Some Reflections on the Hysterectomy
Some Reflections on the Hysterectomy
The shame of removing my ability to do something women have been doing since time immemorial is yet to go away.
I have a unique situation in that I have regularly journalled since I was a child. I have LiveJournal entries going back 20 years and physical diaries that I kept even longer than that. That means I have the ability to take a look at what I was thinking and how I’ve changed over time.
I’m thinking of starting a new feature, in a kind of “Throwback Thursday” style, where I rummage through my old journal entries, reflect on how I used to think and the context surrounding my thoughts at that time, and discuss how I feel about it today. I don’t know how regular it will be yet, but let’s start now.
For this entry, I’m going to track my desire to have children versus my desire to have a hysterectomy. At this point in time, today in 2022, pursuing and undergoing a hysterectomy is my biggest regret.
January 6, 2005
“Do you want kids/if yes, how many: Yes, yes. Must have children. AS MANY AS POSSIBLE XD”
I would have been 16 years old at the time of this entry.
In my LiveJournal years, there were always tons of these surveys going around with dozens of questions for people to just fill out when they were bored. So this is just one of those where it asked me if I wanted kids. Clearly, I wanted them.
There’s also another entry with a different survey later in the same year where I specified that I wanted “three-ish” kids.
March 10, 2010
“I had two separate dreams about having babies last night […] Iiii dunno. It fucks me up a bit. I know I've always wanted to become pregnant and have children. It's pretty much the only thing that I like about having a female body. That I can bear children. I feel bad about it sometimes, because in FTM communities they sort of look down (not everyone, but many) on other transmen who purposely get pregnant. Especially the ones who publicize it (which I can understand).
Basically, it makes me wonder if I should transition. Or if I should wait to. But, I don't want to wait. Like, I have hopes of being on testosterone by the end of the year. However, while I identify with transmen, I identify more strongly with genderqueer ftms... and a lot of them embrace both sides of the binary and everything in between. And many of them go off testosterone for a while. And I just may go on for a bit, and then off, if I feel like it. I may not go off. Maybe it's the estrogen running through me that wants me to have children. Maybe when the testosterone is stronger, I won't want to, anymore (though I'm sure I'll still want children). But hormone replacement therapy also might make you infertile. So, it's a hard choice.”
I believe I’ve posted this excerpt before.
This is about three months after I decided that I was going to socially transition (and solidified it by having my hair cut) and very shortly after telling my parents. I was just about to turn 22. Here, I am acknowledging that “I’ve always wanted to become pregnant and have children,” discussing how much I valued my uniquely female ability to get pregnant, and expressing doubt over whether I should pursue transition or not. I go far enough to admit that I don’t really feel like I am a man and feel more nonbinary (though “genderqueer” was the word du jour back then).
This entry is probably one of the biggest red flags I have. I wasn’t fully committed to transitioning, I wasn’t fully committed to my identity, and I was talking about going on and off a restricted substance that would cause permanent changes to my body, but also wanting to go full speed ahead. I am speaking casually about how taking exogenous hormones might cause me to change my mind about something that was an essential part of the plan I had been making for myself my entire life before that point.
This isn’t someone making a good decision.
April 3, 2010
“I guess maybe the only thing [that I need to know more about] is still the fertility issue. I’d like to know what the percentage is of transmen who become infertile (those that are on testosterone and before they get a hysto, obviously). Part of me has stopped caring about it, though. I’m also looking forward to being able to adopt. I figure if I become sterile, that’s the way it’s going to be. Fate will decide whether or not I can bear my own children.”
This is shortly after the previous entry. Less than a month later, “part of me has stopped caring” about something that, up until a year before this point when I started questioning my identity, was a major part of my life plans.
I frequently see a cavalier attitude towards transition in young people on places like Reddit — “If I regret it later, so be it; at least I’m happy now.” You can see it my entry here where I declare that fate will determine my capacity to have children. It’s a very childish attitude to allow our in-the-moment feelings to determine an irreversible direction of our lives, but this is exactly what the affirmation approach facilitates.
The irony is that there was some part of me who believed that transitioning was a form of exercising control over my life. It wasn’t. It was one big unhealthy coping mechanism. I gave up.
January 1, 2012
“I'm back in Florida, but this time for chest surgery – probably the last step in transition that I'm going to make, assuming I don't change my mind about bottom surgery or a hysterectomy […] There is something a bit frightening about going through with top surgery, and it's not the surgery itself. It's the realization that the transition period will be over. I will no longer really be ‘in transition.’
Being transgender sort of took over my life once I figured it out. A lot of effort went into remaining emotionally and physically sound (and didn't always succeed) as I made my way through the process. Much of the rest of my life was on hold. But I was comfortable with that. When I started seriously questioning, I was ridiculously depressed and just starting mood stabilizers, fresh out of an intense short-term relationship that had been difficult on me, had dropped out of university only two months in, and had no idea in what direction to take my life.
I'm still on antidepressants, haven't been involved with anyone since then, and still don't really know what to do with my life. I took a continuing education class in photography and both enjoyed it and did well, so there's that. But when I get back to Canada and heal, I'm not sure what goals I have for the future.”
This was written a day before I had my double mastectomy surgery, approximately 14 months after first being prescribed testosterone. At this time, in 2012, I intended for the mastectomy to be the final step in my medical transition. I had no intention of getting a hysterectomy.
It’s interesting that I found the supposed finality of my transition “frightening.” What was I scared of? Well, I don’t say it outright, but based on what follows, I was scared of the expectation that I begin my life as an adult. I was 21 when I socially transitioned, 22 when I began testosterone. Transitioning had given me an excuse to put my life “on hold” while I pursued something that I believed was going to change me in such a way that I would finally be successful.
