Gender-affirming hysterectomy in the United States: A comparative outcomes analysis and potential implications for uterine transplantation.
Perspect Sex Reprod Health
; 55(4): 222-228, 2023 12.
Article
em En
| MEDLINE
| ID: mdl-37923702
ABSTRACT
PURPOSE:
Hysterectomy is a gynecological procedure sometimes performed as part of the gender-affirming process for transgender and gender-expansive patients assigned female at birth. Our goal was to compare surgical outcomes between patients undergoing gender-affirming hysterectomy and patients undergoing hysterectomy for benign menstrual disorders. We then explored the implications of gender-affirming hysterectomy for uterine transplantation.METHODS:
We performed a retrospective cohort study using data from the American College of Surgeons National Surgical Quality Improvement Program database from 2009 through 2018. We identified patients undergoing hysterectomy in the United States based on Current Procedural Terminology code. We used the International Classification of Diseases 9 or 10 codes to identify patients with benign menstrual disorders (non-gender-affirming group) and gender dysphoria (gender-affirming group). We compared patient characteristics and surgical complications.RESULTS:
Of the 40,742 patients that met inclusion criteria, 526 (1.3%) patients were individuals with gender dysphoria. Compared to patients who underwent hysterectomy for benign menstrual disorders, gender-affirming patients were younger, were healthier, had a lower prevalence of diabetes, and were more likely to undergo surgery in the outpatient setting, with shorter time to discharge. Complication rates were similar between groups. Logistic regression controlling for the American Society of Anesthesiology classification determined the difference of return to the operating room was not statistically significant (OR 1.082; 95% CI, 0.56-2.10; p = 0.816).CONCLUSION:
Gender-affirming hysterectomy has a safety profile similar to hysterectomy performed for benign menstrual disorders. Researchers should further explore the possibility of uterus donation among these patients as they may be suitable candidates.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pessoas Transgênero
/
Histerectomia
Limite:
Female
/
Humans
/
Newborn
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Perspect Sex Reprod Health
Assunto da revista:
SERVICOS DE PLANEJAMENTO FAMILIAR
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Estados Unidos