Reimagining Uterus Transplantation

By Amani Sampson, Laura KimberlyKara Goldman, David Keefe, and Gwendolyn Quinn.

In 1931, a transgender woman named Lili Elbe received the first known uterus transplant in a human. Unfortunately, she died from organ rejection complications three months later. Her story is often missing from the emerging ethical discourse surrounding uterus transplantation.

Our interest in exploring how uterus transplantation could become an option for all women regardless of genetics came from stories like Lili’s and our review of current media where these questions have surfaced. We began drafting our paper planning to focus on transgender women but then realized there were also other women facing uterine factor infertility left out of the conversation around uterus transplantation, such as women with complete androgen insufficiency. In 2016, Huet and colleagues conducted a study of the characteristics of those seeking uterus transplantation in France and found that a small percentage of women with complete androgen insufficiency inquired about the possibility of receiving a uterus. Transgender women and women with CAIS both share XY genetic makeup, which prevents them from participating in all current uterus transplantation trials.

Since the announcement of the first live birth from uterus transplantation in 2014, transgender women have taken to popular media to advocate for being considered for uterus transplantation. Less has been heard in the media from women with CAIS. Articles such as these in in Stat and Guernica interview transwomen who desire pregnancy. One quote that struck us from a young transwoman speaking to Guernica was: “I don’t feel very different from a cis (sic) woman who is infertile, I just don’t have a uterus or eggs.” In many ways, these women’s comments mirror those of women currently in uterus transplantation trials. We hope our paper will serve as a call to action for more research to expand the field of uterus transplantation to all women facing uterine factor infertility.

 

Paper title: Uterus transplantation in women who are genetically XY

Author(s): Amani Sampson1, Laura L. Kimberly2, 3 Kara N. Goldman1, David L. Keefe1, Gwendolyn P. Quinn1,3

Affiliations:

1 Department of Obstetrics and Gynecology, New York University School of Medicine, New York City, New York, USA

2 Hansjörg Wyss Department of Plastic Surgery, New York University School of Medicine, New York City, New York, USA

3 Division of Medical Ethics, Department of Population Health, New York University School of Medicine, New York City, New York, USA

Competing interests: None

 

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