AbstractObjectiveTo assess how absolute uterine factor infertility affects women who undergo uterus transplantation, how uterus transplantation impacts women with absolute uterine factor infertility and how uterus transplant recipients view uterus transplantation in terms of their reproductive autonomy.DesignQualitative semi‐structured interview study.SettingUterus transplant programme in a large academic medical centre in the USA.Population/sampleTwenty one uterus transplant recipients.MethodsA medical chart review was conducted to collect patient demographic information and clinical outcomes. Semi‐structured interviews collected information regarding participants’ experience.Main outcome measure(s)The outcomes of interest were participants’ experience of infertility, experience with uterus transplantation and general perceptions of uterus transplantation.ResultsSix participants were pregnant (one with a second child), six had experienced early graft failure and removal, five had delivered a healthy baby, and four had a viable graft and were awaiting embryo transfer. The primary themes identified were: the negative impact of absolute uterine factor infertility diagnosis on psychological wellbeing, relationships and female identity; the positive impact of uterus transplantation on healing the emotional scars of absolute uterine factor infertility, female identity and value of research trial participation and the perception of uterus transplantation as an expansion of reproductive autonomy. All participants reported that uterus transplantation was worthwhile, regardless of individual outcome.ConclusionAbsolute uterine factor infertility has a negative impact on women from a young age, affects multiple relationships and challenges female identity. Uterus transplantation helps to reverse this impact, transforming women's life narrative of infertility and enhancing female identity.Tweetable AbstractAbsolute uterine factor infertility (AUFI) adversely affects women. Uterus transplantation helps mitigate the negative impact of AUFI, by transforming women's life narratives of infertility and enhancing female identity.