Today In Science: Lab-Grown Vaginas Are Real

Wow, I've typed the word "vagina" so many times that it's starting to look a little weird. Vagina vagina vagina.
Publish date:
April 16, 2014
vagina, science, medicine, transgender

Here at xoJane, we really love vaginas. And we're really dedicated to vulvovaginal health along with reproductive rights, so all things vagina tend to come to our attention pretty readily. Like, say, this amazing story about doctors at Wake Forest Baptist Medical Center, who grew vaginas in the laboratory and successfully implanted them in teenage patients with a congenital vaginal disorder, who now have fully functional vaginas. Wow, I've typed the word "vagina" so many times that it's starting to look a little weird. Vagina vagina vagina.

So here's the deal: A variety of people could need this kind of medical technology, which means it's totally rad. The study focused on cis teens and young women with a condition called Mayer-Rokitansky-Kuster-Hauser syndrome (MRKH), which causes underdevelopment of the vagina and uterus. Each patient is different, and the condition may be identified at varying ages, but patients typically have trouble menstruating, getting pregnant, and having penetrative intercourse -- in fact, most of them can't do any of these things.

Which is not good medically speaking, but it's also a significant psychological issue. Genitals are important to many people on a psychological level. They're part of our identity, part of who we are, and part of how we interact with people intimately. While I'm not a fan of genital essentialism and reducing people to their genitals alone, that doesn't mean I don't recognize that genitals are really important to their owners and operators. For women, having a vagina is often a really important part of their gender identity, and not having one, or having one that's dysfunctional, is frustrating and emotionally distressing.

Treating this issue, however, has been challenging. Options included building grafts from other tissues in the body, like the skin, intestines, or penis, or trying to slowly create a surgical opening over time. Results aren't necessarily satisfactory, and they don't necessarily work at all, leaving patients with a failed surgery and the psychological fallout.

Some bright medical minds took tissue samples from the vulva and implanted them on a special scaffolding to encourage them to grow. Meanwhile, they prepped their patients, creating an opening to receive the artificially-grown organ. The next step involved carefully implanting the vaginas and waiting to see what happened.

Because the organs were made from the patients' own cells, their bodies didn't reject them. Instead, tissue began growing into and around the matrix of cells, supplying them with blood and nutrients, extending the nerves, and integrating the new organs seamlessly into the body. For the first time, these patients had fully functional vaginas -- and after several years to monitor the patients, the medical team have released their findings.

The patients report that they're able to menstruate, have penetrative intercourse, and experience desire and arousal. And they're pretty darn stoked with their lab-grown organs, which have made a huge difference in their lives. Meanwhile, from the medical side, medical imaging and other tests reveal that the organs developed to full maturity and are doing exactly what vaginas should be doing, although they needed a little help in the form of stenting in the beginning to maintain the opening and help the vagina keep its shape.

This study has huge implications. While the focus was on cis women with a specific condition, it could be expanded to patients who have other congenital conditions involving the formation of the vagina, as well as those who have injuries from accidents, pregnancy complications, or other medical events. With refinement of the treatment process, patients might be able to have successful pregnancies and childbirths.

And, of course, this is huge and important news for transgender women who are interested in gender confirmation surgery. With a variety of techniques available to create vaginal tissue, another entry still opens up new possibilities, because there are some drawbacks to, as a friend puts it, "aftermarket parts." The ability to grow vaginal tissue in the lab allows patients to have tissue with the right level of flexibility, as well as mucus membranes that produce adequate amounts of mucus for lubrication and cleaning, which is a significant issue.

Plus, who hasn't wanted to grow her own vagina?

It would appear that the body is down with bioengineered tissue, and this isn't just important for implanting vaginas. The same medical team was involved in the development of bioengineered urethras, and a similar project with noses was just reported as well. All of these tissues present different challenges in terms of developing cells that will withstand somewhat unique environments -- the nose, for example, also contains mucous membranes and needs cells that will support the complicated machinery of breathing, filtering air, and self-lubrication. (Really, your nose is a work of art. Gaze upon it with appreciation in the mirror tonight.)

This is a very small study, with only four subjects. More research is obviously necessary before it's made widely available, and it may not be an option for all patients who need bioengineered vaginas to treat congenital or acquired conditions, or who want gender confirmation surgery. But it's a fantastic start, and it opens up a world of possibilities for people who have been struggling with the medical and psychological issues that surround such conditions.

The ability to grow and implant human tissues in the lab is growing more and more advanced, which also makes me feel, a bit, like I live in the future. It points to the possibility of growing major organs, for example, which would relieve pressure on transplant lists. Because genitals can be such an important part of someone's individual identity, this study resonates especially powerfully with me -- because someday soon, we could live in a world where everyone who needs a fully functional, healthy vagina can have one. And I'm all about vaginas for all (who want them).