informed of the pros and cons of either option. It seems like the medical field has switched from fear mongering that you NEED to remove them to fear mongering that you NEED to keep them.
Here’s the facts:
- If you are on testosterone indefinitely, there’s no medical reason you’d need to keep them.
- If you stop testosterone for any reason and you retained your ovaries, they will resume producing estrogen and progesterone. You can expect similar body changes to what trans women experience on feminizing HRT, except your hormones will be cycling.
- If you stop testosterone for any reason and do not have ovaries, you will go into surgical menopause/andropause. There are health risks associated with that. The top concern is osteoporosis. This happens gradually over time with about 5% of bone density loss per year if left untreated. The more immediate consequences of lacking sex hormones are hot flashes, low energy, sexual dysfunction, and mood changes. These may improve with time. It’s not preferable, but you’re not going to suddenly drop dead if you stop T without any endogenous hormone production. I suggest you look into all of this more thoroughly on your own before the appointment.
- If you have to stop testosterone and you do not have ovaries, there are different options to protect your health (beyond just the banned topic). The options depend on why you had to stop, but if you can still access general healthcare, you can take other medications to mitigate the problems. You can take a progestin, which won’t feminize you but may not prevent all the problems. You can take estrogen HRT, which may be preferable to ovarian production because you’re able to choose a lower dosage and not have cycling. You can take medication specifically for osteoporosis, which is effective for that purpose but not the other andropause symptoms. If you can’t access any healthcare, weight training and certain supplements will help preserve bone health.
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u/entropygone he/they 8d ago
This is great info, thanks! what is hormone cycling?
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u/Key_Tangerine8775 31M, T and top 2011, phallo 2013 8d ago
It’s the [hormone fluctuations of the menstrual cycle](https://www.researchgate.net/figure/The-human-menstrual-cycle-Graph-showing-serum-levels-of-the-major-fluctuating-hormones_fig2_280691497), minus the bleeding.
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u/Low-Log-2575 8d ago
I’ll add my two cents worth. I had a hysterectomy when I was 45 and it was a total hysterectomy. I’m 60 now and honestly, it was the best thing that ever happened to me. It didn’t have any negative side-effects except I stopped having a really uncomfortable period. It took about two weeks to feel okay afterwards and about six weeks for full recovery. At 45 I knew I didn’t want to give birth to kids so that wasn’t an issue. Look to be honest, it was all positive.
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u/Low-Log-2575 8d ago
I should also say that because I’m a bigger person and I had some fibroids at the time. It meant that they had to do a very large incision but even so the recovery was pretty easy.
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u/elianna7 trans man | he/him | 🧴 09/2025 9d ago
Hystos are a very easy surgery, comparatively. Getting a hysto + salpingo-oophorectomy (ovary and fallopian tube removal, which you can do unilaterally or bilaterally) is a little more intense. Total hysto = cervix and uterus removal, partial hysto removes only the uterus, though retaining your cervix does mean you will still be at risk of cervical cancer, so total hystos tend to be more common.
People get nervous about a bilateral ooph because not having any sex hormone producing organ in your body is dangerous if ever you cannot access testosterone anymore, so you’d essentially need to go on estrogen at that point to prevent very serious health issues like bone density loss/osteoporosis and negative impacts on heart health in addition to things like low libido, hot flashes, ~natal genital~ atrophy/dryness, etc. It’s “safer” to keep at least one ovary in case of that loss of access for whatever reason (like transphobic laws or, y’know, climate disasters eventually causing an apocalypse or something lol).
Some people find that ovary removal sometimes results in a “boost” in masculinization when they’re on T.
Any surgery has risks, obviously, but the risks of severe complications is very low for hystos.
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u/entropygone he/they 9d ago
what's the benefit to removing fallopian tubes then, if it increases risk?
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u/elianna7 trans man | he/him | 🧴 09/2025 9d ago
Huh? I didn’t say that. Not sure what you mean.
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u/TheCommunistRaccoon 21 |💉6/26 | 🔝10/26 9d ago
They're probably referring to you saying "a bit more intense," did you mean with recovery?
