How can a transgender woman have children?

In past, trans women they could do no more than dress according to the gender they identified with. However, over time, medicine has helped them feel better in many ways. First, like trans men, they have sex-based hormone therapy. But they can also breastfeed or even have a vaginoplasty. They only need to pass uterine transplantwhich even allowed them to be mothers. However, this was considered impossible for a long time due to principles of bioethics.

The truth is that womb transplant surgery itself is in its infancy, even for cis women. Very few interventions have been carried out, but some have been successful. In fact, in 2014, a child was born for the first time to a woman who received uterine transplant. This was not done in trans women, although there was an attempt in 1931, which ended in the death of the patient due to infection.

Today, the hygiene measures as well as the methods used have undergone significant changes. Perhaps it’s time to include trans women in the list of possible uterine transplant recipients. It is for this reason that the Indian surgeon D. Narendra Kaushika, stands for taking this step once and for all. As explained in IFLScience, the utility is already planning how to carry out this intervention for the first time. However detractors around him there are many more.

The difference between transgender and cis women

Before discussing this topic, it is important to clarify who is a trans or cis woman.

Cis women are those whose gender matches the one they were assigned at birth. That is, they were born anatomically female. By contrast, trans women are those who were assigned a male gender at birth.

These are important concepts because they will be encountered repeatedly throughout this article. With them all clear, let’s see why there is so much reluctance to relate to the fact that trans women can get womb transplants.

Montreal Criteria and Uterine Transplantation

Absolute infertility due to uterine factor refers to the inability to have children due to anatomical or physiological failure of the uterus.

During a long time, cis women with this problem they could only adopt or, at the very least, resort to surrogacy in countries where it is legal. Although the truth is that if we are going to talk about unethical activities, surrogacy will give us a good time to comment.

Leaving that aside, over time the possibility uterine transplant. It could be a living donor or someone who has died. The problem is that this is a complex procedure associated with certain risks. When life or death situationas can happen with a heart transplant, the risk is worth it. But if it’s just to be able to have children, there are options like adoption, that comes into play. ethical dilemma. For this reason, in 2012, the so-called Montreal criteria were proclaimed, aimed at principles of bioethics about the need or not for uterine transplantation.

The main principles of bioethics are one of good deeds, one of atrocities, one of autonomy and one of justice. Based on the first, these criteria establish that uterine transplantation would be adequate under favorable circumstances because do good to those in need. On the other hand, this idea is opposed by the concept of harmlessness, since both the donor and the recipient can suffer. physical and emotional damage. For this reason, it would be very important to talk to both sides so that they accept an informed decision. Here the principle of autonomy will be strengthened. Finally, the concept of equity is based on the fact that these interventions favor equality between people.

It should be noted that these principles were proclaimed on the basis of what would be similar to holding uterine transplantation for cis women. At first, trans women were not thought of.

However, as this possibility began to be considered over time, many surgeons indicated that these patients required a number of additional considerations that would be contrary to Montreal criteria. For example, in 2018 Dr. Amel AlgraniProfessor of Law at the School of Law and Social Justice at the University of Liverpool, recalled in the article that it would be necessary to create new vascularization and support uterine transplantation with hormonal treatment this helps both the maintenance of the organ and the possible subsequent pregnancy. On the other hand, the uterus will be placed in non-gynecoid pelvis. This would mean that the hips, unlike most cis women, are not ready for pregnancy and, above all, for childbirth.

These would be additional risks contrary to the principles of bioethics, especially the principles of bioethics. harmlessness. However, for Dr. Kaushik, there would not be so many problems.

How can a womb transplant be performed on a trans woman?

Dr. Kaushik is the director Olmec Transgender Surgery Institute, New Delhi. There, he performs routine interventions on trans women, but has not yet been able to perform womb transplants. However, she believes that it is feasible and will help these women, benefiting their health and making them happier. It is clear that this goes in favor of the principle of beneficence.

As for the donor, although he may be live trans man or cis womanif corpses were used, then some of the risks would be eliminated.

As far as the issue of vascularization and hormonal treatment is concerned, having sufficient information for recipients should not be a problem. And not the fact that her hips are narrower. At the time of delivery, this will be decided with cesarean sectionlike many cis women.

However, it’s all been said working on hypothetical. It must not be forgotten that even cis women have received very few uterine transplants to date. Perhaps one day they will become a much more common reality, and this already includes trans women. Meanwhile, they have many other rights to fight for. Because, unfortunately, they are still considered different from other women in much more than what a womb transplant implies. We have evolved, yes, but not enough.