The uterus in transgender men

Area of Science:

• Medical Science
• Gender Affirming Care
• Reproductive Health

Background:

• Transgender men may experience gender dysphoria related to reproductive organs.
• Gender-affirming hormone therapy and surgery are common in gender transition.
• The decision to retain or remove the uterus and ovaries is a significant consideration.

Purpose of the Study:

• To explore the implications of retaining or removing the uterus and ovaries for transgender men undergoing gender-affirming care.
• To discuss the benefits and drawbacks of hysterectomy and oophorectomy in this population.
• To emphasize the importance of fertility preservation counseling.

Main Methods:

• Review of current medical literature and clinical practices.
• Analysis of the psychological and physiological impacts of uterus/ovary retention versus removal.
• Consideration of fertility preservation options and outcomes.

Main Results:

• Retaining the uterus preserves fertility but can cause psychological distress and has uncertain long-term effects with androgens.
• Uterus and ovary removal (hysterectomy and oophorectomy) can be performed with minimally invasive techniques, but results in definitive infertility.
• Data indicate a low incidence of pregnancy or oocyte use by transgender men post-treatment.

Conclusions:

• Clinicians must counsel transgender men on the permanent infertility associated with hysterectomy and oophorectomy.
• Discussing all fertility preservation options before gender-affirming surgery is essential.
• An individualized approach to uterus and ovary management is paramount, respecting patient autonomy.