April 23, 2024

Do reproductive rights survive gender reassignment?

Another adventure in the Wild West of assisted reproduction, this time from Israel. An Israeli woman who is undergoing sex reassignment surgery wants to freeze her ovarian tissue before she has her hysterectomy.

Another adventure in the Wild West of assisted reproduction, this time from Israel. An Israeli woman who is undergoing sex reassignment surgery wants to freeze her ovarian tissue before she has her hysterectomy. Egg freezing would have been easier, but she had already started hormone therapy and this has disabled her ovarian function. 

Although an ethics committee has approved the procedure for the unnamed woman, the Israeli Ministry of Health has denied permission because “it is not, to date, a standard procedure in Israel”. Cryopreservation is allowed only for young women who are to be treated for cancer. The Ministry also argues that cryopreservation is meant for “self-use” under current regulations and since the woman will no longer have a womb, she can no longer become pregnant. 

The wo/man has appealed to the Israeli Supreme Court, arguing that s/he is being discriminated against and that denying access to cryopreservation to a person undergoing sex reassignment violates a right to healthcare and the right to procreate. 

In the latest issue of BioNews, Vardit Ravitsky, of the University of Montreal and Professor David Heyd, of the Hebrew University of Jerusalem, argue that the Ministry of Health is ethically wrong. What if the transgender person, now functioning as a man, were to partner with a woman who could act as a surrogate with the help of donated sperm? They would form a family, or rather, a “reproductive unit”:

“Rather than considering each individual in this scenario separately, which leads to the framing of the female partner as a surrogate, we should consider this through the lens of the couple’s reproductive project. The couple, as the ‘reproductive unit’, already has the required egg and uterus; all they are missing is donated sperm.”

What about the effect upon the child of this complicated parentage? Things are already quite complicated in the world of assisted reproduction, Ravitsky and Heyd argue. Another step forward is unlikely to make much difference. In any case, the paramount consideration is “reproductive autonomy”:

“Although the situation might seem confusing, it is not necessarily more problematic than numerous others. Many children are born today to two mothers or two fathers; to a genetic mother who is not the birth mother (in surrogacy); to a birth mother who is not the genetic mother (in egg donation), and more. We doubt that this scenario would raise substantially new challenges to the child’s identity.”

As a postscript, the world’s first “pregnant man”, Thomas Beattie, who had three children before completing gender reassignment surgery, is divorcing his/her wife and alleging serious emotional and physical abuse at her hands. S/he became briefly famous in 2007 posing for a photo which portrayed him/her as heavily pregnant but with facial hair. ~ BioNews, May 15; Daily Mail, April 26

Michael Cook
Creative commons
reproductive rights
transgender