Gynecologic Surgery

About Hysterectomy and oophorectomy

Drs. Mitzi HawkinsTami Rowen, Alison Jacoby, and Gaetan Pettigrew offer this surgery as part of gender affirming care for transmasculine patients.

You will have a full intake prior to scheduling surgery where we will discuss the surgery type, review the role of removing the ovaries (oophorectomy) and the route of removing the uterus (hysterectomy). For most patients a minimally invasive approach is offered, either transvaginally or via laparoscopy (making very small incisions on the abdomen). We do not offer metoidioplasty or vaginoplasty at this time, though we can offer a vaginectomy (removing vaginal tissue and closure of the entrance) if it is desired.

Should you remove your ovaries?

This is a very personal decision. There is conflicting evidence on the role of the estrogen produced by the ovaries on the risk of heart disease or osteoporosis. Keeping an ovary can mean that you continue to experience cyclic hormonal symptoms, even without a uterus or menstruation.  The ovaries also contain eggs for reproduction. Even without a uterus you can still use the eggs for a pregnancy. Thus if you are interested in having this option it may be beneficial to retain the ovaries. We are happy to discuss this further in your initial visit and in the surgical planning.  For those patients not interested in future reproduction and who intend to continue on long term testosterone therapy at least until age 50, keeping a single ovary is likely of minimal if any benefit.

Surgical assessment and referral process

At UCSF, we want you to have the best possible result from your surgery with the greatest satisfaction. UCSF criteria for surgery are based on the World Professional Association for Transgender Health SOC (Standards of Care) 7th Edition, and are required by most insurance companies. Prior to scheduling your initial consultation, please send the following:

  • Your insurance card and identification

  • A completed UCSF Gender Affirming Health Program Surgery Patient Packet
  • Medical Clearance Letter from your medical provider indicating that you are medically cleared and prepared for surgery, and capable of providing consent for surgery. In some cases, you may be asked to have a medical consultation at UCSF prior to scheduling your consult with the surgeon.  The letter should follow this format.
  • Undergo a behavioral health assessment and obtain referral documentation in line with WPATH guidelines. More detail on this process and the requirements can be found here.

Referral letters and documentation should be faxed or e-mailed to:

UCSF Gender Affirming Health Program
415-353-3399 fax
[email protected]

Please include your legal name, chosen name (if different), and date of birth with all communication.