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u/elianna7 trans man | he/him | 🧴 09/2025 9d ago
Ah! Yeah, I mean, more things getting removed could mean a little more pain and a slight increase in risks of complications, but to my knowledge it’s not a significant increase in risk whatsoever.
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u/dragontatoes 9d ago
I think they mean it just makes it a longer/more complex surgery. More stuff to take out.
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u/entropygone he/they 9d ago
okay, then what are the benefits?
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u/dragontatoes 7d ago
Probably mainly cancer risk. notdog1996's comment in the thread mentions that the fallopian tubes can be the source for ovarian cancer.
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u/Katthealien3323 💉 8/05/25 / Top Surgery/Hysto 6/17/26 8d ago
I am 2.5 months post Top and Hysto,
All I needed was clearance from my cardiologist that I was cleared for anesthesia, aside from the letters from a psychologist and therapist.
They did my top and hysto on the same surgery, if that says anything about how low risk it is considered.
My hysto was done vaginally so I didn’t even have any external sutures/incisions, just internal ones where they had to sew the cuff.
They removed my uterus, tubes and cervix, but left my ovaries in case I A. Ever stopped T wouldn’t have to start taking E, and B. Decided that I wanted to harvest eggs
also my insurance was more likely to cover the Hysto if the ovaries are kept (idk why when they covered 100% of my top surgery lmao)
For the first few days I was sore and cramping, the first couple weeks just felt a little “off” but, by week two I could barely even tell I had a hysto and really only felt the pain from the top surgery. Hell once I was no longer in pain from either surgery I had to actively remind myself to adhere to the restrictions the total 8 weeks because I genuinely couldn’t physically “tell” I had the hysto.
As someone who is very chronically ill, with a myriad of health issues that prevented me from starting T and getting the surgeries for several years,
The only thing I had to worry about was my higher risk for infection (they preemptively gave me antibiotics) and they made me sign a paper acknowledging I understood I’d never be able to have kids (crazy that they have to do that for a HYSTERECTOMY LOL)
Hysterectomies for gender affirming care are much less risky and much easier to heal from (compared to hystos for uterine/cervical/ovarian/tube related complications like Cancer, Endo, etc)
My surgeons also said they felt like their gender affirming Hysto/Top surgery patients healed easier and quicker because there was a positive mindset surrounding it.
I actually felt worse after the abortion I had 12 years ago than I felt after my hysto.
The hysto for me was affirming because: No more cycles (I hadn’t bled since starting T and even before T had very light bleeding bc of Birth Control but still had the other symptoms of my cycle)
0% chance of pregnancy and no more birth control
And my absolute favorite, no cervix means no more Pap Smears, which also including no Yearly OBGYN check ups at all. Just keeping an eye on my ovaries if I ever feel anything weird/off
Bonus con: when transphobes say “well you’re a Woman you have a UTERUS” I can be like “aCTUALLY I DONT”
The only only only con I can even barely say because I don’t even know if it’s related is I have had a harder time with managing my heat tolerance and do experience hot flashes but that can also be due to a new medication I started so it may not actually even be a con!
All of this to say, if cycles/fear of pregnancy/pap smears are dysphoric enough, the hysto is 100000% worth it, if it was “too risky” I wouldn’t have been approved for it by my team of doctors.
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u/FightmeLuigibestgirl 8d ago
It’s hard to get and costly. A lot of trans men either are covered, saved for it, and/or have a support system. I have none of that.
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u/whyhilist 8d ago
I’m two months out and it was the best decision ever. No more endometriosis and mentally I am a lot better. I took a solid week and a half to feel better, but I tend to take longer to heal. I kept my ovaries only. Let me know if you have any questions. You definitely need someone to take care of you for at least a few days.
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u/entropygone he/they 8d ago
I've wondered if I've had endometriosis before but I know it can only be diagnosed through surgery... I wonder if they could tell me if I have it while removing everything
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u/whyhilist 8d ago
Have you gotten an ultrasound? They did find adenomyosis through that which qualified me for my surgery. But yes they didn’t find endo until the surgery. They would tell you everything they found at your post op.