But it was clear that I was not. My body had changed, but my mind, my coping skills, and my capacity for day-to-day functioning remained the same. I was still reliant on antidepressants, still having difficulty finding a positive relationship, and still unsure of how I wanted to proceed with my life. Of course that would be frightening.
August 15, 2016
“I feel like this is around the age people really start thinking about whether or not they’re going to have kids if they don’t have any yet, and I’ve waffled on it. But I’m gonna talk to my doctor about having a hysterectomy since it’s covered by OHIP for trans people now. I’m just not sure I wanna take hormones again (which I believe you have to do if you have a hysto since you aren’t producing estrogen anymore?). Anyway I know I don’t want to birth children. I might have them (adoption or otherwise). But it is more likely that I will just have partners who have kids.
It’s the obligation thing. Pets are hard enough. I can’t be responsible for actual people full-time for 18 years.”
I just want to take a quick moment to point out that I would never have gotten a hysterectomy if it wasn’t covered by OHIP (the Ontario Health Insurance Plan, part of Canada’s universal medical system). I wouldn’t have been able to afford it. Even though I had stopped taking testosterone by this time, I still identified as transgender. The identity was the only reason the surgery was approved. It was completely medically unnecessary and never would have been approved otherwise.
I wasn’t aware that partial hysterectomies (i.e., retaining the ovaries) were possible at this time. Clearly, I wasn’t looking too deeply into it when I wrote this entry. It was more of a passing thought.
It may or may not sound “mature” of me to recognize that, when I wrote this entry, I didn’t feel like I was capable of raising a person. However, the context is important. When I wrote this entry, I was smoking pot from the moment I woke up until the time I went to bed. I had stopped taking testosterone only a couple of months beforehand. I was living with family who had children, and it was not a healthy environment. I had undiagnosed developmental disabilities that I couldn’t address because I didn’t know I had them.
I’m not surprised that I felt much more ambivalent about whether I wanted children when I felt like my entire adulthood had been failure after failure.
December 31, 2017
There is a note in my 2017 year-in-review that I had a hysterectomy consultation in November of that year. This would have been a few months after meeting my bestie. At this time, he was considering having an orchiectomy, and to be frank, I think I was influenced by him. I had certainly been thinking about the surgery, as seen in the 2016 entry, but being around another person who was trans-identified and thinking about surgery pushed me forward. This wasn’t his fault, and I think I influenced his decisions, as well. It was just two mentally unhealthy people feeding off of each other.
May 5, 2018
“I had a hysterectomy on Tuesday, have known the date for two months, have been planning it for more than half a year, and I think I’ve literally told less than ten people.
I’m not sure what to make of that, really, or if it means anything at all. I think maybe it’s just more proof that I’m growing less and less interested in people (which makes little sense because I have finally determined that I feel very lonely, but makes sense again when I acknowledge that I don’t go out of my way to talk to anyone… too much effort for not enough reward).
Anyway, no more uterus.”
Most of my excerpts here are just parts of bigger journal entries, but this was the entire entry. It is probably one of the saddest things I have ever read.
I was so depressed around this time. I didn’t want to talk to anyone. I barely left my apartment. I barely moved at all.
I was desolate. (A single line entry several days later reads: “honestly i just wish i liked any aspect of my life.”)
I think the pursuit of a hysterectomy was a bit of a self-fulfilling prophecy. I felt myself growing further and further away from the rest of society, and this was a means of cutting myself off even further by removing the means with which I could help society grow.
I don’t have much more to say.
February 5, 2021
“Honestly I'm not extremely distressed over not having boobs at this point in time. Maybe I'll change my mind in the future and have some kind of regret. Who knows.
I'm actually more bothered that I went through with the hysterectomy, but maybe that's more because I wish the option of children was more easily accessible to me. (As it stands I still have ovaries, though.)
I'm about to turn 33 though and I don't see kids happening in the next two years so maybe I'll be too old to get pregnant before I'm ever ready. Then it wouldn't matter.”
This is something unpublished that I wrote three months after I decided to detransition. I wrote quite a bit that has never seen the light of day.
It’s now been about 20 months since I decided to detransition, and I want to first point out that I do actually regret my mastectomy now. It’s been an incredibly long time since the procedure was done (ten years), so the pain of it isn’t nearly as difficult when compared to the hysterectomy. In this same entry, I discussed the sensory issues I had with wearing bras and having breasts in general, and this was framed as sort of the upside to not having them anymore, which is why I say I’m “not extremely distressed.” However, at the time I wrote this, I had hopes that, in detransitioning, it would be easier to “pass” as a woman than it has been. The fact that I am still being seen as male is weighing on me a lot more than it did when I was still only picturing what I might be in for at the beginning of detransition.
I think when I said “maybe I'll be too old to get pregnant before I'm ever ready” I was thinking of the potential of altruistic surrogacy. Obviously, I can’t ever get pregnant myself.
Later in 2021, I ended up going to a fertility clinic to see what my options were. It was after this time, when I truly understood the gravity of how difficult it would be to have children (including via adoption), that my regret grew to the levels they have reached today.
There are a lot of women who choose not to have children; who may choose hysterectomies and are perfectly content, even enthusiastic, about it. I’m not one of those women, and before my brain was addled with gender bullshit, there was no indication that I would ever be one.
I wanted to become pregnant. I wanted to bear my own children. I wanted to breastfeed. I can’t do any of these things now.
Maybe I will be a mother in the future. That is yet to be determined. But the shame of not being able to fulfill something that was once so important to me—something women have been doing for time immemorial—has yet to go away.