Is It Immoral for Men to Gestate? Transgendered Women?

Pamela · 01-30-2015, 10:56 PM

Presented for discussion purposes only. I'm interested in what you all think of this.

from here

The first child ever successfully gestated in a transplanted uterus and brought safely to term was born in Sweden in September. The healthy baby boy's 36-year old mother had been born without a uterus. The transplanted organ was donated by a 61-year old family friend who had herself given birth to two children.

Eggs were extracted from the woman's intact ovaries and fertilized in vitro using her male partner's sperm. This produced eleven embryos that were then frozen. A year after the transplant, physicians installed a single embryo in the woman's new womb which resulted in the pregnancy that led to the birth of the baby boy.

The Swedish woman who gave birth last year is one of nine women into whom researchers transplanted donated uteruses in 2013. Two of the recipients had to have their transplants removed due to infections and blood clots. There's no news of any pregnancies so far from the other recipients.

As it happens, there are other human beings who are born without uteruses: males and transgendered women. Is there any reason—biological or ethical—why they should not be considered as possible uterus transplant candidates? With regard to biology, it is already quite common to successfully transplant solid organs such as kidneys, livers, and hearts between different sex donors and recipients now.

More research will be doubtlessly be required, but there do not seem to be any insuperable physiological barriers to figuring out how best to connect up the proper blood supply to the donated organs and manage relevant hormonal issues in men and transgendered recipients. In the case of transgendered women, they will already be following a supplemental hormone regimen. The supply of organs could be quite large since post-menopausal women can be donors.

So are there any moral reasons why men and transgendered women should not be permitted to gestate? One handy ethical rule of thumb with regard to deploying a novel reproductive technology is that it should be about as risky as conventional procreation. As a reference point, note that in the United States about 3 percent of babies are born with a major structural or genetic birth defect. The Swedish infant got a near perfect APGAR score, demonstrating that it is possible to safely bring a baby to term in a transplanted womb.

In the December 2014 issue of Bioethics, University of Illinois College of Medicine bioethicist Timothy Murphy asks if uterus transplantation becomes routine and effective "would there be any morally significant reason why men or transgender women should not be eligible for the same opportunity for gestation?" He concludes in his article, "Assisted Gestation and Transgender Women," that the answer is no.

Murphy is mainly arguing against Australian bioethicist Robert Sparrow who asserts, "Because pregnancy is not a reasonable expectation in men, men who wish to become pregnant are not capable of establishing that this desire should be granted the same moral weight as women's desires to become pregnant." Both philosophers are fixated on the question of whether the state is obliged by the interests of some of its citizens in giving birth by means of the assisted gestation to pay for research and the medical provision of the technology. Murphy thinks that the answer is "yes," but he is wrong. Sparrow is wrong for different reasons. He thinks that the answer is "yes" for women, but "no" for men. It should be "no" for both.

Setting public health conundrums aside, one citizen does not, in general, have a moral claim on the money and time of another citizen merely to benefit himself and his interests. Thus there is no moral justification for the public funding of assisted gestation research and treatments for either men or women.

Sparrow goes badly astray when he claims that "no negative right to male pregnancy exists." As conventionally defined, a negative right is a right to be free to hold and practice a belief, to pursue an action, or enjoy a state of affairs without outside interference. Sparrow rather convolutedly comes to his perplexing conclusion largely because he thinks that male pregnancy will only be possible if there is a corresponding positive right requiring that the government pay for the development of assisted gestation technologies applicable to men. Women have a positive right to research funding and treatments, but men do not. Since Sparrow believes that assisted gestation for men will necessarily not be developed without government funding then it doesn't matter if male pregnancy is outlawed. Thus one cannot have a negative right to do something that in fact one cannot do. This evidently passes for sophisticated philosophical reasoning nowadays.

Murphy is, however, right when he notes that Sparrow's "analysis of assisted gestation would not cut at all against privately-funded research, since private parties are, in general, free to spend their money according to their own lights. It is therefore entirely possible that private funders could support and bring to successful completion a program of assisted gestation research for men and transgender women." This point is bolstered by the fact that privately-funded research is largely responsible for most of the advances in assisted reproduction made during the past four decades.

