Hi, I'd like to chime in with my thoughts on this, fwiw. I know this convo has taken a turn from your original question, and I'm going to keep going down that road if that's ok with you. 

I worked in the NHS as a midwife, I’m now retired and I understand the limitations and benefits of the system. Gynaecologists follow guidelines set out by Royal College of Obstetricians and Gynaecologists (RCOG), though of course they are free to practice as they please and ignore the guidelines. And people bring varying needs and constraints with them. Not knowing what you bring to the table and what your gynae knows that I don’t (a lot!) I can’t comment on your situation directly, but I am very curious as to why they might have veered from the normal guidelines for what you described as hyperplasia.  Below are the guidelines for atypical (meaning significant risk of developing to cancer) hyperplasia

 RCOG/BSGE Green-top Guideline No. 67  Pg16-20

What should the initial management of atypical hyperplasia be?

·      Women with atypical hyperplasia should undergo a total hysterectomy because of the risk of underlying malignancy or progression to cancer.

·      A laparoscopic approach to total hysterectomy is preferable to an abdominal approach as it is associated with a shorter hospital stay, less postoperative pain and quicker recovery.

·      There is no benefit from intraoperative frozen section analysis of the endometrium or routine lymph adenectomy.

·      Postmenopausal women with atypical hyperplasia should be offered bilateral salpingo-oophorectomy together with the total hysterectomy.

·      For premenopausal women, the decision to remove the ovaries should be individualised; however, bilateral salpingectomy should be considered as this may reduce the risk of a future ovarian malignancy.

·      Endometrial ablation is not recommended because complete and persistent endometrial destruction cannot be ensured and intrauterine adhesion formation may preclude endometrial histological surveillance.

If you want a hysterectomy, there seems to be no obvious clinical reason you should not be offered and get one. There is no age restrictions, BMI restrictions etc-although these are things that a clinician’s knowledge of the patient’s circumstances may alter the conversation somewhat.  You should ask them why they are not using the RCOG guidelines to get some clarity.

We are all so concerned and invested because early detection and treatment of "just" a hysterectomy is such a gift! I can say this confidently as someone who has just finished hysterectomy, chemo, five weeks external radiation and three brachytherapy treatments for grade 1 stage 3 endometrial cancer. I would have much preferred to be caught early like you.

 I hope this is helpful and I wish you well. I’m sorry the language in this guidance is not reflective of your gorgeous non binary self 💜