Successful womb transplants have given birth (sorry!) to the notion that transgender women or even cisgender men could bear children.
It sounds like the scenario of a bad comedy – blokes with bulging biceps raiding the fridge for pickles and ice cream as they massage their baby bump. Ooops, I forgot: Arnie got there first. In his 1994 film Junior, he plays a pregnant Austrian researcher. And, yes, it is the second-worst comedy ever made, according to one reviewer.
But technically pregnant people with XY chromosomes may be possible. In 2014 a Swedish baby became the first child to be born from a “borrowed” uterus. Since then five more have been born in Sweden. Late last year came the first American baby gestated in a transplanted uterus, thanks to a team at Baylor University Medical Center, in Dallas.
This has not gone unnoticed by the gay community. “I get e-mails from all over the world on this, sometimes from gay males with one partner that would like to carry a child,” says Matts Brännström, the surgeon behind the successful uterus transplants in Sweden.
Even for natal women the operation is so complicated that a womb transplant for natal men seems years away. An article in Scientific American sums up the prognosis:
The dynamic process of pregnancy also requires much more than simply having a womb to host a fetus, so the hurdles would be even greater for a transwoman. To support a fetus through pregnancy a transgender recipient would also need the right hormonal milieu and the vasculature to feed the uterus, along with a vagina. For individuals who are willing to take these extreme steps, reproductive specialists say such a breakthrough could be theoretically possible—just not easy.
But what about the ethics of such an endeavour? Not complicated at all, at least for some bioethicists. In the latest edition of the Journal of Law and the Biosciences, Amel Alghrani, of the University of Liverpool (UK) strongly defends the idea that they have a right to gestate. “Transgender, non-binary, and other gender plural individuals have the same procreative liberties as cisgender individuals,” she contends. Denying them this right would be tantamount to cissexism.
This would be true even if the person in question already had children as a cisgender man. It is the lived experience that matters, she writes:
the question here is not necessarily one of having children; transgender women may already be parents and have had children both prior to gender affirming surgery transitioning and post, depending on what type of surgeries and hormonal therapies they have chosen. The question is one of securing an experience imagined as important to one's (gender) identity and hoped-for parental bonds.
Denying this right could possibly be a tragedy for the person involved, Alghrani says:
Whilst it is true that one may not traditionally regard a cisgender male not being able to get pregnant as a human tragedy, this may be because it is not yet possible and people do not have sympathy because someone cannot do the impossible. For instance, I may not sympathize with someone unable to teleport. But in a world where cisgender men can get pregnant/people can teleport, we may think differently and see it as a tragedy. Furthermore, rights are not based on whether something is perceived as a tragedy or not.
She concludes that (assuming a view of liberty which stems from John Stuart Mill) no good arguments exist to confound a right to gestation for transgender women, non-binaries and so on:
…those who would exercise procreative liberty so that they can gestate a child do not have to show what good it would do, rather those who would curtail freedom have to show not simply that it is unpopular, or undesirable, but that it is seriously harmful to others, or to society and that these harms are real and present, not future and speculative.
The transgender ideology raises many contentious issues, but there can be few more peculiar than this one. In a perverse way, it could be viewed as a consequence of abortion rights. If a woman has a right to do away with a child because it is a “part” of her body, why shouldn’t a man have a right to create a child as part of his body? After all, the child is no more than a product.
As Dr Alghrani so ably demonstrates, an ethical case for this bizarre possibility is already locked and loaded. All that is needed is a willing team of capable doctors. Pregnant men – another battleground in the Wild West of assisted reproduction.
Michael Cook is editor of MercatorNet