Perioperative Considerations for Gender-Affirming Hysterectomy

Hysterectomy is medically necessary for transgender and gender diverse patients experiencing dysphoria. During the surgical evaluation, patients should be asked about their desires for childbearing and counseled about gamete preservation. There should also be coordination with a multidisciplinary team of surgeons if patients desire other gender-affirming procedures at the time of hysterectomy. Many perioperative considerations should be given, including the continuation of testosterone perioperatively. Surgery should be performed minimally invasively if possible. Complications specific to gender-affirming hysterectomy are rare, and patients should be well counseled on expected postoperative pain and bleeding.