Surgical Outcomes for Transgender Men Undergoing Hysterectomy

Innie Chen; Vincent Nguyen; Meryl Hodge; Ranjeeta Mallick; Hélène Gagné; Sukhbir S Singh; Abdul Jamil Choudhry; Rihua Xie; Yan Liao; Shi-Wu Wen

doi:10.1016/j.jogc.2019.05.009

Surgical Outcomes for Transgender Men Undergoing Hysterectomy

J Obstet Gynaecol Can. 2020 Jan;42(1):25-30. doi: 10.1016/j.jogc.2019.05.009. Epub 2019 Oct 31.

Authors

Affiliations

¹ Faculty of Medicine, University of Ottawa, Ottawa, ON; Ottawa Hospital Research Institute, Ottawa, Ottawa, ON; Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON. Electronic address: ichen@toh.ca.
² Faculty of Medicine, University of Ottawa, Ottawa, ON.
³ Ottawa Hospital Research Institute, Ottawa, Ottawa, ON.
⁴ Faculty of Medicine, University of Ottawa, Ottawa, ON; Ottawa Hospital Research Institute, Ottawa, Ottawa, ON; Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON.
⁵ Ottawa Hospital Research Institute, Ottawa, Ottawa, ON; Nanhai Hospital, Southern Medical University, Guangdong, People's Republic of China.
⁶ Ottawa Hospital Research Institute, Ottawa, Ottawa, ON; Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON.

PMID: 31679919
DOI: 10.1016/j.jogc.2019.05.009

Abstract

Objective: This study sought to assess surgical outcomes of hysterectomy performed for transgender individuals compared with hysterectomy for individuals with menstrual disorders.

Methods: This retrospective cohort study was conducted using the American College of Surgeons National Surgical Quality Improvement Program database. Data of transgender individuals who underwent hysterectomy and individuals who underwent hysterectomy for menstrual disorders were extracted from the participant use data file (2015-2016). Transgender individuals were compared with individuals with menstrual disorders for surgical outcomes within 30 days of hysterectomy, by using appropriate statistical tests. A two-sided P value of less than 0.05 was considered statistically significant (Canadian Task Force Classification II-2).

Results: The study identified 89 cases of hysterectomy for transgender individuals and 4439 cases of hysterectomy for menstrual disorders. Compared with patients who underwent hysterectomy for menstrual disorders, transgender patients were more likely to be younger (mean ± SD 30.79 ± 9.68 years vs. 42.6 ± 7.04 years), have a normal body mass index (25.84% vs. 17.77%), be classified as American Society of Anesthesiologists class I (34.09% vs. 10.46%), and have outpatient surgery (76.40% vs. 53.55%) (P < 0.05). Overall incidence of postoperative complications was low for both groups. No significant difference in surgical outcomes was observed for re-admission, superficial or deep/organ space infections, wound dehiscence, sepsis, blood transfusion, deep vein thrombosis, pulmonary embolism, or death. Transgender patients who underwent hysterectomy on average required decreased operative time (120.4 ± 79.2 minutes vs. 131.2 ± 64.3 minutes) and decreased lengths of stay (0.82 ± 0.82 days vs. 1.35 ± 2.73 days).

Conclusion: This study suggests that transgender patients undergoing hysterectomy were younger and healthier than patients undergoing hysterectomy for menstrual disorders. Surgical complications were low for both groups, and significant differences in surgical outcomes were not observed.

Keywords: Transgender; hysterectomy; patient safety; surgical complications.

MeSH terms

Adult
Canada / epidemiology
Cohort Studies
Databases, Factual
Female
Humans
Hysterectomy / adverse effects*
Male
Postoperative Complications / epidemiology
Postoperative Complications / etiology
Postoperative Complications / mortality
Quality Improvement
Retrospective Studies
Surgical Wound Infection / epidemiology*
Surgical Wound Infection / etiology
Surgical Wound Infection / mortality
Transgender Persons*
United States / epidemiology