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First baby born in UK to woman with transplanted womb

veidr

Glad for this family, but also:

This is interesting to me at the margins, because one of the things I learned when my wife got pregnant the first time was that the womb is not exactly the warm cradle of nurturing that I had always (without thinking much about it) imagined, but in many ways a blast door or containment vessel to protect the mother (host) from the fetus (roughly, xenomorph) that would otherwise explode like an aggressive parasite (killing them both).

So I mean, you probably don't want to have any leaks or weak stitches in your uterus transplant...

Keywords: fetal microchimerism, placental barrier, trophoblast invasion

dwroberts

> fetal microchimerism

This is just a fact of reality for any women that have children though.

Eg male chromosomes from fetuses being found in women’s brains: https://pmc.ncbi.nlm.nih.gov/articles/PMC3458919/

(I don’t think this is believed to be unusual or an example of ‘containment failure’ of the womb)

Qem

> Results also suggested lower prevalence (p = 0.03) and concentration (p = 0.06) of male microchimerism in the brains of women with Alzheimer’s disease than the brains of women without neurologic disease.

It appears it may even be protective.

anvandare

Pregnancy is, it seems, just another (evolutionary) war.

https://aeon.co/essays/why-pregnancy-is-a-biological-war-bet...

Red in tooth and claw at every layer, from the smallest cell to the entire biosphere.

sitkack

> It’s no accident that many of the same genes active in embryonic development have been implicated in cancer. Pregnancy is a lot more like war than we might care to admit.

Amazing article. Another reason that hardshelled laid eggs are such a great invention. The offspring can do its thing from a safe distance.

andai

The article suggests the external egg also limits the creature to a small brain.

andai

My uncle said yesterday that man's harsh nature goes back to Rome: Homo homini lupus.

The article says it goes back a lot further than Rome!

> So if it’s a fight, what started it? The original bone of contention is this: you and your nearest relatives are not genetically identical. In the nature of things, this means that you are in competition. And because you live in the same environment, your closest relations are actually your most immediate rivals.

wahern

In all non-human species selfless cooperation falls off a cliff beyond siblings, and AFAIU this comports well with Game Theory-type models for understanding genetics. Popular examples of non-human cooperation, naked mole rates and bonobos, actually live in communities dominated by sisters. (It's not often noted, though, in the breathless narratives extolling the virtues of cooperation and anthropomorphizing the rest of the animal kingdom.)

Human behavior, however, is still a deep, deep mystery in terms of evolutionary biology. I'm always wary of people applying evolutionary principles to human behaviors. Writ large you can see contours of what we would expect to see, but even then it's unclear why the boundaries are where they are, or to what degree we're projecting expectations into the data, etc. The speculation quotient is extreme. I wouldn't put any stock into evolutionary biology-based explanations for human behavior. And just as a practical matter, it's not like most people would leave their most hated cousin to die in a ditch; and though most people wouldn't leave anyone to die in a ditch--at least, if they knew that's what they were doing--I'm betting they're more likely to save a cousin than a stranger.

thaumasiotes

> My uncle said yesterday that man's harsh nature goes back to Rome: Homo homini lupus.

What's "homini" supposed to mean?

petermcneeley

The baby probably does not benefit from the death of the mother.

spwa4

That depends. Look it up. You will find there is a point where it switches. Normally the body (of both baby and mother) will protect the mother. Something goes wrong or just gets too far "out of spec"? Miscarriage. After a few months, the body goes so far as to sedate the mother and child before terminating the pregnancy. There is research claiming it actually shuts down the baby's nervous system before decoupling.

But about a month before birth things switch around. The womb partially disconnects from control systems of the mother's body and ... there's an extremely scary way of pointing this out I once heard from a medical professor: "you know just about the only thing a human body can still do when it's decapitated? It can give birth"

In less extreme circumstances, you actually have a switch in your circulatory system ... when pregnancy gets to this point and the mother's body loses power, it will initiate a rapid birthing process, and start shutting down organ after organ to give birth with the remaining power. That includes, eventually, the brain. Only the heart, lungs, liver and womb will remain operational. The body will shut down blood flow to the brain to continue giving birth. Once shut down it cannot be turned back on. So this kills the mother, despite the body remaining functional, in some reported cases, for over an hour, and is something gynaecologists get trained to prevent from happening.

