Gender dysphoria, defined as the persistent discomfort with one's gender identity or biological sex, affects between 0.5 and 1.4% of adult males.1 Treatment aims at congruence, to allow those who experience it to find comfort within their gendered self, which optimises psychological wellbeing and self‐fulfilment.2 Although many experiencing gender dysphoria require partial treatment or social transition, others only find comfort following surgical intervention to change their external genitalia and sexual characteristics. Traditionally, infertility has been an unfortunate consequence of the realignment of a transgender person's body with their gender identity. Following a successful clinical trial investigating uterine transplantation (UTx) in Sweden, resulting in eight live births so far,3 UTx appears to be a viable therapeutic option for women with absolute uterine factor infertility (AUFI). More than 42 UTx procedures have now been performed globally, and at least 12 live births have been reported. Following the establishment of the International Society of Uterine Transplantation (ISUTx), and the formation of research teams globally, it is anticipated that UTx will make the transition from research to clinical care in the future. Following these developments, speculation has escalated regarding the possibility of performing UTx in male to female (M2F) transgender women, which would enable them to gestate and give birth to their own children.4 Ethically, the consideration of performing UTx in transgender women is primarily motivated by the considerations of justice and equality. Like all women, psychological harm may arise secondary to a mismatch between reproductive capacity and aspiration. Transgender women have AUFI, and therefore they cannot experience gestation, which may play an integral role in the expression and consolidation of a female identity,5 and is considered by many to constitute a transformative experience.6 Legally, under the Equality Act (2010) transgender people are afforded explicit protection from both direct and indirect forms of discrimination through the characterisation of ‘gender reassignment’ as a protected characteristic. As such, M2F transgender women cannot be subjected to discrimination on the basis of this characteristic. Subsequently, if UTx becomes an established treatment option for women with AUFI, UK and EU legislation would make it legally impermissible to refuse to perform UTx in transgender women solely because of their gender identity. Performing UTx in this population, however, raises a number of anatomical, physiological, fertility, and obstetric considerations. The aim of this manuscript is to discuss these factors and provide an initial framework for assessing the feasibility of UTx in M2F transgender women.