Hysterical Man: 4 Lessons Learned Preparing For Middle Surgery

I’ve been processing the prospect of a hysterectomy for the past year. I’m at the point where I definitely want the surgery and will probably schedule it as soon as I don’t have a bunch more urgent stuff demanding my attention (i.e. when the semester is over). I have to say it’s been an excruciatingly painful aspect of my transition. A few thoughts on where I’m at and how I got here.

Mules are also sterile, and this one is ready for a nap. I guess there’s just something about being between categories. Photo: David Shankbone.

1. Sterility is a really big deal. When I went in to get a prescription for testosterone, my doctor asked me if I wanted to preserve the possibility of having a biological child. I was like, um, yeah, hell no. I was also 21 years old and way more concerned with paying for beer that night than with being a parent someday.

Letting go of the possibility of having a biological child has been the hardest and most heart-wrenching aspect of this experience. I don’t want to use any of the options available to me for having genetic offspring. There are so many reasons for this, I don’t even want to get into it. Suffice to say that even though I don’t want to use what I’ve got–just the prospect makes me queasy–it’s still hard to let it go. It means letting go of the fantasy that I could ever be a biological father. In confronting this reality, I have felt disappointed, cheated, and humiliated. I have felt left out of the great dance of life, a lonely alien. It feels strange to be so sad, yet so repulsed by the options that are open to me.

2. I am in profound denial about my body. I have never accepted the fact that I was born with a female body. I have to admit that I just straight up do not believe it, to this very day. There’s some pretty solid evidence for my view in that I am, you know, a man. Again I ask, WTF God? WTF?

This is a very deep-seated belief that is beyond all logic and is extremely resistant to change. As far as I can tell, I have always carried the worldview that I am male and it seems I always will. This is the reason approaching hysterectomy has been so painful–it has forced me to experience the cognitive dissonance of being transsexual in a whole new horrible way.

My take on this is, to paraphrase Eckhart Tolle, when you can’t accept, accept your non-acceptance. I accept that I am a trans man, that I have a view of my body as male that is not going to change, and that the thing I can change is my body. I accept that I cannot be a good custodian to female reproductive organs. It’s just not realistic for me at all. So a hysterectomy is something I can do for myself and for my health, out of love.

3. Grieving is necessary. I spent a good while feeling heartbroken about my status as soon-to-be-sterile and never having the option to be a biological father. This was an absolutely essential process for me. It’s normal to grieve over this kind of thing, and we need to allow ourselves the space and time to fully go there.

I can now see that a lot of my grief is about lingering shame and pain around being trans, rather than about parenthood (though of some of it really does have to do with parenthood). I have an ingrained belief that being able to father a child has something to do with being a “real man.” I’m still dealing with this; cultural ideas like that are just hard to shake off.

4. Planning a family is about a lot more than gametes. As I began to see the light at the end of the tunnel of my grief, I got a reality check about my hopes to be a parent. Having a child is something I want to do with my wife, obviously, but it’s only recently that I’ve been able to really consider her feelings. In retrospect, I’ve been pretty myopic and selfish about the whole thing; but at the same time, I really could not have gotten to this point without moving through my grief.

Alma has always wanted to adopt and has absolutely zero interest, or really less than zero interest, in ever being pregnant. I can now enjoy the wonderful match we have in this area and feel good about supporting her in her bodily autonomy.

I’m enjoying my new-found clarity about my own feelings, hopes and fears. I’ve come to realize that I actually do not care about having a biological descendant or sharing that connection with a child. I do care very much about being a father someday and I hope to adopt children with my partner. There is a scary vulnerability in this, as I have no idea if it will work out. But it’s real and it’s honest, a genuine dream.

How has your transition impacted your feelings and choices about fertility and parenthood?

Thanks to Lesboi for teaching me the term “middle surgery” for hysterectomy.


  1. Lesboi

    Thanks for the link to my site rimonim. I can’t take credit for the term middle surgery though. I first saw it on Becoming Jordan’s blogpost at onbecomingjordan.wordpress.com/2013/07/16/one-giant-step-forward/. Where he first heard it I don’t know.

    So much of what you said about how you’re feeling rings true even for me as a late bloomer. There is a mourning phase and although I was probably no longer able to bear my own child I still had to deal with the fact that this would not ever be an option after the surgery. I’ve written on several occasions about how much dysphoria I felt as a young person around the idea of ever becoming pregnant and having children of my own. I had a really hard time believing those parts were inside my body too and even today still find it hard to believe. It just feels like such an impossibility. But they were and in your case are part of your body. And yes, sterility is a really big deal. I’m glad you’re taking the time to wrap your head around this and give it the energy it deserves and I wish you nothing but happiness and success as you move forward in your life. Rock on!

      • Lesboi

        You’re very welcome. I really get a lot out of reading your posts and value what you have to say. It really is weird to feel grief for something I’ve always detested. I felt it was more of a making peace kind of thing. In my case, I think they made it pretty clear that they were not going to let go of me easily but in the end my surgeon won the battle. I’m sure yours will go much smoother and less eventful.

  2. Tea With Ess

    When we were in the middle of trying to conceive we tried on me as well a few months. I was miserable the whole time and the prospect of actually become pregnant scared the shit out of me. I can honestly say that I won’t miss my reproductive organs, I would rather feel relieved since there would be absolutely no chance for me to become pregnant then. It sure helps that we have a baby already, but for a while we honestly thought that I was the only chance for us to have children. I’m so happy that it all worked out the way it did. I wouldn’t be a good parent of I had to go though a pregnancy and my wife would not be a good parent if she hadn’t been pregnant (she would have been madly jealous of me if I carried the baby). And then there’s the period stuff and all the other messy bits that I wish to remove as well. The whole thought of my reproductive organs make me queasy and I prefer to not think too much of them. Being reminded of them monthly is awful!

  3. Dexxy

    These are huge decisions. Bigger than we realise until it is in our face and needs an answer. Thank you for this, your thought process on this topic is helpful and informative. Hope you work it all out and continue to live happily.

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