The Transplant

MAN GIVES BIRTH

SAN ANTONIO: Paul Richardson, president of the American Society for Reproductive Medicine, stunned a packed auditorium at the society's annual meeting when he announced that a man has given birth to his own daughter, following a womb transplant from his deceased wife. Dr. Richardson said that he knew that this procedure was feasible, since "There's plenty of room to put a uterus in there. Men and women have the same blood vessels." He added that although it was necessary for the baby to be delivered by Caesarian section, there were no complications, and father and daughter are doing fine. Dr. Richardson declined to provide any details about the identity of his patients.

* * *

I reread the article for the hundredth time, noting ruefully that Dr. Richardson ought to have said, "mother and daughter are doing fine." His refusal to disclose any details about me or my baby included his decision to withhold some details which would have shocked the nation, and provided endless fodder for the supermarket tabloids. I glanced over at my infant daughter, sleeping blissfully in her crib beside my bed, and told myself that the incredible, painful journey had all been worth it. Not that I would ever have wished this on myself, or on the wonderful woman who had set it all in motion...

We were high school sweethearts, dating on and off through college, and when I asked her to marry me after I landed my first job, she didn't hesitate. We were so in love! That first year of our marriage was the happiest time of my life, coming home every day after work to find her waiting for me in our little apartment. She worked too, but we were never too tired for sex, usually several times a night. They say that if a newlywed couple puts a penny in a piggy bank every time they make love during the first year of marriage, then takes a penny out every time they make love after that, the piggy bank will never be emptied. Sadly, we never had the opportunity to give it a proper test.

We took a short second honeymoon after our first anniversary, and I could tell that something was wrong when my wife's behavior started to change. She complained of constant headaches, and her usual sunny disposition was frequently interrupted by periods of profound depression. When we got back home, I insisted that she make an appointment with her doctor. We both assumed that her condition was no big deal, which only made her diagnosis more of a shock: my wife was suffering from a brain tumor - glioblastoma - the worst possible news. The doctors gave her six months to live.

This wasn't the first tragedy in my life. Both of my parents had died in a plane crash when I was in college. As their only child, I inherited a sizeable fortune, which didn't take away the pain, but it enabled me to quit my job to devote myself full time to helping my wife cope with her illness. After studying all of the available treatment options - surgery, chemotherapy, radiation and various experimental therapies - she decided that, given the miserable side effects and the overwhelming likelihood of failure, she would prefer to live her life to the fullest for as long as possible, rather than spend the next six months shuttling between doctors and hospitals in a futile attempt to prolong the inevitable. And she wanted to have a baby, which seemed impossible until we consulted Dr. Richardson. He explained to us that we could preserve an embryo and have it implanted in vitro once a surrogate mother was identified.

The thought of bringing a baby into the world served as a kind of tonic for her, and for the next several weeks it was almost like we were back on another honeymoon. We made love constantly, and when she missed her period, and Dr. Richardson confirmed that she was pregnant, we had the embryo frozen, since the odds were that she wouldn't live long enough to carry the baby to term. Sure enough, soon her condition began to worsen, and she began to suffer from drastic mood swings.

She was obsessed with how her baby would be brought into the world, so we scheduled a sit-down with Dr. Richardson to talk about the alternatives. It was a meeting which was to change my life forever. The doctor started by explaining that under normal circumstances, a couple would seek out a surrogate mother who would be paid to have the embryo implanted in her womb. Once she carried the baby to term, the newborn would be presented to his or her biological parents, under the terms of a detailed legal agreement which all of the parties would have to sign.

"How can we be sure that this woman won't try to keep my baby for herself?" my wife asked.

"Well, the legal agreements are binding and specific," the doctor assured her. "Although I have to tell you that there have been cases where surrogate mothers have tried to assert custody. And recently, a court actually ruled in favor of the surrogate. I believe this case is still under appeal."

