Marci Bowers is against uterine transplant for transgender women

[Kirsti2304]

Hey I'm following the topic of uterine transplants for transgender and cis women since over 6 years. Back then it was uncertain if even cis women could give birth with an transplanted womb.

As most of you know since 2014 12 Babys have been born with the use of an transplanted womb. So the chances aren't bad that we maybe see that also transgender women will be able to conceive a baby in the 2020s or 2030s.

Now most recently I have read that Marci Bowers which hereself is a transgender women is against the idea of us being able to get a uterine transplant. She says that we should use our own germs and should accept that we are born with the ability to impregnate women and should not get pregnant ourself.

I think that she is a hypocrite. She herself had children with her wife and for some transgender women that is a great way to start a family. The problem is not all transgender women are attracted to women. Many are in a relationship with a men like myself.

I don't know how it is for other transgender women but I could never have a child with an cis women that I'm not in a romantic relationship with and that will probably never happen because I'm only attracted to men.

So to come to my question what do you think of Marci Bowers opinion?

Sorry for mistakes. English isn't my native language   

[Alexa Ares]

Hi Kirsti

Was Dr Bowers raising health issues or just a moral point of view on the issue.
I am not medically aware of how safe or not it would be for a post srs trans woman to give birth.
I fear it may be dangerous however I am aware I may be wrong on this.

My own view is as long as it can be done safely and people are made aware of the sheer amount of effort that it will entail to be pregnant, there's not a good reason for excluding trans women from this new breakthrough....
Particularly as you rightly say many of us are attracted to men and as such would find It more difficult to find a surrogate for various reasons.

This is really a right for the individual in the same way gay men having surrogate babies is.

I support the right for trans women to be giving birth as long as it won't kill them.

[Devlyn]

Here is the counterpoint that Dr Bowers offered. I don't read it as saying she's against it, just that she's pointing out the potential issues. That's just my opinion. 

Interesting topic.

https://www.healio.com/endocrinology/reproduction-androgen-disorders/news/print/endocrine-today/%7Bd55bcb93-33b3-4338-8717-4c801dc47f97%7D/should--and-could--uterine-transplantation-be-an-option-for-transgender-women

[Colleen_definitely]

Exactly, she's not against it but rather points out that it the cost/benefit balance doesn't look great when you consider the extreme risk of complications and enormous costs involved.

[Sarah1979]

I would absolutely love to be able to give birth, but at that point you would also have to consider the best interests of your child.  Would actually carrying a baby to term be safe, not only for me but for my child?  Until that can be answered more fully, I doubt I could realistically be satisfied trying it.

Sarah

[Linde]

As a person, who made his living with medical research (and specifically with infection control & prevention). I would not be in favor of a transplant of a uterus and the subsequent growing of a baby init.  Medically, we are able to transplant almost anything, but the risk of an infection will be always there, specifically with a normally "dirty" organ like a uterus that would be implanted in a normally steril body cavity.  Furthermore, there are physical differences between the pelvic area of women and of men.  And we have to face the fact, no matter how well the sex reassignment surgery went, our skeleton is still pretty male and will not change.  What influence would that physical difference have on the growing baby (do we even have room enough in our pelvic area??), and on the person carrying the baby to term?

I am of the opinion, not everything that can be done (cloning of humans is an example) should be done!

[Lady Sarah]

Granted, those with a male pelvic bone will never be able to give natural birth. However, many women have C sections, for a variety of reasons. That being said, I see no good reason healthy young trans women should not be allowed this option. If Bowers refuses, they may be able to find someone that will. If they have so much money, they don't know what else to spend it on, they should be able to afford all the medical expenses related to it.

[ErinAscending]

With options being viewed through the lens of the current state of medical procedural technology, it seems like there are plenty of reasons to offer skepticism to the prospect.

What will the options be in another 15 years?  If potential problems are mitigated then there is no reason I see why we shouldn't allowed this option.  The debate starts here.  We'll just have to see where the debate goes as it does.

<3 Erin

[mm]

I am sure there are many tgirls that would like to have a uterus and bear a child, there are several things to consider for sure.  As Dietlind mentions the skeleton differences definitely need to be considered and also the blood vessels are not available to make connection for blood to the uterus which requires a good blood supply when one is pregnant. A c-section would definitely be necessary for deliver.

[GingerVicki]

My opinion...bed rest and a Caesarean section.

[Linde]

I am sure there are many tgirls that would like to have a uterus and bear a child, there are several things to consider for sure.  As Dietlind mentions the skeleton differences definitely need to be considered and also the blood vessels are not available to make connection for blood to the uterus which requires a good blood supply when one is pregnant. A c-section would definitely be necessary for deliver.

C sections are not a big problem anymore.  I actually was involved in developing a better and new method to keep wound infections with c sections to  minimum.  But any surgery is still a surgery and bears certain risks, and should only be taken if absolutely necessary. 
I worked for 33 years in medical research (I was involved in developing the first breast implants), and in the case of a trans women who has an implanted uterus, the risk is way larger, because we have to deal with scar tissue at the incision site.  This makes the incision more complicated and the subsequent healing, too!
We cannot predict what will be possible in 20+ years but being possible does not mean that it will be done.  And when some new technology or stuff is in it's early phase, visibility studies will be conducted to make sure that there is a market for the new technology or device.  Somebody has to be willing to dole out the money to continue the work (cause I want to continue to get my monthly pa check), and those people want to see a return of investment.
If the market is so small or exotic, that not much return is to be expected, investors do not pay.  The only financing would be governmental grants, and the way they flow lately, I have my doubts that much money for such a tiny market would be available.
Yes ladies, also the medical world is turning because of money, we can be as blue eyed as we want, if nobody wants to give the development money the uterus will be hidden away in a dark cabinet in some lab somewhere on the globe!

