Beyond montreal: a critical evaluation of the Montreal Criteria for uterine transplantation

Uterine transplantation (UTx) is an innovative and exciting development that is aimed at making available the experience of gestation to those for whom it may otherwise be out of reach. Given the personal and social importance of this experience to many people, this is a laudable goal. Outside of at least one historic outlier, this practice has primarily been discussed in the context of resolving uterine factor infertility (UFI) for cisgender women. The guidelines and protocols that have been established around UTx understand Uterine Factor Infertility (UFI) as the indication for UTx. This article critically evaluates the Montreal Criteria (2012, 2013) as the primary ethical guidelines regarding UTx. This evaluation focuses on and challenges the way the Criteria structure the discussion around UFI as indication for UTx and the requirement for female genetics. I argue that, outside of the initial experimental design of UTx, there are prima facie grounds for making UTx available outside of the indication of UFI, and that for reasons both internal and external to the Montreal Criteria’s analysis of UTx, there are no overwriting ethical reasons to limit UTx to cis-gender women.