Assuming that uterus transplants can be made to work in men and transgendered women who would be happy to pay for the surgery and follow up treatments themselves, are there any ethical reasons that they should be denied the joys and pains of pregnancy and childbirth? The 2013 update to the authoritative Montreal Criteria for the Ethical Feasibility of Uterine Transplantation suggests that given the current concerns over safety and efficacy, it is premature to offer uterus transplants to men and transgendered women now. However, the update acknowledges that this is likely to change and observes that "there does not seem to be a prima facie ethical reason to reject the idea of performing uterine transplant on a male or trans patient."

In support of this judgment, the authors of the update point out that the principle of autonomy is not sex-specific. They argue that a man or trans patient who wants to bear a child does not have a lesser moral claim to that desire than do women. The Montreal Criteria update makes this intriguing analogy: "A male who identifies as a woman, for example, arguably has UFI [born without a uterus], no functionally different than a woman who is born female with UFI." The authors then observe that "such a person's right to self-governance of her reproductive potential ought to be equal to her genetically female peers and should be respected." If it is moral to offer this technology to a genetic female without a uterus, why would it be immoral to provide it to a genetic male without uterus? The answer is that it wouldn't be.

"All people, however sexed in body, have interests one way or another about whether to have children and about how to have them," observes Murphy. "Not only do those interests vary widely, the interests will in some measure be artifacts of the technologies available."

Murphy is right. People's procreative decisions are increasingly made in the context of proliferating reproductive technologies. Technologies that now enable people to pursue their interests in how and when to have children include contraceptive pills and injections, gamete donation, artificial insemination, in vitro fertilization, freezing eggs, sperm, and embryos for later use, surrogacy, intracytoplasmic sperm injection, cytoplasmic transfer of mitochondria into eggs, pre-implantation genetic diagnosis, and freezing ovarian tissue. All of these technologies were once widely considered to be ethically problematic, but are now accepted as moral by most people.

Novel reproductive technologies over the horizon are cloning, the generation of sperm and eggs from somatic cells, tissue engineering to grow new uteruses, editing the genomes of embryos prior to implantation, and artificial wombs. Sometime later in this century it will be possible to transform skin cells taken from a single person into both eggs and sperm. In vitro fertilization could combine those gametes to generate an embryo that might then be gestated in an artificial womb. By that time people will regard uterus transplantation as the technological equivalent of bear skins and stone axes.

For the foreseeable future the vast majority of people will continue to pursue their interests in having children in the conventional way. It's fun and a lot cheaper.

Ultimately, uterus transplantation will be a niche reproductive technology sought by very few people who have been born lacking that organ—be they genetic females or genetic males. There is no moral reason to deny the option of uterus transplantation to those who have an interest in using it and are willing to pay for it. In other words, individuals do have the negative right to pursue assisted gestation.

Disclosure: I am a cisgender male with no current interest in gestating.

Pico and ME · 01-30-2015, 11:06 PM

It is not immoral, morality has nothing to do with it.

DanaC · 01-31-2015, 03:25 AM

Yep - morality has no place in this. Ethical considerations have a place, but that's about whether technologically assisted procreation carries additional risks for the baby once born - that applies whether the parent is female or male.

glatt · 01-31-2015, 06:21 AM

Assuming it's all safe, my only concern would be who pays for it? I have no ethical problem with it. Although it's freaky to think I could carry a child.

Griff · 01-31-2015, 07:50 AM

whs The financials are an issue no matter the gender status of the parent.

xoxoxoBruce · 01-31-2015, 11:22 AM

Morals? Ethics? How do they fit into the capitalist model?

It sounds complicated which to me equates with risky, and I'm sure it's expensive. But like everything else, money talks, bullshit walks. if you really want it.

Lamplighter · 01-31-2015, 11:29 AM

Quote:

...So are there any moral reasons why men and transgendered women should not be permitted to gestate?...