[itsApril]

Marci Bowers is my surgeon and I love my "Body by Bowers."  She is a brilliant and caring physician and surgeon.  (If you have a little extra time, you might want to google for some info about her pioneering work in attempting surgical revisions to undo the harmful effects of female genital mutilation on cis-women.)  So I admit my bias.  I LOVE my doc!

From Dr. Bowers' comment: "But we must consider where we are allocating health care dollars. If you are going to allocate $100,000 or more for someone to have a uterine transplant, require anti-rejection drugs and have a very complicated, medicalized pregnancy — only to need more surgery afterward to remove the uterus — I think that is perhaps an overreach."

https://www.healio.com/endocrinology/reproduction-androgen-disorders/news/print/endocrine-today/%7Bd55bcb93-33b3-4338-8717-4c801dc47f97%7D/should--and-could--uterine-transplantation-be-an-option-for-transgender-women

Medical and surgical treatment of transsexual women is already complicated in both an endocrinological and a surgical sense.  However, the medical technology has developed a long way, and it is developing further.

But a uterine transplant would add a new and completely different overlay of medical problems.  Surgically, the technique of uterine transplantation is in development.  There have been some initial successes in cis-women, but it is far from perfect.  Really, it is still an experimental surgery.  Integrating a functioning uterus into the abdominal and pelvic space available is going to be tough at best.

In addition to the surgical challenge itself, organ transplantation always has the specter of tissue rejection looming over it.  This will require the administration of a regimen of anti-rejection drugs (with all of their own attendant side effects) in order to get the transplant to "take."

Even in a cis-woman, it would be necessary to maintain and manage this anti-rejection regimen for at least a year or more, to allow for surgical recovery and then the normal term of an induced pregnancy.  And this would be on top of the normal range of medical complications cis-women may experience during a pregnancy.

For a trans-woman, there would be an additional overlay of medical concerns related to possible interactions or conflicts between anti-rejection drugs and hormone therapy.

At the end of the process, there would be the risks of yet another surgery to remove the uterus.  If the uterus is not removed after the end of the process, the patient would require regular anti-rejection medication and supervision - for the rest of her life.

Here's my interpretation of where Dr. Bowers is coming from: This isn't a question of whether a trans-woman has a "right" to uterine transplant and childbirth.  The possibility is there, and the medical and surgical technologies are developing.  But this is going to be exotic, difficult, and dangerous.  It will also be enormously expensive, in both monetary terms and also in terms of its demands on the medical resources that society has at its disposal.

Looking at it from that point of view, it makes sense for trans folks who want to become parents to thoroughly explore the less-dramatic methods of doing so.

[Chloe]

Male-assigned infants born with testicles have sperm, and female-assigned infants born with ovaries have eggs . . .

          Leaving All-Of-The-Above aside still leaves one stupid question: if the transplanting of ovaries were indeed possible Whose DNA would the new miracle baby be comprised of?

Would the genetics of the host patient have any influence on the outcome at all? Take a sperm sample of a trans person prior? Ok suppose just answered own dumb q but then again that means in the case of a 'cis female host' then she wouldn't be genetically connected at all?

[GingerVicki]

C sections are not a big problem anymore.  I actually was involved in developing a better and new method to keep wound infections with c sections to  minimum.  But any surgery is still a surgery and bears certain risks, and should only be taken if absolutely necessary. 
I worked for 33 years in medical research (I was involved in developing the first breast implants), and in the case of a trans women who has an implanted uterus, the risk is way larger, because we have to deal with scar tissue at the incision site.  This makes the incision more complicated and the subsequent healing, too!
We cannot predict what will be possible in 20+ years but being possible does not mean that it will be done.  And when some new technology or stuff is in it's early phase, visibility studies will be conducted to make sure that there is a market for the new technology or device.  Somebody has to be willing to dole out the money to continue the work (cause I want to continue to get my monthly pa check), and those people want to see a return of investment.
If the market is so small or exotic, that not much return is to be expected, investors do not pay.  The only financing would be governmental grants, and the way they flow lately, I have my doubts that much money for such a tiny market would be available.
Yes ladies, also the medical world is turning because of money, we can be as blue eyed as we want, if nobody wants to give the development money the uterus will be hidden away in a dark cabinet in some lab somewhere on the globe!

I know that I am dreaming with this response, so please bear with me.

I hope that someday:
Using a persons own DNA grow a uterus, eggs, and whatever while in the person. Then using non evasive procedures connect everything up. This would be applicable to any organ really.

Specifically targeting trans related healthcare is a niche that most of the population would not support funding.

[Linde]

I know that I am dreaming with this response, so please bear with me.

I hope that someday:
Using a persons own DNA grow a uterus, eggs, and whatever while in the person. Then using non evasive procedures connect everything up. This would be applicable to any organ really.

Specifically targeting trans related healthcare is a niche that most of the population would not support funding.

It is actually not such an exotic dream, we can grow tissue i the lab today already.  We cannot really grow tissue to become a certain body part, but that is only a question of time and enough experimentation.  But once we have a prototype of an organ, somebody has to give the go for "mass production", and that go will only be given if enough requests are there for that organ/ respectively for the technology.  I don't think that an uterus and ovaries are in that high demand that this specific technology can be even seen at the horizon.  Everything else is really science fiction on a large scale!