Womb Transplants

[SweetSouls]

I’ve noticed an increase online in the discussion of the possibility of womb transplants for trans women, to allow them to be pregnant and give birth to children.

This is increasingly presented as something in the very near future, largely because of the success of womb transplants into women.

Is this at all realistic? Presumably the mechanics are slightly more complicated than ‘just’ needing a womb transplant, and will this become an ethical debate?

I can’t quite wrap my head around it - mainly because I’d never considered it achievable.

Research is very definitely going on.

Warning this paper is not for the squeamish and raises disturbing questions of female role in these experiments www.biorxiv.org/content/10.1101/2021.06.09.447686v2.full

Transplants have been done in Sweden and the US for women with DSDs and they have resulted in successful pregnancies.

This is not wholly straightforward as the uterus and pregnancies are tolerated by using minimum feasible dosages of immunosuppressive therapies. After pregnancies or a pre-determined time period, the transplanted uterus is removed.

The technology is now ready to go mainstream as the surgery time has come down to a fifth of what it was initially.

There are moves to start transplanting uterii into wider groups. It was due to happen before COVID–19 but that halted the programmes. However, in Sweden, it's due to start up again.

Lots of talk about this on Twitter, with hordes of women opting out of the Organ Donation Register in protest.

The Twitter thread that attracted a lot of publicity on the theme of reproductive justice for transwomen:

archive version: archive.is/B6VNC

Initial research in Sweden: www.gu.se/en/research/research-on-uterus-transplant

Pennsylvania: www.pennmedicine.org/for-patients-and-visitors/find-a-program-or-service/transplant-institute/uterus-transplant

[quote TrainedByCats]Research is very definitely going on.

Warning this paper is not for the squeamish and raises disturbing questions of female role in these experiments www.biorxiv.org/content/10.1101/2021.06.09.447686v2.full[/quote]
Who is paying for this though?

(The ray study is the stuff of nightmares, the animal ethics on this has clearly gone out of the window, we can only hope that human ethics boards are prepared snd will stand firm.)

@SugarHouse1

Lots of talk about this on Twitter, with hordes of women opting out of the Organ Donation Register in protest.

I’m one of them. Sadly. But no choice

This is not wholly straightforward as the uterus and pregnancies are tolerated by using minimum feasible dosages of immunosuppressive therapies.

I have had past experience of patients who had been recipients of a kidney transplant and also one woman who had had a heart transplant. I can't remember the details of their drug regimes but they all sailed through pregnancy (I had been particularly anxious about the heart transplant). Truly miraculous and wonderful for the women concerned.

So I'm not sure how the anti rejection drugs would affect the male uterus transplant recipient in pregnancy. However there is also the issue of cross sex hormones and presumably an artificial hormone environment needed to support pregnancy. Might this affect the development of any baby? Perhaps predisposing to DSD?

I also severely doubt the male cardiovascular system would/could adjust to pregnancy in the way the female system does. I would expect blood pressure problems for starters.
Any baby would likely be small for gestational age and require premature delivery.

How can any of these experiments pass ethical approval?

No chance.

This is an old thread and my thoughts previously still apply.

The idea all you need to do is stick a womb in is misogyny in its most base form.

Our whole bodies are involved. A male body does not have the, anything. To do all the incredibly complex things a female body does during pregnancy.

The idea that it's just the womb (jar/ vessel) that is involved in growing a baby is male supremacist nonsense that goes back to at least the ancient Greeks.

So all this investment in this when women in this country find it really difficult to get treated for birth injuries. We are expected to live with the after effects and not complain.

So I'm not sure how the anti rejection drugs would affect the male uterus transplant recipient in pregnancy

As you indicate, there are lots of other issues to be researched and resolved before transplant into a male to sustain a viable pregnancy is realistic.

It might be interesting to see the ethical approval in Sweden or other centres when they initiate this.

From the UK paper below, I wouldn't be too surprised if people start using this as an argument for starting hormone treatment in children to bypass some of the anatomical and pelvic issues. My substantial apprehension is that one of the plausible uses of this surgery will be to restore fertility and pregnancy tolerance in transmen who started transition early.

(US) Perceptions and Motivations for Uterus Transplant in Transgender Women :

Question What are the perceptions and motivations of transgender women for uterus transplant?

Findings This survey study of 182 transgender women found that to more than 90% of the respondents indicated that uterus transplant may improve quality of life in transgender women, alleviate dysphoric symptoms, and enhance feelings of femininity.

