this post was submitted on 13 Feb 2026
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Let's hope we figure things out again. I'd love to exchange reproductive systems with a trans man.
I do have the protocol saved with me at least :3
if you're curious, the one who got it before was Lili Elbe, in a time when immunosuppression and medicine was much less advanced.
Depending on whether you've had orchiectomy or not, the course would differ.
If you've not had orchi, you'd need to discontinue certain feminising medication (spironolactone, finasteride) before pregnancy, to lower risks of birth defects. otherwise, eg. a female fetus would develop as masculine, much like with cis gals that have congenital adrenal hyperplasia (a hormonal condition that yields intersex-like phenotypes).
Best would be to have orchi (this is also part of why I'm planning to do it). A lack of gonads likely does not have a detrimental effect on pregnancy, as cis gals w/ severe ovarian insufficency or prenatal oophoroectomy (ovary removal) still manage to carry out a pregnancy. This is thanks to exogenous initial hormone support (ie., taking hormones) and a following endogenous placental hormone production (that is, the placenta also produces hormones).
Intersex pregnancies also have occurred, though these only resulted in male offspring so far. For blood risk management, a good parallel is trans men who discontinue T to stimulate ovaries, which still managed to result in good pregnancies.
For blood circulation and support, the internal iliac vessels within the pelvis should be considered for vascular anastomosis for a graft, to combat thrombosis. A uterus transplant may need a slightly different treatment of the supportive ligaments and connective tissue.
The biggest challenge would be neovaginal anastomosis (ie., connecting the neovagina to uterus); how well blood-supplied the areas are and the microbiome (though, dandelion here did a revolutionary research for microbiome in where she achieved a cis like microbiome, so success!).
The best approach would be to look at people with Mayer-Rokitansky-Küster-Hauser syndrome who have undergone McIndone vaginoplasty, followed by an uterus transplant.
Additionally, my personal addition - assuming you did not have pelvic widening surgery (yes, that's a thing) or were only able to start E after the fusion of hips finished (around 23 yo tho might be as late as 28?), it'd have to be a C-section, or born at 33 weeks (which is pretty survivable without large complications, in the modern day). Personally, I don't mind a C-section (and many cis women do that anyway), and I prefer the baby to be grown to healthy sizes. Besides, longer times of being pregnant, yay!
so, it's definitely possible. the only big issues are:
Until we figure out how to actually grow a uterus from your own stem cells, (or creating an entire uterus from grafting) we'd be unable to do it without immunosuppresion.
But the fact is, this is possible using current tech, and there have been a few hundred transplants already. So it's very much possible!