Medical experts talking publicly about allowing biological men to give birth might be racking their brains on the technical details, but they are already sold on the question of ethics. And even if they held doubts, the Equality Act would prevent surgeons from treating biological women and transgender women differently when deciding whether to conduct womb transplants.
The appetite for the medical procedure is certainly there. Professor Mats Brännström helped to deliver the first live birth from a transplanted uterus in 2014. He now receives emails from “all over the world” from biological men asking about a womb transplant. The professor told EuroNews his only concern is that the West might “rush into this because we have patients who are very interested.”
Nicola Williams, who is a lecturer in the ethics of human reproduction at Britain’s University of Lancaster, warned that male anatomical differences may complicate uterus transplantation in men who identify as women. She told the paper that
there are definitely equality-based reasons for considering uterus transplants in transgender women … but there are also hormonal and anatomical considerations that mean that it won’t be possible to just directly translate this procedure into the transgender population.
Professionals would, for example, have to take into account the differences in the pelvic vascular anatomies of men and women.
Surgeons in the UK see these issues being overcome in about a decade. And given that those who are vocal on such matters “don’t,” in the words of Professor Brännström, “think there are any ethical boundaries,” it appears likely that womb transplants for biological men will take place after this ten-or-so-year wait. If there is a public debate on the ethics of this question among surgeons, it is a quiet one.
Stephen Wilkinson, a professor of bioethics at the University of Leicester, not only views this possibility favourably but also “can’t see any in-principle objection to offering this intervention to trans women.” He said:
There are lots of positive ethical reasons for doing so. So if we’re going to treat trans women as women and accept their gender identity, and treat them equally in law and in social practices, it looks as if their claim is as strong as anybody else’s.
Supporting this view, EuroNews cited a study that suggested the ability of biological men who identify as women to give birth would “enhance perceptions of their femininity.” So, the procedure would be good for the patients and, according to Chloe Romanis, a professor of biolaw at Durham University, for most others, since “most people who are liberal-minded read our Equality Act legislation and said, honestly for the purposes of the law, a trans woman is a woman.”