My wife burst into tears. "What if that happens to us? To you?" she added, looking at me with imploring eyes. "Maybe they'll try to claim that since the baby's mother is dead, you shouldn't get to keep it," she sobbed. The doctor tried to reassure her, which only intensified her despair.

"Doctor, is there any other alternative?" I asked, trying to get the discussion back on track.

His answer was not what I was looking for. "Well, there might be another way, although it hasn't been tried before. We've been consulting with several transgendered women who are interested in having womb transplants."

"How could that possibly help us?"

"Well, the same legal issues could arise, of course. Unless the surrogate was really the father. Then there could be no dispute between a biological and a birth parent, since they'd be one and the same."

"You mean my husband could be the surrogate?" my wife asked.

"Now hold on," the doctor said. "Your husband is not a transgendered woman." I'm sure the horrified expression on my face told him he'd crossed a line.

But my wife wasn't about to be discouraged. "Just because he's not a transgendered woman, that doesn't mean he couldn't have my baby, does it?"

"Putting aside the medical issues, we have all sorts of legal and ethical considerations here. First, would your husband even consider such a procedure, once he realized what it entailed?" he asked, looking pointedly at me.

"What do you mean?" she asked.

The doctor sighed. "The implantation of a womb into a male body is theoretically possible, provided the proper environment has been established. Again, our research is still in the preliminary stages, but we assume that the right hormonal balance will have to be in place in order for the surgery to be successful."

"And what would that entail," I asked, surprising him. The doctor didn't know how fragile my wife's mental condition had become. The whole discussion sounded insane to me, but my wife was grasping for hope, and I had to throw her a lifeline.

The doctor seemed to sense that things were spiraling out of control. "If you're serious about pursuing this, I think we should get together tomorrow with my research assistant. And before you leave," he said, looking at me, "we'll need to take a blood sample."

* * *

That evening, my wife was almost her old self, and she let me take her out to dinner at our favorite restaurant. She put on a dress for the first time in several months, and my heart ached for her as we sat across a romantic table. Would this be the last time she'd ever be this way?

Inevitably, the conversation turned to the subject that fixated her: our baby. "Do you think we'll have a boy or a girl?" she asked me, as if she were going to be alive to see it.

"It doesn't matter to me," I smiled. "As long as she looks like you, if she's a girl I mean."

"Aw c'mon, you'd have made a pretty girl." It wasn't the first time she'd said such a thing to me: I was shorter than her when she wore heels, and I scarcely outweighed her. Once, when we were in high school, she'd dressed me up in her cheerleader uniform for a Halloween party, and I was embarrassed by all the "she's so cutes" I got from her girlfriends, and a couple of the guys too...

I tried to change the subject. "You look so pretty tonight."

"I feel so much better after today. I hope it's a girl!" A little cloud crossed her eyes. "I guess you'd be both the father and the mother?"

"Let's not get ahead of ourselves! We'll know a lot more after we talk to the doctor again tomorrow."

"I wonder why they needed that blood test?"

I'd been wondering about that myself. "I dunno, maybe they have to find out if we're compatible?"

"Well, I could have told them that!" She squeezed my hand. "I just want to say something. Lots of guys would have run for the hills when the doctor suggested that you might be my surrogate." I was about to tell her that the doctor hadn't gone quite that far, but she plowed on. "I know this cancer has been as hard on you as it has been on me, and I just want to thank you for hanging in there with me."

My heart melted. "Baby, I'd do anything for you, you know that." They were words which I would soon come to regret.

* * *

The next day, the doctor introduced us to his assistant, a pretty young woman named Nicole. It seemed she had spent the last year conducting laboratory experiments to determine whether a womb could be successfully transplanted into a male body. One of the key considerations was the level of estrogen and the absence of testosterone, she explained. For the womb to flourish and be capable of nourishing a fetus, female hormones were essential. I squirmed nervously as she took us through the results of my blood test. "You have normal hormones for a male," she observed. "Unless we intervene, you would not be a candidate for surrogacy."

"What do you mean by intervene?" my wife asked.