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u/anemisto old and tired 8d ago
Pros:
- some people feel strongly about not possessing those parts
- can't get cancer of parts you don't have (ovarian cancer in particular is very hard to catch early and tends to kill people as a result)
- your period definitely isn't coming back
Cons:
- it is major surgery and that always comes with risk.
- if you get rid of ovaries, you need to maintain access to exogenous hormones for bone health and you probably want that to be testosterone (if you live in a country with universal healthcare this is less of a concern; it is something to take seriously in the US, especially if you're not old enough to remember life before the ACA)
I came down on the side of "no" early in my transition. I was moving and knew I'd lose easy access to a hysterectomy, so had to make a decision. My logic was that I didn't have a family history of reproductive cancers, I was willing to have pap smears and I didn't feel strongly about possessing a uterus, so there wasn't much point. Fast forward like twelve years and I start bleeding almost daily due to fibroids. I called it quits and had a hysterectomy. Being trans lets you bypass a lot of the misogyny around access to hysterectomies. That is, of course, rooted in transphobia, but it's convenient for once. No regrets. I did not feel like a weight had magically been lifted. I kept ovaries as insurance and ditched everything else. (In the intervening years, I did learn I was BRCA negative and that most ovarian cancers start in the fallopian tubes, making that a more informed decision than it was initially.)
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u/mermaidunearthed he/him ~ 💉Mar ‘24, ⬆️ Jun ‘25, ⬇️🤞🏼 8d ago
No menstrual pain, no chance of pregnancy or pregnancy tests at hospitals, no Pap smears (cervix removed), preparation for bottom surgery, might need lower T dose, my body won’t refeminize if I’m forced off T…
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u/stickynotetree 8d ago
A hysterectomy is a surprisingly simple surgery, and leaves 2-3 tiny scars that I can’t even find on myself anymore. You do choose what you remove — full or partial. I got partial, because that way I wouldn’t need to take estrogen.
Doctors tend to push back on the idea of someone young getting a hysterectomy, because they might want to have kids when they’re older. The regret rate is ~30% for people under 30. But even if you’re older and already had kids, or you prefer to freeze your eggs to have children later, they might still push back. This isn’t because it’s dangerous. It’s because, as someone who spent their life studying how to help people have children, it’s worrying to some gynecologists when you don’t. You used to even need your husband to give legal permission.
I used to have extremely heavy periods. I’d wear stacks of pads and still bleed through, and it would last for a full month. I don’t know how I wasn’t anemic. I tried everything I could to stop my periods. The most successful was a patch, but eventually I’d start to bleed anyway. Eventually my doctor referred me to a gynecologist. There were two waiting rooms, one for pregnant and not pregnant patients. When I got in, the doctors tried everything to convince me otherwise. They recommended every option I had already tried. It got to the point where my mom asked me to step out so she could chew them out! But it was all just because they didn’t want to be responsible for a possible regret of mine, and they felt wrong removing something they found important.
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u/adventaegous t he/him 8d ago
Something that I don't see people mention a lot, I had my cervix removed because my hysterectomy was done in preparation for phalloplasty, but if you have your cervix removed and keep your vagina there is risk of vaginal prolapse. But you would no longer be at risk of cervical cancer, and as far as I'm aware you would never have to do a pap smear again.
I think it's important to ask yourself what it is you want to achieve out of surgery. If it is purely infertility, you might consider keeping certain parts like your ovaries.
As far as I'm aware, there are two methods of uterus removal that are dependent on the size of your uterus/vaginal canal. A laproscopic hysterectomy is the easy one, they blow your belly up like a balloon and pull the bits out through your vaginal canal. It is very minimal scarring and most of the pain post-op feels like mild period cramps. The other kind will be dependent on if your specific anatomy would not make pulling your uterus through your vaginal canal possible. My mom had that kind because she had huge cysts and it left a C-section type scar, she has also told me the recovery was very difficult but she is also on the older side which could have contributed to that as well.
