LIVE WOMB DONORS: Biological women who undergo hysterectomy for sex change could give wombs to trans-identified males who want full female experience: youth gender clinician

Researchers in gender medicine are looking into ways that young trans-identified, biological females could become live organ donors, providing their unwanted reproductive organs to biological males who identify as women and fantasize about being able to menstruate and give birth.

Alicyn Simpson, a trans-identified male who works in the gender clinic at the University of Pittsburgh Medical Center (UPMC) Children’s Hospital, gave a shocking presentation on the topic last year during a Fertility in LGBTQAI+ event. 

Simpson, who is a community navigator for the youth gender and sexual development program at UPMC Children’s Hospital, began the talk by advocating for adolescent sex changes and discussing the need to offer fertility preservation to the young people about to embark on an irreversible medical pathway that will leave them infertile for life. 

The talk took a bizarre turn when Simpson introduced the topic of uterine transplants for transgender males.

After first acknowledging that the subject was "a little bit controversial" and "raises a lot of ethical questions," Simpson presented 2021 research that investigated the possibility of young women who believe themselves to be men donating their uteruses and vaginas to men who believe themselves to be women.

Citing 42 successful uterine transplants, all performed on actual women who for one reason or another had no uterus, and 12 live births that have been recorded following these transplants, Simpson suggested that research indicates this to be a viable option for males who identify as women.

"So live donation has been something the community has talked about for decades. It was really seen as magical thinking. For this would be a live donation from a person who was assigned female at birth but identified as a transgender man," said Simpson. "And they said, Well, you know, I have these parts. I don't want them. You want them. You need them. So what if I gave them to you? How would that work? And apparently based on their research, this is actually viable."

Simpson then explained that most trans-identified males surveyed expressed a desire to have functioning female reproductive organs.

In a study of 186 trans-identified males, "most of them reacted very favorably, something like 90 percent...in favor of various aspects of having a vaginal transplant, having a uterine transplant…having menstruation, experiencing gestation and carrying life inside them," Simpson told the audience.

The study itself acknowledges the anatomical differences between males and females, but the research team does not consider the narrow pelvis, the presence of a surgically constructed "neo-vagina," the differences in vascular anatomy, or the lack of ligamentous support for the uterus in biological males.

As far as ethical considerations go, the paper states that according to some, restricting uterine transplants to "genetically female recipients" and "excluding TGW [transgender women] violates their right to gestate."

In a similar vein, young women who identify as men "should not be excluded from serving as UTx donors," as this would be a violation of their autonomy.

The study notes the ideal circumstance that many of the women who believe themselves to be men are "young and healthy," making their reproductive organs suitable for transplantation into a male.

In a small study of 31 trans-identified females, “96.7 percent had positive attitudes [towards becoming live organ donors] initially and 84 percent wanted to volunteer for uterus donation after hearing detailed procedural information," despite the fact that the surgery comes with increased risk of post-op complications compared to a standard hysterectomy due to the need to preserve blood vessels.