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WELCOME
HYSTERECTOMY2020
WELCOME
Thank you for your interest in learning moreabout hysterectomy surgery at Boston MedicalCenter (BMC).
We strongly suggest that you sign up forMyChart. This gives you direct online accessto portions of your electronic medical record,including details of past or upcomingappointments and appointment reminders. Youwill also have the abil ity to connect with yourcare team to ask non urgent medicalquestions. Please visit mychart.bmc.org tocreate an account.
Sincerely,
The Center for Transgender Medicine andSurgery Team (CTMS)
Phone: 617.638.1833
Fax: 617.414.7158
2020 HYSTERECTOMY
CONTENTS
Surgical Overview................................................................... 1
Required Steps........................................................................ 2
Documentation Requirements........................................... 3
Patient Checklist..................................................................... 6
Department Contact Information...................................... 7
Insurance Information........................................................... 8
HYSTERECTOMY2020
SURGICAL OVERVIEW
1
HYSTERECTOMY
Hysterectomy: Surgical removal of the uterus and cervix.
Bilateral Salpingo-oophorectomy: Surgical removal of the fallopian tubes and ovaries.
Removal of the ovaries is optional at the time of hysterectomy for gender affirmation.
Options for oocyte storage and fertility preservation are also available if desired. A patient
can retain their ovaries and still be on testosterone therapy.
The surgeon performs the majority of hysterectomies laparoscopically (meaning through
small 1-2 centimeter incisions on the lower abdomen, usually 4-5 incisions total). The
length of a hysterectomy operation depends upon many factors, but in general lasts
between 2 and 5 hours. With any laparoscopic surgery, there is always a potential for
needing to convert to an open surgery with a larger incision if the hysterectomy cannot be
completed with small incisions.
HYSTERECTOMY
THE STEPS Due to the complexity and permanence of surgery,we have specific requirements in place to ensureyour safety and that will allow us to provide the bestpossible care. Below is a list of the mainrequirements and steps a patient will need tocomplete prior to surgery.
2
REQUESTS & DOCUMENTATION1
BMC – Facility, NPI #1346218294 Dr. Shannon Bell – OBGYN, NPI #1912206707 Please see page 3 for details.
Please see page 4 for details.
Prior to your consultation we will require documentation from your primary care provider.
We also require two behavioral health support letters from two different behavioral healthprovider prior to your consultation.
The purpose of this consult is to provide you with an opportunity to clarify anyquestions regarding surgery, insurance coverage, etc.
First-time consult appointment with the surgeon
CONSULTATION2
HYSTERECTOMY
PRIMARY CARE PROVIDERS
3
PCP's full support for patient to undergo this surgery Current medication l ist Current problem list Current allergy l istLength of time the patient has taken supervised hormone therapy(should be for at least 12 months, unless this is medicallycontraindicated) Length of time of the PCP/patient relationship and date of mostrecent PCP visit (should be within 12 months)
Cover letter for fax should be addressed to: Center forTransgender Medicine and Surgery
One Boston Medical Center Place, Boston, MA 02118
Primary Care Providers (PCP) should send in a request for aconsultation. The request should include the following information in theform of a letter or as part of a clinical note:
For internal referrals, providers may use the Epic system and submit todepartment specialty: Ambulatory Referral to the Center for TransgenderMedicine and Surgery.
Consult requests and patient information may be sent to us via one ofthe following ways:
Preferable, FAX: 617.414.7158
MAIL: Boston Medical Center Center for Transgender Medicine and Surgery
SECURE EMAIL: [email protected]
Visit our website at: www.bmc.org/center-transgender-medicine-and-surgery.
Please don’t hesitate to contact us with questions.
HYSTERECTOMY
BEHAVIORAL HEALTHPROVIDERS
4
The patient’s general identifying characteristics and information,including date of birthThe BH provider’s experience with treating transgender patientsThe duration of the BH provider’s professional relationship with thepatient, including the type and duration of evaluation and therapy orcounseling to dateResults of any psychosocial assessment including any diagnosesA description of how the criteria for surgery have been met Specify the exact surgery procedure your patient is pursuingIdentify support systems, any progress made in transition socially ormedicallyAny BH diagnosis or concerns and how they are being managedProvider's contact information/letterhead and a statement that thisprovider is available for coordination of careProvider's signature and date
Persistent, well-documented gender dysphoria/gender incongruenceCapacity to make a fully informed decision and to consent for treatment18 years of age or olderIf significant medical or mental health concerns are present, they mustbe stable12 continuous months of gender-affirming hormone therapy asappropriate to the patient’s goals (unless hormones are medicallycontraindicated)
Patients need support letters from two licensed Behavioral Health (BH)providers. Letters must meet the requirements of the health insurancecarrier as well as those listed below. Letters should include the followinginformation:
Criteria for hysterectomy surgery:
The criteria for surgery is based on the WPATH Standards of Care.
Note that for these letters, one must be from a clinician who has had atherapeutic relationship with the patient, while the second may be froma clinician who who has met with the patient in an evaluative role.
HYSTERECTOMY
BEHAVIORAL HEALTHPROVIDERS
5
Cover letter for fax should be addressed to: Center forTransgender Medicine and Surgery
Support letters should be addressed to "Boston Medical Center Surgeon"and sent to us via one of the following ways:
Preferable, FAX : 617.414.7158
MAIL: Boston Medical Center Center for Transgender Medicine and Surgery One Boston Medical Center Place, Boston, MA 02118
SECURE EMAIL: [email protected]
Visit our website at: www.bmc.org/center-transgender-medicine-and-surgery
Please don’t hesitate to contact us with questions.
HYSTERECTOMY
6
CHECKLIST
OBGYN CONSULTATION DATE COMPLETED ____________________
SUPPORT DOCUMENTS
1. PRIMARY CARE REQUESTDATE SENT TO CTMS ____________________
2. HORMONE PROVIDER DOCUMENTATION (AS NEEDED)DATE SENT TO CTMS ____________________
3. BEHAVIORAL HEALTH LETTER #1
DATE SENT TO CTMS ____________________
DATE SENT TO CTMS ____________________
4. BEHAVIORAL HEALTH LETTER #2
PLEASE USE THIS FORM TO KEEP TRACKOF COMPLETED AND PENDING TASKS.
HYSTERECTOMY
CONTACT
For detailed information about services please email us [email protected]
Micha Martin LCSW, Project Manager............................... 617-638-1833
Peer Navigator...................................................................... 617-638-1833
Pam Klein RN, Nurse Liaison............................................... 617-638-1827
Brenna Cyr LICSW, Behavioral Health Lead...................... 617-638-8133
Urology................................................................................... 617-638-8485
Plastic Surgery..................................................... 617-638-8419 Option #1
7HYSTERECTOMY
Insurance coverage and benefits are specific to each individual's benefit plan.Not all insurance coverage is the same even within the same insurancecompany (Blue Cross, Aetna, Tufts, etc.).
For information about your coverage benefits, call the member servicesphone number listed on your insurance card to ask about coverage for thespecific services you need. You have the right to request a copy of yourmedical policy for any gender affirmation medical treatments.
If you have additional questions regarding insurance, call and ask for anappointment with Patient Financial Services at 617.414.5155.
INSURANCE
8HYSTERECTOMY
