I learned something at the Philadelphia Trans Health Conference that made me sit up and take notice. Well, it’s not that I didn’t sit up and take notice of anything else, but this particular tidbit is worth repeating.
I don’t remember who it was – one of the surgeons I listened to, or maybe one of the docs in the medical track of workshops that ran during the conference (I apologize to the person I’ve forgotten who talked about this because I cannot give them credit) – but they mentioned that they knew of trans men who’d had a hysterectomy but discovered when they went for another procedure, sometimes even years later, that they still had female reproductive organs that they had been unaware of.
Although I don’t know that this situation occurs often, I can see how it could come about relatively easily, so I thought I would provide some information on this subject in case some readers are unaware of how this scenario can arise.
In order to discuss this topic, we first need to review the female/trans male reproductive organs.
On the left, we can see a diagram of the major reproductive structures: the uterus, ovaries, fallopian tubes (also known as oviducts), the cervix and vagina.
Okay, now let’s talk about these organs in relationship to the surgery.
The word “hysterectomy” comes from the Greek “hystera” which means “womb” (i.e. the uterus) and “ectomia” which translates as “excision.” And so, a hysterectomy is the excision of the uterus. A hysterectomy can be complete, where the uterus and the cervix are both removed, or it can be partial, where only the fundus (the end) and the body of the uterus are removed and the cervix is left intact.
However, you’ll notice that nowhere in this definition is there mention of removal of the ovaries or oviducts.
With that in mind, it’s probably not difficult to understand, especially in situations where the surgery is being performed for reproductive medical reasons, how a trans guy could go in for a “hysto” thinking that all of his reproductive organs are going to be removed and end up still possessing ovaries and oviducts because the surgeon (only) performed a hysterectomy.
The key to avoiding this potential situation, then, is two-fold: First, have a discussion with the surgeon and ask him/her exactly what is (and is not) going to be removed. Second, in addition to a hysterectomy, ensure (if this is what a person wants) that a bilateral salpingectomy will be performed, which is removal of both fallopian tubes (oviducts), along with a bilateral oophorectomy, the removal of both ovaries. When these two surgeries are combined, it’s called a bilateral salpingo-oophorectomy.
In this way, a person can ensure that a hysterectomy isn’t only a hysterectomy.