Is it strange that I'm not even remotely interested in getting a hysterectomy?
Zak: I don’t think so, partially because I’m not remotely interested in getting a hysterectomy either. I know that some people feel dysphoria for having certain parts, but to me it doesn’t really make a difference because they are internal, aren’t really functioning at full capacity because of testosterone, and I think I’ve mentioned before how much I hate surgery. I’m still likely going to have a hysto, though, because that’s what my doctor has recommended and what she (and other doctors I’ve talked to) think would be best for my health. I think this is how many people view the hysterectomy, as a health measure instead of as an exciting, transitional milestone (though of course there are people who view it that way as well). Whether or not it is the best thing for your health, I really don’t know. It does seem to be highly recommended for people who are on testosterone for the rest of their lives, though.
In summary, no, I don’t think it’s strange.
Do you guys have any advice for people whose insurance wouldn't cover hormones or hysterectemies? I'd like to start hormones, and while I might be able to afford that, I'm too scared to because my insurance doesn't cover hysterectemies and those are very, very expensive.
Zak: I’m by no means an expert on insurance, but I’ll try to take a stab answering this (I’m going to assume you are in the US, because you didn’t state otherwise and that’s pretty much what I know about). In regard to your insurance not covering hormones, luckily prices for hormones really vary and so you can start by trying to get the best deal possible. You’ll probably want to do injections instead of the gel, since injectable T is MUCH cheaper without insurance. You also might want to discuss cost with your doctor, since they might know of a brand that’s cheaper or a good pharmacy to get it from. They might not, though, in which case you can always turn to the community. Many people have suggestions for what pharmacies to go to for T and how much they charge, which can be helpful when shopping around for the best deal. For instance, I know many people turn to online pharmacies like Stroheckers for their testosterone. Of course it’s important to you make sure that you’re going somewhere reputable if you end up going with an online pharmacy. Talking to multiple people who have used a specific pharmacy should help with that (also trust your gut).
I’m actually quite surprised that your insurance doesn’t cover hysterectomies. Hysterectomies are typically covered by insurance, although your doctor may or may not have the code the surgery a certain way in order to make it clear that it is not an elective surgery. For most trans* people on testosterone, this is not usually a problem. I don’t know what to advise if your insurance absolutely doesn’t cover hystos. I’d recommend reading this consumer reports health article on hysterectomies, though, because it discusses a little bit about price mark-ups, insurance coverage, and other topics that might be of use to you. One of the major take-home messages of the piece is that the price of the same procedure can really vary depending on the hospital so shop around.
May I ask how you're going about getting your hysterectomy? I really want to get one but I don't have endometriosis (just had the surgery to check last week) so I don't know if I can have one just for the pain and heavy bleeding and have insurance cover it. I am seeing my gyno friday but she'll prolly press that I check into bowel issues but I don't. Do I just expressly state what I want due to years of misery because of excessive pain and bleeding?
I specifically sought out a trans-friendly gyno, who has experience with many transgender people and non-binary / genderqueer people.
In California it apparently goes under “voluntary sterilization” and this is covered by insurance. My insurance could possibly “guess” I am trans (since I sometimes declare my top surgery in medical records, and insurance is currently covering injectable T) and so refuse to cover it under the pretense that it’s for purposes of gender transition, which my insurance explicitly does not cover. But that is unlikely, and you can appeal. To be honest, I am a little frightened it will get rejected, but my surgeon seems to be willing to help should that arise.
To clarify, my insurance gender marker is still F - which is advisable for this surgery - but my surgeon has dealt with cases of stealth men with an M gender marker successfully, so it can be done.
In many cases, this is something you should work out with your surgeon. (Cis) women get this procedure all the time, for a myriad of reasons, and if your surgeon is willing to work with you then you can probably find a way to make it happen.
Six Weeks Post-Hysto
Tuesday marked six weeks post-op from the total laparoscopic hysterectomy and bilateral salpingo-oopherectomy I had performed on July 26th. I had my post-op appointment with my surgeon yesterday which was also the first time I’ve seen him since surgery. The appointment was pretty brief - he checked all three abdominal incisions to make sure they healed correctly, pressed on my abdomen to check that everything felt normal, gave me all the necessary paperwork I need to legally change my gender marker, and ordered blood work to be done in a month to evaluate my testosterone levels (my surgeon is also my endocrinologist.)
