Here I sit, sans ovaries, uterus, fallopian tubes and cervix. I was able to have my female 'parts removed in 1999 in tandem with my double mastectomy. I was fortunate to have an understanding OB-GYN and am eternally grateful to her.

So, why would I aspire to write about something that I have already had?

Simply put, I am empathetic towards my fellow brothers who are desperately trying to have their total hysterectomies. Namely because of finances, approval without a medical reason, etcetera.

I have often wondered how this issue can be resolved to benefit all those engaged, perhaps one day seeing a solidarity formed ending misconceptions and preconceptions which may hopefully result in providing help for those who desire to rid themselves of these organs inherently female instead of hindering them.

There may not be a medically defined reason to perform such a surgery but that does not mean it is no less important or life saving.

For many Transmen, having female reproductive organs is a mind-fuck and can have devastating physiological implications and consequences. This is where the life saving issue comes into play.

Face it, a genetic male without an intersexed condition does not have ovaries, fallopian tubes, uterus and cervix. It's biology; it's evolution - the perfect configuration of each sex to further the species; men have testes, females have ovaries, males produce sperm to fertilize the egg produced by the female, the female carries the child in her uterus, and so on.

I have pondered after hearing from so many Transmen who have not yet been able to have their hysterectomies [due to be turned away by doctors]: who is more deserving? Who rates highest on the top rung of the ladder for this surgery? Those with immediate medical issues or those who are female bodied, male brained and disgusted by their female reproductive organs?

Perhaps disgusted is a bit dramatic but many do feel that way. Perhaps frustrated is a more descriptive term.

Are they no less important?

Add to that the fact that the majority of Transmen report painful, heavy periods pre-T plus many have spotting or a reoccurrence of their periods while on T. These issues are the true definition of "insult to injury"; a mind-fuck extraordinaire.

Then we have the issue of who will understand us and our desires? What doctor will listen to us, hear us and help us?

There are so many Transmen out there who cannot find an understanding OB-GYN to give them a break; to perform a much desired and much needed operation without suffering the humiliation of being turned away especially after being subjected to 'the feet in the stirrups' probing. Not to mention enduring the horrified or judgmental reactions by others for daring to walk in to an OB's office alone looking male. Many times, if the doctor entertains the idea, the Transman has to wade through miles of red tape to simply schedule the surgery.

But why is it that there are many understanding OB-GYN doctors and so many who are not?

There is no letter perfect answer especially as to why there are those who so dubiously reject Transmen without attempting to learn more. Perhaps it's prejudice, apathy, lack of education on the subject or fear of the known and unknown.

We all understand what apathy is: they just don't care. Or what prejudice, fear and the unknown is; they are disgusted by what we represent to them or they don't understand us.

What do I mean by 'known'? What could that possibly mean?

The fear of reprisal; the fear of being sued.

Fact: OB-GYN's are sued more frequently than any other physician or surgeon which also results in them paying out highest claims  ¹

Fact: An OB-GYN doctor/surgeon pays the highest malpractice insurance of any doctor or surgeon in the United States. ²

For instance; In Dade County Florida malpractice insurance went from $249,000 to $277,000 between 2003 and 2004 - that's a per year premium, folks - the casualty is, less OB-GYN's in practice now - they cannot afford it. ²

Fact: The following states OB-GYN doctors pay the highest premiums in the USA: Florida, Nevada, Michigan, New York and the District of Columbia. ²  So if you reading this live in those areas and have been turned down or the doctor asks you for letters to ensure you are a viable candidate for such surgery without  a major medical reason, this is probably why.

Fact: It's getting harder to find an OB-GYN in practice these days. Many just quit their practices due to fear of law suits and rising malpractice insurance costs. ³

For instance: In 2004, out of 40 OB's practicing at Hartford Hospital in Connecticut, just 15 remain. ³

Higher insurance costs not withstanding, they may fear we may change our minds later and sue them.

What, you say? Change our minds????

Oh yes! It does happen; not often but it sure does. There are former Transman out there who changed their minds and went back to being female after years of THRT and even breast removal, and yes, even after a total hysterectomy!

I recently received an email from a former Transman (whose name I will not reveal so please do not ask me), whose photo and bio once graced the pages of the T-Male Photo Gallery.

He was a strapping man, bearded, very masculine looking with male pattern baldness. One would have never guessed by looking at him that he had ever been a woman. Yet he decided to live as a woman again. One reason she gave for stopping testosterone therapy, renouncing her maleness then going back to living as a woman and living a lesbian lifestyle was that she had a stroke, which she blamed on testosterone use. The stroke seemed to not be severe enough to incapacitate her. Her emails were perfectly cogent, no sign of any brain damage. In her new photos she looks healthy and happy, her smile was completely normal, a wide toothy grin, no drooping corner of the mouth or face, no drawn up arm or hand.

Stroke is mainly linked to a family history of stroke or heart attack, diet, weight issues, high blood pressure, high cholesterol, ect.

A simple inexpensive blood test performed 2 times a year would reveal the condition attributed to testosterone use that may result in a stroke. It's very rare. But cases like these frighten doctors. If one does it, they think all of us will one day change our minds.

In my opinion, if we are set on going back to a former life, we will find a way to do it without taking responsibility for our decision. It's easier to blame something or someone. I feel this was the case in this incident of reversal.

So, it does happen and the fear of this happening by an OB-GYN, is more prevalent because of their lack of education about us. But keep in mind, it is not their fault that they don't fully understand. Think about it...why would they?

And also keep in mind that, if you are turned down, it's really not about YOU; it's about them. I know it's hard to look at it that way but taking it personally will just compound your overall frustration. Frustration can lead to poor decision making.

So what do all these facts mean to you?

It's going to be harder and harder for Transmen to find a compassionate OB-GYN to perform a hysterectomy without an emergency situation or a medical reason recognized by their guidelines.

However, what many OB-GYN's don't realize or refuse to acknowledge, is that a hysterectomy can be an elective surgery, requested by the patient without an immediate medical reason. One valid reason for an elective hysterectomy is having a family history of cervical, ovarian or urterin cancers. Another is debilitating painful periods with heavy bleeding. Granted, if one has been on THRT long enough, the periods do stop (there are exceptions) however, painful heavy bleeding is not common and there are reasons for this occurring long before THRT.

Yet, if you are in child bearing years, many won't touch you. Many doctors feel age 29 is the cut off point. This may vary so you will need to ask. It stands to reason that a younger Transman in the age range of 18 - 25 may have the hardest time if there is no medically necessary reason, though many older Transmen have had a hard time, take for instance Robert Eads ⁴.

Part 2 coming soon