I -think- this is actually relatively lightly regulated, as a surgery rather than a drug, and for the first one in particular might be a stochastic matter of whether one of the clinics decides to be willing around the same time they get a sufficiently motivated patient.
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Replying to @life_minutiae @TheShyWoof and
In a world where this weren't "politically charged" I'd place my bets on it happening within a decade In the world we actually live in, all bets are off -- I can unfortunately also see the pathway by which HRT and GRS are banned in most countries within the next decade
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Replying to @arthur_affect @TheShyWoof and
What would you estimate as the probability that it's already been attempted at least once, or carried through to a birth at least once?
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Replying to @life_minutiae @TheShyWoof and
I dunno My knowledge of this world only comes from what makes it to the mainstream press, so I have no priors for judging the likelihood of what's happening underground
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Replying to @arthur_affect @TheShyWoof and
Interesting - my impression was that the uterus transplant community (which was driven by Turkish and Saudi attempts early on) very quickly declared trans procedures off limits and then some US and UK researchers pushed back against their categorical exclusion.
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Replying to @life_minutiae @TheShyWoof and
I know that the first such transplant in the US (which happened at the Cleveland Clinic) came with a big burst of press about the criteria for approval, the first of which was straight up "patient must be a cis woman" (Not in those terms, but you know)
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Replying to @arthur_affect @life_minutiae and
I mean tbf it goes further than that The official criteria for a uterine transplant candidate today requires the patient must have functioning ovaries So it's pretty much only available to patients with MRKH (where the uterus doesn't develop but the ovaries do)
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Replying to @arthur_affect @life_minutiae and
The way the bioethicists stacked this up, they care a lot about where the DNA came from They consider it unethical to implant *both* a uterus *and* an "outside" embryo in a patient That's going to a lot of trouble to gestate an embryo that "could've been born elsewhere"
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Replying to @arthur_affect @life_minutiae and
The idea is that if the embryo is conceived from your own ovum then it starts off, ethically, "your embryo" and it's an injustice to compel you to relinquish "your" embryo to gestate in someone else's womb against your will
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Replying to @arthur_affect @life_minutiae and
The current ethical framework for a uterine transplant is "We're giving a mother the right to give birth to her own baby instead of having to give it away to someone else (surrogacy)" It's framed as trying to keep the pregnancy *more* "natural" instead of less natural
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I'm bringing this up because I was struck, upon reading this, at how arbitrary this is -- you can follow the logic but it's still pretty clearly motivated reasoning, like the arguments for why IVF and surrogacy are more "natural" than this are really obvious
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Replying to @arthur_affect @life_minutiae and
And I really feel like they're clinging to this because it's a can of worms -- like once you remove this carefully constructed figleaf that "We're just helping the patient do what they could do with no medical intervention at all if they didn't have MRKH" all hell breaks loose
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Replying to @arthur_affect @TheShyWoof and
So I think one of the most comprehensive recent papers is this one (from a UK team), and I'm struck given what you said by how it explicitly mentions sperm preservation and IVF prior to implantation.https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/1471-0528.15438#bjo15438-bib-0016 …
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