Gender-affirming hysterectomy
Removal of the uterus, with or without ovaries, planned as gender-affirming care and, when needed, as a step toward genital reconstruction.
A pelvic operation with a transition calendar around it
Hysterectomy for transmasculine and non-binary patients is gender-affirming surgery, not a silent gynecologic extra. It can stand alone. It is also, for many people, a required or preferred step before metoidioplasty or phalloplasty, especially when vaginectomy and urethral work are planned.
Oophorectomy (removing ovaries) is a separate decision: hormones, bone health, and fertility. We do not bundle ovaries out of habit. If you may want genetic children, egg or embryo banking happens before, with time on the calendar, not a pamphlet the night before.
The Chrisalys team coordinates this with your genital plan so you are not recovering from a hysterectomy in the same month as a flap. Insurance in California commonly covers gender-affirming hysterectomy. Letters and pre-authorization still apply. Fertility wishes should be spoken in the first visit.
Decisions inside the operation
Hysterectomy
Typically laparoscopic or robotic-assisted when anatomy allows, with a recovery measured in weeks, not days.
Oophorectomy, or not
Removing ovaries ends ovarian hormone production. Keeping them is a valid choice. We will not treat it as a default.
Vaginectomy timing
Sometimes later, with urethral reconstruction. Sometimes discussed now so the pelvic plan is one story.
Coordination with bottom surgery
Enough healing before meta or phallo. Stacking everything because travel is expensive is how complications happen.
What to expect.
Consult including fertility
What you want removed, what you want to keep, and whether you need time for banking.
Clearance and authorization
Medical clearance, letters, and insurance. See /insurance/wpath-letters if you are gathering documentation.
Surgery and pelvic rest
Activity limits are specific. We write them down. Travelers should not fly the next morning.
Frequently asked questions
Do I have to have a hysterectomy before metoidioplasty?
Not always for simple release. When urethral lengthening and vaginectomy are planned, hysterectomy is often part of the sequence. Your operative plan will say so in writing.
Will I need to change testosterone after oophorectomy?
Possibly. Ovarian hormones stop. Your prescriber adjusts. We coordinate; we do not take over endocrine care from the recovery bay.
Is gender-affirming hysterectomy covered in California?
Medi-Cal and many managed-care and private plans cover it when medically necessary. Pre-authorization is common. Start at /insurance/pre-authorization.
Plan a gender-affirming hysterectomy
Fertility and later genital surgery belong in this conversation.