I remember seeing a video by Buck Angel on this a while ago so I may be slightly hazy on the details but I think transmen often end up having to have their uterus removed after being on testosterone for more than two years. Buck wanted to highlight this issue because it isn't often discussed.
Testosterone causes the female organs to atrophy and this means that after a while of taking it, orgasm becomes excruciatingly painful. IIRC some transmen posted that they were in agony for up to 14 hours after orgasm. No one had warned them about this side effect of testosterone although it is apparently quite common.
It's so debilitating that some transmen seek hysterectomies to alleviate the pain, although this in turn can lead to other negative outcomes.