The uterus in transgender men.
Transgender men experience a disharmony between their birth sex and their intimate sense of gender belonging. Gender-affirming hormone therapy and gender-affirming surgery (GAS) are often inherently part of the gender-affirming process. In this context, we should ask whether it is better to keep or remove the uterus. Keeping the uterus and ovaries avoids a surgical procedure and a pubic scar. Furthermore, it preserves fertility and the possibility of carrying a baby. On the other hand, keeping the uterus is often psychologically unbearable for transgender men and the long-term effects of androgens on the uterus and ovaries remain uncertain. Conversely, hysterectomy and oophorectomy are part of the GAS process. New mini-invasive surgery procedures for hysterectomies decrease the risks and limit the likelihood of scars to a minimum. In practice, the data suggest that very few transgender men carry a pregnancy and/or use their oocytes after gender-reaffirming treatment. Clinicians should counsel their transgender men patients about the definitive infertility consequences of hysterectomy and oophorectomy and discuss all fertility preservation options before undertaking GAS. Individualized approaches must be preferred to systematic procedures regarding the personal decision to keep or not keep the uterus and ovaries.
['Carbonnel|Marie|M|', 'Karpel|Lea|L|', 'Cordier|Bernard|B|', 'Pirtea|Paul|P|', 'Ayoubi|Jean Marc|JM|']
D000728:Androgens D003376:Counseling D005260:Female D005298:Fertility D059247:Fertility Preservation D000068116:Gender Dysphoria D005783:Gender Identity D062985:Health Services for Transgender Persons D006801:Humans D007044:Hysterectomy D008297:Male D010052:Ovariectomy D018456:Reproductive Medicine D057829:Sex Reassignment Procedures D013739:Testosterone D063106:Transgender Persons D014189:Transsexualism D016896:Treatment Outcome
transgender Hysterectomy fertility preservation female-to-male male