Okay so coming from my own experience, if you’re thinking about getting a hysterectomy or know you’re going to want one as part of your transition, I heavily advise getting it done the earlier the better in your medical transition process. Obviously I advise thinking long and hard about it and making sure it’s the right thing for you. But yes, if you can even get it done before starting testosterone that would be the most ideal, in my opinion.
Why is that? Well, testosterone causes this lovely thing called vaginal atrophy. Vaginal atrophy is when the inner linings of the vagina shrink and dry out, loose a lot of lubrication and get fragile and prone to bleeding. Basically testosterone shuts down your on-board reproductive system so it’s like “yeah bro I’m gonna just… shed all this extra weight because whatever you don’t need it” in medical terms, you know?
As far as I know, vaginal atrophy isn’t a sudden onset as soon as you start testosterone. Like pretty much everything with medical transitioning, there’s a timeline for it. Vaginal atrophy starts around 3-6 months on T, and it takes about 1-2 years for its maximum onset. At the time of my hysterectomy, I was on testosterone for over 4 years.
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A few more things about my own vagina (things that are unique to me and may or may not be shared by others.) My vaginal opening is about the size of my pinky finger. My gynecologist says it’s a combination of what I was born with and how I’ve never had any penetration. During surgery they had to use a device to expand that opening so they could get everything out, because the surgery was done laparoscopically, which means they used a camera and everything was taken out though my vagina. That device caused lacerations and a bunch of bleeding both internally (due to the atrophy/dryness) and externally. The resulting bleeding was more than they expected and I was kept in the hospital overnight to keep tabs on it. So basically, that’s why I suggest the earlier the better. Or stopping testosterone for a bit/taking estrogen and gaining the lubrication and lining back. (I haven’t suggested that to my doc yet so I don’t know if that is feasible.) Anyways, explore your options if you know you’ve been on T for a while with resulting vaginal atrophy and plan on a laparoscopic hysterectomy.
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Okay, so that’s my own unqualified advice from personal experience. Because I’m not a doctor person. As I always advise, if you’re thinking about getting a hysterectomy, talk to your doctor. Figure out your options. Don’t let me scare you away, I’m just sharing this so peeps can be more aware of how to prepare themselves and what to expect.