Medical treatments for transgender people have gone “mainstream,” according to Richard Paulson, an obstetrician-gynecologist in Los Angeles and the president of the American Society for Reproductive Medicine.
With that comes the prospect for a medical development that could shatter some of the most strongly-held beliefs for centuries about biological sex and the ability to conceive a child.
In short, some scientists believe that transgender women — those who were assigned male at birth — could soon give birth.
Paulson said at the society’s annual conference in San Antonio, Texas, this week that the science is in place to allow transgender women to receive donated wombs and potentially give birth, according to the Telegraph.
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“You could do it tomorrow,” Paulson said. Basically, he sees no medical reason why it couldn’t happen.
“There would be additional challenges, but I don’t see any obvious problem that would preclude it,” he continued. “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.”
However, there’s some reason to believe that Paulson might be a bit overconfident.
For starters, all documented trials on uterus implants have been with patients who were born female.
There has been some success with womb transplants in women in recent years. Swedish doctors helped deliver the first baby born to a mother with a donated uterus in 2014, according to Scientific American. Since then, at least four more such babies have been born in Sweden, and the first British attempt at the procedure will be carried out next year, says CBS News.
The first attempt at a uterus transplant in the U.S., though, failed in Feb. 2016, according to the New York Times, before one of four women to undergo the procedure was able to keep her implanted uterus in Oct. 2016, according to TIME.
Transgender men, assigned female at birth, have already given birth — including Trystan Reece and his partner Biff Chaplow, who had their first biological child this summer, and Thomas Beatie, who has given birth to three children since 2008.
The male pelvis is shaped differently than the female pelvis, though, which would require any future transgender woman who attempts to give birth to do it via caesarean delivery, Paulson said at the conference. The idea of transplanting a uterus into someone who was born as a man so they could give birth to a child would also stoke a firestorm of ethical debate — based not only on traditional Western norms —but also on long-term health implications for babies and mothers.
Marci Bowers, who is both a transgender woman and a gynecological surgeon in northern California, told Scientific American that she worries about dangers to the fetus from a potentially unstable biological environment in a transplanted womb for transgender women.
“I respect reproduction and I don’t think we’ll ever see this in my lifetime in a transgender women,” Bowers told Scientific American. “That’s what I tell my patients.”
So, even with those caveats, are transgender women going to seek out treatments that might allow them to give birth?
“Yes,” Arthur Caplan, head of medical ethics at NYU School of Medicine told Yahoo. “But I don’t see making this a priority. In terms of making the best use of resources, this won’t get over the threshold.”