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Discordant Expectations of Global Intimacy: Desire and Inequality in Commercial Surrogacy - Kristen E Cheney, 2021

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Sociological Research Online

Discordant Expectations of Global Intimacy: Desire and

Inequality in Commercial Surrogacy

Kristen E Cheney

First Published February 1, 2021 Research Article

https://doi.org/10.1177/1360780420984169

Abstract

Gestational surrogacy – carrying someone else’s baby (or babies) to term and giving

birth to them – is perhaps one of the most intimate acts a human being can perform for

others. However, the proliferation of commercial surrogacy has drawn concern and

criticism, with many scholars arguing that it both creates and exacerbates global social

and economic inequalities. Commercial surrogacy thus raises both the possibility of

global intimate connection and the specter of reproductive exploitation. I therefore

explore the various, shifting, and often discordant desires for intimate connection

between the intending parent(s), the surrogate mother, and the resulting child(ren) in

commercial surrogacy. I then examine how those intimacies intersect with commercial

surrogacy’s socioeconomic inequalities. Weighing commercial surrogacy’s driving

desires and intimate practices against its commercialization, I end with a

reconsideration of the procreative desires and intimate practices that spur current

international commercial surrogacy (ICS), urging an emphasis on reproductive justice.

Keywords

intimacy

inequality

reproductive justice

stratified reproduction

surrogacy

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SOU, Alm.del - 2020-21 - Endeligt svar på spørgsmål 754: MFU spm. om, hvilke erfaringer der er med rugemoderskab, både ift. barnets udvikling og kvinden der føder barnet, i den danske og internationale litteratur, til social- og ældreministeren

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Discordant Expectations of Global Intimacy: Desire and Inequality in Commercial Surrogacy - Kristen E Cheney, 2021

Introduction

This article explores the dynamics of intimacies and inequalities within commercial

surrogacy arrangements. I became interested in surrogacy as an extension of my

investigations into adoption – adoption and surrogacy being the main options for

people who want children but cannot have them through natural birth processes. I have

been struck not only by the assisted reproductive technology (ART) business’

industrialization of reproduction but by the relational tensions in commercial surrogacy

arrangements. Teasing out the strands of intimacy through a review of numerous

recent social studies of surrogacy (cf.

Deomampo, 2016; Jacobson, 2016; Pande,

2014),

here I highlight the power relations inherent in the negotiation of intimacies

within commercial surrogacy, particularly in cross-border practices.

In conceptualizing intimacy, I follow

Lynn Jamieson (2011:

151), who focuses on

‘practices of intimacy’ in building connections between people as a means of defining

the concept of intimacy through the processes by which it is created. This approach

helps highlight the dynamic and shifting nature of intimacy – emotional, physical, and

even genetic (relatedness) – rather than defining it as a static ‘thing’. Jamieson notes

that in many cultures, intimacy is closely related to family and is indeed often assumed

to be an essential feature of family life. It is not, however, as prominent in non-Western

cultures. She also highlights the role of globalization and potential commodification in

mediating certain intimate relationships, pointing out that intimacy does not necessarily

bring about equality between parties. This complex dynamic between intimacy and

economics is echoed in studies which discuss commercial surrogacy as a form of gift

exchange (Rudrappa,

2015),

adding surrogacy to the broad category of intimate labor

(Boris

and Parreñas, 2010)

being performed largely by women, including domestic and

care work. This conceptualization of intimacy is instructive for thinking about how

surrogacy practices can become points of contention in commercial surrogacy, which

often involves relatively wealthy intending parents seeking surrogate services from

poorer people. Despite the potential for commercial surrogacy to forge intimacies

across not only national but racial and class borders, I argue that – because of its

entanglement with markets and the way it is presently managed by states,

organizations, and families – it tends to create discordant expectations of intimacy and

exacerbates global reproductive inequalities.

This article will therefore explore, first, the various – and often discordant – desires for

intimate connection between the intending parent(s), surrogate mothers, and the

resulting child(ren) – and, second, those intimacies’ intersections with commercial

surrogacy’s socioeconomic inequalities. Though Jamieson does not explicitly mention

surrogacy, it certainly qualifies as an example of a commercial practice in which

‘participation in the “modernity” of intimacy might make palatable relationships that

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could otherwise be described as inadequate or even failed’ (Jamieson,

2011:

158).

