Vestering Asra, van de Grift Tim C, Groenman Freek A, Huirne Judith A F, Kreukels Baudewijntje P C, van Mello Norah M
Department of Obstetrics and Gynaecology, Amsterdam UMC, location Vrije Universiteit Amsterdam, Amsterdam 1018HV, The Netherlands.
Amsterdam Reproduction and Development, Amsterdam 1105AZ, The Netherlands.
J Sex Med. 2025 Apr 8;22(3):517-525. doi: 10.1093/jsxmed/qdae183.
Although many transmasculine individuals undergo 1 or more gynecological surgeries (ie, hysterectomy, oophorectomy, tubectomy, or colpectomy), little has been published about motivation, subjective experiences, and the effect on dysphoria and quality of life.
The aim of this study was to acquire an in-depth understanding of patients' motivations and experienced outcomes of gynecological gender surgery.
In this qualitative study, in-depth semi-structured interviews were conducted. Nine participants were included who were: on the waiting list for their first gynecological surgery (n = 2), or who had either undergone gynecological surgery as part of their transitioning (ie, hysterectomy) and were on the waiting list for another gynecological procedure (ie, colpectomy, n = 2), or who had undergone gynecological surgery and did not wish to undergo any further surgeries (n = 5). In-depth semi-structured interviews were conducted. Topics discussed were motivation to opt for a specific surgery, expectations, and experiences. Thematic analysis was carried out to compose themes from the interview transcripts using the concepts of body image and gender affirmation as a theoretical lens.
The primary outcomes of this study were composed themes based on thematic analysis of the interview transcripts.
Three subthemes were identified, displaying how gynecological surgeries could contribute to gender affirmation: body representation matching oneself; achieving functional congruence; and enabling further surgical transition.
This study offers valuable insights for healthcare professionals in patient counseling and shared decision-making and provides a foundation for developing patient-reported outcome measures tailored to transmasculine individuals.
To our knowledge, this is the first qualitative report to study the motivations for and outcomes of gynecological gender-affirming surgeries in such depth; however, the results cannot be directly applied to other settings without considering the local context, including factors such as legislation and insurance policies.
This study highlights how gynecological surgeries, unlike more visible gender-affirming procedures like chest surgeries, address internal conflicts related to the masculine identity by altering the body's functioning, thereby playing an important role in the process of gender affirmation.
尽管许多跨性别男性个体接受了1次或更多次妇科手术（即子宫切除术、卵巢切除术、输卵管切除术或阴道切除术），但关于手术动机、主观体验以及对性别焦虑和生活质量的影响，相关报道甚少。
本研究旨在深入了解患者接受妇科性别手术的动机及手术体验。
在这项定性研究中，进行了深入的半结构化访谈。纳入了9名参与者，他们分别是：在等待首次妇科手术的名单上（n = 2）；或者已接受作为过渡一部分的妇科手术（即子宫切除术）且在等待另一项妇科手术（即阴道切除术，n = 2）的名单上；或者已接受妇科手术且不希望再接受任何进一步手术（n = 5）。进行了深入的半结构化访谈。讨论的主题包括选择特定手术的动机、期望和体验。采用主题分析法，以身体意象和性别肯定的概念为理论视角，从访谈记录中提炼主题。
确定了三个子主题，展示了妇科手术如何有助于性别肯定：身体表征与自我匹配；实现功能一致；以及实现进一步的手术过渡。
本研究为医疗保健专业人员在患者咨询和共同决策方面提供了有价值的见解，并为制定针对跨性别男性个体的患者报告结局指标奠定了基础。
据我们所知，这是第一份如此深入研究妇科性别肯定手术的动机和结果的定性报告；然而，在不考虑当地背景（包括立法和保险政策等因素）的情况下，结果不能直接应用于其他环境。
本研究强调，与胸部手术等更明显的性别肯定手术不同，妇科手术通过改变身体功能来解决与男性身份相关的内心冲突，从而在性别肯定过程中发挥重要作用。