Given how common it was even a century ago for women to die giving birth, one wonders how often this mechanism was involved.

tgv

But some form of evolution might make it a local optimum. It would at least require 3 or more offspring per pregnancy, and could not happen in mammals, though.

Barrin92

what an odd coincidence to see David Haig mentioned in the article. I just stumbled over his interview on Sean Carroll's podcast a few days ago, discussing the exact same topic (https://www.preposterousuniverse.com/podcast/2020/11/30/125-...)

"And so while the cooperative outcome would be the most efficient, you lead to a situation in which there are conflict costs, and I think this explains why things go wrong so often during pregnancy. Of course, at first sight it's strange, my heart and my liver have been functioning very well for for 62 years, and yet during pregnancy, you have a natural process that only lasts for nine months, and yet many things go wrong during it. And I would argue that the reason why pregnancy doesn't work as smoothly as the normal functioning of the body is that in normal bodily functioning all the parts of the body are genetically identical to each other and working towards survival of that body, but in pregnancy, you have two different genetic individuals interacting with each other and natural selection can act at cross-purposes, there's a sort of politics going on, and we know that politics does not always lead to efficient outcomes."

gwerbret

> So I mean, you probably don't want to have any leaks or weak stitches in your uterus transplant...

With this sort of surgery, they wouldn't be cutting into the uterus (womb) itself when extracting it from the donor, but instead will cut around it to remove it, along with some very essential plumbing. The receiving mum will also be on industrial-strength immune suppressants anyway.

Where you DO have to worry about leaks and weak stitches is with said plumbing (uterine arteries and veins) -- they have to support virtual firehoses of blood through the duration of pregnancy, and their damage is one reason why a delivery can go south very, very quickly. Obstetric medicine is definitely a high-risk sport, which is why their malpractice insurance rates are head and shoulders above any other medical specialty. But I digress...

tommica

This is at the same time the most horrible description of what is going on, and the most hilarious :D "roughly, xenomorph" really got me!

ben_w

There is, famously, an alternative reading of the Alien franchise where it's about a non-consensual pregnancy in a society that forbids abortions.

CPLX

Pretty sure that’s not some fringe theory. Didn’t the director and visual designers consciously use rape as the model for how to depict the Alien attacks?

null

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mcv

Absolutely. From what I understand, there's been an evolutionary war for resources between the womb and the placenta, which is a big part of why human pregnancies are so complicated and invasive compared to other mammals (because no other mammal has this anywhere near as extreme as we do).

Why us and not other mammals? No idea.

Ygg2

> containment vessel to protect the mother (host) from the fetus (roughly, xenomorph) that would otherwise explode like an aggressive parasite (killing them both).

You can also flip the perspective the fetus is trying to survive in a hostile environment designed to strangle it. If it isn't clawing for every ounce of food and air it will become a miscarriage. It must interface with a system built for millenia designed to kill anything that doesn't have its code.

In truth, it is the equilibrium that evolution has achieved. Placenta must account for the most vicious fetus, and fetus must account for most vicious placenta.

diggan

Not to mention when multiple fetuses are involved. It's a miracle there are as many twins+ as there are.

treve

I think in this metaphor the placenta is actually on the fetus' side and also had the baby's DNA.

Ygg2

Did you read the article? It's not. It's somewhat fighting against it. Plus immune system would see baby's DNA as corrupted, since half of it is just wrong.

hinkley

They also check the blood type of the baby and the mother and I believe this is to make sure the mother won’t throw clots, and to take precautions if there’s a mismatch.

kccqzy

> not exactly the warm cradle

That would be the gestational sac, no?

lifeisstillgood

It’s incredible and Inwish long life and happiness to the newborn and her family

I would like to reflect on the timing of this - the UK Supreme Court just ruled something about a woman is a “biological” definition - and I am willing to put a lot of money on many people on both sides of that contentious debate struggling with the idea that “someone born without a womb is a woman” and “hey we can transplant wombs now”

Thousands of scientists and medical practitioners have taken thousands of baby steps to get to this point. We should fund every single one of them - we never know where research will take us.

pyuser583

I don’t think anyone struggles with “someone born without a womb is a woman.”

