Since gender reassignment surgery is to transform a normal person into the opposite gender, not to "fix" a disease, it seems to me that some of the problems experienced by post hysterectomized women might be the same whether your uterus was removed for disease reasons (fibroids) or for sex reassingment. Here is an interesting article where at least someone in authority is asking the question:
I would like to see a study where they had three groups: Normal people, women with prolapse problems due to childbirth, etc., and the trasgender group. To give stats for the third group without comparing information for the other two just doesn't seem to have much meaning. A quarter of post - op trasgenderized patients end up disatisfied with their sexual function. I would like to know what the percent of nomal men and women would self-assess their sex lives the same way. We may be giving transgender disodered individuals a better result, a worse result, or an equivalent result.
With what I have learned from Christina and the Whole Woman books makes me think that if I were a transgender person wanting to go from female to male, I would leave the uterus IN, as that is the "keystone" support structure for the whole pelvic floor. In the reverse, changing a man into a woman, they leave the prostate and the buried extension of the penis. These items provide the internal sexual feeling comparable to a womans. So why wouldn't a women becoming a man want to keep her uterus for the same reason incidentally (it moves during orgasm and provide "deep" orgasmic sensations) but also performs the important function of holding the other organs in place so that a prolapse is less likely to occur. She could have the ovaries removed for the hormone change. Just leave the uterus like a brick holding things in place.