After defining surrogacy and its trends, I turn to the different actors and their

expectations of intimacy. Many intending parents and surrogate mothers frame their

choices to engage in commercial surrogacy differently over time, as alternately altruistic

and market-based (Deomampo,

2016).

Next, I therefore detail how the framing of

commercial surrogacy as ‘helping’ others to create families cultivates discordant

expectations of intimacy, creating both distance and closeness, as it also challenges

and reinforces global reproductive inequalities.

Weighing commercial surrogacy’s driving desires and intimate practices against its

commercialization calls for both the protection of women’s and children’s rights and the

need for reproductive justice.

Reproductive justice

is a concept that came out of

feminist communities of color, which ‘contextualizes reproductive choices and decisions

by including the intersecting economic, social and political forces that shape the lives of

women, their families and their communities’ (Generations

Ahead, 2017: 278).

therefore conclude by considering various alternative conceptualizations of commercial

surrogacy practice that try to account for and/or overcome the tensions between

intimate desires, market forces, and reproductive justice.

What is surrogacy?

Before unpacking the dynamics of intimacies and inequalities in commercial surrogacy,

it is important to be clear on the definitions of terms, as they can be confusing.

Surrogacy is the act of carrying a fetus to term on behalf of another parent or parents.

Traditional surrogacy involves the use of one’s own oocyte (egg), which is rather rare

these days. With the advancement of ARTs, the bulk of contemporary surrogacy

arrangements are gestational, meaning that others’ fertilized embryos are implanted in

the womb of the surrogate mother, who carries the non-genetically related child to term.

Gestational surrogacy ostensibly also helps prevent disputes about legal parentage,

which typically favors genetic connection over social (or, in this case, biological

)

parentage.

Aside from traditional versus gestational surrogacy, another important designation is

between altruistic versus commercial surrogacy. This is perhaps the more contested

distinction, as many policymakers consider commercial surrogacy ethically

questionable, both in terms of potential exploitation of women as surrogate mothers

and of surrogacy possibly constituting the sale of children (United

Nations Human

Rights Council Special Rapporteur on the Sale and Sexual Exploitation of Children,

2018).

Even in cases where altruistic surrogacy is allowed by law, it can be difficult to

differentiate the permitted costs to be covered by intending parents from commercial

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arrangements. Therefore, while Russia and some US states have legalized commercial

surrogacy, some EU countries have banned it – and many more have banned

all

forms

of surrogacy. However, the EU have found it challenging to place sanctions on their

citizens going abroad to seek commercial surrogacy services.

Finally, there is a distinction between domestic and international surrogacy. Within

domestic arrangements, in which intending parents contract a surrogate mother in their

own country – as, for example, happens often in the United States commercially or the

United Kingdom, where only altruistic surrogacy is allowed – there is much more

potential for intimate interactions between intending parents and surrogate mothers. In

fact, someone whom the intending parents already know may offer to carry their child

for them. But even in cases mediated by an agency, where a stranger is recruited to

become a surrogate mother for an intending parent(s), there tends to be much more

focus on relationship building – especially where surrogate mothers and intending

parents live in geographical proximity (Jacobson,

2016).

International arrangements, on

the other hand, are typically marked by fewer opportunities for intending parents and

surrogate mothers to get to know one another or develop intimate practices, not only by

virtue of physical distance but by language barriers. There also tend to be greater

cultural and class disparities between the parties – though some foreign parents

nonetheless manage to be present and forge intimate ties with surrogate mothers

during at least part of the pregnancy (Carone

et al., 2017; Smietana, 2017).

In the next

main section, I return to how and why agencies brokering commercial surrogacy

arrangements are much more likely to manage the expectations of the various parties

by discouraging contact than by cultivating it (Pande,

2014).

Trends in surrogacy

The rise in prevalence of commercial surrogacy is tied to both scientific advances in

ARTs and to decreasing childbirth rates in Western countries. This is attributed

primarily to the age-related infertility of women deferring motherhood due to gendered

economic inequalities and waning social support such as accessibility of childcare (cf.

