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Young Adult Patients with Testosterone Management Concerns after Gender-Affirming Hysterectomy and Bilateral Oophorectomy: A Case Series

  • Ellis P. Barrera
    Affiliations
    Division of Gynecology, Department of Surgery, Boston Children's Hospital, 333 Longwood Ave. 5th floor Room LO-545, Boston, MA 02115, United States
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  • Frances W. Grimstad
    Correspondence
    Corresponding author at: Division of Gynecology, Department of Surgery, Boston Children's Hospital, 333 Longwood Ave. 5th floor Room LO-545, Boston, MA 02115, United States.
    Affiliations
    Division of Gynecology, Department of Surgery, Boston Children's Hospital, 333 Longwood Ave. 5th floor Room LO-545, Boston, MA 02115, United States

    Department of Obstetrics, Gynecology, and Reproductive Biology, Harvard Medical School, Boston, MA, United States
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  • Elizabeth R. Boskey
    Affiliations
    Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, MA, United States

    Center for Gender Surgery, Boston Children's Hospital, Boston, MA, United States
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      ABSTRACT

      Many transgender and gender diverse adolescents and young adults will pursue hysterectomy for the purpose of gender affirmation. This procedure often includes bilateral salpingo-oophorectomy (BSO), which has potential implications for long-term health should individuals choose to stop, or lose access to, exogenous testosterone. Although most of these individuals intend to remain on testosterone indefinitely, not all do, and little information exists on such cases following bilateral oophorectomy to guide counseling and practice. This case series documents 3 individuals who had interruptions in their testosterone use after hysterectomy with BSO for reasons including external barriers, internal barriers, and concerns about side effects. Patients should be appropriately counseled on hysterectomy options as bilateral oophorectomy is not required in the absence of specific indications.

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      References

        • Grimstad F
        • Boskey ER
        • Taghinia A
        • Ganor O
        Gender-affirming surgeries in transgender and gender diverse adolescent and young adults: a pediatric and adolescent gynecology primer.
        J Pediatr Adolesc Gynecol. 2021; 34: 442-448
        • Grimstad FW
        • Fowler KG
        • New EP
        • et al.
        Ovarian histopathology in transmasculine persons on testosterone: a multicenter case series.
        J Sex Med. 2020; 17: 1807-1818
        • James SE
        • Herman JL
        • Keisling M
        • et al.
        The Report of the 2015 US Transgender Survey.
        NationalCenter for Transgender Equality, Washington, D.C.2016
        • Evans EC
        • Matteson KA
        • Orejuela FJ
        • et al.
        Salpingo-oophorectomy at the time of benign hysterectomy: a systematic review.
        Obstet Gynecol. 2016; 128: 476-485
        • Grimstad F
        • Boskey E
        Empowering transmasculine youth by enhancing reproductive health counseling in the primary care setting.
        J Adolesc Health. 2020; 66: 653-655https://doi.org/10.1016/j.jadohealth.2020.03.012
        • Hembree WC
        • Cohen-Kettenis PT
        • Gooren L
        • et al.
        Endocrine treatment of gender-dysphoric/gender-incongruent persons: an endocrine society clinical practice guideline.
        J Clin Endocrinol Metab. 2017; 102: 3869-3903
        • Committee Opinion No. 605
        Primary ovarian insufficiency in adolescents and young women.
        Obstet Gynecol. 2014; 124: 193-197https://doi.org/10.1097/01.AOG.0000451757.51964.98
        • ACOG Committee on Gynecologic Practice
        ACOG Committee Opinion No. 774: Opportunistic salpingectomy as a strategy for epithelial ovarian cancer prevention.
        Obstet Gynecol. 2019; 133: e279-e284https://doi.org/10.1097/AOG.0000000000003164