Hysterectomy FAQs

Pre-op insurance requirements?

  • Insurance companies generally follow WPATH guidelines. WPATH guidelines currently require 2 letters from providers, one can be your primary care or hormone specialist and the other from a mental health specialist.

  • However, many insurance companies follow the previous WPATH recommendations of 3 letters: 1 from your hormone specialist and 2 from mental health providers (1 provider needs to be a PhD or MD). Please check with your insurance carrier for their specific requirements.


California sterilization state law requirements:

  • Non-Federally funded (not Medi-cal or Medicaid) patients, must be 18 years old to undergo elective sterilization surgery. Exceptions to this rule include the following: under 18 years of age and have entered into a valid marriage OR is on active duty with the U.S. armed services OR received a declaration or emancipation OR is at least 15 years of age, live apart from your parents or guardians, and manage your own financial affairs.

  • Federally funded (have Medi-cal or Medicaid) patients, must be 21 years of age to undergo elective sterilization surgery.


Do I have to have the uterus removed prior to a metoidioplasty?

  • If you are electing to have the vagina removed then the uterus must be removed  first. If you are keeping the vagina, then the uterus does not have to be removed.

Do I have to have my fallopian tubes removed?

  • If you are having the uterus removed, then doctors are recommending removal of the fallopian tubes.

  • Fallopian tubes have been shown to be a source of ovarian cancer and without the uterus, they do not provide any benefit.


What about my ovaries?

  • Reasons to keep ovaries include future fertility and recent studies show they are still producing estrogen, even with testosterone.This estrogen can help protect bones and prevent cardiovascular issues like stroke or heart attacks.


How long will I be in San Francisco? 

  • About 3 weeks. the preoperative visit in the office a few business days prior to surgery and then a post op visit 2 weeks after surgery.


How long is surgery?

  • The surgery, once we are in the operating room takes 1-1.5 hours.


Will I go home the day of surgery?

  • Yes, this is usually a same day procedure.


Will I have a large scar?

  • No, we offer minimally invasive surgical options: laparoscopic or robot assisted laparoscopy.