AMA Journal of Ethics (June 2023)

[NitroNine]

Late with this, I realise, but I don’t recall it being posted in previous discussions^ about the idea uterus transplants for TW are imminent…

Should Uterus Transplantation for Transwomen and Transmen Be Subsidized?

^ First successful womb transplant in UK (August 2023)
Ah, the one I was thinking of - Using braindead women as surrogates - was from February 2023, so before the AMA article was published.

I was sure this 2018 BJOG article (Uterine transplantation in transgender women) was discussed here too, but search isn’t helping…

Reading that made me feel sick 🤢

There have been lots of these threads, but not a recent one I am aware of.

https://www.mumsnet.com/talk/womens_rights/3605548-Imperial-College-Womb-Transplant-Survey-Redux

This is where a man applied to complete the feasibility study Imperial carried out in 2019. He was sent accompanying literature about how it would be against the Equality Act to not offer uterine transplants to these men.

From the AMA: “The lack of a uterus also closes off the prospect of gestating a child in a way that is available to women as a class. It follows that lack of a uterus is an obstacle to full participation in the social goods attached to women’s identity.”

the nerve, if we said that about motherhood we’d be accused of having a patriarchal view of women as child bearers.

I'll write what I always write when this comes up. This business of uterus "transplants" into men appears to be about science but it is not. It's about getting the idea out there that men can give birth too, but not just yet, there are a few technical details to be sorted out first. So while we're waiting for the inevitable, let's get on with the social sciences side of things and accept that since men can give birth too (not yet, but soon, soon, it's bound to happen), then there are no real differences between men and women in terms of things that are material and significant, they're just bodies with an interchangable set of parts. The actual differences are surface ones like the chosen forms of appearance.

It is about trying to change how people think by assuming a medical horror is a run-of-the-mill thing just round the corner. It's Overton Window stuff, not science.

Every time I hear the issue of womb transplants for trans individuals brought up, apart from all the sensible, scientific and logical arguments about the technical feasibility, risks to the individual, embryos and potential babies, I counter it by suggesting this:

If social justice for trans people demands we should prioritize this as an act of equality for transwomen logically equal political will, time and technology should be used to develop a testicular transplant service for transmen, so that they can authentically experience fathering children by ejaculation.

To hijack an earlier quote:
"The lack of testicles also closes off the prospect of fathering a child in a way that is available to men as a class. It follows that lack of testes is an obstacle to full participation in the social goods attached to men’s identity.”

After all, a testicular transplant into some sort of groin outpouching/fake scrotum with some plumbing mechanism to connect it to a neopenis on a female would feasibly be technically easier and probably safer than perfoming a uterine transplant into a male individual, preparing the womb for embryo transfer, maintaining the pregnancy without a female hypothalmic-pituitary-gonadal axis while also preventing organ rejection, not to mention the issues of potential childbirth with a male pelvis, no cervix and a neovagina that does not have the functional capablities of a vagina.

As most men are born with 2 testicles, there really should be no shortage of donors as all these performative chaps who vehemently demand that women should be kind and accept transwomens demands, could start their allyship and advocacy for the trans community at home by donating one of their testicles to allow a transman to live authentically. It would be akin to the altruistic donation of kidneys to unrelated donors, with much less risk for both donor and recipent.

Or, taking the argument about using womens bodies as surrogates if they are declared brainstem dead to its logical conclusion, we could examine the ethical issues around harvesting testicles from brain dead men, since they would not be using them, and this would supply a social need (please, no one make the joke that we would have a clear oversupply....)

It also makes me feel a bit Swiftian - but that's just a modest proposal😁

As per previous threads,

• transplant for a recipient who is a woman
• implant for others.

Very wise words which we would all do well to bear in mind.

Agree @nauticantthat is spot on. Get over the ‘Ik’ factor and all the rest follows.

SamelDJackdson, I think the prostate would be a further barrier. I'm told that removing a prostate from a living man is very risky, so it would have to come from a cadaver. And it would have to be made to function and plumbed in along with the testicles. I don't think a woman "naturally" impregnating a man is on the horizon. She will have to use a turkey baster on the man who has had a successful vaginoplasty / uterus /ovaries transfer. Or maybe IVF, with the sperm "harvested" direct from the testicles in a similar way to the eggs.

And the resulting baby (poor thing) will still be other people's baby and they will be some sort of surrogates. The law on inheritance should be interesting!

Thanks for this clear and insightful summary, Nauticant. It’s useful to be able to express briefly, what had been a jumble of worried thoughts in my head. It’s a softening-up exercise that we have to expose and resist.

Doing the rounds again on social media thanks to a glowing Facebook/ YouTube short from Doctor Karan

https://youtube.com/shorts/XHguGjC5PQs?feature=shared