Uterus transplants

[BluesandClues]

Whilst I detest the mirror; I read the article and wondered where all the uteruses will come from

www.mirror.co.uk/news/world-news/doctor-planning-risky-womb-transplant-26882914

Honestly, given the surgeon in question claims "Many of our patients tell us that their sexual partners don’t even notice that they weren't born with female sex organs," I think anything else he has to say about his work can safely be ignored on that basis alone. This study on microflora of the results of MTF SRS wasn’t actually scoring for odour as it wasn’t a criteria but still noted a foul smell of the vagina was observed in most patients. It also explains some differences a partner would, in fact, notice. Unless Dr Kaushik is doing the atomic-level-rearrangements referenced by a PP; he’s basically using this article to drum up business.

Those uteruses to experiment with are going to come from women who[se families] are desperate for the money, let’s face it. India still has huge issues with organ trafficking - unsurprisingly they were exacerbated by COVID. Menstrual taboos are so enduring that last year there were women in India celebrating getting better menstrual huts. What could possibly go wrong with that combination of things?

And all that to satisfy some males desire to be a woman. It will never work anyway. It might be sitting in their body, but it will never function.

Ethicists are addressing some controversies in the area. It's not implausible that this will be framed as part of reproductive justice.

Womb UK mentions that there are current human studies in London. They mention MRKH or any type of womb-related infertility and invite people to contact them.

wombtransplantuk.org/research/current-research-programme

[The current] set of criteria is emblematic of how fast scientific innovation can outpace fundamental bioethics standards, and may itself be already outdated, in that it requires the recipient to be a "genetic female", whereas research on the possibility to perform UTx on transgender women is already in progress. That future scenario goes to the heart of UTx and its fundamental purpose: not life-saving but, as far as transgender women are concerned, life-enhancing.

Research has clarified the primary motivation for which transgender women would opt for UTx. Findings from a recent survey unequivocally reflect the "life-enhancing" purpose: an overwhelming 90% majority of respondents expressed the belief that having a transplanted, functioning uterus and vagina would benefit their sex life and perceived sense of femininity, improving quality of life overall (4). Such findings are rather similar to those regarding the perceptions of biological women with [absolute uterine factor infertility] AUFI: 95% of respondents in a UK study exploring the attitudes of women toward uterus transplant stated that, despite the additional risks posed, they would choose uterus transplant over surrogacy and adoption (5).

Hence, it is not unreasonable to assume that in transgender women, UTx may go a long way towards the achievement of reproductive aspirations, benefit quality of life overall, and be effective in allaying dysphoric symptoms. After all, gender dysphoria entails discomfort and even distress with one's biological sex. It has the potential to severely affect quality of life overall. Treating gender dysphoria in transgender women relies on a multidisciplinary approach involving medical, psychological, and surgical specialists.

Psychological input, hormonal therapy, or gender affirmation surgery are all potential options according to a highly individualized assessment for each patient. Nonetheless, UTx intended as a means for transgender women to foster their sense of femininity does present considerable contraindications. UTx is in fact ephemeral in nature: following childbirth, the graft has to be removed in order to eliminate the need for immunosuppressive medications. If on the other hand UTx were performed for reasons other than reproduction, i.e. to improve dysphoric symptoms, the duration of the graft would have to be significantly longer, hence a worse risk-benefit ratio.

From a merely reproductive perspective, however, it is worth bearing in mind that transgender women may deem pregnancy as the final and conclusive stage in the process of reconfiguring their life aspirations according to the gender with which they psychologically identify. Certainly, the safety of the procedure into a biologically male body will likely be more complicated and risky than performing UTx in a female body.

One of the pioneer scientists who first mastered UTx has acknowledged that transgendered pregnancy may be feasible, but in addition to the anatomical barriers, he has expressed ethical concerns (6). The fundamental ethical question that needs an answer is: if UTx becomes mainstream, safe and effective for biological women with AUFI, would there be any morally tenable grounds as to why transgender women should be denied such an opportunity for gestation? In countries where transgendered women who have transitioned are granted the same legal rights as their female counterparts, this will become a relevant question if UTx is offered as clinical treatment in women.

Arguably, UTx and ever more innovative MAP procedures pose ethical quandaries bound to grow as such practices become available on a large scale (7). Already, in vitro fertilization entails the separation between sexuality and procreation, which has made it possible for same-sex couples and singles to have children through heterologous fertilization (8). Such practices are governed with varying degrees of restrictions by each country, which reflects the diversity of approaches in terms of ethical acceptability (9).…Ultimately, we feel it may all go down to whether procreative liberty ought to be deemed as entailing an absolute right to gestate, and whether transgender women can be denied such a right without infringing upon ethical precepts of equality and non-discrimination. Current bioethics approaches need to undergo a radical update if we are to successfully meet the challenges posed by fast-growing scientific advances, set to shape and mold our lives ever more dramatically.

Umani Ronchi F, Napoletano G. Uterus Transplantation and the redefinition of core bioethics precepts. Acta Biomed. 2021 Nov 3;92(5):e2021435. doi: 10.23750/abm.v92i5.12257. PMID: 34738555; PMCID: PMC8689330.

pubmed.ncbi.nlm.nih.gov/34738555/

There is a line beyond which 'my feelings create reality, not facts, and don't upset me by pointing out reality' just can't go. And this is why it's anything but 'kind' to indulge it at all.

Not to mention: we're living in a world where women's reproductive rights and independence is being taken away from them, where a foetus's life matters so much more than a woman's that abortion is unthinkable, where even ectopic and life threatening pregnancies are under debate because it may have to be better that a woman dies rather than a precious few days old foetus is harmed....

but hey, let's create and kill foetuses while experimenting if male people can get preggers. That's totally ok.