If there are not any (today), I'm sure there are people that can make some up.
Remember when IVF ("test tube baby") used to be society's biggest problem.

Individuals are always pushing society and breaking new ground.
Right now, it's your turn.

sexobon · 01-31-2015, 03:03 PM

The morality of individuals, both men and transgendered women, will be a factor just as it is now for women whether they are augmented by the procedure or not. There are single women who get pregnant to snare a husband, women in marriages on the rocks who think a baby/another baby will recover their relationships, women who see babies as social welfare programs security, income producing surrogates ... etc.. Once the technology becomes available, it isn't going to be restricted anymore than general reproductive rights, it'll just be limited by finances.

There will be men and transgendered women doing the same as above and initially there will be additional motives of celebrity and/or serenity (those who won't feel complete and/or accepted until they can say look, I had a baby, say no more).

While there's no immorality regarding the aforementioned people as categories, there will be individuals among them who's actions delay general acceptance via fueling criticisms by those who just don't like the idea for whatever reason.

Happy Monkey · 01-31-2015, 08:38 PM

If it's as safe for the baby, there's no problem. The only question is how to ethically do the studies properly to discover how safe for the baby it is.

monster · 01-31-2015, 09:57 PM

Immoral is such a vague term.

But as far as I'm concerned, if there's no downside for the baby or the host, then what's the problem? ....As long as -as HM noted- the research required to establish the lack of risk isn't unethical or immoral.

sexobon · 01-31-2015, 10:14 PM

There's always a risk with elective surgeries. The arguments will be over the acceptable level of risk.

