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
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.
The baby probably does not benefit from the death of the mother.
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.
> 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.
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!
> 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.
Not to mention when multiple fetuses are involved. It's a miracle there are as many twins+ as there are.
I think in this metaphor the placenta is actually on the fetus' side and also had the baby's DNA.
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.
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.
> 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.
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.
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.
> 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).
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?
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.
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."
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.
One of the biggest lies ever told by conservatives is that sex is binary.
Physical "sex" is never only binary.
1 in 1500 births is DSD and not binary (aka intersex but that term is outdated)
The woman in this example is DSD
There are dozens of different types of women who are DSD
Some women who are DSD would most definitely fail most genetics tests to prove "women" (like the SRY test that some sports federations use)
Yet some of the women who "fail" SRY tests can give birth, typically using a donated egg or in this case other organs because their organs are either damaged or cancerous from partially activated SRY, etc.
1 in 1500 is a LOT of people
Every time you hear a "bathroom assigned at birth" harassment, realize they are also oppressing millions of women who are DSD, not just transgender
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.
Always found using the word binary in this context to be strange, the correct word would probably be "bimodal" at best.
Biology somehow always ends up being a messy subject with edge cases or paradoxes in some way or another.
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.
Random but nature related: some birds have four sexes
You may be thinking of species like the white-throated sparrow. These have two morphs with distinct behaviours which lead to there being four mating combinations. Still two sexes though.
There are only two elements in the universe: hydrogen and helium. The binary element model is 98% accurate.
>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.
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.
> 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.
Not intending to debate the ethics of abortion, but one of the reasons foetuses are aborted is due to disability, down syndrome being a notable example.
You’ll note that the people who oppose abortion generally also oppose aborting fetuses with disabilities. And among people who support abortion, a decent proportion also oppose aborting fetuses because of disabilities.
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.
For anyone like me who’s unfamiliar with the acronym.
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.
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
You do not need microscopes, telescopes, or even eyeglasses to determine sex differences. The existence of chromosomal abnormalities does not mean we need to change the meaning of words.
"when their bible was invented"
I can tell you that in Czechia and former East Germany, two most atheist places in the Western world, the concept of sex as a spectrum isn't especially popular either. People can be somewhat socially conservative without believing in the bible.
Indeed, and same goes for trans people.
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.
Expressed sexual characteristics are a spectrum when there are mutations in the genes involved in the binary system of sex.
Saying it's a spectrum implies to most people there's some sort of Gaussian distribution and there's not.
There's not like 20% of humans with mammary glands and a scrotum, right? Or 10% with no reproductive organs. Or 15% with both sets.
The obvious flip side of 1 in 1500 is that 1499 out of 1500 are binary.
So there's not really a spectrum as most people would understand that word.
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.
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.
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.
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.
I was deeply moved looking at it as well.
Pretty amazing. I suppose that the effects of immunosuppressants on pregnancy and the unborn child are already well understood.
"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.
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?
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...
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.
I would suspect this is extremely dangerous. The female genome is intricately evolved to handle the hormone war of pregnancy.
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.
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.
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
Yeah exactly.
> 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.
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.
> 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.
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...
This is great news, but I wonder how that ever got approved given the safety implications for mother and child.
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?
> 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.
MRKH is inherited, which adds an additional ethnical layer to this.
Apparently so are most of the male conditions that require ICSI IVF.
Note this is currently not possible without the use of In vitro fertilization
This is really cool but it's ultimately a stop-gap measure.
Where we want to end up is with artificial wombs because that will ultimately give individuals much more control over their reproduction and will do away with the onerous physiological and psychological stresses that pregnancy puts on women.
I could see this being combined with pigs, to place human embryos in pigs to carry humans to term.
An extra-uterine system to physiologically support the extreme premature lamb https://news.ycombinator.com/item?id=14194422
brave new world
My baby banting Soon you'll need decanting
Whose baby is it? If I get a transplanted womb and have hundreds of kids are they mine of the original owners? I would assume the current owner, but Anglo laws tend to be completely backwards when it relates to sex.
I don't think there is any womb out there that is going to produce 100 kids for you.
In the UK, whoever gives birth to the child is the mother.
This is incredible technology. But I am crying in American at "Each transplant costs around £30,000, he says."
That seems extraordinarily affordable for a permanent, life-altering operation that needs 30 medics and takes 17 hours.
For a comparison, check out what a 1-month supply of a biologic drug costs: https://www.goodrx.com/stelara
The think that was the point, it's unimaginable that something like that could only cost 30k in the US.
It will not be permanent, she can have two babies but they will remove the womb afterwards
I'll raise you for the cost of a single dose of Pluvicto:
Only a low multiple of IVF treatment, remarkable!
Completely dwarfed by the total cost of raising a child. It’s a surprisingly expensive hobby.
Yea but in america such a transplant probably costs 300k just to go to the hospital ez
prob also raising a child way expensier if you factor uni and such into it vs UK
I don't think anyone in America is actually paying a bill for $300,000 for a transplant. It's either paid for by insurance, or if someone doesn't have insurance, via hospital charity or a state medical aid plan. The only exception would be an absurdly rich person who doesn't have insurance.
Why would insurance cover a womb transplant?
Insurance often covers IVF
Only in some states, under some circumstances, and not necessarily completely.
Presumably if the need is due to illness
Would insurance cover a transplant that isn't necessary for survival?
Don't forget the people who don't have insurance and are too poor to pay for the treatment, those suckers.
“American health care is incredibly expensive.”
“That’s ok, other people bear the enormous cost.”
Not really a win, that.
That’s not how it works! The bill of $300k gets negotiated down to like $20k.
So if they do a DNA test, her sister is the actual biological mother I guess.
No, That's not how any of this works... The DNA comes from the egg, the uterus (aka womb) is just an incubation chamber.
Would only have the sister's DNA if it was an ovary transplant.
> Would only have the sister's DNA if it was an ovary transplant.
Fun fact: fetal cells transmit back to the mother and can be spotted in virtually every organ afterwards - it's called "Fetomaternal cell microchimerism" [1].
It's not a far stretch to assume the transfer works also the other way around and you can detect maternal DNA in the fetus/child, but I'm not aware if there has been research around that.
[1] https://www.sciencedirect.com/science/article/pii/S138357422...
Yep, mom→fetus/child is "maternal microchimerism" and it is also widely studied (though less so than the reverse) and seemingly confirmed.