Absolutely intolerant of this being fantasised about in the face of the reality female people are looking at; it is beyond insulting and it's beyond being even faintly acceptable any more. It's past time women stopped all the sucking up and being the bigger people and being tolerant and trying to understand and to reason nicely, and just get really fucking difficult.

It's all just too sick and messed up in my opinion and also those poor rats. For health reasons or life saving research fair enough but I don't think this level of cruelty to animals for needless experiments should be allowed at all.

‘For health reasons or life saving research fair enough but I don't think this level of cruelty to animals for needless experiments should be allowed at all.’

Monstrous. I hate people who torture defenceless creatures.

Well they have done successful uterine implants into women born with a genetic disorder that means they have no uterus (or cervix or ovaries). It can also be done for women who have lost their uterus due to disease or injury. The uterus is implanted and the woman is given the hormones needed to sustain a pregnancy. IVF is done. Then the woman carries the baby to term and gives birth. The uterus is usually then removed because the genetic condition of these women means they cannot produce the hormones naturally to support the uterus implant long term. The baby is then usually born via c-section. This has been done successfully in the US, France and Sweden. Success is measured by the live birth of a baby.

So far the uteri have been sourced through donations (zero money changing hands). Typical donors are deceased organ donors, or women who have finished childbearing.

A recent study Uterine transplantation in transgender women by BP Jones, NJ Williams, [...], and JR Smith www.ncbi.nlm.nih.gov/pmc/articles/PMC6492192/
concluded “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.”

Women are designed to adapt to pregnancy, whether it happens or not. From our ligaments to our hips to our spines to our internal organs to our endocrine system. Men are not. The over simplifying of pregnancy as just being a uterus and milk filled breasts is just ridiculous and reeks of fetishism.

Good grief.

How many uteruses will be wasted on this doomed to fail experiment they could have gone to a woman and been used to allow pregnancy in an actual woman.

And apologies if this is triggering but what happens with miscarriages ? If the body cannot expell the baby and tissue then won't that just mean that they would quite likely end up septic.

Take America the most dangerous developed country to give birth in particularly for black women, will the resources be available to keep checking that the male is not septic without removing already limited and often poor resources for pregnant women?

Of all the things to focus research in that could help improve care for pregnant women, ensure better fetal health etc amd the chosen project is to further affirm the delusion in a males head that they couod ever be a woman.

Oh and of course. What about the baby? Now babies are props to affirm identities?

Disgusting

If I really, really wanted to have a mermaid tail instead of legs I would very much hope my family, HCPs and society in general would consider I needed psychological help, not surgery.

There's a word I feel could usefully be mentioned here but I suspect it's against MN rules for this board. 6 letters, rhymes with an adjective for slightly damp weather. Abundantly evident from Twitter that most female bodily functions are thought of in this way by certain males.

I just knew this would involve a transwomen. Madness and waste of money and resources that could be used to save life.

Not this BS again. Not going to happen.

Well they're welcome to mine. Having just endured yet another gynae procedure having a rod forced through my cervix and my womb scraped leaving me with cramping and bleeding.
I have a feeling if any male bodied person knew anything about being a woman they would change their minds quick sharp .

an overwhelming 90% majority of respondents expressed the belief that having a transplanted, functioning uterus and vagina would benefit their sex life and perceived sense of femininity,

Just noting that one sentence for the moment.

Yes all of this in spades. Mind games. The whole of it makes me sick.

Is there not an international code of ethics that science and medicine follows?

How abhorrent. As mentioned up thread, I fear organ trafficking for wombs for vulnerable women as the next thing.

Certainly will (try to) make sure my organ donation card isn’t abused to take my womb for this Frankenstein experiment when I die. I guess this is where they plan on getting the bulk from. Just sickening.

I wonder under what circumstances would you and other posters agree to a donation after death?

Forgot to say what a terrific post that was from @nauticant.

I don't want my womb being used post mortem, ever. It is not quite clear right now what 'tissues' actually means, if you read the info on organ donation.

Does having a functioning uterus benefit my sex life?

No. No it doesn't. It's either irrelevant or a whopping great barrier in reality

So this is about creating headspace. Major surgery with all the expense to support headspace for better emotional wellbeing. For male people. Creating an illusion that bears absolutely no connection to the reality of a female person.
And the NHS can't afford hip replacements or cataracts or pain management, speech therapy for non verbal kids, the waiting lists are years long...

I find the mention of transmen as a potential source worrying, not because it's realistic but because it's another way of manipulating an already vulnerable group of young teenagers.

I wonder under what circumstances would you and other posters agree to a donation after death?

I am strongly I'm favour of organo donation I hope mine can be used after death. But I would not consent to my uterus being given to a male. So that means I will withdraw consent for my uterus to be donated if its possible without opting out completely.

However , as we dint get to choose the recipients unless its a direvted dontation, i do fear that this plays right into the whole " if I can't have it no one can" narrative that is very common on the tra side. It's an awful situation. Whoever wins women lose.

Good grief, imagine if our healthy reproductive organs are coveted in the same way as other vital organs and could be whipped away under the donor card scheme if something happened to us?!

Its a really grotesque thought and would have me reconsidering my decision to carry a donor card/remain opted in.

Definitely! I told my mother when I was a teenager that I would be happy to have a hysterectomy at that age! Because I had such painful and heavy periods.

Ah, but they DO know about being a woman. It is swishy hair and admiring each others' lipstick and swapping tampax in the public toilets.
You are clearly 'womaning' all wrong.