The doctor cleared his throat. "There are two components, neither of which your husband is likely to agree to. The first would be to put him on a rather massive dose of female hormones, as well as a testosterone blocker, to begin the transition of his body chemistry from male to female. This would have some significant results, not all of which may be reversible, ranging from the softening of his skin, the redistribution of his body fat, the weakening of his musculature and the development of female breasts."

There was dead silence in the room. I was about to dismiss the suggestion out of hand when my wife asked softly, "And what's the second component?"

"Well, to accelerate the process and ensure that the level of testosterone is reduced to negligible levels, we would have to perform a surgical procedure called an orchidectomy. That would entail the removal of his testicles, which is definitely not reversible."

"You want to castrate me?" I shouted. My wife collapsed into tears, and the doctor and his assistant looked on awkwardly on as I took her into my arms and begged her not to cry. "Please don't cry, baby. Please don't cry."

"Did you really mean what you said last night?"

I had no idea what she was talking about. "Of course I did, baby."

"You told me you'd do anything for me. Well, this is what I want. I want you to have our baby."

"But you heard what the doctor said..."

"Are you planning to find another wife after I'm gone?" she cried.

"No, of course not." The thought had never occurred to me.

"Then what's more important than bringing up our child?"

My head was spinning. "Nothing, you know that."

"Then whatever it takes for this operation to be a success, you have to do it. You owe it to me and our baby."

My wife thought that I had agreed to become a woman!

* * *

No doubt the doctor and his assistant were sure that I'd talk her out of it, or flat out refuse. We scheduled a follow-up appointment for the next day, and I drove my wife back to our apartment. She was quiet in the car, and I was trying to think of what to say to her when she took me by surprise once again. "We're going to have to start working on you tonight. I don't want you to do this halfway. I have some clothes that you can try on, till you're ready for your maternity outfits I mean, and I have lots to teach you about makeup and stuff. When we go back to the doctor tomorrow, we have to show him that we're really serious."

I was shell shocked. Did she really think I was crazy enough to go through with this? "Baby, we have to talk about this."

"I know how hard this must be for you, but I've made up my mind. You promised me last night that you'd do whatever I asked, and if it wasn't completely necessary, I would never ask you to do this. Besides, this is not for me, it's for our baby. Our future." I tried to interrupt her, but she kept right on talking. "I've come to accept the fact that I don't have much time left. By some miracle we've found a way to create new life, if you're willing to make this sacrifice. I don't want our baby coming into this world in the body of some stranger, who may not take care of herself, or who may decide to keep our baby for herself. I realize that may be unlikely, but just the possibility of it terrifies me. It terrifies me more than this horrible disease that I have."

I tried several times that night to talk her out of it, but every time I did, she just dug in deeper and deeper. Every time she burst into tears, I'd tell her I'd do whatever she wanted, just to console her. I'm not sure I ever realized how tenacious she could be, and I'm sure my sympathy for her illness lowered my resistance. So after dinner and several glasses of wine, I reluctantly let her join me in the shower so she could help me shave off all my body hair, and that night I let her dress me in one of her nightgowns and a pair of her panties before we went to bed. We snuggled closely together all night, and we even made love in our nightgowns. It was the last time I ever had sexual relations with her.

The next morning, she sat me down at her dressing table and showed me how to put on makeup. I was surprised by how feminine my face began to look as she went to work with her sponges and brushes. She even found some old hoop earrings and clipped them on. Of course, I thought I was just humoring her - until she pulled one of her wigs over my head and brushed it into shape. I was astonished by the result: if I didn't know better, I'd have mistaken myself for a girl!

I was in a bit of a trance as she started to dress me up in her clothes. She fastened a padded bra behind my back, and had me step into a pair of matching panties. I felt totally ridiculous.

