The journal of sexual medicine · 2025
Gynecological gender-affirming surgeries: what are the motivations and experiences? A qualitative study.
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Vestering Asra, van de Grift Tim C, Groenman Freek A, Huirne Judith A F, Kreukels Baudewijntje P C, van Mello Norah M
Аннотация
BACKGROUND: 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.
AIM: The aim of this study was to acquire an in-depth understanding of patients' motivations and experienced outcomes of gynecological gender surgery.
METHODS: 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.
OUTCOMES: The primary outcomes of this study were composed themes based on thematic analysis of the interview transcripts.
RESULTS: 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.
CLINICAL IMPLICATIONS: 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.
STRENGTHS AND LIMITATIONS: 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.
CONCLUSION: 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.
AIM: The aim of this study was to acquire an in-depth understanding of patients' motivations and experienced outcomes of gynecological gender surgery.
METHODS: 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.
OUTCOMES: The primary outcomes of this study were composed themes based on thematic analysis of the interview transcripts.
RESULTS: 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.
CLINICAL IMPLICATIONS: 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.
STRENGTHS AND LIMITATIONS: 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.
CONCLUSION: 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.