When a woman is born without a womb, the doctors should investigate and figure out why that is. Is something else missing? Could there be other issues? A diagnosis should be made.

No such investigation is necessary when a man is born without a womb.

jl6

It’s not that confusing. “Has a womb” is not a common definition of “woman”. Women don’t stop being women after having a hysterectomy.

The woman in question is a woman because her sexual differentiation followed the female pathway. Just because in her case that pathway led to a DSD variant doesn’t undo the rest of her female development or make her a little bit less of a woman, or male, or a third sex.

ben_w

There's at least four common definitions of "woman", and I have in fact seen people use "has a womb" as one of them despite, as you may guess, all the people piling on immediately with a reply along the lines of what you yourself say — that this would exclude women who have had a hysterectomy.

The other three I've commonly seen are:

(1) as you suggest, developmental pathway — which tends to trip people up over androgen insensitivity, and is also why puberty blockers are part of the public debate

(2) chromosomes — which has the problem of 0.6-1.0% of the population doing something else besides the normal XX/XY

and (3) current external physical appearance — which tends to lead to confusion by both transvestites in public, and also in private by anyone who has had top surgery but not bottom surgery.

aisenik

Why do you use the the Nazi demographic term "transvestite?"

(also, you should just not talk about trans people as you display immense ignorance in a very short time, you clearly have a concept of trans bodies that is rooted in fascist propaganda: trans women on HRT develop breasts without surgery).

crooked-v

US Republicans have literally passed laws defining "woman" based on having a functioning womb (https://kansasreflector.com/2023/07/05/what-is-a-woman-heres...).

ChocolateGod

> US Republicans have literally passed laws defining "woman" based on having a functioning womb

The bill referenced makes no direct mention of womb, nor functioning. You're using "literally" a bit unfaithfully there.

from the law

> a "female" is an individual whose biological reproductive system is developed to produce ova,

tomlockwood

What tests with what results would conclusively show which individuals went down which pathway?

jl6

Depends why you need to know and with what level of accuracy. Just looking at their face is about 96%-98% accurate[0], and becomes even more accurate when other cues are available such as voice, gait, and build. For casual purposes, humans are incredibly good at predicting sex, without any technology or scientific understanding. One might speculate that being able to accurately find a mate is an evolutionary advantage.

For the last few fractions of a percent accuracy, a SRY cheek swab test is a simple non-invasive screening test that can flag individuals for further investigation. World Athletics have just implemented this test, stating it is “a highly accurate proxy for biological sex”.[1] A positive result in this screening test could be combined with a finger prick test for testosterone level to provide further information, and at this point we’re into methods of medical diagnosis of DSDs. About 1 in 5000 individuals will have a DSD, some of which are still unambiguously male or female (e.g. XXY Klinefelter syndrome), and some of which are almost unique individuals that defy categorization.

At this point, it is popular to seize on those rare individuals and declare “aha! So sex isn’t binary then! So it must be a spectrum!”, and while this is surely well-intentioned, it is scientifically illiterate.[2] I suspect part of the confusion is interpreting “binary” as a mathematical Boolean value (where exceptions cannot, by definition, exist) rather than as a scientific classification, where exceptions can and do exist and “prove the rule”.

[0] https://www.sciencedirect.com/science/article/pii/S004269892...

[1] https://www.bbc.com/sport/athletics/articles/cj91dr17d1no.am...

[2] https://richarddawkins.com/articles/article/race-is-a-spectr...

googlryas

Why do you suppose such a test could even exist?

noosphr

The biotech coming down the line will make our current culture wars seem like a disagreement between two best friends.

All of the following are nearly possible today:

+ A man implanted with a womb giving birth.

+ A woman stealing genetic material and creating a baby, the gender of the second parent is irrelevant here.

+ A woman wanting an abortion, instead having the fetus removed and placed in an artificial womb under the care of the father.

And one that I was working on:

+ Farm animals grown with their brains shut off, used as compute substrate for biological neural networks, while their biological functions are controlled remotely.

lukemercado

> Farm animals grown with their brains shut off, used as compute substrate for biological neural networks, while their biological functions are controlled remotely.

