Transition with gene therapy?

[Kaltia_Atlas]

So I have been doing some research and have been asking some questions and I have decided to share with y'all what I have uncovered and get your opinions. PLEASE feel free to ask questions, add comments or share any other knowledge of the topic.

 

This topic came to mind when I was speaking with my therapist. One of the major factors to me being transgender is the untold depths of desire to conceive, carry and birth a child. For that matter, just to experience pierods! Anything to put me in the woman category I have dreamed of being in my whole life. So talking with my therapist, we decided some research into UTx and its subsequent surgeries was in order. UTx is uterine transplant btw. Which boils down to, being capable of producing your own estrogen without further HRT. *thats the ultimate goal*. But to achieve this goal, so many walls need to be overcome. 

 

So lets start with the first wall in our way. Bottom surgery. For MtF transgender, the penis is essentially inverted to create a neovagina. *there is more too it than that, however that is the basics*. But once the neovagina is created, the body doesn't really control the internals of the vagina. Not if there were a uterus or the other largely necessary components to control Ph balance and other womanly things I dont fully understand. Anyhow, the penis is reused to create the vagina, but the testicles are removed. Thus removing the majority of testosterone production. Without the hormone producing organ in the body, HRT is a requirement for life. 

 

That brings up the next wall. What if we could produce our own hormones and allow our own bodies to do all the work? Not possible? Blah. Every human being holds two genetic markers in their body. Foxl2 and Dmrt1. Foxl2 is the gene known for activating ovaries and creating estrogen. Dmrt1 is know for activating testicles and creating testosterone. Both are there, however only one is active. So what happens when the sctive one is turned off? The other turns on... A study with mice shows that a full grown male mouse with the Dmrt1 gene deactivated, will start to produce estrogen and other ovarian characteristics from the testicles. The same for a full grown female mouse vice versa. They do not change physical sex in any way. Just the chemical reactions of the genes changing what product comes from what is already there. 

 

Now for my proposal and questions. When an MtF transgender undergoes HRT and bottom surgery, would it be possible to do a UTx, along with gene therapy to activate Foxl2, to allow the MtF to create their own hormones? And eventually, conceive, carry and birth a child? Do some research and let me know what you think. I hope this could be possible in the near future...

 

If only I went to school for biology and research... Then maybe I could do these studies during my own transition.

 

Hugz ❤️

Kali

[Dearhart]

This is something I've thought of since puberty. I've long since wished I could "copy and paste" the whole ovary, uterus, vagina system into my body, cause not being able to bear children is really the sole source of my gender dysphoria comes from. 

 

I'm not sure how gene therapy would play into it, but i know it's doable. 

 

https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/1471-0528.15438

[Kaltia_Atlas]

Ive read that article. One of the biggest issues with doing a UTx in trans women is the transferance of the vaginal tissues. Some of the tissue is not viable from living donors. And the neovagina from the penile tissue has not been verified successful. 

 

Gene therapy would come into play by deactivating Dmrt1 and allowing Foxl2 to activate to fill in those gaps that the neovagina cannot do on its own. Also, it would help to "reform" the vaginal area and help it heal into what the front/bottom area should be after surgery.

 

At the least, that is what ive gathered from my research

[Dana Michelle]

I've read that a uterine transplant costs $200,000. I've also heard that it is necessary to take immune suppressing drugs after having the transplant (which makes the patient more vulnerable to disease including some cancers), and the uterus will have to be removed once pregnancy is finished so that immune suppression drugs are no longer needed.

 

This article from 2012 https://www.nih.gov/news-events/nih-research-matters/organ-transplants-without-life-long-drugs says "Patients must also take immunosuppressive drugs for the rest of their lives", though it also discusses an experimental technique to train the immune system to tolerate the new organ.

 

This article https://theconversation.com/stem-cells-could-regenerate-organs-but-only-if-the-body-wont-reject-them-122017 says that even tissues generated by a patient's own stem cells get rejected.

 

I would like to receive a uterine transplant, but in addition to cost and the immune suppressing drugs, I am concerned about how safe it is. Since a very small number of uterine transplants have been done (and probably none on transgender women), there is very little data.

[Kaltia_Atlas]

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6492192/

This article talks about the trials being done in Sweden. They have completed over 42 successful transplants and of those, 12 resulted in live births to date. There has been 5 successful transplants done in the US and 1 has resulted in a live birth, while several others are waiting for IVF. 

 

The science and technology is there. It is entirely possible to do UTx for women who are born unable to give birth. Not all trials include immunosuppressive drugs. Which is why I bring into question the possibility of using gene therapy for an MtF transgender woman. Since our gene Foxl2 is not active, would activating this gene allow for the UTx to be more successful? would it allow for the neovagina to grow and produce the needed Ph balance in the vaginal canal? 

 

With all of that said, how many trans women would line up for the chance to be able to give birth? I know when i start talking to my endo, i will see if she knows of any trials or any research being done in this field, and if not, then maybe reaching out to groups to see if they would be willing to start trials, or to include a trans woman in a current trial. 

[Dearhart]

If given access to the necessary information and specialists, i would definitely volunteer for the procedure.  Risks be darned. Of course, it's pretty easy to say that now, but still...it's been my one most visceral desire. 

[ToniTone]

I have considered this. Particularly the gene manipulation. Without having read too much into it, I imagine performing targetted gene alteration is complex and far from perfected. Most likely as the science is now, it is unachievable without negatively altering an undesirable part of the sequence, as such causing a mutation in it. But in theory it's possible. Someday, we may have the ability to alter our endogenous endocrine profile...