Then a slip and a dress, which were so foreign to me! The slip was kind of a clingy material, which she explained would help to smooth me out, and the dress she selected hugged my waist before it flared out, just covering my knees. After she zipped me up, I tried to squeeze my feet into some of her heels, but they were too tight. My reprieve was short lived: she had me hike up my dress and she helped me tug on a pair of nude pantyhose, which she said would help my feet slip into her shoes. Her nylons felt very strange against my legs, but they did make them look smooth and silky, and I was able to get her heels on. I even managed to walk round the bedroom in them, although I told my wife they would take some getting used to. A little more jewelry, then she took my hand and led me over to the full length mirror in her closet to see what she had wrought.

I wasn't what I expected! Looking back at me in the mirror was an attractive woman, in a pretty dress and high heels. I glanced over at my wife, who had a strange expression on her face: pride in her creation, mixed with a sense of loss over what had become of her husband. "This is right," she said at length. "This is the right thing to do."

I felt totally vulnerable, standing there in her dress, and I didn't have the heart to fight with her. "Can I change back now?"

"No! You're going to the doctor's office in that dress, remember?"

That snapped me back into my senses. "Are you serious? No way!"

She took my hand. "Sweetheart, listen to me. Of course you're afraid of what's happening to you! I'm a little afraid too, but we have to be brave, for our baby. After that doctor takes one look at you, he'll have no doubt that we're making the right decision. Please don't back out on me now."

* * *

I was certain that after the doctor took one look at me, he'd have me committed to a lunatic asylum. As it turns out, I was mistaken. If the doctor and his assistant were shocked by my appearance, they didn't show it; in fact, I later learned that they'd both suspected that I was transgendered from the beginning.

The conversation quickly turned to practicalities. Since my wife had eschewed drug therapy and radiation for her cancer, there was an excellent chance that her womb would be healthy enough to transplant into my body upon her death. As for my surgery, the doctor emphasized that this would not be a sex change operation: the protocols for that were quite strict, but there was no reason why he could not administer hormone therapy and remove my testicles to make me an acceptable recipient for my wife's womb. I knew that if I backed out now, my wife's last months would be unbearable. Reluctantly, I agreed to go ahead with the transplant.

Once my decision was made, the doctor conducted thorough physical examinations. Other than my wife's brain tumor, we were both in excellent health, but because her condition was likely to deteriorate at any time, he recommended that we proceed with my surgery and hormone therapy immediately. Before we left, he injected me with a massive dose of female hormones.

The next morning, still not believing that it was really happening, I returned to his office for my orchidectomy. It was an outpatient procedure, and I vividly remember lying on an operating table after a local anesthesia was administered, and hearing the doctor snip away my manhood. After he stitched me up, my wife drove me home, and I cried myself to sleep.

I was sore and tender for a few days, and I felt something akin to morning sickness as a result of the hormone shot, but by the end of the week I was ready to return to the living. My wife insisted on dressing me in women's clothing, nothing fancy, just capris and pants for the most part. At night, I'd slip into a nightgown and go to bed with her, but I was never able to experience an erection or make love to her again. Whether it was the hormones, the after-effects of my castration, or all in my head, my nights as a man were over. Still, we snuggled together every night, and I'd never felt closer to her.

We both knew that time was getting short for her, but when the end came, it was worse than I'd feared. Dizziness, incoherence, convulsions, incontinence...we set up hospice care in our apartment, during which I reverted to dressing as a man so as not to confuse her caregivers and the friends and relatives who came to say goodbye. By that point, she was heavily dosed on morphine, but she knew I was there with her, even though she had no idea how I was dressed. After she slipped into a coma, I alerted Dr. Richardson, and we rode together in an ambulance to the hospital to await her last moments.

She died a few hours later, and her womb, or uterus, was transplanted into my body that evening. As the doctor explained to me before I went under, her womb was a hollow, pear-shaped organ which would be implanted into my lower abdomen, between my bladder and my rectum. The broader, upper portion of my womb, which was called the corpus, contained muscular tissue which would expand during pregnancy to hold the growing fetus. It was also supposed to contract during labor to deliver my child, but since I didn't have a vagina, a Caesarian section would be performed before my body tried to go into labor.