I’m sorry, you were working on what? Where does one learn more about this concept?

noosphr

>Where does one learn more about this concept?

One does not.

One builds the tools to run the experiments to discover the rules.

The closest are FinalSpark and CorticalLabs, but they both are only using in vitro neurons as the computational substrate.

Neuralink et al. are working in vivo, but they are only doing output and don't have any plans to do input, let alone to actively disrupt normal neural activity and take control of bodily processes.

If you're very interested feel free to drop me a line.

aaaja

> I would like to reflect on the timing of this - the UK Supreme Court just ruled something about a woman is a “biological” definition - and I am willing to put a lot of money on many people on both sides of that contentious debate struggling with the idea that "someone born without a womb is a woman" and "hey we can transplant wombs now"

MRKH syndrome is a disorder of female sex development, and if you look at this from the perspective of developmental biology it's clear that anyone affected by this must be a woman. I feel it shouldn't be too hard an idea to struggle with.

That they have a working womb transplant technique is impressive from a medical technology point of view but I think not enough has been said about the ethics of this experimentation.

Personally I wouldn't risk exposing my baby to transplant anti-rejection drugs. We don't know how this may impact the short-term or long-term health of the baby.

XorNot

The same could've been said about IVF - the technology is not old, the first person born to it was only in 1978.

clort

As I understand it, the court ruled that specifically within the text of the 2010 Equality Act, where it says 'woman' with no qualifier, that refers only to biological females. I do not know how many such places there are, but other parts of the act do apparently refer to other women and that they should not be discriminated against in the same way.

The court is really saying that the lawmakers did not specify properly what they meant in certain cases and that they should probably modify those sections (they are carefully not to tell Parliament what to do), which can be done and does sometimes get done when such things crop up.

ChocolateGod

> but other parts of the act do apparently refer to other women and that they should not be discriminated against in the same way

Yes, the act (as it should) protects people from discrimination based on gender reassignment, e.g. you can't fire someone for their gender identity or deny them from a service.

The act makes it illegal to discriminate against someone due to their "sex", but a portion of the act allowed for "single sex" spaces where there is reasonable grounds to have them, but the act (reasonably at the time) did not define what sex was.

A piece of Scottish legislation referred to "woman as defined by the Equality Act", but the Equality Act never said if it was referring to biological sex or gender identity, the Scottish government said it would include people with gender reassignment certificates, a "woman's rights" charity disagreed. Hence the court got involved and found the original intention was to refer to biological sex, which was confirmed by the politician that introduced the Equality Act (Harriet Harman).

blippitybleep

On the important issue of discrimination, Clause 9 makes it clear that a transsexual person would have protection under the Sex Discrimination Act as a person of the acquired sex or gender. Once recognition has been granted, they will be able to claim the rights appropriate to that gender.

- Lord Filkin, the Minister who introduced the Gender Recognition Bill in the House of Lords in 2003 (18th December)

remarkEon

This is not actually a struggle whatsoever, it only is if you pretend it is thus. Humans have 2 legs and 2 arms. It I was born without legs, am I still a human?

ben_w

I was born as a baby, but I sure 'aint one now.

Here's another one for you, given how many people care about XX/XY as a distinction of gender: Humans have 46 chromosomes, but by this definition, about 0.6–1.0% of live births from human mothers are of individuals who aren't human.

Language is a tool we use to create categories, don't let language use you. Insisting that everything in reality must conform to the categories that language already has, is mistaking the map for the territory.

remarkEon

Language is more than a tool, though. It's how we understand reality. My native language is English, I speak a little Spanish, more than a little German, and used to speak some other stuff (the use it or lose it kind). And in every effort to learn those language you, well, learn things about how to structure your thought and understanding of things. I think you're mistaking my point for something else.

BriggyDwiggs42

If you’re writing laws, your choice of language matters quite a lot. “Humans have 2 legs and 2 arms” alongside “humans are entitled to unalienable rights” could lead to foreseeable problems, so specifying in your writing that “humans typically have two legs and two arms” would be a smarter bet. It’s not important in a hacker news comment, but is important in law.

contravariant

That's a gross oversimplification. Virilisation is a complex process with many factors.

If you're still human if you're born without legs then clearly neither genetic or developmental traits determine someone's humanity.