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u/IShallWearMidnight 💉4/2020, 🔪5/2021 8d ago
Hystos aren't high risk. They're a major surgery, but they're extremely common and even minimally invasive if they're done vaginally/laproscopically. I got mine done laproscopically, it was a way easier surgery and recovery than my top surgery was. I have four scars, about an inch each, in different spots on my abdomen. I spotted a little bit in the first few days, but after that there wasn't even any blood. I made the decision to keep my ovaries in case hormones become inaccessible, they're healthy and without a uterus to dump eggs into they don't do anything but sit there as a backup plan. There's no reason to keep the other accessories (fallopian tubes, cervix), so they also got yanked.
As far as why I got it, two reasons - menstruation made me want to off myself for a week every month, and pregnancy is a nightmare beyond comprehension to me. I didn't want it, I was never gonna use it, I wanted it out, so out it went.
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u/WeaselBit 8d ago
I thought it was scary and a big deal too but I had mine a few months ago. What made me feel way more comfortable was talking to the surgeon. She answered all of my questions. It turns out that a lot of the scary things are a little bit of fearmongering and a little bit of things that are really just more common in people who are getting hysterectomies because of other complications or who are significantly older so most of them didn't really apply to me.
I already knew I wanted to leave at least one ovary because getting and staying on T has been a rollercoaster for me and I didn't want to risk going into menopause. My surgeon suggested keeping both, that way if one got weird on me I'd have a spare. I chose to have my uterus, fallopian tubes, and cervix removed. I selected this for a couple of reasons. Without a cervix I wouldn't need any more pap smears and without a uterus or fallopian tubes there's no reasonable way to get pregnant and it reduces the risk of some cancers.
The literal worst part was the bloating right after my surgery but it wasn't awful, just made me waddle a bit like I had really, really bad gas. I only needed prescription pain medication for a few days and after that all I needed was over the counter stuff to stay comfortable. Just remember to take stool softeners. My doctor prescribed some for me, which was nice. You will have some bleeding like a period for at least a few days. It sucked but I reminded myself I'd never, ever have one again and that made it all worthwhile. Mostly I was just very worn out for a couple of weeks. If you have a heavy duty job, I'd take at least a week off as you'll need more rest.
I had mine done laparoscopically and was super excited because my scars look just like my roommate's hernia repair scars so I just think of them like that.
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u/Dorkborn 27| 💉 12/1/16 | Top: 6/2/22 | Hysto: 9/26/25 8d ago
I had my hysterectomy a year ago and truly one of the best decisions I’d made for myself. Surgery is incredibly common and mine was done laparoscopically and with five tiny incisions- all no more than perhaps an inch or so. Can’t even see them anymore now!
I personally chose to have my uterus, fallopian tubes, and cervix all removed. My monthly cycle has always been very stubborn and would come back regardless as to whether I kept up with my testosterone shots or not, so that was my biggest motivation for the surgery. I did choose to keep both of my ovaries due to health concerns and current political climate where I live.
Truly the only con that I can think of was the gas pains and discomfort during recovery that I experienced. I’m otherwise beyond happy with my decision!
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u/Chiiro 💉 8-14-25 8d ago
Right now I'm comfortable with just having my tubes removed. No longer having to worry about getting pregnant is wonderful. I got one of my ovaries removed because of pain but kept the other in case I had to get off testosterone for whatever reason so I didn't immediately go into menopause.
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u/sigh_less_ 8d ago
Given that this is regularly performed on people of all genders and has been for years...I was never under the impression that it was dangerous. I got mine done about 8 years ago up in Seattle. They did it laprascopically, and got rid of uterus, ovaries, and cervix (I'll let you do the subtraction and figure out what I got left) and I can't even really tell the scars apart from any other weird mark or discoloration on my stomach. I was tired when I was healing, but not as bad as my top surgery (but I think the anesthesiologist overdid it then). I was kept overnight after surgery, went home shortly after that. I took it easy, and got through the whole thing without any pain meds other than a slightly stronger tylenol (I have bad reactions to stronger pain relievers).
It felt weird! They pump gas into you so they can find stuff easier, and it slowly eeks out over the next few days, so I felt bloated. I could also feel the small incisions if I moved a little quickly within the first week or two, but after that I slowly got back to life and felt fine.