Marre et al., 2018). Smietana et al. (2018)

have also chronicled the rise in surrogacy

use by the LGBTQ+ community and the attendant challenges for reproductive justice.

International commercial surrogacy (ICS) commonly involves white and/or monied

intending parent(s) from wealthier countries hiring women of color from poorer

countries and/or lower socioeconomic classes as surrogates, brokered by international

agencies – although permissive states in the US have also become major hubs for

commercial surrogacy, with many white, middle-class women acting as surrogates

(Berend,

2016; Jacobson, 2016).

Nonetheless, critics claim that the fertility industry is

often premised on neocolonialism and white supremacy (Harrison,

2016; Twine, 2017).

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Of late, commercial surrogacy has been aggressively marketed not only to

heterosexual couples and single women but to gay men in the global North (Riggs

and

Due, 2017),

opening possibilities to fulfill their desires to reproduce, ‘as if recovering

the fertility that was lost by coming out’ (Smietana,

2018:

101).

In some instances,

such marketing actually generates desires for genetically related parenthood where it

had not previously existed (Darnovsky

and Beeson, 2014:

17). But this practice can

actually reinforce both ‘settler sexualities’ and the heteronormative family model

(TallBear,

2018).

Such expanded pronatalism can sometimes even play into pro-nationalist concerns, as

is the case in Israel, which wrote the world’s first domestic surrogacy law at roughly the

same time as a booming reproductive industrial complex was emerging there

(Vertommen,

2017).

This complex is so linked to the Zionist political project that Israel

has made great efforts to accommodate citizens who fall outside the domestic

surrogacy law (primarily gay men and single women) when they seek ICS

arrangements (Shalev

et al., 2017).

Other states that prohibit commercial surrogacy

domestically have likewise shown themselves to be accepting of their citizens utilizing

ICS (Allan,

2017).

With advances in ART, particularly in vitro fertilization (IVF), gestational commercial

surrogacy started expanding into an international business. India quickly became a

popular destination as part of their medical tourism industry, appealing to intending

parents for its low cost relative to other destinations. When India started restricting the

practice due to moral and legal concerns, however, the global market shifted to other,

less regulated countries such as Thailand, Nepal, and Cambodia – all of which had

banned ICS by the end of 2016 due to various scandals and accusations of the

industry’s exploitation of women (Whittaker,

2019).

Georgia and the Ukraine have

since become popular destinations for ICS, as well as a few US states, including

California and New York. In addition, there is now evidence that Indian doctors are

opening clinics in East Africa.

So, as was the case in intercountry adoption markets,

which shifted from increasingly regulated destinations to unregulated ones (Cheney,

2014a),

Africa has become somewhat of a ‘final frontier’ for ICS (The

African Child

Policy Forum, 2012).

The actors and their labels

I have written before about how terminology is one means of setting the tone of the

relationship between actors in ICS (Cheney,

2018a).

The labels one uses are

emotionally, morally, legally, and politically charged – and therefore matter a great deal:

to call someone a ‘commissioning’ versus an ‘intending’ parent – or to call them

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‘parents’ versus ‘clients’ – can either mask or foreground the commercial nature of the

transaction. Moreover, to call the person who carries the child a ‘gestational carrier’, a

‘surrogate’, and/or a ‘mother’ can, as

Beeson et al. (2015)

have argued, either mask or

foreground not only the potential rights and entitlements of those who act as surrogates

but also mask or foreground their affective and reproductive labor in the process – as

well as their very humanity. All terms therefore rub

someone

the wrong way because

they tend to reflect power differentials between parties. Terminology frames surrogacy

practices in ways that either highlight or elide the inevitably commercial nature of ICS

and either open or foreclose possibilities for intimacy. I am consciously using the terms

‘intending parent(s)’ and ‘surrogate mother’ in this article to try to encapsulate the

various dynamics of intimacy while not diminishing the inequalities of commercial

surrogacy arrangements. I also refer to the children born through surrogacy as ‘surro-

children’ to differentiate children born through surrogacy arrangements from those who

are not.

