For most of my life I paid as little attention as possible to everything between my neck and my knees. I was shocked each time I got my period. I didn’t track it and I didn’t prepare for it. It arrived, I dealt with it, and then it was over. I was in so much denial that I left no room for dysphoria.

Between the ages of 21 and 42 I never went to a doctor for a check-up. Or to a gynecologist. I had a superficial physical each time I was promoted at work. Other than that I only went to the dentist and the ophthalmologist.

I didn’t want a doctor to tell me to lose weight. I didn’t want to spread my legs for a gynecologist. I scheduled a routine physical (in 2000) only when I realized that I was the same age that my Dad was when he dropped dead from an aneurysm.

The week before my doctor’s appointment I bought a new cotton futon for my bed. The old one was 12 years old and lumpy. I sleep on my stomach, but I was having trouble sleeping through the night. The nurse practitioner examined me, and told me I needed to lose 40 pounds. She asked me how long it had been since I saw a gynecologist. I told her the truth. She insisted on doing a pap smear and a pelvic exam. After the exam she asked me if I’d noticed a lump in my abdomen. She guided my hand over my belly from the left side to the right side. I felt it. She said it was probably a benign fibroid and that I should get a sonogram and then consult with a surgeon about getting a hysterectomy.

When I went to sleep I felt the lump again. It was big. It wasn’t the mattress.

The first surgeon I consulted wanted to do a complete hysterectomy (uterus, cervix, and ovaries) and put me on estrogen replacement therapy for the rest of my life. I knew that if I had the hysterectomy I would never get my period again, but I also knew that many hysterectomies were unnecessary. The women’s health movement critiqued gynecologists for urging women to get hysterectomies once they were past childbearing age, and for prescribing and promoting estrogen as the fountain of youth even though it had potentially harmful side effects.

I did some research and read about myomectomies, a surgery where the fibroids are removed, but the uterus, cervix, and ovaries are left intact. Sometimes fibroids grow back, but there was a good chance that I’d make it to menopause intact and that I would be able to go through a natural menopause. I also considered a partial hysterectomy (only removing the uterus). I did not ask myself what I wanted to get out of the surgery, I only thought about the best way to remove the fibroids.

I had the myomectomy. Everything was “good” for about five years. My period came and went, and I pretended that it wasn’t happening to me. Then, I started bleeding heavily and irregularly. I became anemic. I found a gynecologist who was willing to try to get me through menopause without a hysterectomy. I tried Lupron, but hated the side effects. I had a D&C to remove a hanging fibroid. Eventually we agreed on a partial hysterectomy; leave the cervix and the ovaries in, take the uterus and the fibroids out. No need for estrogen replacement therapy. No more bleeding or periods. I felt better immediately after the surgery.

I felt so good, that I didn’t go back to a doctor or a gynecologist for another eight years. Not until I’d lost the 40 pounds and come out as trans.

I regret not getting the partial hysterectomy the first time around. Other feminist paradigms (love your body shape just the way it is, love your breasts no matter how big/small they are, and be mistrustful of synthetic hormones) made me question getting top surgery (2014) and taking, or not taking, testosterone (still on the fence).

One thing I’ve learned during my transition is to ask myself “What do I want to get out of this?” instead of “What should I do?” For top surgery, the answer was that I wanted my pre-puberty chest back and I wanted to stop binding. If I still got my period, or had a lot of estrogen in my system, I might want to take testosterone, or some other drug, to stop it. But, when I ask myself what I want to get from testosterone now, I struggle to come up with an honest or compelling answer.

Notes: I generally don’t read a lot of articles on menstruation, menopause, or uteri. I still ignore my lower half. However, I do like this piece from Spacious Perspicacious “On being nonbinary and having an evil uterus“. I also like this piece “I Use Hormones For Things You Might Not Approve Of‘ by s.e. smith.