Womb Transplants For Men

 

Humanae vitae: "Consequently, unless we are willing that the responsibility of procreating life should be left to the arbitrary decision of men, we must accept that there are certain limits, beyond which it is wrong to go, to the power of man over his own body and its natural functions - limits, let it be said, which no one, whether as a private individual or as a public authority, can lawfully exceed."

This article in EuroNews caught HJ's eye: Uterus transplants are already a reality. What does it mean for transgender women getting pregnant?

Medical experts talking publicly about allowing biological men to give birth might be racking their brains on the technical details, but they are already sold on the question of ethics. And even if they held doubts, the Equality Act would prevent surgeons from treating biological women and transgender women differently when deciding whether to conduct womb transplants.

The appetite for the medical procedure is certainly there. Professor Mats Brännström helped to deliver the first live birth from a transplanted uterus in 2014. He now receives emails from “all over the world” from biological men asking about a womb transplant. The professor told EuroNews his only concern is that the West might:

“Rush into this because we have patients who are very interested ... I say to them we haven't done enough research, but I think it will be possible in the future. It may take five or 10 years, I would say. If it's an efficient method with no risk, I don't think there are any ethical boundaries," he added, pointing out that "many societies already allow for people to undergo gender-affirming procedures that help them transition to their self-identified gender. We change the legal statutes, we do corrective surgery for other things in the body. So this is part of it."

Nicola Williams, who is a lecturer in the ethics of human reproduction at the University of Lancaster, warned that male anatomical differences may complicate uterus transplantation in men who identify as women. 

She told the paper that "there are definitely equality-based reasons for considering uterus transplants in transgender women … but there are also hormonal and anatomical considerations that mean that it won’t be possible to just directly translate this procedure into the transgender population." 

Professionals would, for example, have to take into account the differences in the pelvic vascular anatomies of men and women. Surgeons in the UK see these issues being overcome in about a decade. And given that those who are vocal on such matters “Don’t,” in the words of Professor Brännström, “think there are any ethical boundaries,” it appears likely that womb transplants for biological men will take place after this ten-or-so-year wait. 

If there is a public debate on the ethics of this question among surgeons, it is a quiet one. Stephen Wilkinson, a professor of bioethics at the University of Leicester, not only views this possibility favourably but also “can’t see any in-principle objection to offering this intervention to trans women.” He said: There are lots of positive ethical reasons for doing so. So if we’re going to treat trans women as women and accept their gender identity, and treat them equally in law and in social practices, it looks as if their claim is as strong as anybody else’s."

In collaboration with other researchers, Wilkinson and Williams carried out a survey of 182 transgender women to study their reproductive aspirations. More than 90 per cent of the respondents indicated that a uterus transplant could improve their quality of life and alleviate symptoms of gender dysphoria, with most agreeing that the ability to gestate and give birth to children would enhance perceptions of their femininity. 

Just as the desire to experience gestation has spurred uterus transplant research in women who suffer from uterine factor infertility, uterus transplants in transgender women should also be considered in the same light, the researchers conclude. "I feel quite strongly that uterus transplantation enables a specific type of experience," said Chloe Romanis, Associate Professor in Biolaw at Durham University. "Wanting to be a parent is one thing, but wanting to be a gestational parent is another; it's quite a unique experience," she told Euronews. "It's something that people will feel very strongly about, it's something that people will feel speaks to their identity, not just as a person, as a parent, but also as a woman. So I think that that's something that we need to respect."