Basically my sans aus ship children x ship children . The ships children that you can ask are first the skeleton version then the human version the ship children are different in both...........and also fusions and ship children are different than eachother. Fusions are basically skeleton who were made by their parents magic combining and ship children are made by ya know how a normal child is made but in skeleton or even in the human because they are technically skeleton with human skin,they have souls and hp and all that they don't show pregnancy its just in their soul and they're are no gender restrictions tho its rare to see a female skeleton . So yeah a female and other or male and another male can have a kid without any sort of surgery . Unless its their au codes