Histologic Findings in Gynecologic Tissue From Transmasculine Individuals Undergoing Gender-Affirming Surgery

Area of Science:

• Reproductive Endocrinology
• Surgical Pathology
• Transgender Health

Background:

• Gender-affirming surgery is integral to gender transition for transmasculine individuals.
• Histologic examination of surgical specimens can provide crucial insights into the effects of hormonal therapy.

Purpose of the Study:

• To evaluate and catalogue histologic findings from gynecologic surgery and cervical cytology in transmasculine individuals.
• To understand the influence of hormonal therapy on specific organs.

Main Methods:

• Retrospective study of 55 transmasculine patients undergoing gender-affirming gynecologic surgery (January 2015 - June 2020).
• Review of surgical pathology and cervical cytology slides by two pathologists.
• Analysis of tissue from uteri, ovaries, vaginectomy specimens, and cervical cytology.

Main Results:

• Most patients (94%) received testosterone for over a year.
• Endometria were predominantly inactive (75%).
• Common findings included transitional cell metaplasia in the cervix and vagina, prostatic-type glands in cervices (20%) and vaginectomy specimens (67%), ovarian follicular maturation (57%), and mesonephric remnant hypertrophy.

Conclusions:

• Comprehensive histologic evaluation aids understanding of androgen therapy's effects in transmasculine individuals.
• Awareness of normal histologic variations is crucial for optimal patient care.
• Findings contribute to the multidisciplinary approach in transgender healthcare.