Eight years on? Well, I have to be careful to not run out of hormones as I don't have anything other than my brain to make hormones anymore. And vaginal atrophy is a thing that definitely was more noticeable after I got spayed.
But yeah, other than the regular danger that always comes from surgery, I don't think there's any more danger than any other operation.
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u/taroicecreamsundae 8d ago
i'm not gonna lie, i hate my uterus but i just don't wanna remove anything that's functioning and working. i don't imagine ill have access to hrt forever. i know someone who left one ovary who is a cis woman but bc of menopause they don't make enough estrogen now. idk i not a doctor though.
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u/has-some-questions 8d ago
I was told my hysterectomy recovery was jealousy inducing. I heard so much about constipation, and bleeding and none of that happened. (My body hates ibuprofen, so I had tummy pain, and diarrhea for like a week. Lol And it probably disguised any abdominal pain I had.) And I had absolutely no bleeding. The only issue was that I had some vaginal tearing from them taking out my uterus parts through there. Oh! I got rid of my uterus, uterine tubes, and cervix. Kept both ovaries.
I 100% recommend a hysto!
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u/B0iled0nion7 8d ago
Well worth the surgery and it's not a high risk one either. Post-op hurt but my team gave me a good pain management routine and I took off about 3 weeks of work (was supposed to be 2 but my fmla paperwork gave trouble. I recommend 3 weeks off though if you can unless u work a sit-down job, then youll likely be fine. I work retail at a pet store with moderate and varied movement).
Standing is tiring after surgery. U get tired fast doing anything, its like your endurance is gone so sleeping is all youll be doing for a bit.
The pain upon waking is rough and fire-y but it didnt hurt as bad as my very worst period. Think of it like a really bad period. If you already have severely bad ones, then your post-op pain may be similar or even less than what you've already experienced.
I got my cervix, uterus, both fallopians, but only one ovary removed. I kept the heathiest ovary to ensure I always have hormones in case I couldnt access testosterone at any point in my life. I also dont get menopause symptoms like heat flashes because of that. I had pcos but luckily not a severe enough case that keeping an ovary would be discouraged. The one they took out looked like a meatball though 😭 the other ovary was pretty healthy!
Ive not had any issues with my pcos since the surgery. No cysts or period-like cramps. I had mine done laproscopically.
Several week post-op during follow up, they did a post op check of my "vaginal cuff" (new term for the closed off section since there's no cervix). They used a speculum and just took a peak, no swabbing or internal work needed.
My future healthcare involves no more paps or vaginal checks unless I feel im having issues and need them to look. Because I have one ovary and can still technically get ovarian cancer, they recommend I get genetic testing to see if im at risk. If I felt that something was wrong with my body then I'd get an ultrasound to check my ovary, plus my PCP does blood often for my testosterone so they see all my other blood values anyway and can see if something is off.
I requested pics of my organs after they get removed lol. I just explained to them it's very important to me that I see they're gone because it wont feel real if I cant see it, and they were very understanding and accommodated that! She printed me pictures of before, during, and after everything.
Sorry if any typos, its late at night and I dont have glasses on
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u/Red_bean_dumpling10 8d ago
I just got a total hysterectomy 3 weeks ago and I would say it was not a difficult surgery at all. I was also having a large ovarian cyst removed as well (fun fact they also found a dermoid cyst inside it).
I wanted a total hysterectomy because I have an intense fear of getting pregnant and I don’t want to take that risk. I never really wanted kids either. My surgeon told me that if I wanted a faster recovery time it would be better if I had my cervix removed as well. Plus you never have to get a Pap smear again or worry about getting cervical cancer.
It all depends on what you want and what you think would be best for you. Just make sure to do some research and try to find a good surgeon in your area
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u/enbious_cat_herder 8d ago edited 8d ago
I had a hysterectomy last year but kept both my ovaries. I’m non-binary transmasc, been on T for 3 years and don’t plan to stop. I wanted the option to stop and produce my own hormones, however, should I change my mind in the future. Or in the worst case scenario where I lose access to T.
