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. 2025 Apr 11;10(2):160-169.
doi: 10.1089/trgh.2022.0090. eCollection 2025 Apr.

Gender-Affirming Hysterectomy and Oophorectomy Counseling Practices for Transmasculine Adolescents

Frances W Grimstad  1   2 , Steven J Staffa  3 , Til Kus  4   5 , Elizabeth R Boskey  6   7
Affiliations

Gender-Affirming Hysterectomy and Oophorectomy Counseling Practices for Transmasculine Adolescents

Frances W Grimstad et al. Transgend Health. .

Abstract

Purpose: No research exists on oophorectomy counseling during hysterectomy counseling in transgender men and nonbinary (transmasculine [TM]) adolescents assigned female at birth. The purpose of this study was to understand variations in gender-affirming hysterectomy (GAHyst) and oophorectomy counseling among clinicians caring for TM adolescents.

Methods: This is a cross-sectional, online survey of clinicians who counsel TM adolescents (≤18) on GAHyst.

Results: Of 78 eligible respondents, 76% (59) prescribed gender-affirming hormone therapy (GAHT) and 12% (9) performed GAHyst. Only 71% (n=55) always separately addressed uterine and ovarian removal during GAHyst counseling. Forty-one percent (n = 32) stated they encouraged removal of the ovaries at least some of the time in patients on GAHT who were undergoing a GAHyst. Half (50%, n=39) counseled on the option to only remove one ovary at least some of the time. Those who performed GAHyst were more likely to counsel on the option of removing one ovary versus both (89% vs. 47.0%). Roughly half (42.3%, 33) stated that they provide different GAHyst counseling at least some of the time for patients on testosterone GAHT, compared with those who are not. Although no respondents routinely recommended GAHyst to patients on GAHT, one-third (29.5%, 23) sometimes encouraged it.

Conclusion: Clinicians have diverse approaches to counseling about GAHyst and oophorectomy, and many who provide GAHyst counseling do not themselves perform the procedure. More research is needed on the best approaches to GAHyst and oophorectomy counseling in TM adolescents, as well as better educational resources to standardize approaches and improve equitable care.

Keywords: adolescent; counseling; hysterectomy; oophorectomy; testosterone; transgender.

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References

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