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\begin{document}

\title{``I'm not getting paid to give you a TED talk on how my trans body
works''. A qualitative study exploring healthcare encounters for
hysterectomy as part of Female-to-Male gender affirming surgery}



\author[1]{Sara Filoche}%
\author[2]{Sarah Ingamells}%
\author[3]{Denise Steers}%
\author[1]{Claire Henry}%
\author[4]{Tai Hartley-Parsons}%
\affil[1]{University of Otago Wellington Department of Obstetrics Gynaecology and Women's Health}%
\affil[2]{University of Otago Wellington}%
\affil[3]{University of Otago Wellington Department of Psychological Medicine}%
\affil[4]{Wellington New Zealand}%


\vspace{-1em}



  
  \date{May 24, 2024}


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\begin{abstract}
\textbf{Background:} Healthcare for transgender people can be unsafe and
inequitable. \textbf{Objectives}: To explore the experiences of care
surrounding hysterectomy as part of female to male (FtM) gender
affirming surgery. \textbf{Design:} Qualitative observational study
\textbf{Setting:} Aotearoa/New Zealand \textbf{Participants:} Ten people
(out 12 people) who underwent FtM over a four-year period.
\textbf{Results:} No one person's experience of the FtM journey was
affirming across the whole surgery journey. Transgender health literacy
was central to inclusive practice as it mediated bodily autonomy being
upheld. FtM (hysterectomy) surgery was described as ``
\emph{life-saving}''. The physical care environment influenced the
experience of the healthcare encounter. For example, the waiting room
was intimidating, with a gendered clinic name and toilets. Some
participants took a female support person/partner so that ``
\emph{people looking would assume that I was there supporting her, not
the other way around}.'' Communication misalignments were evident around
information provided/understood about fertility and ovarian
preservation, requirement of a pre-operative pregnancy test, and
post-operatively, about bleeding and when sexual intercourse could be
resumed. Participants were also placed in the position of both receiving
care and providing education: `` \emph{I also shouldn't have to be going
in there for treatment, and then being expected to educate the medical
professional that's meant to be helping me\ldots{} I'm not getting paid
to give you a TED talk on how my trans body works}.''
\textbf{Conclusions:} A whole care pathway approach to increasing
transgender health literacy will facilitate better alignments in
communication, uphold bodily autonomy and lead to equitable inclusive
practice.%
\end{abstract}%



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