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

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 bar-riers, 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.