So at what point do we call someone a woman born without a uterus? When a 'normal' pregnancy would have resulted in them having a uterus? When different genetics would have resulted in them having a uterus? Or when she herself complains that she lacks a uterus?

remarkEon

I'm applying the same logic, I'm not simplifying anything. You are using the word "humanity" to mean something different from what the rest of the thread is talking about. To address what I think your point is, many wish to expand the malleability of basic biological concepts based on edge cases. Edge cases for which we already have definitions and categories. You are doing so now, by attempting to entrench ambiguity on the entire concept of "woman" by observing that the woman in TFA was born with a specific, heritable, abnormality that prevented the nominal development of a uterus.

basisword

The Supreme Court wasn’t deciding anything other than the intention of an existing law and the meaning of the words in that law (which were unclear enough to require clarification). BOTH sides of the debate claiming that the Supreme Court has now defined what constitutes a “woman” are wrong and doing nothing but polarising people for their own selfish gain.

qingcharles

This ^. It was your standard run-of-the-mill statutory interpretation case. Limited to a single badly defined statute, written somewhat carelessly. This is common for statutes.

What often happens is that a "supreme" court like this will file an opinion attempting to clarify the meaning as best they can, but it really requires a statutory amendment by the legislators to fix it. Often that is what happens next.

EA-3167

Unfortunately when you try to explain this to people, the most common response (regardless of which side they're on) is to express that "Yes, but OUR side is right, so misrepresenting the ruling in our favor is right too."

ChocolateGod

The same kind of people where if you're not on their extreme, you're on the opposite extreme and might as well be Satan himself.

You're not allowed to be in the middle anymore.

ck2

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crypteur

Nothing in nature can ever be described with 100% accuracy by any model. But that doesn't mean models are useless. So imagine why we would use the binary sex model instead of three or a spectrum or what have you.

nathan_compton

Simple models are useful, but they shouldn't determine who is allowed to live a normal, productive, life without some very compelling justification. Like the "binary sex model" is handy, but nothing about it makes it obvious that we should definitely and always lock gender (another non-binary model often simplified usefully into a binary) directly to biological sex.

TheCoelacanth

There are only two elements in the universe: hydrogen and helium. The binary element model is 98% accurate.

BriggyDwiggs42

Is a bimodal distribution, or a somewhat reductive “typical male, typical female, intersex” model, so difficult to understand that we can’t use it? I don’t think people are stupid.

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ck2

Random but nature related: some birds have four sexes

akimbostrawman

>1 in 1500 births is DSD and not binary (aka intersex but that term is outdated)

about 1 in 2000 births have less than 4 limbs but i don't see anybody claiming its a spectrum.

wat10000

You don’t hear about it because everybody understands that disabled people exist and the broad consensus is that we should accept them, and assist them to a reasonable degree. There’s little reason to discuss it. If people born with less than 4 limbs were subjected to the same treatment trans people get, you’d better believe we’d be out here talking about how not everybody has 4 limbs and we should accept that.

spondylosaurus

I mean, congenital limb differences are quite literally a spectrum. An entire limb can be absent, or just part(s) of it, or most of the limb can be present but irregularly formed...

You can even mix and match with which parts are present vs absent. I know someone with an arm that stops just above the elbow but still has several (usable!) fingers extending from it. So no joint, but sorta-yes hand.

null

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ChocolateGod

As far as I'm aware, no one is born with both sets of working reproductive organs and in most cases there is still a "dominant" gene expression, and only some extremely rare cases where current tests fall short.

So I don't see 1 in 1500 people being oppressed by the court ruling.

belorn

Sex is binary to a similar degree that humans are born with 10 fingers and 10 toes. Nothing in nature is fixed 100% of the times, but rather exist on a line of probabilities.

macintux

For anyone like me who’s unfamiliar with the acronym.

https://en.wikipedia.org/wiki/Disorders_of_sex_development

froh

thanks for the link. and the section in controversy is really worth reading for nuance and thoughtful conversation.

the humans with intersex conditions themselves object the term, as it tags them as sick, a "disease". their personal experience based political interventions have lead to the prohibition of cosmetic surgeries on genitals of minors, or forced hormonal sex assignment on minors, in several European countries that is. so they can decide on their own when they are old enough. that's all the personally affected humans ask for, for the next generation: let them be as they are and allow them to decide on their own.

dubiousdabbler

It's really offensive to tell people with DSDs they aren't their sex. Sex is binary. People with DSDs are female or male, except for extremely rare cases.

mftrhu

You can't say "$TRAIT is binary" when you follow that up with "$TRAIT can only be true, false, or sometimes something else". That's not a binary trait by definition.

