Can You Grow One with Teeth? The political and ethical issues raised by “lab grown vaginas”

Not too long ago, I came across this news story about lab grown vaginas. Apparently, a team of researchers from the U.S. and Mexico grew vaginal organs in a lab for four teenage patients who had “underdeveloped” or absent vaginas.

The Wake Forest Institute for Regenerative Medicine has posted materials about the study here and here.

The story raises interesting questions about whether this new medical technology will serve to enforce gender and sexual norms or whether it could serve to enable gender and sexual play; however I argue in this post that these questions are not all that easy to answer.

vaginal scaffold

Vaginal Scaffold (Credit: Wake Forest Institute for Regenerative Medicine)



Basic Info about the Procedures

The female patients all had Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, a genetic condition that results in an “underdeveloped” or absent vagina. To grow the vaginas, the doctors created a tube-like vagina scaffold specifically shaped for each patient out of a fabric-like material. Then they removed a small piece of vulvar tissue from each patient and placed it on the interior surface of the scaffold (muscle tissue was placed on the exterior surface). After giving the tissue samples about a week to grow on the scaffold, the doctors then surgically implanted the entire “engineered construct” into the patient. The procedures were performed between five to eight years ago, and the patients were between 13 and 18 years old at the time of their surgeries. In April, the doctors published their assessment of the surgeries: “Vaginal organs, engineered from the patient’s own cells and implanted, showed normal structural and functional variables with a follow-up of up to 8 years.” According to the doctors, the patients reported “normal” levels of desire and sexual satisfaction, as well as painless intercourse.

A Quick Note on Intersex

The four patients could be classified as “intersex” or as people with a “disorder of sex development” (for a not-un-controversial discussion of the two terms, see Alice Dreger’s blog post on the issue). In the past, medically unnecessary surgeries were performed on intersex children before they were capable of giving consent in order to “normalize” their bodies. In addition, information about their condition (including information about the medical procedures performed on them) was frequently withheld from intersex children (for a good intro to these issues, see Suzanne Kessler’s Lessons from the Intersexed).

This case does not appear to involve these types of injustices. It seems that all of the patients were old enough to consent to the procedures, although some might argue that a thirteen year-old is too young to choose to undertake this procedure. Presumably, all of the patients were given accurate information about their bodies and the procedures.

However, the case still raises issues related to gender normalization.

Enforcing Gender Conformity and the Coital Imperative?

It does not sound like these surgeries were “medically necessary” in the sense that the condition being addressed (an “underdeveloped” or absent vagina) was not life threatening and did not cause physical pain. According to one source, two of the patients may now be able to become pregnant as a result of the procedure – but whether procedures to restore reproductive function should be considered medically necessary is an open question.

For all of the patients (who all presumably identify as female), the absence of a vagina could certainly cause emotional pain, but we could argue that this pain is the result of oppressive social norms that equate femininity with vaginality (I just made up that word) and female sexuality with heterosexual vaginal penetration. Thus, these surgeries can be interpreted as an effort by everyone involved (including the teenagers themselves) to bring the young women’s “ambiguous” bodies into line with gender and sexual norms.

It is possible that if gender and sexual norms were not so rigid, these young women, their families, and the doctors involved would not have thought it necessary to pursue these surgeries. We should probably also ask some pointed questions about how sexual desire and satisfaction were defined and assessed in each case.

Enabling Gender and Sexual Play?

On the other hand, we could argue that the procedure could enable queer sexual practices (who says a vagina has to be used for heterosexual penetrative intercourse?). We could also argue that even if these lab grown vaginas are only used to enable heterosexual penetrative intercourse, if this is what the young women want, then we should applaud a procedure that allows them to pursue their own form of sexuality, whatever that is.

In addition, it is possible that these types of procedures could enable some form of gender play in the future. I do not know whether this procedure could ever benefit MtF folks who seek gender reassignment/gender confirmation surgery (the vaginas were grown from each patient’s own vulvar tissue), but it might be possible. In addition, it might be possible to grow “atypical” vaginas according to a patient’s own particular desires (e.g. a vagina with teeth).

Still, while these rejoinders are important, I don’t find them entirely convincing. While the procedure could enable queer sexual practices and/or gender play, it is unlikely to do so – this medical technology, like many technologies, will most likely be used in “normal” ways – to enable “normal” sex and to create “normal” bodies. As a broader point, medical technologies that do not seek to bring a body into line with society’s norms are less likely to ever be conceived of, let alone developed.

A short video of one of the young women, released by the researchers, confirms this point. She says, in Spanish, “I truly feel fortunate, because I’ll have a normal life – completely normal.”

Will anyone want one with teeth? (Credit: Flickr - Rob van Hilten)

Will anyone want one with teeth? (Credit: Flickr – Rob van Hilten)

It’s Complicated

In short, there is no easy answer to the question of whether this medical innovation is a “good” thing. I can only conclude that the technology is both feminist and sexist, queer and heteronormative, at the same time.

All I can say at this point is that, while we continue to think through the ethical and political implications of this technology, we should respect the efforts of the young women involved, as they were working to make their own lives more liveable given the constraints they were facing.

Photo of Patient with a lab-grown vagina

Patient in video provided by researchers (Credit: Wake Forest Institute for Regenerative Medicine)

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