November 2026

Can Transgender Women Get Pregnant?

By Your Health Magazine Health Information Team

Transgender women cannot currently become pregnant or carry a pregnancy. A transgender woman who was assigned male at birth does not have a uterus or ovaries, and estrogen therapy or gender-affirming surgery does not create these reproductive organs. As of November 2026, there has been no confirmed successful pregnancy in a transgender woman.

Why Can’t a Trans Woman Get Pregnant?

Pregnancy requires a functioning uterus where an embryo can implant and develop. Ovaries normally produce eggs, although donor eggs can be used with in vitro fertilization, or IVF. Transgender women typically do not have a uterus, ovaries or fallopian tubes.

Genital gender-affirming surgery can create a vulva and vagina, but a surgically constructed vagina does not connect to a uterus. Therefore, vaginoplasty does not make pregnancy possible. Feminizing hormone therapy can promote changes such as breast development and altered fat distribution, but estrogen and other hormones cannot cause a uterus or ovaries to develop.

This is different from the situation for some transgender men and nonbinary people who were assigned female at birth. If they retain a uterus and ovaries, they may be able to become pregnant, even if they have previously used testosterone. A person’s ability to carry a pregnancy depends on their reproductive organs and health—not their gender identity alone.

Could Uterus Transplantation Make Pregnancy Possible?

Uterus transplantation has allowed some cisgender women born without a uterus, or those who lost uterine function, to carry pregnancies. According to a 2026 review of U.S. uterus transplant outcomes, dozens of babies have been born following these procedures.

However, uterus transplantation for transgender women remains theoretical and is not an available fertility treatment. The Womb Transplant UK research team’s statement on transgender recipients explains that significant research is still needed before the procedure could be considered technically feasible and acceptably safe.

Potential challenges include attaching and supplying blood to the transplanted uterus, supporting it within the pelvis, connecting it to a surgically created vagina and determining how to safely maintain a pregnancy. A recipient would also need IVF, anti-rejection medication and intensive medical monitoring. Delivery would be by cesarean section.

Uterus transplantation is a major operation even for current recipients. It may involve complications for the donor and recipient, organ rejection, infection, blood clots and pregnancy complications. It should not be viewed as an imminent option for transgender women.

Can a Transgender Woman Have a Genetically Related Child?

Although a transgender woman cannot currently carry a pregnancy, she may be able to have a child genetically related to her by using sperm with an egg from a partner or donor. The resulting embryo must develop in the uterus of another person, such as a partner or gestational carrier.

Family-building goal	What may be possible now
Carry a pregnancy personally	Not currently possible for a transgender woman without a uterus
Have a genetically related child	May be possible if viable sperm is available
Have a partner carry the pregnancy	May involve unassisted conception, insemination or IVF, depending on the circumstances
Use a gestational carrier	An embryo created with donor or partner eggs and available sperm may be transferred to the carrier
Build a family without pregnancy	Adoption and foster parenting may be options, depending on personal circumstances and local requirements

How Hormone Therapy and Surgery Affect Fertility

Feminizing hormone therapy commonly reduces sperm production and can affect sperm quality. However, the effect varies, and reduced fertility does not necessarily mean that no sperm are present. Someone who retains functioning testes may still have the potential to produce sperm.

Fertility may recover in some people after hormone therapy is medically adjusted, but recovery is unpredictable and may take time. A person should not stop or change prescribed hormones without guidance from the clinician managing their treatment.

Removal of the testicles, called orchiectomy, permanently ends sperm production. For this reason, professional guidance from the American Society for Reproductive Medicine on transgender fertility and family building recommends discussing fertility goals before starting hormone treatment or undergoing surgery that could affect reproductive potential.

Sperm banking before treatment usually provides the greatest number of future options. People who have already begun estrogen or anti-androgen therapy may still be able to freeze sperm, but testing is needed to determine whether usable sperm are present. In some cases, a fertility specialist may discuss medical or surgical sperm-retrieval techniques.

People seeking more background on estrogen formulations can also read about estradiol patch strengths and dosing terminology. Hormone doses must be individualized and should not be changed for fertility purposes without medical supervision.

When to Talk With a Fertility Specialist

Consider speaking with a reproductive endocrinologist, urologist or fertility specialist who has experience caring for transgender patients if you:

May want genetically related children in the future
Are considering estrogen, puberty suppression, anti-androgens or gender-affirming surgery
Have used hormones and want to know whether sperm production is still present
Want information about sperm freezing, IVF, donor eggs or gestational carriers
Have concerns about the emotional, medical or financial aspects of fertility preservation

A consultation does not commit someone to having children or delaying gender-affirming care. Its purpose is to provide accurate information so that decisions can reflect the person’s priorities. For reliable general information about reproductive health, infertility, medicines and other conditions, readers can also explore MedlinePlus health topics.

The Bottom Line

A male-to-female transgender person cannot currently become pregnant because today’s hormone treatments and gender-affirming surgeries do not provide a functioning uterus. Uterus transplantation is being studied as a possible future pathway, but it has not produced a confirmed pregnancy in a transgender woman and is not available as routine care. Transgender women may nevertheless have several paths to parenthood, including using preserved or retrievable sperm with a partner or gestational carrier, as well as adoption or foster parenting.