BriggyDwiggs42

>it’s really offensive to tell people with DSDs they aren’t their sex.

Not really true. Some people maybe.

>Sex is binary

Sex is complicated. Traits cluster bimodally, but it would be reductive, scientifically inaccurate, to say it’s a simple binary.

>People with DSDs are female or male

That depends on how female and male are categorized. The line between in the trait cluster and outside of the trait cluster is arbitrary. So it depends where you draw that line.

ck2

Some people who are DSD consider themselves binary.

Some people who are DSD take great pride in being non-binary.

People who are DSD have been documented for CENTURIES

https://en.wikipedia.org/wiki/Intersex_people_in_history

But that's my whole point, "sex" a spectrum and it's one of the big lies perpetuated by people who insist everything was known and set in stone, when their bible was invented, despite never having microscopes or telescopes or even eyeglasses

seethedeaduu

Indeed, and same goes for trans people.

megaloblasto

The point is sex is a spectrum, we don't have to put everyone in little boxes then get upset when things aren't so clearly defined.

aaaja

The woman in the article has a DSD that only affects female sex development. Plus she has working ovaries. From either of these facts one can conclude that she is female.

I don't know why you think this is a conservative lie. It is not.

null

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jesprenj

> The first baby born as a result of a womb transplant was in Sweden in 2014. Since then around 135 such transplants have been carried out in more than a dozen countries, including the US, China, France, Germany, India and Turkey. Around 65 babies have been born.

https://www.bbc.co.uk/news/health-29485996

dleeftink

I stopped and looked at the natal photo for a while. It is a feeling I have not had before. This new life, chanced not only by lineage but multiple family members and a host of research and medical staff.

The image shows very little technology, but to me, is the epitome of how life and progress can unite.

mbonnet

I was deeply moved looking at it as well.

A4ET8a8uTh0_v2

[flagged]

ericwood

Why stop there? Clearly any kind of medical intervention is against nature’s wisdom.

_bin_

There’s actually a very good case that, while we shouldn’t deny care to people, those with some conditions should not reproduce, morally speaking. Those who are sickly or low iq or carry certain congenital conditions (if they are aware of them) definitely shouldn’t. I have a few congenital problems and, while they’re manageable, they’ve affected my life enough I feel it would be wrong to pass them on absent gene editing to prevent doing so.

The alternative is the quality of the human genome declines to zero and our whole population gets one shotted by being in the same room as a damn peanut.

People love to straw man this obvious issue, saying, “oh so you support forced sterilization?” No, I didn’t say that. They love to point out that this choice also isn’t perfect and talk about “disability rights” or whatever. But they are letting the perfect become the enemy of the good. We owe future children more than to saddle them with lifetimes of ailments because we were too selfish to do otherwise.

A4ET8a8uTh0_v2

Do I seem to argue against it? It is intended to ask a simple question:

"At what point does it get silly?"

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basisword

>> Nature, in its wisdom chose that that couple should not be able to have offspring.

I think it’s arrogant to claim you know what “nature” chose, if indeed it “chose” anything at all.

A4ET8a8uTh0_v2

Heh. I do not believe so for one reason and one reason only. It is not exactly secret what it chooses on a rather daily basis. That as a race we have managed to remove ourselves somewhat from the grip of that choice is a testament to our arrogance. In other words, I do not think you are accurate. I know, because I see things in front of me. I am uncertain on how you know what you know.

Ken_At_EM

+10 Points. Awful take.

