Sex & Relationships

Male Pregnancy Is Technically Within Reach, But Will Society Allow It?

Some transwomen would likely be the first to sign up.

Photo Credit: Balkonsky / Shutterstock

Any woman who has ever been pregnant has wished that her male partner could experience what she went through. And by that we mean they probably wished that men could experience the nausea, weight gain, fatigue, and of course pushing something the size of a watermelon out of your vagina. Perhaps some men have dreamt about being able to nurture life in their bodies. In fact, there’s a whole internet homosexual subculture called “mpregs” who fantasize about getting impregnated by everything from Justin Bieber to werewolves. But for some male-to-female transgendered people, carrying a child is a real desire because they feel a call towards motherhood. And one day soon, our technology could be advanced enough to make this dream a reality for transwomen but it is unlikely that our society will be on board due to their moral objections. 

When male pregnancy has been portrayed in works of popular culture, it has been either horrifying or comic. Most of the time male pregnancy is depicted either in a distant future and galaxy as a horrifying gastrointestinal parasite ready to erupt out of your guts, i.e. acid-drooling alien. Or, it is turned into a farce. It’s hard not to chuckle at the buddy comedy “Junior.” Just seeing Schwarzenegger and DeVito side-by-side is funny on its own.  But the core humor is that Schwarzenegger, a man sensationalized as being the manliest man ever to exist on the spectrum of manhood, is taking on the “woman’s role” of pregnancy. Pop culture tends to reflect a general ethos towards a subject matter, and the impression left is that a pregnant man is something absurd, terrifying and not likely to happen in our lifetime. 

But human male pregnancy is no longer relegated to the realm of fiction, and may become a reality a lot sooner than most people would think. “My guess if five, 10 years away, maybe sooner,” Dr. Karine Chung, director of the fertility preservation program at the University of Southern California’s Keck School of Medicine, told Yahoo! News recently. 

The possibility of male pregnancy arose with the first-ever uterus transplants. Uterus transplants were initially designed for women who are suffering from uterine factor infertility (UFI). But, the argument goes, if a womb can be transplanted into woman with a damaged or non-functional uterus, theoretically, why could the same not be done to a man?

In February of this year, the U.S. performed its first ever uterus transplant on 26-year-old Lindsey McFarland. The surgery was performed by a team of surgeons at the Cleveland Clinic and took about nine hours to complete. The uterus was taken from a deceased donor and transplanted into McFarland’s pelvis. The donor’s blood vessels were connected to McFarland’s vasculature and pelvic ligaments. 

Unfortunately, the procedure failed. Shortly after a press conference announcing the operation’s success, Dr. Andreas Tzakis, told CNN that the transplant had to be removed due to a yeast infection. The infection ultimately compromised the blood supply to the newly implanted uterus. It also compromised the blood supply to one of her legs, which the surgeons were thankfully able to save. It was devastating loss for the team, and an even greater loss for McFarland. 

Though McFarland’s case did not end happily it, uterus transplants can yield sustainable pregnancies. Before the Cleveland team attempted the, it had already been successfully completed several times by a team of Swedish surgeons. According to Yahoo!, the Swedish team successfully transplanted uteruses which led to five pregnancies and four live births. The difference was that the Swedes harvested uteruses from live donors. 

All of that is well and good, but it’s reasonable to ask how this procedure would work on the anatomy of a biological male? Men have a much narrower pelvic inlet than women do. They also lack major blood vessels women have in their reproductive system which help the uterus attach and be viable. Biological males also don’t produce the female hormones, progesterone and estrogen, needed to support a pregnancy. Apparently, all these things just make the procedure more complicated, not impossible. “It’s doable, it just hasn’t been done,” says Dr. Chung. Despite all those obstacles, Chung insists that “male and female anatomy is not that different … Probably at some point, somebody will figure out how to make it work.”