Meaning This report on the desire and willingness of transgender women to undergo uterus transplant may support the need for further animal and cadaveric model research, which is necessary to assess the feasibility of performing this procedure in transgender women.

jamanetwork.com/journals/jamanetworkopen/fullarticle/2775302

From UK perspective with some discussion of ethics and relevant issues: Uterine transplantation in transgender women

Sexual dimorphism arises predominantly due to the outcome of gender‐determined autosomal genes, which are regulated by sex‐specific hormones and influenced by hormone receptor sensitivity.35 This dimorphism has been demonstrated in the pelvis, where despite similar growth patterns throughout childhood, it is not until puberty when the growth trajectory increases in females, and not until the late twenties when the pelvis attains the most favourable obstetric dimensions. As such, if M2F transgender women undergo hormone therapy at a young enough age, they may develop similar pelvic morphology to natal females.
…

Despite a number of anatomical, hormonal, fertility, and obstetric considerations that require consideration, there is no overwhelming clinical argument against performing UTx as part of GRS. However, the increased radicality associated with the retrieval operation, including a longer vaginal cuff and more extensive ligamentous dissection, potentially necessitates the use of deceased donors. Alternatively, F2M transgender men may offer an alternative donor pool should they accept the increased risk compared with standard hysterectomy. Prior to undertaking UTx in transgender women, further research should be undertaken including cadaveric retrieval and implantations to assess the feasibility of the anatomical considerations discussed herein. Furthermore, it is recommended that animal studies are revisited to identify potential unknown risks and determine whether genetic males can successfully conceive and maintain pregnancy.

The reproductive aspirations of M2F transgender women deserve equal consideration to those assigned female at birth and, subject to feasibility being shown in the suggested areas of research, it may be legally and ethically impermissible not to consider performing UTx in this population.

www.ncbi.nlm.nih.gov/pmc/articles/PMC6492192/

The pregnant male rat study absolutely made me sick when I read about it a while back.

I had nightmares where the rats were replaced by a transwoman with a real woman sewn onto her after seeing those photos.

Any researcher who takes part in this research should be sectioned or imprisioned.
There is no justification for causing even one animal to endure that procedure & no moral or ethical reason for this research to ever be carried out.

I think this is one of the few things I've come across that I would honestly call evil.

I opted out of the organ donor scheme because of research like this.

And I've just seen that Tish's thread covers the same papers and comments on them.

@SugarHouse1

Lots of talk about this on Twitter, with hordes of women opting out of the Organ Donation Register in protest.

The paper donor card I carry lets you select which part of your body you want to donate. You can choose any part of my body, or select only the bits you feel comfortable with. It's the same with the online register isn't it? Can't remember because, at the time, I selected any part of me.

I hope people don't completely opt out, just because of this.

I hope people don't completely opt out, just because of this.

Likewise.

It's never going to happen. No human male is ever going to get pregnant.

Transplants ARE plants

(sorry couldn't resist it)

:The paper donor card I carry lets you select which part of your body you want to donate. You can choose any part of my body, or select only the bits you feel comfortable with. It's the same with the online register isn't it? Can't remember because, at the time, I selected any part of me.

I hope people don't completely opt out, just because of this.'

IIRC it doesn't include reproductive organs on the list.

There is s background thing saying yeah they're not taken.

But. Things change. And you've got no option to say no to those organs at an individual level.

I can see why some women are wary.

Esp given the cavalier and often callous approach to anything to do with our reproductive systems all over the place and through history, and still to a greater or lesser extent it's still pervasive.

It would be absolutly brutal on the man, like being blown up from the inside.

I don't understand what its going to be attached to. Do they think its like putting in a battery or something, i just don't get it.

@Deadringer

I don't understand what its going to be attached to. Do they think its like putting in a battery or something, i just don't get it.

Yes- misogyny. The same as the ancient Greeks etc.

A vessel/ incubator. Jar?

As with breastfeeding. The idea that women's bodies might be doing stuff that is subtle and complicated and important is pretty much discarded.

Anything we can do science can do just as well/ better.

The concept of the woman not being important is very visible in anti abortion messaging. The pictures always have the foetus floating in nothing. The woman is invisibilised.

The constant fixation with writing out the woman and trying to grow babies without them I think stems from:

The total paranoia men have always had about paternity
The resentment that we can do something really important that they can't.

So much fiction and films etc over the years which come down to men being able to create life. It's all over the place when you start looking!

Other kinds of transplants are to save people’s lives. A womb transplant is clearly not. And it requires the death of a woman. It just seems one more way that men think female bodies are for their use (surrogacy is another).

If I were of childbearing age, I would be opting out of organ donation for this reason.

The idea that women's bodies might be doing stuff that is subtle and complicated and important is pretty much discarded.

Because the world still tends to think of men’s bodies as the default human body, and women’s bodies as an aberration.

@ShortBacknSides

Other kinds of transplants are to save people’s lives. A womb transplant is clearly not. And it requires the death of a woman. It just seems one more way that men think female bodies are for their use (surrogacy is another).

If I were of childbearing age, I would be opting out of organ donation for this reason.

iirc for Sweden, most of the uterus transplants to date have been from a family member or friend.

However, in other countries, it seems there is no shortage of women who are willing to donate a uterus whether as a live or dead donor.

It would be interesting to know if we can specify the donations to which we do/not consent in the event of our deaths.

'Other kinds of transplants are to save people’s lives. A womb transplant is clearly not.'

Ah. It's a different sort of much more trivial thing though. Like hair transplants.