Teever

[flagged]

A4ET8a8uTh0_v2

How is it awful? There is already too many humans on this planet and here we are spending resources on bodies that would obviously not even begin to exist save for technology. If anything, I am likely more reasonable here than the emotional gasps of 'ooh science'. Is it an interesting solved challenge? Sure. Is it something that is going to further remove us from reality.. also yes.

nick238

Just for clarity, "in UK" is qualifying the whole thing, not that she just happened to be in the UK. A woman in Alabama had a child via a uterus transplant, among other places.

romaaeterna

"Grace was born with a rare condition, Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, where the womb is missing or underdeveloped, but with functioning ovaries"

A rare, congenital, condition.

smeej

> He told the BBC around 10 women have embryos in storage or are undergoing fertility treatment, a requirement for being considered for womb transplantation. Each transplant costs around £30,000, he says, and the charity has sufficient funds to do two more.

Is this because they're not connecting the transplanted uterus to the fallopian tubes or something? Or is there some other reason that it wouldn't be possible to conceive the "old-fashioned way" post-transplant?

Creating and freezing embryos otherwise seems like a very strange thing for a woman to have done who has no uterus, unless she was already considering surrogacy. Where was she expecting them to grow?

Requiring the embryos to be created before knowing whether the womb transplant would be possible or successful seems really odd to me.

saalweachter

Surrogacy is already a thing; stored embryos have a use without womb transplants.

throwawayk7h

It would be quite interesting to see how public discourse about gender is affected by this, and in particular if this procedure is done successfully on a transgender woman. Regardless of your political outlook, it will no longer be possible to say that the ability to give birth is a condition for being a woman. (And what will happen should chromosome replacement become possible? It seems unlikely that anyone would really invest in such a procedure, but is it medically feasible?)

aaaja

Harvesting a female reproductive system from a dead woman and stitching it into a male? I can't imagine the public discourse will be positive.

I will be honest, even typing that first sentence out gave me a wave of nausea. In a way that thinking about, say, life-saving heart transplants does not. Imagining it feels like a sexual assault.

remarkEon

There will certainly be people that drive toward this outcome, yes. With no thought or concern for the life that is the result of this Lovecraftian horror.

ericmcer

If the procedures got so good that a trans woman/man was indistinguishable from one born that way who would still object to them claiming the gender they choose, most of the arguments fall apart at that point.

mftrhu

They would just move to calling the procedure a violation of the "natural order" - "Lovecraftian horror", "Frankenstein arrangement", "something Mengele would do" - argue that it is akin to rape, create conspiracy theories about uteri being stolen, and/or invoke "Think of the children!"

I saw all of that already. Some of it in this very thread, some of it on the defunct /r/GenderCritical: I remember someone proposing committing suicide by volcano to keep her uterus out of "male [sic] hands".

aisenik

Almost everyone who opposes trans people's existence today. Opposition to trans rights is rooted in patriarchal hegemony and the control of bodies. Our existence is a fundamental threat to the foundational perspective of the predominant power-structure in society.

No one does a womb-check before granting women validity. It's always been a vibe thing and people who do not conform to the prescribed model of existence as a man or woman are constantly denied full privileges under the framework. It's not just trans women getting the short end of the stick here, it's everyone: men who do not embrace dominance culture or otherwise display "effeminacy" are denied true Man status, women who don't meet beauty standards or possess a submissive demeanor are slurred as bull-dykes or the dreaded transexual.

This isn't an issue with any real reasonable basis for it's opposition, it's a golem of pure hatred and disgust in a suit vs. people who want to live full, free lives.

editing to add: the first known uterine transplant was performed on Lili Elbe who received treatments through the Institute of Sexology in Germany. The Institute was famously destroyed by the Nazi regime. It's barely coincidental that fascism has risen again as medical science brings this technology to maturity. Trans women gave their lives for this medical miracle.

amarant

I can't help but wonder if there is any hope of this working for trans persons in the future?

Could someone born as a man have a transplanted womb and get pregnant through in-vitro fertilization, in theory? anyone here with more medical knowledge who can comment on how likely that is to work at some point in the future?

spondylosaurus

Considering how many trans people who are assigned female at birth get hysterectomies (tissue that would otherwise be discarded), maybe there could be a "give a uterus, take a uterus" matching program...

tredre3

Maybe I'm missing the point you're trying to make but people who get hysterectomies aren't doing it for fun, they're doing it because the organ is diseased so giving it to someone else wouldn't work.

kgwgk

Among those "trans people who are assigned female at birth" who "get hysterectomies" how many would you say are doing it because the organ is diseased. (Not that the proposal is practical, of course.)

throwawayk7h

This is not true; trans men get hysterectomies for different reasons than that it is diseased.