01-30-2015, 10:56 PM	#1
Pamela Deplorable Join Date: Oct 2013 Location: Dallas, TX Posts: 767	Is It Immoral for Men to Gestate? Transgendered Women? Presented for discussion purposes only. I'm interested in what you all think of this. from here The first child ever successfully gestated in a transplanted uterus and brought safely to term was born in Sweden in September. The healthy baby boy's 36-year old mother had been born without a uterus. The transplanted organ was donated by a 61-year old family friend who had herself given birth to two children. Eggs were extracted from the woman's intact ovaries and fertilized in vitro using her male partner's sperm. This produced eleven embryos that were then frozen. A year after the transplant, physicians installed a single embryo in the woman's new womb which resulted in the pregnancy that led to the birth of the baby boy. The Swedish woman who gave birth last year is one of nine women into whom researchers transplanted donated uteruses in 2013. Two of the recipients had to have their transplants removed due to infections and blood clots. There's no news of any pregnancies so far from the other recipients. As it happens, there are other human beings who are born without uteruses: males and transgendered women. Is there any reason—biological or ethical—why they should not be considered as possible uterus transplant candidates? With regard to biology, it is already quite common to successfully transplant solid organs such as kidneys, livers, and hearts between different sex donors and recipients now. More research will be doubtlessly be required, but there do not seem to be any insuperable physiological barriers to figuring out how best to connect up the proper blood supply to the donated organs and manage relevant hormonal issues in men and transgendered recipients. In the case of transgendered women, they will already be following a supplemental hormone regimen. The supply of organs could be quite large since post-menopausal women can be donors. So are there any moral reasons why men and transgendered women should not be permitted to gestate? One handy ethical rule of thumb with regard to deploying a novel reproductive technology is that it should be about as risky as conventional procreation. As a reference point, note that in the United States about 3 percent of babies are born with a major structural or genetic birth defect. The Swedish infant got a near perfect APGAR score, demonstrating that it is possible to safely bring a baby to term in a transplanted womb. In the December 2014 issue of Bioethics, University of Illinois College of Medicine bioethicist Timothy Murphy asks if uterus transplantation becomes routine and effective "would there be any morally significant reason why men or transgender women should not be eligible for the same opportunity for gestation?" He concludes in his article, "Assisted Gestation and Transgender Women," that the answer is no. Murphy is mainly arguing against Australian bioethicist Robert Sparrow who asserts, "Because pregnancy is not a reasonable expectation in men, men who wish to become pregnant are not capable of establishing that this desire should be granted the same moral weight as women's desires to become pregnant." Both philosophers are fixated on the question of whether the state is obliged by the interests of some of its citizens in giving birth by means of the assisted gestation to pay for research and the medical provision of the technology. Murphy thinks that the answer is "yes," but he is wrong. Sparrow is wrong for different reasons. He thinks that the answer is "yes" for women, but "no" for men. It should be "no" for both. Setting public health conundrums aside, one citizen does not, in general, have a moral claim on the money and time of another citizen merely to benefit himself and his interests. Thus there is no moral justification for the public funding of assisted gestation research and treatments for either men or women. Sparrow goes badly astray when he claims that "no negative right to male pregnancy exists." As conventionally defined, a negative right is a right to be free to hold and practice a belief, to pursue an action, or enjoy a state of affairs without outside interference. Sparrow rather convolutedly comes to his perplexing conclusion largely because he thinks that male pregnancy will only be possible if there is a corresponding positive right requiring that the government pay for the development of assisted gestation technologies applicable to men. Women have a positive right to research funding and treatments, but men do not. Since Sparrow believes that assisted gestation for men will necessarily not be developed without government funding then it doesn't matter if male pregnancy is outlawed. Thus one cannot have a negative right to do something that in fact one cannot do. This evidently passes for sophisticated philosophical reasoning nowadays. Murphy is, however, right when he notes that Sparrow's "analysis of assisted gestation would not cut at all against privately-funded research, since private parties are, in general, free to spend their money according to their own lights. It is therefore entirely possible that private funders could support and bring to successful completion a program of assisted gestation research for men and transgender women." This point is bolstered by the fact that privately-funded research is largely responsible for most of the advances in assisted reproduction made during the past four decades. Assuming that uterus transplants can be made to work in men and transgendered women who would be happy to pay for the surgery and follow up treatments themselves, are there any ethical reasons that they should be denied the joys and pains of pregnancy and childbirth? The 2013 update to the authoritative Montreal Criteria for the Ethical Feasibility of Uterine Transplantation suggests that given the current concerns over safety and efficacy, it is premature to offer uterus transplants to men and transgendered women now. However, the update acknowledges that this is likely to change and observes that "there does not seem to be a prima facie ethical reason to reject the idea of performing uterine transplant on a male or trans patient." In support of this judgment, the authors of the update point out that the principle of autonomy is not sex-specific. They argue that a man or trans patient who wants to bear a child does not have a lesser moral claim to that desire than do women. The Montreal Criteria update makes this intriguing analogy: "A male who identifies as a woman, for example, arguably has UFI [born without a uterus], no functionally different than a woman who is born female with UFI." The authors then observe that "such a person's right to self-governance of her reproductive potential ought to be equal to her genetically female peers and should be respected." If it is moral to offer this technology to a genetic female without a uterus, why would it be immoral to provide it to a genetic male without uterus? The answer is that it wouldn't be. "All people, however sexed in body, have interests one way or another about whether to have children and about how to have them," observes Murphy. "Not only do those interests vary widely, the interests will in some measure be artifacts of the technologies available." Murphy is right. People's procreative decisions are increasingly made in the context of proliferating reproductive technologies. Technologies that now enable people to pursue their interests in how and when to have children include contraceptive pills and injections, gamete donation, artificial insemination, in vitro fertilization, freezing eggs, sperm, and embryos for later use, surrogacy, intracytoplasmic sperm injection, cytoplasmic transfer of mitochondria into eggs, pre-implantation genetic diagnosis, and freezing ovarian tissue. All of these technologies were once widely considered to be ethically problematic, but are now accepted as moral by most people. Novel reproductive technologies over the horizon are cloning, the generation of sperm and eggs from somatic cells, tissue engineering to grow new uteruses, editing the genomes of embryos prior to implantation, and artificial wombs. Sometime later in this century it will be possible to transform skin cells taken from a single person into both eggs and sperm. In vitro fertilization could combine those gametes to generate an embryo that might then be gestated in an artificial womb. By that time people will regard uterus transplantation as the technological equivalent of bear skins and stone axes. For the foreseeable future the vast majority of people will continue to pursue their interests in having children in the conventional way. It's fun and a lot cheaper. Ultimately, uterus transplantation will be a niche reproductive technology sought by very few people who have been born lacking that organ—be they genetic females or genetic males. There is no moral reason to deny the option of uterus transplantation to those who have an interest in using it and are willing to pay for it. In other words, individuals do have the negative right to pursue assisted gestation. Disclosure: I am a cisgender male with no current interest in gestating.