Managing expectations of intimacy in ICS

Surrogacy is a procedure that, as Carolin Schurr and Elisabeth Militz point out, involves

‘multiple processes of attachment, detachment and reattachment’ (Schurr

and Militz,

2018:

1626). ICS in particular is an example of what Sara Ahmed (Ahmed,

2004)

refers

to as an ‘affective economy’, where emotions act as a form of currency:

… the market of surrogacy can only be economically effective – in the sense of generating

capital – when it succeeds in forging attachments across physical, cultural, social and

emotional distances, while at the same time controlling intensities of attachment in order

to facilitate processes of detachment to guarantee and finalize the exchange of the baby

in the market encounter. (Schurr

and Militz, 2018:

1631)

Heather Jacobson’s ethnography of surrogate mothers in the United States,

Labor of

Love: Gestational Surrogacy and the Work of Making Babies

(2016), details how much

time and energy brokering agencies spend mediating the expectations and

relationships of both parties in domestic commercial surrogacy arrangements – in

which, as mentioned above, physical proximity may allow for more intimate practices

than in international arrangements. Intending parents and surrogate mothers in the US

may get to ‘deeply know’ each other (Jamieson,

2011:

151) during conception and

pregnancy, with intending parents in a better position to attend prenatal doctors’

appointments with the surrogate mother (Jacobson,

2016).

In international arrangements, on the other hand, intending parents and surrogate

mothers’ relationships are typically much more reliant on – and thus more heavily

mediated by – agencies. Some brokers may allow for face-to-face meetings when

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intending parents are in a position to travel to the country of the surrogate mother. This

has been true in the US and Mexico, for example. But in India, clinics and agencies

typically discouraged intending parents’ contact with surrogate mothers, often framing

them as conniving gold-diggers to be distrusted by intending parents (Majumdar,

2018:

221). Some southeast Asian brokers in countries such as Thailand promoted complete

anonymity, partly to prevent the parties from sharing information on payment that might

lead to surrogates demanding more money (Whittaker,

2019:

65). But the majority are

somewhere in between, with agencies facilitating occasional, virtual contact between

the intending parents and surrogate mothers through mediated and interpreted online

video chats. Where intending parents actually travel to the destination country for the

birth of the child, they may or may not see the surrogate mother but (with the exception

of the US) are often discouraged from attending the birth – sometimes at the request of

the surrogate mother herself (Whittaker,

2019).

Nevertheless, various actors in an ICS arrangement can have very different

expectations of the experience. Intending parents’ feelings about resorting to ICS to

have a child, surrogate mothers’ motivations and emotions, and children’s feelings as

they grow up and learn that they are the product of an ICS can all change over time –

before, during, and after contractual obligations have been fulfilled. Discordance, then,

can result in a breakdown of the market exchange as well as the changing

expectations of various parties (Jacobson,

2016).

And yet, evidence has shown that at

many moments throughout and beyond the commercial surrogacy arrangement, there

can be intimate discordance between intending parents and surrogate mothers – and

also between them and the children who are produced through such arrangements. In

the US, it is often assumed that the contracting parties in commercial surrogacy

arrangements will maintain a certain level of attachment with a surrogate mother, at

least until the baby (or babies) is/are born and delivered to the intending parents.

Jacobson (2016)

argues that in the US this is a means of masking the commercial

nature of the arrangement. Post-birth, though, surrogate mothers are trained to

conform to industry expectations of detachment, as in India before the ICS ban (Pande,

2014).

In ICS, physical distance poses an additional hindrance to attachment, but with

information and communication technologies, distance can be negotiated as a kind of

safety zone to facilitate an ‘appropriate’ level of interaction while avoiding

overly

intimate

connections. Intending parents can video chat with their surrogates to forge

intimate ties and keep up with developments in the pregnancy (Berend,

2016),

but

where language poses a barrier, that interaction is usually mediated by clinic staff or

other invested intermediaries. Intimate desires can thus change over time in

accordance with structural limitations and possibilities – though again, intending

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parents have more control over this than surrogate mothers (Schurr

and Militz, 2018:

1638–39).

