Hysterectomy Queries of Professor L. Gooren
Professor L. Gooren and Stephen
Whittle
[Abstract] Full Text [PDF]
1. Is a hysterectomy recommended for all
female-to-male transsexual people?
I assume that also removal of the ovaries is
included in the term hysterectomy. Yes, I do recommend though the evidence
for a yes is not super strong, but I would recommend it. Upon androgen
administration ovaries become poly-cystic and simliar to those of women who
suffer from a disease called poly-cystic ovarian syndrome. The latter is
known to have a bigger change to become cancerous. Until recently this was
rather theoretical but we have seen one case of ovarian cancer in an f-to-m
after 8 years of androgen treatment and one case after 8 months of androgen
treatment. In scientific terms, these findings do not constitute a
scientific proof but they have made us cautious and have bolstered our
already existing policy to recommend hysterectomy + ovariectomy after 18-24
months of androgen treatment.
2. How soon after commencing hormone
treatment should an FTM undergo hysterectomy?
This is difficult to say, but arbitarily I
would say within 4 years.
3. Should all FTMs plan to undergo a
hysterectomy at some point in their life?
Not necessarily, but within a certain span of
time.
4. Are there specific problems an FTM might
experience eg. breakthrough bleeding, which might indicate an early
hysterectomy?
No, this bleeding nearly always can be managed
with progestational drugs.
5. What would be the reasons for an FTM not
to undergo a hysterectomy?
A high risk for undergoing surgery, which is
rare.
6. Is there any particular method that a
surgeon should use, and if yes, why?
In Holland we have a gynaecologist who is able
to do a vaginal hysterectomy which leaves no scar. It is a bit difficult
intervention in a person whose vaginal canal has not been widened by child
birth so the average gynaecologist is hesitant to do it. It would be good to
find a gynaecologist who is prepared to do this. It is technically more
difficult. An alternative is so-called laparoscopic removal of uterus and
ovaries which leaves a minimal scar if any. Laproscopy is insertion of a
tube into the abdominal cavity and operate through that peeping hole and
remove tissue through it.
Citation:
in Boys' Own, No 30, December 1999