01-30-2015, 11:06 PM	#2
Pico and ME Are you knock-kneed? Join Date: Jul 2008 Location: Middle Hoosierland Posts: 3,549	It is not immoral, morality has nothing to do with it. __________________ Jesse LaGreca in 2012 “Seven Deadly Sins: Wealth without work, Pleasure without conscience, Science without humanity, Knowledge without character, Politics without principle, Commerce without morality, Worship without sacrifice.” – Mahatma Gandhi

01-31-2015, 07:50 AM	#5
Griff still says videotape Join Date: Feb 2001 Posts: 26,813	whs The financials are an issue no matter the gender status of the parent. __________________ If you would only recognize that life is hard, things would be so much easier for you. - Louis D. Brandeis

01-31-2015, 11:22 AM	#6
xoxoxoBruce The future is unwritten Join Date: Oct 2002 Posts: 71,105	Morals? Ethics? How do they fit into the capitalist model? It sounds complicated which to me equates with risky, and I'm sure it's expensive. But like everything else, money talks, bullshit walks. if you really want it. __________________ The descent of man ~ Nixon, Friedman, Reagan, Trump.

01-31-2015, 08:38 PM	#9
Happy Monkey I think this line's mostly filler. Join Date: Jan 2003 Location: DC Posts: 13,575	If it's as safe for the baby, there's no problem. The only question is how to ethically do the studies properly to discover how safe for the baby it is. __________________ _________________ \|...............\| We live in the nick of times. \| Len 17, Wid 3 \| \|_______________\| [pics]

01-31-2015, 06:21 AM	#4
glatt ™ Join Date: Jul 2003 Location: Arlington, VA Posts: 27,717	Assuming it's all safe, my only concern would be who pays for it? I have no ethical problem with it. Although it's freaky to think I could carry a child.

01-31-2015, 03:03 PM	#8
sexobon I love it when a plan comes together. Join Date: Oct 2009 Posts: 9,793	The morality of individuals, both men and transgendered women, will be a factor just as it is now for women whether they are augmented by the procedure or not. There are single women who get pregnant to snare a husband, women in marriages on the rocks who think a baby/another baby will recover their relationships, women who see babies as social welfare programs security, income producing surrogates ... etc.. Once the technology becomes available, it isn't going to be restricted anymore than general reproductive rights, it'll just be limited by finances. There will be men and transgendered women doing the same as above and initially there will be additional motives of celebrity and/or serenity (those who won't feel complete and/or accepted until they can say look, I had a baby, say no more). While there's no immorality regarding the aforementioned people as categories, there will be individuals among them who's actions delay general acceptance via fueling criticisms by those who just don't like the idea for whatever reason.

01-31-2015, 09:57 PM	#10
monster I hear them call the tide Join Date: Dec 2005 Location: Perpetual Chaos Posts: 30,852	Immoral is such a vague term. But as far as I'm concerned, if there's no downside for the baby or the host, then what's the problem? ....As long as -as HM noted- the research required to establish the lack of risk isn't unethical or immoral. __________________ The most difficult thing is the decision to act, the rest is merely tenacity Amelia Earhart

01-31-2015, 10:14 PM	#11
sexobon I love it when a plan comes together. Join Date: Oct 2009 Posts: 9,793	There's always a risk with elective surgeries. The arguments will be over the acceptable level of risk.

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