Surrogate mothers

Surrogate mothers have varying ‘capacities to determine their own affective

investments and attachments’ (Schurr

and Militz, 2018:

1638), as per the parameters

discussed above. The interaction between surrogate mothers and intending parents in

ICS is often dictated by contract in favor of the convenience of the intending parent(s),

partly because of the fact that they are the ones who are paying. However, most ICS

contracts do not lay out stipulations about the relationships between intending parents

and surrogate mothers

after

the birth of the child(ren), as contracts tend to terminate

upon the birth and transfer of the child(ren) (Schurr

and Militz, 2018:

1639).

The assumption of most intending parents – and thus the industry that favors them – is

that the surrogate mother will cease to be an active part of the child’s life after birth,

though this may not be what either the surrogate mother or the intending parent(s) has

in mind. Intending parents may send pictures of the child in infancy and even

toddlerhood, but contact usually tapers off over time. And yet, despite the industry

attempts to rule out post-birth relationships in certain contexts, surrogate mothers often

desire to maintain some kind of connection. Some surrogate mothers claim that they

have an unbreakable bond with the children they have gestated by virtue of that labor.

One surrogate mother in India told Amrita Pande, ‘After all it’s my blood even if it’s their

genes . . .’ (Pande,

2014:

148). In Indian cosmology, this ‘blood’ actually imparts

identity to children. But as mentioned, surrogate mothers’ expectations can be highly

mediated by the brokering agencies and clinics, in ways that refute such cultural

beliefs:

Daisy Deomampo (2016:

159) noted in her ethnography,

Transnational

Reproduction: Race, Kinship, and Commercial Surrogacy in India,

that

while surrogates told me that they wished to know more about their clients, [the clinic

doctor] claimed to speak for them, saying, ‘The surrogate doesn’t want anybody to be in

touch or turning up at her door. So they’re not interested, you know.

However, Deomampo goes on to point out that surrogate mothers would rearticulate

their desires to meet or maintain contact with their surro-children in terms of their

reproductive labor rights (Deomampo,

2016:

170). Similarly, most of the surrogate

mothers in Schurr and Militz’s (2015) Mexican study of surrogacy were in fact hopeful

‘that [my surro-child] will one day knock at my door’, as one told them (Schurr

and

Militz, 2018:

1640).

International Surrogacy as Disruptive Industry in Southeast Asia

(2019), medical

anthropologist Andrea Whittaker points out that cultural beliefs about blood and

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obligation also undergird expectations of global intimacy among Thai surrogates. She

explains that the Buddhist concept of

bunkhun

– gratitude or indebtedness in return for

selfless acts, care, or assistance – is closely tied to motherhood and thus linked to Thai

surrogate mothers’ expectations of both intended parents and their surro-children.

Because she gave her labor and nurturance through the sharing of blood in her womb,

the typical Thai surrogate mother sees herself as forever karmically bound to her surro-

children through the suffering of child birth. But the sharing of blood also implies a kind

of kinship, and surrogate mothers would try to claim their relatedness through, for

example, referring to intended parents and surro-children with fictional kinship terms,

for example, ‘sister’ for the intending mother or ‘niece/nephew’ for surro-children

(Whittaker,

2019:

59–64).

Despite these sentiments,

Pande (2014:

145) emphasizes that ‘it is important to

recognize how the process of [commercial] surrogacy alters the women’s existing kin

ties . . . [In India] many surrogate mothers kept their surrogacy a secret from their

children’ while their relationships with their husbands were also strained. Though many

women found ICS more empowering than other work available to them, it remained

stigmatized as ‘dirty work’ akin to prostitution (Majumdar,

2016:

220). In the early days

of India’s growing ICS industry, husbands were deeply ambivalent about their wives

participating in ICS: though they needed the income, husbands resented being usurped

as breadwinners, and they did not like having to cope without their wives, who were

usually confined to a clinic after the first trimester of their surro-pregnancies. However,

some husbands (and their families) started pushing reluctant wives into surrogacy as

they saw others in their communities reaping the material benefits and realized how

lucrative commercial surrogacy could be (Nadimpally

and Majumdar, 2017).

Throughout, many surrogate mothers claimed that they were in fact doing it not for the

intending parents so much as to better provide for their own children (Cheney,

2018a).

What about the children??

There is very little research at present to know how surrogate-born people feel about

the circumstances of their births and/or contact with surrogate mothers. A 2014 study in

the United States indicated that children to whom their surrogate birth was disclosed

generally looked favorably upon their surrogate mothers and are curious about them

(Jadva

et al., 2014).

