The legal paradox of uterus transplantation in transgender women: reproductive innovation and regulatory limits after For Women Scotland.

Uterus transplantation (UTx) is a novel reproductive technology that intersects organ transplantation and assisted reproduction. Although births following UTx are a clinical reality, the procedure raises legal questions not anticipated by UK legislative frameworks. This article examines whether UTx may lawfully be provided to transgender women for reproductive purposes under UK law through analysis of the Human Tissue Act 2004, Human Fertilisation and Embryology Acts 1990 and 2008, Gender Recognition Act 2004, and the Supreme Court decision in For Women Scotland Ltd v The Scottish Ministers. The article considers whether a transgender woman may lawfully receive a uterus transplant and whether fertility treatment may be provided to facilitate gestation. It argues that the Human Tissue Act 2004 contains no sex-based restriction on organ recipients and therefore does not prohibit transplantation into a transgender woman. However, the reproductive purpose of UTx depends upon access to fertility treatment. Applying the reasoning in For Women Scotland generates uncertainty regarding the legislative meaning of 'woman'. The current statutory framework casts serious doubt upon the legality of providing fertility treatment necessary for gestation. This analysis demonstrates the tension between medical innovation and a legislative framework developed before UTx was contemplated, highlighting the need for legislative clarification.