UK Edition
Sex-change men 'will soon be able to have babies'
Society should prepare itself for the near arrival of the first babies born to transgender mothers, one of the world’s leading fertility specialists has said.
The science is now available to allow women who began life as men to receive donated wombs and attempt to begin pregnancy as early as “tomorrow”, according to Dr Richard Paulson, President of the American Society for Reproductive Medicine.
Dr Paulson said trans medicine had now become “mainstream” and that people who had undergone gender reassignment surgery would inevitably want to take advantage.
British experts have warned, however, that initiating a pregnancy in a transgender woman may be unethical as it would safer for the child to be born via a surrogate mother.
They said that if womb transplantation for natural women becomes freely available on the NHS, hospitals may also have to offer it to transgender women due to equalities legislation.
Transplanting a womb is a complicated, lengthy procedure and only a small number of women have undergone the procedure so far.
However, expertise is being developed at increasing numbers of centres.
Dr Paulson said there was no anatomical reason why a womb could not successfully be implanted into a transgender woman.
“You could do it tomorrow,” he said.
"There would be additional challenges, but I don’t see any obvious problem that would preclude it.
"I personally suspect there are going to be trans women who are going to want to have a uterus and will likely get the transplant.”
While men and women have a different shaped pelvis, he added, there would nevertheless be room for an implanted womb.
However, the shape of the male womb means transgender women would have to give birth via cesarean section, he said.
Since 2014 at least five babies have been born to women who had received wombs in a series of operations in Sweden.
Other womb transplant programmes are cropping up in Europe and in the UK doctors have been given permission by the regulator to begin their own charity-funded programme.
Womb transplantation is complicated partly because the organ is located next to a number of major blood vessels.
Recipients have to undergo long-term immunosuppressive treatment to prevent the organ being rejected.
Professor Julian Savulescu, a Philosopher and bioethical specialist at Oxford University, said: “Uterine transplantation represents a real risk to the fetus, and future child.
“We ought avoid exposing fetuses and future children to unnecessary significant risks.”
“Although technically possible to perform the procedure, you would also need to be very confident the uterus would function normally during pregnancy.
“Uterine rupture could cause the death or permanent disablement of the fetus,”
He added that public resources should not be used to fund the procedure for transgender women.
About 7,000 women a year in the UK are born without a womb, and others are forced to have theirs removed due to cancer and other conditions.
In July this year a British man made history by becoming the first to give birth.
Hayden Cross, who was born a woman, gave birth to a baby girl after falling pregnant thanks to a sperm donor, however he had put a full sex change on hold.