A Qualitative Analysis of the Fertility Experience and Gender Identity in Young Women Following Hysterectomy for Benign Disease

Abstract

AbstractHysterectomy may impact young women’s perceptions of their gender identity and fertility status, with implications for quality of life. However, research into this important area is limited, particularly among women with benign disease. To investigate gender identity and fertility in this population, semi-structured interviews were conducted with 18 women who underwent hysterectomy for benign disease at age 39 or younger. Women were asked to describe their experience of hysterectomy and how it affected their perceptions of their gender identity, fertility status and overall quality of life. Thematic analysis was used to analyse and code responses. Three themes were identified; Implications of Infertility, I am a Woman and Womanhood Compromised. Within these themes, 3 sub-themes were identified. Implications of Infertility comprised three sub-themes describing women’s varied relationships with their post-hysterectomy infertility: Plans Fulfilled, Acceptable Compromise and Persistent Grief. A novel finding was that women engaged in a “trade-off”, whereby relief of gynaecological symptoms outweighed their desire for a child/further child/ren. The study also found that women with an extensive history of infertility may have more trouble adjusting to the outcomes of their hysterectomy than women who were satisfied with their fertility history. Counselling around identity and how this can be influenced by fertility status may be needed. Further research into the psychological processes involved in the “trade-off” is also needed.