A Guide to Hysterectomies

Deciding to get a hysterectomy is a deeply personal choice and can be a powerful part of a medical transition for many transmasculine folks. Whether it’s for gender affirmation, health concerns, or both, having accurate and affirming information makes the process a lot less intimidating. In this post, I’ll walk you through the different types of hysterectomies, how to navigate insurance, what to expect for prep and recovery, and share tips that can help along the way.

Types of Hysterectomy Surgeries

There are a few different types of hysterectomies, and it’s helpful to understand the distinctions so you can make an informed choice with your provider.

• Total Hysterectomy
  This is the most common option and involves the removal of the uterus and cervix. Many surgeons will recommend this for transmasc patients to reduce the need for future gynecological exams.

• Supracervical (Partial) Hysterectomy
  Only the uterus is removed, and the cervix is left in place. Some folks prefer this to reduce surgical time or potential side effects, but it's less common for gender-affirming surgery.

• Hysterectomy with Salpingo-Oophorectomy
  This involves removing the uterus, cervix, ovaries, and fallopian tubes. For some, especially those on testosterone long-term or seeking to reduce estrogen production, this is preferred.

Surgical approaches may include:

• Laparoscopic (minimally invasive)

• Vaginal

• Abdominal (open surgery)

Each comes with different recovery times and risks—laparoscopic is often preferred for quicker healing.

Navigating Insurance & Legal Barriers

Navigating insurance for a hysterectomy can be tricky, especially in the current political climate, but it’s definitely doable with the right preparation.

Insurance Tips:

Insurance laws change frequently, so it's always a good idea to:

• Call your insurance company directly

• Ask for their Summary of Benefits and Coverage (SBC)

• Check your plan for coverage of “gender-affirming care.” Some plans explicitly cover hysterectomies for transgender individuals.

• Ask your provider to code the procedure as medically necessary. This may include reasons like gender dysphoria, pelvic pain, or endometriosis.

• Use correct language/documentation. Some folks have success when letters of support from doctors or therapists use DSM-5 language (i.e. gender dysphoria).

• Request clarification in writing when possible
  

If you're uninsured or underinsured, some folks find success through:

• Local LGBTQ+ health centers

• Trans health funds or grants (e.g., Point of Pride, Genderbands)

• Planned Parenthood (in some states)

Insurance Coverage Resources for Gender-Affirming Care

Movement Advancement Project (MAP) – LGBTQ Equality Maps
MAP offers interactive maps showing which states explicitly require private insurance or Medicaid to cover gender-affirming care. It’s updated regularly and easy to read.

National Center for Transgender Equality (NCTE)
NCTE has comprehensive resources on trans healthcare rights, including info on insurance appeals, Medicaid/Medicare, and legal protections per state.

Out2Enroll
Out2Enroll helps LGBTQ+ folks navigate the health insurance marketplace, including guides to finding trans-friendly plans and understanding coverage.

GLMA – Health Professionals Advancing LGBTQ+ Equality
While more geared toward professionals, GLMA’s site includes provider directories and policy tools that can be helpful when navigating coverage and care access.

Preparing for Surgery

Here are a few steps to help you get ready, both physically and mentally:

Pre-Op Appointments

You’ll likely meet with your surgeon and possibly an anesthesiologist. This is the time to ask about the surgical approach, risks, and recovery timeline.

Lab Work & Clearances

You might need blood work, a pelvic exam, or a letter of readiness from a mental health provider (depending on location or insurance requirements).

Logistics & Packing

• Arrange a ride home and help for the first 24–72 hours.

• Prep your space with comfy clothes, heating pads, electrolyte drinks, and easy meals.

• Pack light: slip-on shoes, loose clothing, lip balm, and your ID/insurance card.
  

What Recovery Looks Like

Most people need at least 2–6 weeks to recover, depending on the type of surgery.

Common Post-Op Effects:

• Fatigue and soreness in the lower abdomen

• Difficulty with heavy lifting or standing for long periods

• Changes in mood or hormonal adjustment (especially if ovaries are removed)

• Constipation (stock up on stool softeners!)

Tips for a Smoother Recovery:

• Walk around gently to prevent blood clots

• Take pain medication as directed—don’t be a hero

• Listen to your body and rest as needed

• Stay hydrated and eat small, nourishing meals

For those who had their ovaries removed, talk to your doctor about potential long-term hormone changes. You may need to adjust your testosterone dosage accordingly.

A Few Last Words

Getting a hysterectomy is a major step—emotionally, physically, and logistically. But it can also be an incredibly affirming and freeing experience. Whether you're pursuing it as part of your medical transition or for other health reasons, your experience is valid. Take your time, ask questions, and advocate for yourself every step of the way.

You deserve care that honors your body and your journey.