Obviously, such a possibility would have a huge impact on transwomen who want to experience pregnancy and childbirth. Hormone therapy for trans individuals has existed for decades. Transwomen can take the female hormones necessary to suppress testosterone, and even grow breasts that can lactate. By taking these hormones, transwomen can prepare the donor uterus for pregnancy. Doctors can also perform a procedure on transwomen to widen their pelvic inlet. Although transwomen lack the vasculature that biological-females have to feed to the uterus with blood, doctors say that the transplanted womb can be attached to the internal iliac vessel. Once the uterus is in place, the usual route for implanting an embryo into womb is through the vagina and cervix. Transwomen who have undergone sex-reassignment surgery still lack the necessary ligaments in the vagina that would attach to a transplanted uterus. Fortunately, Dr. Elliot Jacobs, a plastic surgeon in Manhattan, says that connecting a constructed vagina to a transplanted uterus is “not a major surgical feat.”

Transwomen who signed-up for this surgery would need to have had a constructed vagina, and would need to wait at least a year before attempting to transplant a donor uterus. If the transwoman had at any point saved her sperm, she could theoretically use it to fertilize an embryo and would be able to carry a child that is biologically her own. 

Many transwomen feel a pull towards motherhood, just as many biological females do. “I bet just about every transgender person who is female will want to do it, if it were covered by insurance,” Dr. Christine McGinn, a transwoman plastic surgeon who performs sex reassignment surgeries told Yahoo! News. McGinn herself is the mother of two adopted twin boys. She added, “The human drive to be a mother for a woman is a very serious thing. Transgender women are no different.” 

Chastity Bowick, a medical case manager in Worcester, Mass., is just one of many transwomen who dreams of carrying a child. “I hope it becomes a reality,” Bowick told Stat News. “I absolutely would be willing to do it … Ever since I was old enough to understand the concept of parenting, I wanted to be a mother. I didn’t know how that would ever happen, but that’s what I wanted.” 

Still, although the technology may be advancing and biological barriers to making male pregnancy happen are being broken down, many non-biological factors stand in the way to making it graspable reality for trans women. First is cost. Transplants are extremely expensive, according to Yahoo! News, it can cost up to $1.3 million for a donor heart. Many transgender people find themselves sociologically and financially marginalized, and that cost is just something out of reach for the majority of transwomen. “It’s a class issue; you’ll have only wealthy people able to do this,” McGinn said. Angelica Ross, CEO of TransTech Social Enterprises in Chicago, added that many trans people will not be able to afford the surgery due to discrimination in the workplace, keeping them for holding a steady job. “Because of getting fired from job after job, most trans people, especially trans people of color, are barely able to take care of themselves, much less a child,” she said.

Social barriers also stand in the way of making this procedure possible. Technically, there have been pregnant men before. In 2008, Thomas Beatie made headlines after becoming the world’s “first pregnant man.” Beatie is a transman who began taking hormones at the age of 23. However, he did keep his reproductive hormones. His ex-wife Nancy was unable to have any more children after a hysterectomy so Beatie put his hormones on hold and the couple decided to go through IVF. Beatie became pregnant using donor sperm. Since Beatie’s first child, Susan, Beatie gave birth to two more children. While many came out to support Beatie, other people objected violently or were just uncomfortable with the idea of a pregnant man. During a TLC special about Beatie’s first pregnancy, he told the cameras that he and his family received daily death threats. 

Beatie was able to get pregnant without overly complicated procedures. But this would not be the case for transwomen looking to get a uterus transplant. Due to the controversy surrounding the procedure, it is highly unlikely that a transwomen would be put on a waiting list for a donor uterus over a biological female suffering from UFI. “Are people going to want to do it? Yes,” Dr. Arthur Caplan, head of medical ethics at the NYU School of Medicine told Yahoo! News. “But I don’t see making this a priority. In terms of making the best use of scarce resources, this won’t get over the threshold.”

Although the technology to allow a biological male to get pregnant may be ready within the next ten years, it is unlikely that our society would be ready for it. There’s little chance it would be covered by insurance. It is also unlikely that transwomen’s dreams of pregnancy would be prioritized over an anatomical female. Although both groups of women are suffering from infertility issues due to the consequence of their birth, the majority of our society will sympathize with the women who were born with the genitalia associated with natural pregnancy and birth.  As for biological males who identify as such and dream about getting knocked up, well, that’s just never going to be taken seriously.   Out of all the species of organisms inhabiting this planet, only members of the syngathidae family- seahorses and pipefish- display “male pregnancy.” When people see that phenomenon in nature they’re amazed at the curiosity of the world we live in. When people see an 8-month pregnant six-foot-four lumbersexual walking down the street they get upset. 

 

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