Testosterone and Ovarian Cancer / Endometriosis Risk

[JakesTherapySession]

So I'm pre-T and am so ready to transition. Been out since 2009 and attempting to live stealth without any treatment whatsoever but dysphoria is killing me.

The biggest apprehension I have towards T is paranoia towards my health. I also have obsessive compulsive disorder with a lot of my obsessing lately fixated towards my carcinophobia, fear of getting cancer. Part of this fear, I feel, is more legitimate and valid because on both sides of my family, most people who are DFAB have had some kind of hormone/reproductive related cancer.

My aunt (cis woman) had a hysto, and bilateral mastectomy simply due to the risks and finding growths and stuff.

Knowing this makes me freak out and think I'm gonna get some kind of cancer within a few months of starting T or something. Also knowing that ovarian cancer is like... really hard to detect until it is too late, I keep thinking going on T will be some kind of death sentence for me.

I don't see a lot of people saying they developed any issues due to T, very few if any. And logically I know there's no evidence that T affects cancer risk, but I do know that the body produces aromatase which converts T to E, and aromatase inhibitors are kinda risky too.

I'd like to get a hysto/oopho immediately after starting T, if I can afford it, but I'm legit afraid they won't let me have it, I'm not sure how long I'll have insurance and I don't know how much hysto's cost for trans men without insurance. And I'm also afraid of complications from hysto/oopho, as I'm aware damage to other areas of the body can occur as a risk.

Basically I'm extremely paranoid to the point of losing sleep but also dysphoric to the point where I can't handle being in my current position anymore and am sick of being held back by anxiety. What should I do?

Sorry, this is probably all a bit incoherent.

[FTMax]

There is absolutely no data which can confirm or deny the idea that testosterone use in trans men increases your risk for reproductive cancers. It is a myth. The reason a hysterectomy is encouraged for trans men who are on T long term is due to atrophy and increased risk for endometriosis because you're typically not shedding the uterine lining. Your only confirmed risk comes from your hereditary disposition to reproductive cancers.

You should be discussing this with your healthcare provider. They may be able to green light a hysterectomy for you early on. I'm not sure what kind of insurance coverage you could expect if the medical necessity was to avoid cancer. Mine was covered as a prerequisite to bottom surgery, but my plan is trans inclusive. Anyway, a total hysto with bilateral salpingo-oophorectomy would be a 100% cancer risk reduction. So if you want to avoid cancer, it seems like that is the route you need to be going down - maybe even before T, because it seems like you're hung up on it.

There are very few risks with a hysterectomy, and they are mostly related to the bowels and bladder and their potential for being nicked during surgery. It's like a 1% chance. When I asked my doctor before she did mine, she actually couldn't remember the last time anyone had had a bladder complication during surgery with her. She had to go look it up for me. I've had no complications whatsoever. I feel great. I've spoken with a lot of guys about their procedures, and it seems like very, very few people have issues. Especially if it's done laparoscopically.

I'm not sure what you could expect as far as out of pocket prices for a hysto. Most doctors charge different (lower) prices if they know you're paying out of pocket. I paid with insurance. They paid the hospital and my doctor $36k. I paid a little over $1500.

[JakesTherapySession]

That makes sense, yeah.

I never actually considered getting it done before I go on T, I didn't know that was possible. That might be the most preventative thing to do and would make me feel 100% secure in going on testosterone. I'll definitely talk to my doctor about that next time I see him. I have Kaiser Permanente in Southern California/Riverside county.

As far as risks just being from nicking organs, that makes sense and it is relieving. I have a bit of a fear of the morcellator spreading some malignant stuff that wasn't previously seen cause apparently that's happened, but I'm guessing maybe there's ways to get a hysto without the use of that.

How long did it take for you to recover from the hysto, was it easy?

[FTMax]

How long did it take for you to recover from the hysto, was it easy?

Surgery was at 11am on a Thursday. I walked out of the hospital around 3pm the same day, had dinner, walked my dog, slept, and took Friday off work to relax. I went back to work on Monday as usual. I only used painkillers on the day of surgery, because I felt like it was a good idea. I didn't need them. Much easier to recovery from than top surgery, but that is my only other point of comparison.

People's recoveries seem largely dependent on what exact procedure they have done. I had a laparoscopic assisted vaginal hysterectomy with a bilateral salpingo-oophorectomy. I just had an incision in my belly button and one on my pubic bone, so my only visible scar is tiny. There was no big trauma to the lower stomach like you'd have with an abdominal hysto. Definitely, definitely ask to have it done laparoscopically if you can.