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jagger27

It might work with a C-section. Reassignment surgery isn’t stretchy enough for a live birth. For trans girls who start before male puberty they might get enough pelvic rotation for there to be enough room for it, though.

spondylosaurus

Not transfem myself, but considering the risk of tears and other unpleasantness from a vaginal birth I know I'd probably opt for a C-section if I were in that position regardless... recovering from bottom surgery once is tough enough without the miracle of life wreaking havoc on the place after :P

jagger27

Yeah exactly.

aaaja

What would be the point of that? I'd be surprised if it got past an ethics committee.

Aside from this, the male pelvis isn't shaped to accommodate a womb, and males don't have the hormonal milieu to enable pregnancy.

The closest that researchers have come to having a male gestate a foetus was in rats. But they had to connect the bloodstream of the male rat to a pregnant female rat, where both were implanted with embryos at the same time. Even then, it worked less than 5% of the time.

derektank

Presumably, the point would be that a trans woman wanted to have kids without using a surrogate (which some people have ethical qualms with)

aisenik

I've had my eye on the UTx op for the better part of the decade. It is my understanding that there's no medical reason to expect it would not be successful in a trans woman. I don't have recent numbers but we passed >100 uterine transplants a while back. The most complicated physical requirement is a functional vagina for discharge (which is generally on the roadmap for trans women interested in carrying a child).

I am unaware of trans women having received this operation yet, but Lili Elbe died after the first uterine transplant nearly 100 years ago, before the Nazi regime destroyed trans medicine and eradicated contemporary trans existence. Given the global climate, I don't expect any trans recipients to be eager for publicity. It will happen, and soon.

drooby

I would suspect this is extremely dangerous. The female genome is intricately evolved to handle the hormone war of pregnancy.

thrance

Are you an expert in the field? All I've read so far on the subject induicates that it should be doable in the near future.

throw_m239339

> I can't help but wonder if there is any hope of this working for trans persons in the future?

why just trans? it would work on any male regardless of what they identify as if it were possible. No need for penis removal either, C-section would work.

aisenik

Unless the procedure has changed dramatically, it requires a functional vagina. Neovaginas are qualified but I would not expect most male-identified people to opt for vaginoplasty.

thrance

I guess trans women would have more of a desire to give birth than men. As one of the latter, I don't particularly seek experiencing child-bearing.

throw_m239339

> I guess trans women would have more of a desire to give birth than men.

No, since plenty of trans men have babies. All these considerations would be completely irrelevant.

thrance

Apparently [1], it's not completely out of the question, but more research is needed before it can be safely attempted on a trans woman.

However, I fear the largest hurdle will be a political one, with so many nutjobs [2] so hell-bent on imposing their dogmatic definition of gender on everyone.

[1] https://www.euronews.com/health/2023/08/23/uterus-transplant...

[2] https://www.theguardian.com/books/2025/apr/18/jk-rowling-har...

Thorentis

Ah yes, the nut jobs are the ones opposing what for almost all of human history, is something so far beyond the imagination as to be bordering on the grotesque.

thrance

What historical "truth" are you defending? Flat earth? Racism? You're being a bit vague.

If you couldn't tell, that was a jab at your appeal to tradition.

sebazzz

Pretty amazing. I suppose that the effects of immunosuppressants on pregnancy and the unborn child are already well understood.

throwawayk7h

Lab-grown vaginas made from the patient's own stem-cells have also been transplanted into women [1]. Hopefully soon it will be possible to get the whole #!/usr/bash.

[1] https://en.wikipedia.org/wiki/Vaginal_transplantation#Labora...

(I don't know why this lab stopped performing this procedure though.)

amelius

This is great news, but I wonder how that ever got approved given the safety implications for mother and child.

bluescrn

Wondering the same. Surrogacy would seem like a much safer option. Just use the working womb without transplanting it. Why put two people through major surgery, plus additional risks for the baby?

lloeki

> Surrogacy would seem like a much safer option. Just use the working womb without transplanting it.

In some jurisdictions the former could be illegal while the latter would be legal.

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