“Why would we take men? This is an OB/GYN”: Gender, hysterectomy, and the patriarchal dividend

Abstract

Hysterectomy experiences among transmasculine individuals represent a powerful case to examine gendered dynamics in healthcare, especially given the continued cultural association between the uterus and womanhood. In this paper, I draw on theories from feminist science and technology studies and medical sociology to examine in-depth interviews with 46 trans or nonbinary individuals who have had, want, or are considering an elective premenopausal hysterectomy. I find that trans men and nonbinary patients must negotiate what I call the structural feminization of gynecology which often leads to poor healthcare experiences. This paper also extends theories of a “patriarchal dividend” in medicine by examining reported differences in medical experiences when patients are perceived as cisgender women versus as trans men or nonbinary. I find a double bind inherent in the patriarchal divided in healthcare: masculinity often leads to better care, but the patriarchal dividend is constrained by the stigma introduced by being a trans patient. In the process, I extend social scientific knowledge of a highly common yet understudied procedure while expanding scholarship on medicine, gender, and embodiment.