CHSU Discovery

Abstract
Total laparoscopic hysterectomy (TLH) is a common minimally invasive surgery; rising obesity rates prompt investigation into how body mass index (BMI) affects surgical outcomes, especially among underrepresented populations like transgender males.
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Most research on TLH outcomes focuses on cisgender women—few studies address transgender men, despite increasing rates of gender-affirming hysterectomies. Testosterone therapy in transgender men affects BMI and may alter uterine histopathology, though current findings on endometrial changes are mixed.
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Higher BMI is associated with increased surgical complications (intraoperative and postoperative); long-term testosterone therapy (> 1 year) leads to histopathologic changes in the uterine endometrium (i.e., inactive/atrophic).
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The primary aim of this study is to provide critical insights into the impact of BMI on TLH outcomes in transgender men in comparison to cisgender women. The study's secondary aim is to highlight the effects of testosterone therapy on BMI and uterine histopathology and the impact on surgical outcomes between study groups.