Doctors consider uterine transplants for male pregnancy

The satirical tabloid Weekly World News was known for wacky headlines like “Five U.S. senators are space aliens” and “Bigfoot kept lumberjack as love slave.” In 1992, the publication trumpeted another sensational headline: “Pregnant man gives birth.”

The tabloid probably generated a few chuckles in the grocery checkout line, but more than 30 years later, some scientists and doctors are trying to turn the satire into reality. Recent progress in transplant medicine gives new hope to women with uterine conditions that prevent pregnancy. But the developments have also generated buzz among men who identify as women and want to bear children.

In 2014, Swedish doctors delivered the world’s first baby via cesarean section from a woman with a donated uterus. Three years later, doctors at Baylor University delivered the first uterine transplant baby in the United States. Both mothers were born without uteruses, which normally would have made pregnancy impossible.

Last May, Alicyn Simpson, a man who identifies as a woman, gave a presentation at the 2022 Oncofertility Consortium, a professional medical conference. Simpson said that transgender people have talked for decades about women who identify as men donating their uteruses to men who identify as women, always dismissing the idea as “magical thinking.” But now that scientific advances have allowed women without uteruses to have babies, Simpson told conference attendees that men won’t be too far behind.

“One of the biggest considerations I had at the age of 20 was the potential for pregnancy,” said Simpson, the community navigator for the Gender and Sexual Development Program in the pediatrics department at the University of Pittsburgh School of Medicine. “One of the main reasons I do the work that I do is to push us in that direction.”

Simpson’s complete presentation, which was available on YouTube two weeks ago, has since been taken down. But Twitter users circulated clips of the talk, including one which garnered 1 million views.

Could a biological man one day receive a transplanted uterus and deliver a baby? A few doctors think so.

Dr. Mats Brännström, the Swedish surgeon who delivered the world’s first baby from a transplanted uterus, told Euronews that ever since his success, men have eagerly inquired about the procedure. “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,” he told the news network. Brännström added that since many countries already approve of cross-sex hormones and transgender surgeries, he didn’t see any ethical problems with taking the next step and allowing men to undergo uterine transplantation.

One doctor is hoping to speed up that schedule. Dr. Narendra Kaushik, a surgeon who runs a gender reassignment surgery center in New Delhi, told the U.K. publication Mirror last May that he plans to attempt the world’s first uterus transplant for a man who identifies as a woman. Kaushik did not say when he would perform the transplant.

Researchers are quietly mapping out the details of how such a procedure could allow a man to carry a pregnancy. One article published in the British Journal of Obstetrics and Gynaecology discussed how to overcome a specific “anatomical hindrance” in men. In another controversial study, scientists castrated male rats, then surgically joined them to female rats so their hormones could flow into the male’s transplanted uterus. The large majority of the babies born from the male rats died, leading one scientist to conclude that “females are not simply males with a uterus.”

“There will be a lot of deaths, rats and otherwise, if this kind of experimentation continues,” said Paige Cunningham, former executive director of the Center for Bioethics and Human Dignity at Trinity International University in Deerfield, Ill.

Some doctors add that uterine transplants pose serious problems for everyone involved—the doctor, the donor, the transgender patient, and the baby. Dr. Jeff Barrows, an OB-GYN and senior vice president of bioethics and public policy for the Christian Medical and Dental Associations, said uterine transplants don’t save a life like heart or kidney transplants, nor are they necessary to create one. The procedure is risky, expensive, and uses medical resources that serve no life-saving purpose. A man who wanted to receive a uterine transplant would have to undergo at least three surgeries, take potent anti-rejection drugs, and spend hundreds of thousands of dollars. Scientists still know little about the long-term effect on the babies born this way in women—and nothing about the ones that could be gestated in men.

“You have a situation where the complete reason for doing it is so that this person can have an experience of pregnancy, which is very self-centered,” Barrows said. “I just can’t see any ethical basis for uterine transplantation in transgender women at all.”