[Kaltia_Atlas]

The therapy in interested in only refers to altering a single gene. Deactivating Dmrt1. So in theory, it should be as simple as a single regimine of the therapy to alter the active state of Dmrt1 in the entire body. 

 

This of course would require already having had the full bottom surgery and any other necessary surgeries to consider the body female. The final surgery which should be when the gene therapy would br used, would have to be the Its.

 

As far as gene alteration, there are more than 50 different gene therapies ACTIVE and in use today. The knowledge is there. I want to push it further.

[Dana Michelle]

21 hours ago, Kaltia_Atlas said:

A study with mice shows that a full grown male mouse with the Dmrt1 gene deactivated, will start to produce estrogen and other ovarian characteristics from the testicles. The same for a full grown female mouse vice versa. They do not change physical sex in any way. Just the chemical reactions of the genes changing what product comes from what is already there.

 

2 hours ago, Kaltia_Atlas said:

The therapy in interested in only refers to altering a single gene. Deactivating Dmrt1. So in theory, it should be as simple as a single regimine of the therapy to alter the active state of Dmrt1 in the entire body. 

 

This of course would require already having had the full bottom surgery and any other necessary surgeries to consider the body female. The final surgery which should be when the gene therapy would br used, would have to be the Its.

 

As far as gene alteration, there are more than 50 different gene therapies ACTIVE and in use today. The knowledge is there. I want to push it further.

If altering the gene causes the testicles to produce estrogen, how would it work on someone with full bottom surgery? With full bottom surgery, the testicles are removed.

[Kaltia_Atlas]

Thats where the UTx would be required. If the organ that produces hormones is available, the active gene uses it to prodice its intended hormone. Wether it be testes or ovaries, the gene is what decides which hormone to produce. 

[Dana Michelle]

2 hours ago, Kaltia_Atlas said:

Thats where the UTx would be required. If the organ that produces hormones is available, the active gene uses it to prodice its intended hormone. Wether it be testes or ovaries, the gene is what decides which hormone to produce. 

Does the uterus produce hormones or does UTx include an ovarian transplant?

 

[Kaltia_Atlas]

The UTx is the whole reproduction system. Uterus, ovaries, all the way to the vaginal canal *at least what can be used from a donor*

 

The intention of a UTx is for women who are unable to produce eggs. Their system for what ever reason does not function properly. This transplant allows them to be capable to become pregnant again/to begin with.

[Kaltia_Atlas]

So... Doing a little more research, its possible the UTx is just the uterus. I'm wondering if there is a further surgery that would include ovaries. A complete transplant. Not totally sure. 

[Dana Michelle]

1 hour ago, Kaltia_Atlas said:

So... Doing a little more research, its possible the UTx is just the uterus. I'm wondering if there is a further surgery that would include ovaries. A complete transplant. Not totally sure. 

I've heard it is easier to transplant only the uterus than to transplant the entire reproductive system. On Wikipedia it says, "Ovary transplantation, giving rise to successful pregnancies, will result in children who will have the genetic inheritance of the organ donor and not the recipient; it has so far only been carried out on identical twins." https://en.wikipedia.org/wiki/Transplantable_organs_and_tissues#Ovary It also says Lili Elbe had an ovary transplant (and later died from surgical complications). When it says it has only been done in identical twins, I don't know if that means that ovary transplants that resulted in pregnancy have only been done in identical twins, or if any ovarian transplant (whether it results in pregnancy or not) where the patient survived has only been done on identical twins.

[Kaltia_Atlas]

I'll be asking my endo about it when I have my first appointment

[HollyElizabeth]

Oh how I dream about being able to get pregnant and carry a baby full term and finally give birth. It's been a dream of mine to be a biological mother, but I don't think medical science is at the point were this can be done safely. The moment it is, sign me up. God I wish it was.

[Kaltia_Atlas]

@HollyNoel I completely agree! After doing more research, it is medically safe, but VERY complicated, and extremely expensive. I dont see it being possible in my life time, but I hope that the next life gives me this ability. :)

[Elizabeth Star]

I'm in, sign me up.

[HollyElizabeth]

I'm with you Elizabeth. I really want to be a biologic mother even if it means going through the pain of natural child birth. Lol

[Heather Nicole]

This all sounds amazing. I have a pregnant coworker and just today I was noticing how much I so very envied her condition, and so just this evening the idea of transfemale pregnancy (or...getting to be pregnant myself) has been on my mind. The idea that someday in the foreseeable future, transwomen could have things like a self-sustaining vagina (instead of a self-closing one) and a new life growing inside their own body...makes me wish I was younger, with a better chance of living to reach it!!!

[DragonflyGirl]

I'm too old, but one day a trans woman will be pregnant!

 

I hope I live to see it because I'll be so happy for her.

[Dana Michelle]

The male pelvis is too narrow for childbirth so most transwomen would have to have a C-section when the time comes that transwomen can receive uterine transplants. I don't know how much variation there is in pelvic widths, so maybe there are some transwomen lucky enough to have a wide pelvis. Also, if male puberty is blocked in a transwoman before it has a chance to start and female puberty is started (with HRT) then maybe they would develop a more female pelvis, but I'm not sure.

[HollyElizabeth]

Dana Michelle. One uterious transplant with a side of new pelvis please. Lol