Racism affects every aspect of our lives, including the ways we visualize and form our families. The global momentum and awareness that have been gathering to challenge systemic racism and other structures of injustice can also influence our collective thinking about “family.” In the current context, how can we think about family formation by surrogacy in transformative ways? What new vision can we create as we dismantle the forces that perpetuate racial inequities, constrain options for women, maintain and increase wealth gaps within and between countries, and deny recognition of LGBTQ parentage?
Decisions about creating families are intensely personal, but they’re made in a world with entrenched patterns of injustice. Existing racial and economic hierarchies are largely replicated in cross-border surrogacy relationships. International surrogacy, as currently practiced, depends on inequalities. And each arrangement is part of a multibillion-dollar fertility industry where profit is often the bottom line, putting all participants at risk.
In most cross-border surrogacy arrangements, intended parents have relative financial security, social support systems, and access to medical and legal services, while surrogates often have little or no financial security, legal safeguards, or access to independent medical care.
Young women who provide eggs for surrogacy arrangements are also generally seeking additional economic means. They are usually viewed as an initial profile on a screen but are invisible thereafter, their voices and needs absent from further consideration.
Where cross-border surrogacy happens
The global locations of surrogacy and egg donor “hubs” change rapidly. Over the past few decades, a pattern has emerged: exploitative practices become evident in a hub country with lax or no regulation, leading the government to enact regulation. That prompts the industry to move to another country where no regulation (yet) exists. The rapidly expanding fertility industry has always moved faster than the law, leaving surrogates and egg providers subject to the greater negotiating power of other parties, misinformation, poor medical care, and violation of their rights.
India was the first major international surrogacy destination, but once government restrictions came into force, the industry moved to Thailand, Nepal, and Cambodia. As those countries enacted regulation, hubs emerged in the precarious economies of Eastern Europe, particularly Ukraine, Georgia, and Russia. Now there are indications that the next destinations will be on the African continent, in countries such as Nigeria, Ghana, and Kenya. At the same time, people with economic means in countries that prohibit or restrict surrogacy increasingly seek arrangements in the United States.
Why people choose international surrogacy
People choose international surrogacy over domestic arrangements for a variety of reasons: affordability; legal constraints in their home country; discrimination based on sexual orientation or marital status; and privacy. Most intended parents want surrogacy arrangements that are fair and ethical, but many factors are outside their control. Surrogacy markets and relationships operate in the context of tiered positions of social and economic privilege, determining who is supported to have children and who is not. People who are not in positions of privilege are not financially or socially encouraged to use surrogacy to become parents.
The bigger picture
Historically and currently, people from marginalized communities in every country have experienced interference, coercion, and discrimination regarding their reproduction decisions. These injustices have been carried out both through governmental policies and practices, and by individuals from socially privileged groups.
In resource-rich countries, people from advantaged backgrounds have been encouraged and helped to have children, while people who are not in positions of power have faced numerous forms of reproductive oppression. Yet people from these groups have often been expected to raise—and now to bear—the children of the privileged groups.
It may feel challenging for those considering surrogacy to confront longstanding inequalities and power dynamics. These issues can feel remote and outside their control. But entering into surrogacy relationships without addressing them can perpetuate systems that devalue and exploit the work and lives of women of color, Indigenous women, working-class and poor women, women in resource-poor countries, and young women. Intended parents who decide to enter into international (and domestic) surrogacy arrangements can influence the contract as well as the larger landscape by advocating for the rights and health of surrogates and egg providers, in addition to their own and those of their potential future children.
A new direction
In the current period, as racial and economic inequities are becoming more visible and widely understood, we are compelled to look at family formation through the lens of social transformation. We can bring to individual family decisions an understanding of our collective history and its legacies of reproductive oppression. We can consider the multiple factors that affect all parties involved in international surrogacy arrangements. We can center the voices of those with the least power (egg providers, surrogates, and children); enact polices and ensure robust research that safeguard their rights and health; and ensure that LGBTQ people have the right to raise families without discrimination.
We have an opportunity to think anew about all aspects related to the surrogacy industry, and understand that each personal journey is part of a broad and complex picture in an unjust system. Please join us.