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When Mats Brännström first dreamed of performing uterus transplants, he envisioned helping women who were born without the organ or had to have hysterectomies. Two years ago, in a medical first, he managed to help a human womb–transplant patient deliver her own baby boy. But his monumental feats have had an unintended effect: igniting hopes among some transwomen (those whose birth certificates read “male” but who identify as female) that they might one day carry their own children.

He wanted to give them a chance at birthing their own children, especially in countries like his native Sweden where surrogacy is illegal. Cecile Unger, a specialist in female pelvic medicine at Cleveland Clinic, says several of the roughly 40 male-to-female transgender patients she saw in the past year have asked her about uterine transplants.

More efforts are expected in the United States: Cleveland Clinic, Baylor University Medical Center, Brigham and Women’s Hospital, and the University of Nebraska Medical Center are all registered to perform small pilot trials with female patients who are hoping to carry their own children.

The trouble is that uterine transplants are extremely complex and resource-intensive, requiring dozens of health personnel and careful coordination.

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