But this study involved just 19 children born through domestic

arrangements, and it is unclear how many of those were commercial or altruistic

surrogacies. A psychological study of thirty 6- to 12 -year-old surro-children born to gay

fathers in Italy noted that children with secure attachments to their fathers were more

likely to explore their surrogacy origins (Carone

et al., 2020).

Though the article is not

explicit about whether the children were born through altruistic or commercial

arrangements, it does state that all 30 children were born through gestational

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surrogacies abroad (all forms of surrogacy being prohibited in Italy), implying that most

were likely commercial arrangements. It would be interesting to see whether this fact of

a commercial exchange has an impact on surro-children’s feelings about their

surrogacy origins, particularly once they reach adolescence.

More child-centered

research, while methodologically challenging, is needed to capture the perspectives of

surrogate-born people over the life course.

Some adoption studies scholars examine surrogacy’s parallels with adoption and the

lessons adoption might hold for parents of surrogate-born children (Crawshaw

et al.,

2017).

For example, adoption research indicates that the earlier the circumstances of a

child’s birth are disclosed to them, the better children react and the more the

circumstances become normalized over time (Scherman

et al., 2016).

However,

‘Disclosure decisions are contingent, fluid and complex, as they have the potential to

challenge affective relations of kinship. After disclosure, the surrogate children might

rearrange their affective attachments, seeking the gamete donor or surrogate laborer

out . . .’ (Schurr

and Militz, 2018:

1640), effecting a re-attachment. Like adoption, ICS is

slowly moving from being shrouded in secrecy and stigma toward more openness as

the use of surrogacy for family formation is gradually normalized. Even where the

circumstances of their births are disclosed from an early age and surro-children are

encouraged to explore their identities and origins in surrogacy, a relationship with a

commercial surrogate mother or gamete provider in another country is seldom

encouraged so much as identification with their birthplace. As one intending parent told

Majumdar (2016),

I will explain to them everything and even show them photographs of the surrogate mother

pregnant, in hospital, etc. But . . .

To me it is more important that they understand that

India as a country and culture is their mother (emphasis added by author).

(p. 224)

It is likely that as they come of age, many surro-children will express interest in getting

to know their surrogate mothers (and gamete providers) in order to have a greater

understanding of their own origins (Dempsey

and Kelly, 2017).

Advocates for the rights

of donor-conceived people have argued passionately for access to information about

gamete providers – whom they refer to not in cold, scientific terms as providers of

genetic materials, but with affective kinship terms like ‘father’ or ‘mother’.

For this

reason, total anonymity of gamete providers should be discouraged (Crawshaw

et al.,

2017).

The same opinion may evolve regarding surrogate mothers as surro-children

continue to explore their origins and the intimate meanings they attach to them. The

preservation of records pertaining to the circumstances of any child’s birth is therefore

essential – especially where it concerns donor conception or surrogacy (Cheney,

2014b).

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Adoption studies also teach us that intending parents’ expectations that surro-children

should always be ‘grateful’ just for having been born are fraught and problematic. Many

adoptive and donor-conceived people have grown up to become critical of adoption

and/or donor conception practices, especially where an exchange of money has taken

place. Expectations of gratitude are often used to silence their critiques of the practice.

Intending parents

Intending parents’ motivations for getting involved in surrogacy and their feelings about

it, while complex, have been well documented and are often overrepresented in both

popular and scholarly literature. Intending parents are usually driven to ICS by a desire

for children – but for whom pregnancy and gestation may otherwise be impossible (e.g.

gay men or women who cannot conceive and/or carry a child to term) or otherwise

undesirable. Public discourse is usually produced from their point of view and/or in

sympathy with them. It is also clear that the intending parents’ desires take precedent,

and that they therefore have the most power to dictate the terms of the practices of

intimacy in ICS (Deomampo,

2016; Schurr and Militz, 2018; Whittaker, 2019).

As the

initiators of ICS, who are typically wealthier and have more rights over the child both

legally and affectively, decisions about whether and how to maintain contact with

surrogate mothers before or after birth is in reality largely theirs to dictate.

As mentioned above, intending parents’ desires for intimacy can change over time.

