how to have a gender-affirming hysterectomy in melbourne part 1: finding a surgeon
The first thing you need to know is there’s no escaping the round abstract silhouettes of gynaecological graphic design. Those voluptuous torsos will follow you everywhere from clinic logos to booklet covers to consent forms. All information sheets will refer to you as a woman, all internet advice will start with “hey ladies”, and if you google specific hysterectomy-related questions you will be recommended a site called “hyster sisters”. Just expect to be misgendered in tiny ways throughout this entire process.
A hysterectomy seems to be a sad occasion for a lot of people. The fact sheet from my hospital has a pretty solemn tone. It feels a bit weird to be ecstatic about something that makes other people miserable. But I’ve been wanting to be sterilised since I could pronounce the word, and I’ve been asking doctors every few years since I was a teenager.
The first doctor I consulted at 18 was emphatic that no one would sterilise me until I was 30. The doctor I visited for a second opinion said the same. In the meantime I took Yasmin, an oral contraceptive that prevented any chance at pregnancy by eliminating my libido, but also abolished my periods. At 30 I had finally reached the age of rational reproductive decision-making, so a few days after my birthday I visited the GP. That doctor told me that sterilisation doesn’t happen in Australia, that the only semipermanent contraception I could get was an IUD, and refused to refer me to a gynaecologist or gynaecological surgeon. At this point I still believed everything doctors said, so I got that IUD. Going into shock during the insertion and having constant cramps for 6 months was just the motivation I needed to earnestly look into a full hysterectomy. The next doctor I asked was really supportive! And referred me to a gynaecologist who didn’t exist. The reddit group r/childfree suggested the name of a gynaecologist, but I couldn’t find a number or any information for her. My life became busy with a PhD and mental health, so I just put it in the too-hard basket.
After submitting my PhD I got a bit more spare time and a bit more tired of bullshit so I became serious about finding a doctor and a surgeon. I googled around and emailed five gynaecological surgeons in Melbourne. I told them I was nonbinary and 35 and looking to be sterilised. Three replied: Dr Melissa Cameron said they couldn’t discuss details outside of consultations (which cost $250), Dr Alex Ades replied with yeah we sure do sterilisation come on over, and another replied with hell yeah nonbinary come get snipped we got two bricks with your name on it. That was Dr Latika Cilly, so I made the earliest appointment I could (about two months) and in the meantime asked my GP to write a referral.
In between the GP appointment and the surgical consult with Dr Cilly, I read everything I could about the different types of hysterectomies and the recommended recovery process for each. I decided my priorities were: being infertile, stopping periods, and reducing cancer risk. I looked into the types of surgical methods and how my hormones and mood might be affected. I tried to find out whether my existing medication would interact with the anaesthetic. I read stories of people whose lives had fallen apart after having the surgery. I read accounts of trans people who’d had hysterectomies, but they’d all been on testosterone for years. Being more concerned with my body than my bank account, and being a naturally optimistic person, I didn’t look into Medicare rebates, OOP fees, or private health insurance. I decided to ask for a full hysterectomy, which removes the uterus, tubes, and cervix, but leaves the vag and ovaries in place. My main concern was whether removing a cervix permanently affects penetrative sex.
My girlfriend of the time came with me to the appointment for moral support and memorying. I was anticipating a lot of questions and resistance. I was expecting Dr Cilly to judge my conventional femme appearance, interrogate my nonbinary bona fides, give me a stern lecture about regrets, and tell me it would cost $10,000 and also be impossible, since that had been my experience so far. But Dr Cilly was great. She was wonderful. She didn’t quiz or patronise me, she was like “you’re obviously old and self-assured, let’s get you chopped up”. She looked at me hard and said “permanent” and I said “yes great perfect” and then she gave me a very quick but still pretty uncomfortable vaginal exam and then she gave me a very rough quote and booked me in for surgery in 6 weeks’ time. I asked her whether removing a cervix makes your vag shorter or causes pain during sex, but she said it didn’t.
After the appointment I couldn’t really take the news in. It seemed too good to be true. Even now, with 5 days to go, I am absolutely certain something’s going to happen that’ll mean it has to be cancelled. I did hit a snag — I’m uninsured so it looks like it’ll cost around $3500 all up, if the surgery all goes smoothly. It’s $2000 for the surgery itself, around $1000 for the overnight hospital stay, and around $400 for the anaesthesia, though I won’t know the exact amounts until they actually present me with the bills. I don’t know if Medicare will give me any back. I don’t know how much it would cost with private health insurance. I’d pay anything really, and I have the savings, and all dollar amounts over $100 are just incomprehensibly large to me, and $3500 turns out to be just $175 per year of longing, so I’m going ahead with it. (post-script — little did I know that going for surgery in the private system had so many hidden costs)
I’m excited to get the snip. I’m thrilled to be the end of my line. I’m really psyched to be incapable of producing an heir. I’m really looking forward to never passing on my legacy. Even in a post-climate-apocalypse scenario, I won’t be forced to repopulate the human race!
If I tell people about my upcoming snip in an enthusiastic tone, people usually respond in kind. But a few people have been a bit odd. One person seemed really flustered and said “Well I suppose you can have a meaningful life without kids” (I suppose so!) A lot of people have asked what my boyfriend thinks.
The hospital fact sheet says that I’ll be off work for a month. It says I can’t drive for 3 weeks, lift anything heavier than two kilograms for 4 weeks and or have sex for 6 weeks. I’m supposed to do stretching and breathing exercises so I don’t get blood clots. They also give me exclusive surgery socks to wear, very cool. It did say I should be able to have a shower and walk around the house, but whether that’s the minimum or maximum I don’t know. It also says that during the surgery everything in your lower half gets a bit scrambled and the loo can get dicey for a while.
:/
