To read about hysterectomy in the news is to read about disaster: emergency hysterectomy after a denied abortion, deadly hysterectomies during war, coerced hysterectomies on detained migrants. While we rarely read about this in news headlines, many people want a hysterectomy, choose a hysterectomy, and are happy to have had a hysterectomy. This emphasis is reflected in the financialization of health care. Yet, these same people who wish to choose hysterectomy might then be told they are not sick enough, are too young, or haven’t had enough babies to warrant a hysterectomy. This analytical framework is rooted in reproductive justice, is trans-inclusive, and accounts for the complex ways race, gender, history, and politics come together to stratify choice.