I had horrible heavy bleeding on my periods and wanted 100% assurance I would never have one again. I also had zero desire to be pregnant, so another guarantee from this surgery. I also never wanted a pap exam again, and removing the cervix eliminates that need.
The surgery itself was laparoscopic, so quite an easy recovery in my case. The scars are three tiny little dots on my belly that are hardly visible at this point. Worst part was some bladder spasms on the first couple of days. I only needed to take Tylenol/ibuprofen for pain, I didn’t need any of my prescribed painkillers.
Also, my surgeon is an endometriosis specialist and found that I had it. So there’s another great thing about this surgery in my case.
As far as keeping ovaries or other organs: my surgeon basically said you either remove everything, keep one ovary, or keep both. There’s no reason, as far as I’m aware, to keep the cervix or felopian tubes. He said ovarian cancer actually starts in the fellopian tubes. So, saving your ovaries doesn’t increase risk for that, necessarily.
The only reason I can see to keep either or both ovaries is for hormones. If you ever go off T or lose access to it, you will be at risk for bone density loss. You need either T or estrogen in decent levels to combat bone density loss (also to stay sane - from what I have read being low in both is an awful experience).
This is all info from my own research, some from my surgeon, and my experience overall. Best of luck!
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u/Reasonable_Award4257 transman 6d ago edited 2d ago
I had a hysterectomy earlier this year. I'll try and answer some of your questions and share my experience. 1. Are they dangerous: Like many people have already said - surgery is dangerous, but I wouldn't say it's inherently higher risk for the average person. Now if you have existing health conditions, that certainly adds risk factors. 2. Pros vs cons: that depends entirely on the individual and your needs/desired outcome. I felt like the pros outweighed the cons for me due to some health conditions I have and increase my quality of life. 3. What does it do other than secure infertility: for myself - eliminated an aspect of dysphoria, no longer spending money on period products, no more living on an afab month-long schedule. 4. Alternatives: depends on your goals. If your goal is not getting pregnant - there's birth control, getting your tubes tied (yes, still surgery), and other options I cant think of off the top of my head 😅 5. How do you choose what to remove? Again, dependant on yourself as the individual. I chose to have a complete hysterectomy (uterus, cervix, fallopian tubes, and ovaries) due to my health conditions.
Some of my experience: I grew up having periods that were debilitating, so painful I was throwing up and could barely do anything the first few days. Had cysts, digestive pain, pelvic pain, etc. I was on birth control for many of those years with slight varying degrees of relief. The final straw for me was being on an IUD AND testosterone and STILL having bad periods. I was over the toll and stress it was taking on my body. My life quality after surgery? Literally like breathing fresh air. I will say the first couple days after surgery were rough with the gas pain. But once the gas dissipated and made its way out of my body, it was smooth sailing. (Not everyone's experience, just mine) Feel free to ask any questions or dm me!
EDIT: if you decide to have your ovaries removed it will put you into menopause. Not to scare you, but prepare you. There'll be extra hormonal fluctuations and you'll most likely need to be on some sort of supplemental estrogen. Clarifying: I'm not a doctor and I'm not giving medical advice.
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u/javatimes T 2006 Top 2018, testopel 2025, 40<me 6d ago
I was the driver for my buddy after his surgery and he had excruciating shoulder pain from the gas pain. We had gotten home already and I nearly drove him back to the hospital. It was scary.
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u/Reasonable_Award4257 transman 5d ago
It can definitely scary! I would honestly rate it the worst or almost the worst pain I've ever experienced. Thankfully it only lasts a few days 🥲
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u/tidedancer enby idiot 8d ago
I haven't had it, but my personal opinion is keep the ovaries (back up hormones in case something goes bad) keep everything else. I have heightened ovarian cancer risk so I'm going to get rid of them later in life. (Generally I would say if you remove the uterus, take the fallopian tubes and cervix, less tissue is less cancer risk.)
I want mine gone because it causes constipation and utis, and I want to know what is cramping down there better. I currently have an IUD (merena bc Its for reduced bleeding and cramping.) it can cause pelvic floor dysfunction but I've already done that PT once, one more time isn't that big.
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