Christin Milloy:

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Transgender Uterus Transplant: My Body, My Choice (Part 1)

As a liberal and a feminist, I am fiercely pro-choice. I believe each individual has an inalienable human right to autonomy over their own body, a right that should be protected. I find it reprehensible that patriarchal legislators, overwhelmingly men, would abuse the power of law to limit a person’s access to modern reproductive health technologies such as birth control and abortion.

My philosophical position on choice is certainly informed by my experience as a woman, but it is not determined by that experience— I know this because I’ve been pro-choice since I was a young man.

As a trans woman, just like any woman who finds she is physically unable to carry a pregnancy, the question of choice (as it pertains personally) has remained purely an academic matter of ethics and morality. Because I theoretically can’t get pregnant, unintentionally or otherwise, my “personal stake” in this fight has been limited to just satisfying my activist compulsion to do right and help others. So far.

Image of a sonogram in which a fetus may or may not be vaguely discernible (honestly, it's difficult to tell)

One day.

As it happens, in the matter of choice, my own choice for my body and myself would be to carry a pregnancy if I could.

I’ve always felt parenting a child was an important goal in my life, one that I must strive for. And while I do think adoption is wonderful, I would really like to try bringing life to my own genetic offspring first. But my options were limited by my biology: Never having ovaries or eggs, my only access to reproductive cells from my body would be sperm. Because the various medical treatments of my transition would cause sterility, it was necessary for me to freeze sperm samples, something that I undertook to do at great expense: A reproductive insurance policy, so I could make the necessary changes to my body and its chemistry without letting my potential for parenthood slip away.

I did it, despite knowing that my only chance to eventually have my child would be if I ended up with a partner who both could and would carry, or if my partner and I ultimately found a willing surrogate (which is legally complex in Canada, in yet another example of unjust legislative limits imposed on personal bodily autonomy).

I froze my reproductive cells even knowing that, barring some magical development in medical technology occurring within my childbearing years, I could certainly never be pregnant, and that has always been a source of great personal anguish.

To be clear, the ability to carry a pregnancy (or lack thereof) has no bearing on the legitimacy of any woman’s identity. I am no less a woman today, nor would I be moreso if I could somehow become pregnant: My mere existence justifies my female identity, and if you don’t believe that, then go piss up a rope.

My desire to commence motherhood via pregnancy rather than by other means is not about what I am, it’s about who I am: An important part of who I am is the desire to create life with a partner I love, and raise a new person into the world. And for reasons beyond my awareness or control, I live with a powerful, visceral emotional imperative to physically create and hold that life safely inside me, as part of me, until it’s ready to become a person.

But that desire always stood in painful contrast to the fact I’ve always known that pregnancy was impossible for me. Until now.

The sole reason I can’t carry a child is that I suffer from a condition known as uterine-factor infertility (UFI). Specifically, the absence or nonfunction of the uterus, a condition I share with many women both cis and trans alike. UFI has always historically represented a hopeless and permanent barrier against gestation to all afflicted.

Enter Uterine Transplantation (UTx): With a transplanted uterus, I and other women suffering UFI can theoretically experience gestation.

UTx has long been science fiction, and yet for me it has represented a tangible thread of hope to which I secretly clung in my mind for more than a decade. Fast forward to now, and science fiction has become reality: Human UTx has been achieved.

In the hope to finally bring fertility to women suffering UFI, there have been a number of experimental trials. After disappointing failures in Saudi Arabia (2000) and Turkey (2011), a team of doctors in Sweden (led by Professor Mats Brannström) finally succeeded with a new technique in 2013, and have reported multiple uneventful live births, with more on the way.

It exists.

I can have a baby. Maybe.

This is precisely the point at which Trans-Exclusionary Radical Feminists (TERFs, who call themselves feminist but hate trans women and call us men) will say that I’m trying to appropriate womens’ bodies, to steal and own and use parts of them for myself to satisfy a sense of male entitlement, like some kind of pregnancy Dracula. For what it’s worth, I promise never to take anyone’s uterus without their consent.

Anyway, my desire for UTx is as a means to the end of my desire to carry, and not motivated by some bewilderingly nefarious compulsion to spoil that ability in someone else. Still, while synthetic alternatives will doubtless someday appear, it’s unavoidable at this early stage that the organ donors will be women (or trans persons designated female at birth, who by the way are considered women by TERFs).

But as long as the practice of organ donation happens within an ethical framework of informed consent, it’s morally acceptable. Isn’t it? Again, it’s a philosophical question of choice and bodily autonomy.

Anyway, from under the shadow of Sweden’s emerging success came Canada’s far less illustrious contribution to this field of study… Continued in Part 2.

Parts 1 and 2 of this article first appeared together (slightly edited) in This Magazine, print edition (2015).

One Comment

  1. Alex
    Thursday, 2017.01.26 at 22:50

    I don’t have much to say here besides 1. I agree with you 2. Wow, technology! 3. Ugh, TERFs.

    Except that you are the second woman to tell me that she had a physical desire to have a child…the first was a friend of mine in school.

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Christin Milloy