Sexual function and orgasm experience pre- and post-gender-affirming hysterectomies

Transgender and gender-diverse people (TGD) may seek gender-affirming care, which can include medical and surgical interventions. National estimates approximate that gender-affirming hysterectomies (GAH) are the most common gender-affirming genital reconstructive procedure.1 Nonetheless, the only research on sexual function and hysterectomy is on cisgender women, in which the average age (42.25, vs. 29.91 for GAH) and surgical indication (eg, abnormal uterine bleeding, fibroids, pelvic pain, etc.) are distinct from the TGD population.2 Given this research gap, we aimed to better characterize sexual function in people receiving GAH. This information may be useful to anyone caring for TGD individuals considering a hysterectomy. This study utilized a prospective, descriptive design, in which survey data were collected preoperatively (baseline) and postoperatively at 3-month intervals (3, 6, 9, and 12 months). Adult patients assigned female at birth (AFAB) scheduled for a GAH at a single tertiary care center were invited to participate in this study at their preoperative clinic visit (recruitment period November 2023-July 2024). Exclusion criteria included being non-English speaking, having received genital reconstructive surgery (eg, phalloplasty or metoidioplasty), or receiving a hysterectomy for a primary indication other than gender affirmation (eg, cancer risk reduction, symptomatic uterine fibroids, etc.). All participants consented to participate in the study, which the IRB approved on November 1, 2023 (study number 23-39134).