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Thoughts on hysterectomy

January 2008

(This was taken from a personal journal entry)

Things are progressing fine in terms of moving. I'm tying up loose ends here in Maine, thinking about a massive yard sale in the spring because there's no way I'm moving all of the crap I've accumulated in the 4+ years that I've been at this apartment. Four years! By the time I move I will have been in Maine for ten years. I almost don't believe it. While I'll miss it, I am feeling ready and excited for the change.

One thing I'm batting around in my head is whether or not to pursue a hysterectomy while I'm still here in Maine. There is a great gynecologist in town who is very trans friendly and has helped a few friends of mine through their different surgeries and other procedures. I know she is willing to work hard to get insurance coverage, too. I also have quite a bit of sick time built up at work which I will not get paid out when I leave my job if it's unused. I could even push my work departure date ahead a little, and spend my last few weeks in town recovering from surgery. I feel like this is a perfect opportunity to do this, so I don't know what my hesitation is about. I am not nervous about the actual surgery itself. It's just that I have never really had any problems with my reproductive organs (knock on wood) and I can't convince myself to remove presumably healthy, though mostly non-functioning organs. On the other hand, I know that I am one of the lucky ones to be this far into medical transition and to not have had any major issues come up so far. It seems like most guys want or need to have a hysto two or three years after starting testosterone because of bad cramping, breakthrough bleeding, or some other reason.

Here's what I know... I can not foresee a time in my future when I will not want to be on testosterone. There have been two separate times when I have gone for several months without an injection, and both times I have experienced a return of my menstrual cycle and regression of some physical changes brought on by testosterone. I was unhappy about all of that. Conversely, I have been generally more satisfied with my emotional state when I've been off testosterone, other than being upset about previously stated physical repercussions. Yes, I am "more in touch with my emotions" when my T levels are down. Unfortunately I am also profoundly unhappy with the way my body feels and looks, which results in being "more in touch" with feeling shitty about myself. Not a good trade off. So we have established that I will be dependant on synthetically controlled hormone levels for the rest of my life.

Still, for some reason I hesitate around this decision. Why worry about removing organs I don't use or need? Well, what if I do need them someday? What if (hypochondriac alert) there is some kind of prolonged shortage of testosterone (there has been before) and I am unable to get my prescription filled? Would it be better for me to have my body producing some sort of hormones, even if they're not the ones I want, rather than none at all? My partner is unable to carry children. What if adoption agencies refuse to place a child with a trans/queer couple? Will there come a time when my desire to have a family becomes so strong that the best possible solution would be for me to carry a baby myself? It's not impossible.

So I don't know. I know none of my doomsday scenarios are very likely, but there they are, nagging away in my head and heart and preventing me from pursuing this surgery even though the cards are all in place right now. I just don't know. Do I have surgery soon while it'd be relatively easy, or do I keep my fingers crossed that I continue to be healthy in that area and put off surgery for the sake of maintaining feasibility of a couple far-fetched situations?

In the meantime, I should also try to have my sex changed on my birth certificate (and subsequently with Social Security). That's another thing I have hesitated on for who-knows-what reason, but the reasons not to do it pale in comparison to the reasons to have it done, at this point. I want to move back to Massachusetts and be able to have the option of whether or not to disclose my history to people. It'll be better if I can cut down on the trail of legal documents leading to trannyville wherever possible.

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