Requests for hysterectomy and bilateral salpingo-oophorectomy (HSBO)

Requests for HSBO (Hysterectomy and salpingo oophorectomy – historically transmen receiving testosterone were advised to have this surgery. There is currently no evidence for an increased risk of endometrial or ovarian cancer with testosterone treatment, but any symptoms which could suggest a problem with these organs, particularly vaginal bleeding, pelvic pain or abdominal bloating should be investigated further. The WPATH (World Professional Association for Transgender Health) recommend against routine oophorectomy or hysterectomy solely for the purpose of preventing ovarian or uterine cancer for transgender and gender diverse people undergoing testosterone treatment and who have an otherwise average risk of malignancy.