In the months between receiving my surgery date and the date of the operation itself, I avoided thinking of the realities of the procedure. Having genitals so incongruent with what I should have been born with has caused me to have an immense phobia of other people seeing my naked body; it’s the main focus of my worst nightmares. Admitting to myself that I was a man in need of a hysterectomy also stirred deep feelings of embarrassment and shame that made me feel physically sick.
The night before surgery, when the time came that I could no longer postpone having to confront it head-on, I broke down and had an anxiety attack. I was able to calm myself down by rationalizing to myself that it was a medically necessary corrective surgery that would increase my quality of life for all the years I have left, which I was always aware of but had lost sight of after obsessing over the unpleasant details. Knowing that it was something that would bring me that much closer to feeling normal really aided me in coping with the mental and emotional trauma of the surgery and hospital stay. I can’t say my experience in the hospital was as torturous as I was expecting - the surgery went without a hitch and the nurses in the recovery ward all went above and beyond to try to make me feel comfortable - but it was still a painful invasion of my personal privacy that I carry no fond memories of.
Now, six weeks out, I can say that I was not expecting the peace of mind that I’ve experienced since surgery. There’s been a quiet increase in my own confidence that stems from feeling more at home in my body than I ever have before. I feel more normal, more like myself.
Might be getting a hyyyyssstttoooooooooo, muthafucka!!
I talked to Dr. Bagley at FABEN Gynecology in Jacksonville, FL. She’s into it and “wants to help”, in her words. She’s also willing to code things so that I pay the least amount of monies. And can do it any day and just needs a week or two notice.
So far, this process is easier than I thought. Ultrasound and pap in two weeks. Here we go.
I'm going to bake myself a cake in May to celebrate my TAH-BSO Day.
*TAH-BSO = Total Abdominal Hysterectomy + Bilateral Salphingo-Oopherectomy
I had all my baby making equipment removed in May 2010. (Or was it June?) I figure three years is a good point to celebrate.
I will make extra large red velvet cupcakes for ovaries. With tiny blobs of cream cheese frosting representing oocyte follicles.
And marshmallow strips for fallopian tubes.
A doughnut for a cervix. Sugar crystal, or just a plane cake doughnut. (I don’t like glazed donuts very much.)
Not sure what for the uterus - some kind of pastry probably. Something that goes good with raspberry jam. XD (Or maybe just more red velvet cake.)
I’m not including the vaginal canal or external genitalia because 1) I didn’t have that removed and 2) EW.
(IKR “ew” at vagina but not at eating marshmallow fallopian tubes, hey what can I say everyone has their limit)
Hey, you replied to my hysto post. How did your hysto go? What type did you have done?
I had my hysto approximately 2 years ago. I had it done laproscopically (keyhole), and had not only a complete hysto but also an oopherectomy where they take out all female internal reproductive organs entirely.
Surgically everything went perfectly and I found it less painful than my chest surgery. What no one prepared me for however was the emotional upheaval I went through the first few days after my hysto.
It is quite common to bleed for some time after having this operation, so be advised you may be triggered by having to wear sanitary napkins or something similar to catch blood.
I was really really lucky and did not bleed one single drop even the day of surgery, thank goodness. I don’t know how I would have coped with the pad thing.
Suddenly not having anything that produced estrogen in my body really seemed to shake it up physically and more so emotionally until my body was able to get used to not having that shit there I guess. It was pretty heavy days emotionally speaking.
Personally, I was ecstatic - that surgery meant I didn’t have shit in my body that shouldn’t have been there in the first place, that I could change my birth cert to male and therefore marry my Fiance of many years.
I’d been on T for 6 years at that point, but straight after my hysto I found myself bursting into tears for no apparent reason, being very irritable and irrational. I chalked it up to the hormones no longer battling away inside me for supremacy, and the fact that my endocrine system was getting used to a whole new set of rules. The emotional upheaval lasted maybe a week or so.
After speaking with Women who had the procedure done, and then later on other men like myself - they re-iterated the initial feeling of depression/irritability a few days after surgery.
Just exercise self care and be aware that you may become a little emotional in the days after a hysto. I have the emotional capacity of a walnut most days, and was sure this is something that wouldn’t affect me, but it did.