Transgender Medicine Specialist

Her Medical Clinic: Roy Silver, MD

OB-GYN located in Beverly Grove & Downtown, Los Angeles, CA

When you’re making a transition between genders, it’s important to find supportive medical care. Dr. Roy Silver, of Roy Silver MD, with locations in Beverly Grove and downtown Los Angeles, provides a transgender-friendly practice, offering minimally-invasive hysterectomy for women transitioning to men. Call the office or book an appointment online to consult with Dr. Silver.

Transgender Medicine Q and A

How does minimally-invasive hysterectomy work?

Traditionally, hysterectomies have been performed as abdominal surgery, including both a large incision and its accompanying scar, up to two days in hospital, and as much as eight weeks of recovery time. It’s estimated that around 80% of the 600,000 procedures performed annually in the United States use conventional abdominal techniques.

However, laparoscopic surgery for hysterectomy provides a way to approach the procedure without major scars or long recovery times. Depending on the details of the hysterectomy procedure, minimally-invasive laparoscopic techniques use as few as two small keyhole incisions in the abdomen. In some cases, the hysterectomy may be performed entirely through the vagina, requiring no abdominal incisions at all.

Dr. Silver is an award-winning laparoscopic specialist, so he can handle any aspect of your female-to-male hysterectomy surgery.

How do recovery times compare between conventional and laparoscopic procedures?

Abdominal hysterectomy represents major surgery with slow, painful recovery due to the disturbance of muscle tissue. Recovery time is typically six to eight weeks. Full laparoscopic procedures as well as vaginal hysterectomies each have a recovery time of approximately two weeks.

Must I have a hysterectomy to be transgender?

The choice to undergo any transition surgery is completely up to you. The way you feel about your identifying gender is more essential than any procedure. Some people may not be comfortable with the idea of surgery, but that doesn’t affect their identification.

There are several points to consider, however, when you’re considering hysterectomy. First is your comfort visiting a gynecologist once you’ve attained your full identification as a man. This may be embarrassing or uncomfortable for some, but it would be necessary as long as you have a uterus and ovaries. Additionally, some states require genital surgery as a condition for legally changing your gender.   

Finally, there are medical reasons to consider. Testosterone therapy stops your menstrual cycles, and some doctors suspect that this may increase your risk for cancer in the female reproductive organs and therefore recommend full hysterectomy. Clinical evidence is still building to support this theory. On the flip side, once your uterus and ovaries are gone, your body no longer manufactures its own testosterone, so you will be completely reliant on testosterone therapy.

Notes: For women transitioning to men. Offers minimally invasive laparoscopic hysterectomy. Mention that it’s a transgender friendly office.

What should I consider before deciding to have a hysterectomy?

Be aware that you need to undergo a pelvic examination prior to the surgery. Pelvic examinations can be embarrassing and emotionally challenging for transgender men, but they are a necessary part of the process.

In many states, including California, you can't legally change your gender until a licensed physician certifies that you've undergone "clinically appropriate treatment" during your transition. The doctor can complete this form for you after performing a hysterectomy.

Before a hysterectomy, make sure you understand how the surgery can impact your hormones. You'll no longer have female hormones, but you'll also lose the small amount of testosterone produced by the ovaries. This means you'll need to rely on testosterone therapy for all of your testosterone, and that may mean dosing changes.

What are the advantages of a minimally invasive hysterectomy?

Hysterectomies were once done only as open abdominal surgery that required very large incisions of up to a foot long. Today, doctors can perform hysterectomies with minimally invasive techniques that require a few tiny incisions around 8-12 mm each.

The smaller incisions cause far less blood loss and also result in dramatically smaller scars. Patients experience less pain as well. Recovery time is around two weeks after a minimally invasive hysterectomy compared to six to eight weeks for open surgery.

If you’re going through a transition or planning to begin your transition soon, know that the Doctor is transgender-friendly and wants to help. Make an appointment with the online tool or call anytime to get started.