Hysterectomy, the surgical removal of the uterus, and most likely, the cervix- involves removing surrounding organs and tissues, such as the fallopian tubes and ovaries. The uterus is where a baby grows during pregnancy. During your periods, it is the uterine lining that you shed as blood. You lose the ability to get pregnant and you will not get your period after a hysterectomy. It is a gender-affirming, masculinizing surgery of your bottom.

Reason

For trans men or a transmasculine person, having a uterus can be a constant reminder of the gender that they do not identify with. Periods, period pains and other related maladies of the menstruation cycle prove to be more of a challenge for them.

Procedures

In India, two methods are followed usually-

1. Abdominal Laparoscopic hysterectomy technique
   An abdominal hysterectomy is a surgical procedure that removes your uterus through an incision in your lower abdomen.

2. Vaginal Hysterectomy
   In this technique, a small cut is made near the vagina and the womb is removed through it successfully. This procedure has a much faster recovery time as compared to abdominal because of a smaller incision. This procedure might be painful for you if you have never had penetrative sex before or if you have a very small vagina.

Types of Hysterectomy

1. Total Hysterectomy
   Total hysterectomy is when there is a removal of the entire uterus, including the cervix.
2. Supracervical Hysterectomy
   Supracervical hysterectomy is when there is a removal of just the upper part of the uterus. The cervix is left in its place. This type of procedure may be done if you want to keep your cervix or if difficulties arise during surgery that makes the removal of the cervix complicated.
   If you have had irregularities in your pap smear, it is advisable to do a total hysterectomy so that you don’t meet with complications later on.
3. Radical Hysterectomy
   This is a total hysterectomy with the addition of tissues around the uterus called parametrium tissues. This surgery is reserved for when there is a detection of cancer in the body.
4. Oophorectomy
   This is when there is the surgical removal of just the ovaries.
5. Salpingectomy
   This happens when there is a removal of the fallopian tubes.
6. Salpingo-oophorectomy

This is when one or both of the ovaries and fallopian tubes are removed. When one ovary and fallopian tube are removed, it is called unilateral oophorectomy. When both are removed it is called bilateral oophorectomy.

Pre Surgery Care

• Meet your gynaecologist at regular intervals. First for regular checkups and then till the dates leading up to the operation to check if everything is okay.
• A week before the operation get done with your reviews and sign consent agreements.
• Eat the medicine given before the operation.
• Maintain a healthy diet.  Take proper care of yourself and don’t tire yourself out.
• Unless you are instructed otherwise, you are not supposed to eat or drink anything after midnight- before the surgery.
• Reach the hospital 2 hours prior and help with the pre-surgery procedures.
• Ask before you can take any medicines before your surgery.

Post Surgery Care

• Avoid any strenuous activity till you feel strong enough to handle it.
• Avoid driving till you are off your pain medication.
• If you went back with staplers in your body, make an appointment to get them removed.
• If you have abnormal symptoms like high fever, bleeding, severe pain, severe nausea etc., you should consult the doctor as soon as possible.

Hysterectomy is not a major operation and requires a maximum of 48 hours of supervision. It takes about 70k-1.5L.

Make sure to listen to your doctors and take proper care of yourself. Hysterectomy would require assistance so try and make sure that there is someone who can take care of you the first few weeks after the operation because even a little strain can lead to a lot of pain.