Future promise

An assertion that seems bound to come true at some point is that reassignment will become a procedure that results in an entirely functional male or female rather than a sterile one. Additionally one that doesn’t require hormone replacement and whose reproductive tissues are direct analogues to what their natal tissues would have been.

The question is not if this will happen, it is more why this will happen and how long it will take.

Trans females

Artificial ovary research, in the article linked, is talking about very early research in animal models. The driving force is human infertility as a variety of causes can rob a woman’s fertility. Artificial ovaries may also, the article comment, have a utility as an alternative in hormone replacement. It should be noted though that HRT is problematic  in terms of breast cancer risk for at least some women.

The research given here starts with follicles, so for a trans person they would first need to differential stem cells into ovarian follicles. They also are using cells from the remaining ovary. So this is not going to help trans women very soon, but it sure is interesting.

Artificial vaginas are a whole different matter. The researchers at Wake Forest cultured a vagina using the patient’s own appropriate cells and implanted it. The patients had a fairly rare problem called Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, where the vagina and uterus are mostly or completely absent. This is usually treated by constructing a neovagina with skin grafts taken from an area like the inner thigh.

The result of the implantation was impressive. All four girls ended up with full functioning vaginas, reported enjoying sex and had normal periods (if the uterus was functional).

There’s no current plan to start using this for trans women, but there doesn’t seem to be any particular barrier to making use of it either. More normal mucosal vaginal tissue would clearly be a welcome change for any of us getting gcs.

Now if you happen to be a rat and need a uterus there’s an answer with these lab grown uteri. I’m imagining it will be awhile before they get to human women with this.

As the last part of the puzzle, this Gizmodo article talks about a lab growing Tissue Engineered Fallopian Tubes (the inner layer anyway).

Here the story is complete. Putting this together into a  real live female reproductive tract in a trans woman is not a near term prospect and the horizon for this is pretty far out if for no other reason than the expense and the priorities.

Trans males

My dear brothers, life really is harder for you when it comes to creating working parts, but there are some promising things  coming along. This article in pubmed talks about creating testicular implants that provide testosterone. The bad news? Unless you’re a mouse they aren’t quite ready for you and it doesn’t provide fertility.

But Wake Forest really is the bomb. This article in Military Times talks about creating artificial penisis for combat vets with pelvic injuries as well as procedures to enable fathering children starting from just a single sperm cell.

Another article interesting for trans men is the ability to create genuine sensitivity in the head of the penis. These researchers used microsurgical techniques to connect the dorsal nerve to interior pelvic nerves and restore sensation. It brings to mind what might be done with transplanted clitoral glans tissue which cannot be moved now.

Others have shown how germ cells (sperm and ova) can be created from stem cells, bridging issues for both trans men and trans women who want bio children.

Conclusion

It may also be that much cooler things will come along that let us tell the body to change the sexual organs or other such things that would seem like science fiction now (hey, it happens in other creatures in nature). I can’t predict the future, I hope this bent your mind just a little.

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