Hysterectomy for Trans Men: The Decision, Procedure and Recovery

A hysterectomy for trans men is surgery to remove the uterus, and sometimes the ovaries, as a masculinising gender-affirming surgery. It is often performed laparoscopically (keyhole surgery), which usually means a shorter hospital stay and quicker recovery than open surgery¹. It is one option among many on the masculinising pathway, not a requirement of being a trans man, and the decision is individual and made with a clinical team.

When I was learning about the masculinising procedures (I am a trans woman, so this was research rather than my own pathway), the thing I most wanted explained plainly was the ovary question, because so many pages blurred two separate decisions into one. So here it is, checked by a consultant gender-affirmation surgeon: what the operation removes, how it is done, the decision around the ovaries, and what recovery is really like. This article sits within our wider guide to gender-affirming surgery, and within the masculinising procedures overview.

What is a hysterectomy for trans men?

A hysterectomy removes the uterus; when the ovaries are removed as well, the procedure is called an oophorectomy. As a gender-affirming surgery for trans men, it is one of the recognised masculinising procedures, alongside chest (top) surgery, metoidioplasty, and phalloplasty². It is often done laparoscopically, through a few small incisions, rather than as open surgery.

It is worth saying clearly: surgery is one option among many, not an endpoint or a requirement of being trans. Many trans men have no internal surgery at all. The most commonly sought gender-affirming surgery for trans men is chest (top) surgery, not hysterectomy.

The decision about the ovaries

Whether to remove the ovaries is a separate, individual decision, not an automatic part of the operation. A hysterectomy removes the uterus; an oophorectomy removes the ovaries, and the two can be done together or the ovaries can be kept.

Your surgeon weighs this with you, taking in your testosterone therapy, your bone health, and your own preference. If the ovaries are removed, the body no longer produces its own oestrogen, so hormone therapy and bone health are reviewed carefully. The point we want to land is that this is a distinct choice, decided with your clinical team, rather than something that simply happens.

How the surgery is performed

The operation is usually performed laparoscopically (keyhole surgery) under general anaesthetic, through a few small incisions, which generally means a shorter stay and quicker recovery than open surgery¹. The exact approach depends on your anatomy and your surgeon’s assessment.

Under the WPATH Standards of Care, Version 8 (2022), most genital and internal gender-affirming surgery asks for one referral from a qualified health professional, after SOC-8 simplified the older two-referral norm². On the NHS, you reach surgery through a Gender Dysphoria Clinic pathway. For the full route, see gender-affirming surgery on the NHS and the pathway to gender-affirming surgery.

Recovery after a hysterectomy

Most people take a few weeks off work and avoid heavy lifting for several weeks while the internal tissues heal¹. Keyhole recovery is generally faster than open surgery, but the internal healing takes longer than the small external scars suggest, so pacing matters even on the days you feel well.

A point I heard again and again from trans men who had been through it: the temptation to do too much, too soon, because the outside looks healed, is the thing to guard against. Follow your surgeon’s lifting and activity limits. For how to get ready, see preparing for gender-affirming surgery.

How this fits the wider picture

A hysterectomy is one masculinising option, and for most trans men it is not the first or most common surgery they consider. Satisfaction with gender-affirming surgery is high overall, and regret is low: a 2021 systematic review and meta-analysis of around 7,900 patients found regret in about 1 in 100³. That figure is low but not zero, and it sits alongside individual, unhurried decision-making with your clinical team. Nothing here is personal medical advice. For the broader options, return to the masculinising procedures overview.