Introduction Uterus transplantation has shown success in treating women with uterine factor infertility who want to carry their own pregnancy. Methods We report the medical, sexual, and psychological outcomes of our first cohort of 13 living donor hysterectomies. As we have transitioned from open to robotically assisted hysterectomy, this report represents the complete series of open donor hysterectomies at our center, all with ≥6‐month postoperative outcomes. Results The open donor hysterectomy had a median of a 6.5‐hour surgical time, 0.8 L estimated blood loss, 6‐day hospital stay, and 28‐day sick leave. Three donors had a grade III or IV complications, one reported new‐onset psychological symptoms, and 9 experienced transient sexual discomfort. All complications were addressed and resolved, and all donors returned to their presurgical social and physical activities. Conclusion Since uterus transplantation is not life‐saving or life‐extending, the risks in living uterus donation must be weighed against the benefit of giving another woman the opportunity to give birth to her own child. This report provides data to support more detailed informed consent regarding the medical, psychological, and sexual complications of open living donor hysterectomy and allows for further evaluation of the ethical acceptability of this procedure.

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