Psychological profiles and dyadic symptom concordance in transgender men and their partners awaiting hysterectomy with bilateral salpingo-oophorectomy

Background Gender dysphoria is associated with substantial psychiatric burden, yet the psychological distress during the preoperative period of gender-affirming surgery, the psychological characteristics of romantic partners, and dyadic psychological concordance within transgender individual-partner pairs remain unexplored. In this study, we examined preoperative psychological profiles of transgender individuals and their romantic partners, and exploratory postoperative psychological changes following total laparoscopic hysterectomy with bilateral salpingo-oophorectomy (TLH+BSO).Methods In this prospective longitudinal study, 42 transgender men presenting for TLH+BSO and 18 of their romantic partners were assessed preoperatively using the Symptom Checklist-90-Revised (SCL-90-R). Dyadic psychological concordance was examined in 18 matched transgender men-partner pairs. Preoperative and postoperative psychometric scores were compared in a postoperative subsample (n = 9).Results Transgender men demonstrated preoperative psychological distress, with obsessive-compulsive symptoms, paranoid ideation, and interpersonal sensitivity showing the highest burden. Romantic partners presented with statistically comparable distress profiles across all SCL-90-R subscales. Significant positive dyadic correlations were observed for psychoticism (ρ = 0.710, pFDR = 0.011), obsessive-compulsive symptoms (ρ = 0.664, pFDR = 0.016), paranoid ideation (ρ = 0.596, pFDR = 0.033), and the Global Severity Index (GSI) (ρ = 0.579, pFDR = 0.033). In the exploratory postoperative subsample (n = 9) who underwent TLH+BSO, reductions were observed for SCL-90-R subscales of depression, interpersonal sensitivity, anger-hostility, paranoid ideation, and psychoticism, and for the GSI, alongside improvements in Body Image Scale and Experiences in Close Relationships-Revised overall attachment scores.Conclusions Transgender men and their romantic partners demonstrate comparable preoperative psychological distress and significant dyadic symptom concordance, consistent with interpersonal stress transmission models. These findings support extending perioperative psychiatric assessment and support to the romantic partners of transgender individuals undergoing TLH+BSO.