Surgical Outcomes for Transgender Men Undergoing Hysterectomy.

ABSTRACT

OBJECTIVE: This study sought to assess surgical outcomes of hysterectomy performed for transgender individuals compared with hysterectomy for individuals with menstrual disorders. METHODS: This retrospective cohort study was conducted using the American College of Surgeons National Surgical Quality Improvement Program database. Data of transgender individuals who underwent hysterectomy and individuals who underwent hysterectomy for menstrual disorders were extracted from the participant use data file (2015-2016). Transgender individuals were compared with individuals with menstrual disorders for surgical outcomes within 30 days of hysterectomy, by using appropriate statistical tests. A two-sided P value of less than 0.05 was considered statistically significant (Canadian Task Force Classification II-2). RESULTS: The study identified 89 cases of hysterectomy for transgender individuals and 4439 cases of hysterectomy for menstrual disorders. Compared with patients who underwent hysterectomy for menstrual disorders, transgender patients were more likely to be younger (mean ± SD 30.79 ± 9.68 years vs. 42.6 ± 7.04 years), have a normal body mass index (25.84% vs. 17.77%), be classified as American Society of Anesthesiologists class I (34.09% vs. 10.46%), and have outpatient surgery (76.40% vs. 53.55%) (P < 0.05). Overall incidence of postoperative complications was low for both groups. No significant difference in surgical outcomes was observed for re-admission, superficial or deep/organ space infections, wound dehiscence, sepsis, blood transfusion, deep vein thrombosis, pulmonary embolism, or death. Transgender patients who underwent hysterectomy on average required decreased operative time (120.4 ± 79.2 minutes vs. 131.2 ± 64.3 minutes) and decreased lengths of stay (0.82 ± 0.82 days vs. 1.35 ± 2.73 days). CONCLUSION: This study suggests that transgender patients undergoing hysterectomy were younger and healthier than patients undergoing hysterectomy for menstrual disorders. Surgical complications were low for both groups, and significant differences in surgical outcomes were not observed.