Should Uterus Transplantation for Transwomen and Transmen Be Subsidized?

[PorcelinaV]

https://journalofethics.ama-assn.org/article/should-uterus-transplantation-transwomen-and-transmen-be-subsidized/2023-06

If transmen are seeking hysterectomies as part of their transition do they become a source of live donors? A lot are young and healthy women, so potentially good donors.

It's been suggested. Transgender Males as Potential Donors for Uterus Transplantation: A Survey

And also in the Imperial College paper from the surgeons who carried out this first female womb transplant (my bold):

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.

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

It's worth reading the whole paper. Apparently periods are intrinsically female. How terfy!

Not only is withdrawal bleeding an important sign of graft function, but it is intrinsically part of being female and therefore contributes to gender identity, which may have psychological benefits.

F2M transgender men may offer an alternative donor pool should they accept the increased risk compared with standard hysterectomy.
IDK what the rules are around transplant donation, but I don't think anyone should guilt trip people into doing something that is medically against their best interests.

Quite. And I think that population would be especially vulnerable to that.

They say that they need "as much donor vagina as possible:

To overcome this anatomical hindrance in M2F transgender women, a utero‐vaginal transplant could be performed, utilising as much donor vagina as possible, en‐bloc with the uterus (Figure
(Figure1).._
11). This would be achievable using a similar technique to that employed at radical hysterectomy, with preservation of the vaginal branches of the uterine vessels. This would necessitate retrieval from deceased donors, excluding female living donors. An alternative donor pool may be female to male (F2M) transgender men undergoing hysterectomy and vaginectomy, although the increased radicality of the hysterectomy may not be acceptable. However, recent evolution of the surgical technique, following cases in China20 and Dallas,21_ has potentially significantly reduced donor risk. The modified technique utilises venous drainage of the graft via the ovarian or utero‐ovarian veins, as opposed to the unpredictable and tortuous uterine venous plexus which leads to the internal iliac veins. This negates the need for the complex and time‐consuming ureteric dissection away from the uterine veins, reducing surgical risk. Moreover, it reduces operative times from 12 hours to 4–5 hours, which in turn decreases potential venous thromboembolism (VTE) risk. This dissection also favours minimally invasive retrieval techniques, which should enhance recovery and reduce potential morbidity further. As most F2M transgender men will also undergo bilateral oophorectomy, whereas the ovaries it would not be transplanted, it would allow the retrieval of elongated ovarian vascular pedicles to facilitate the implantation.

I’m going to be radical here and say that uterus transplants should not be available to anyone. There should be more done to support adoption.

One of the surgeons that operated on that transwoman went on to work at a concentration camp, where he performed grotesque experiments on prisoners, including Jewish women.
https://twitter.com/TwisterFilm/status/1408150587175227396

The history of this type of surgery needs to be looked at in context, and the context is not one of kind-hearted, empathic surgeons who devoted their lives to their patients' welfare.

Could surgeons who went on to investigate how long it took prisoners to freeze to death, ever have centred patients? Or perhaps did they always see human beings as their toys to play with?

The history of this type of surgery needs to be looked at in context, and the context is notone of kind-hearted, empathic surgeons who devoted their lives to their patients' welfare.

It's disturbing how this moves on. Breast implants (see how no-one has trouble recognising the difference between a transplant and implant in this context) have a repulsive history. This includes implants as augmentation to Japanese comfort women who are better understood as sex slaves: allegedly European and other men were more accustomed to larger bosoms than were typical for Japanese women.

https://www.mumsnet.com/talk/womens_rights/4865102-a-history-of-breast-implants-warning-disturbing-content

Funny how being a transman doesn't change your female status of service-person to males.

It would be an implant not a transplant.

But then in this day and age, transplants ARE plants, so who even knows!

Does anyone ever feel that the human race has collectively lost it's mind?
I mean actually, some people are certifiably insane. The fact that some of them are doctors, is mind boggling.

Funny how being a transman doesn't change your female status of service-person to males.

Isn't it. Perhaps some of these male people could reciprocally volunteer their penises for a penis transplant to "trans men".

Correction accepted graciously.

Bit scared at the thought of a Very Hungry Human Caterpillar.

https://twitter.com/GrahameParkGirl/status/1694636521494659429?s=19

Link to the lovely video of the tw who wants a womb transplant just to get pregnant and have an abortion.

HootyMcBooby76
Does anyone ever feel that the human race has collectively lost it's mind?

I hear people say how shocked they are that women are so hated; but for me the biggest shock is how many people don't have an internalised identity or set of rules, and can be persuaded to think that what everyone else does must be the right thing to do.

It really seems like we have lost the ability to say NO to the demands of deluded individuals.

I was not at all comfortable with this. I have no experience of infertility, so maybe I'm just not empathetic enough here, but it seems like a major operation on two people, so that one of them can have children. To make it worse - "...some long-term health risks, so the uterus will be removed after a maximum of two pregnancies."

I'm rather surprised that it only cost £25k (not paid for by the NHS, though staff gave their time for free). I certainly wouldn't support public funding for this kind of operation.

I heard one of the doctors involved in the womb transplant talking on the radio and saying they won't be able to do more than about twenty per year because of the costs and availability of donated organs. In this scenario I can't see how any proposal to transplant a womb into a male would get approval - it would be incredibly wasteful.

The chances of a male pregnancy being successful seem incredibly remote - it's hardly a process that always works perfectly in the female body as most of us know. For a start:

a)Transplant patients have a higher risk of giving birth prematurely and some immunosuppressant drugs can't be used. They are also more likely to have complications
https://www.kidneycareuk.org/about-kidney-health/living-kidney-disease/pregnancy-and-sexual-health/pregnancy-and-kidney-transplant/#:~:text=It%20is%20recommended%20that%20you,changed%20to%20pregnancy%20safe%20preparations.

b)Pregnancies using egg donations have a higher risk of many complications than other IVF pregnancies.
https://evidence.nihr.ac.uk/alert/assisted-reproduction-using-donated-eggs-has-higher-risk-of-complications-for-mothers-and-babies/#:~:text=The%20first%20successful%20assisted%20reproduction,of%20maternal%20illness%20and%20mortality.

And according to this article in the Washington Post doctors don't even know all that much about how pregnancy works in the female body anyway, fairly basic stuff like how the placenta is formed. So how on earth are they going to replicate these processes in a male body which has no idea what it's supposed to be doing?

https://www.washingtonpost.com/national/health-science/long-overlooked-by-science-pregnancy-is-finally-getting-attention-it-deserves/2019/03/06/a29ae9bc-3556-11e9-af5b-b51b7ff322e9_story.html

@Soontobe60 sadly there are things being done to increase babies for adoption, such as making abortions harder to get. I know US and UK are very different on this issue, but overturning Roe vs Wade was in part about increasing babies for adoption.

This is one reason why there is so much interest in surrogacy.

Are there any pressures on the TW to be offering their unwanted penises and all the accompanying vasculature plus a bit extra to transmen?

Thought not.

The women who want to have penises are simply expected to harvest the flesh required to make a simulation of a penis off their own bodies, which is both dangerous and sounds agonisingly painful.

But it seems the majority of TW do still want their penis, and even if they have 'bottom surgery' it's inverted. So it seems like it would be a one way trade, quelle suprise.

One of my proudest memories is of sitting on the gym floor at school after refusing to try what seemed to me a risky acrobatic leap and the teacher glowering at me and saying 'Look at her obstinate face!'. I'd have been about 10 at the time. Telling my dad later he laughed and said 'Yes, you always were pig-headed'. Saying 'No' gets easier each time you say it.