Though some intended parents initially want to cultivate intimacy with the surrogate

mothers they hire, the stress of multiple IVF treatments, miscarriages, and other

setbacks can eventually lead them to dial back their expectations to that of a more

straightforward business transaction (Deomampo,

2016:

84–87). As an intending

parent hiring a surrogate in India told

Deomampo (2016),

At first, I wanted to know them and everything about them and talk to them. But I think

after our miscarriage, I’m probably changing to, ‘Look, this is a business deal’. I can’t get

attached to them; I want the best surrogate I can get. And I probably want to put a little

more business relationship into it than last time. (p. 87)

Such feelings of ambivalence can also mark the intending parents’ relationships with

surrogate mothers after their children are born. An intending mother in Switzerland told

Schurr and Militz in 2017,

I don’t know yet whether and when I will tell our daughter about her Mexican surrogate. I

know some people have the picture of their surrogate in the nursery. But I really don’t

want the surrogate’s picture like an icon of Maria hanging over her bed. I just want us to

be a normal family . . . (p. 1638)

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signaling that surrogacy is still considered too far outside the reproductive norm to

maintain the relationship over time. At times, involving a surrogate or gamete donor in

one’s configuration of family can be seen as disruptive of the project of securing a

normative nuclear family unit, and so parents may minimalize surrogates’ and

providers’ roles (Whittaker,

2019:

63–64). This process of detachment meant ‘to

delineate the boundary of their nuclear family after birth is often combined with multiple

processes of attachment and reattachment’ (Schurr

and Militz, 2018:

1639).

Parents also decide whether to disclose the circumstances of their birth to surro-

children. Indications are that, as with adoption, parents of surro-children are starting to

disclose the use of surrogacy to their children more often and at earlier ages. But (as

with adoption) they are framing it in ways that carefully secure the nuclear family

relationships over those with surrogate mothers (Nordqvist,

2019). Jamieson (2011:

157) points out that ‘Practices of intimacy might then overlap with and become

enmeshed in the reproduction of generational power’. With their great power to control

the narrative also comes great responsibility:

The way in which intended parents handle processes of affective/effective attachment and

detachment along the life-course of their children will shape the global and intimate

connections of their ‘assisted world family’ . . . But much also depends on the surrogate

laborers’ capacities to make their desires effectively to detach or affectively to stay

attached to the surrogate baby prevail against the unequal power relations that saturate

the global fertility industry. (Schurr

and Militz, 2018:

1640)

Inequalities

Despite ICS’ potential for cultivating global intimacy, scholars remain concerned with

how it engenders and even exacerbates certain inequalities – of race, class,

geography, and privileged access to the very technologies that make ICS possible.

Sayantani Dasgupta and Shamita Das Gupta have described the Indian surrogacy

industry as a post-colonial regime that ‘privileges Western white parenthood, and

specifically Western white maternity, over Indian motherhood’ (DasGupta

and Das

Dasgupta, 2014:

195). These inequalities are largely maintained by the detachment

and distancing techniques of intending parents, the ICS industry, and even surrogate

mothers themselves.

Deomampo (2016)

has argued that intending parents tend to position their surrogates

as racially Other, either as objects of rescue (facilitating a kind of patrimonial

attachment) or as conniving businesswomen (facilitating detachment). This also helps

them to naturalize and justify the inequities of ICS’ intimate yet commercial exchange.

Indeed,

Pande (2016)

argues that this construction upholds the

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notion of surrogacy as a labor market by highlighting a fundamental paradox – wherein a

market that literally produces humans and human relationships is critically dependent on

the maintenance of a global racial reproductive hierarchy that privileges certain

relationships while completing denying others. (p. 254)

Jacobson untangles a similar paradox in the US commercial surrogacy industry:

working- and middle-class women acting as commercial surrogates staunchly reject the

notion of money as a motivation to engage in commercial surrogacy. Instead, they seek

‘perfect journeys’ (i.e. fulfilling intimate connections) with their upper-class intending

parents that reinforce their motivation to help others to become parents. However,

being of a lower class and in a less powerful position in the relationship makes it

difficult for surrogate mothers to cultivate the kinds of intimate practices that make

surrogates’ desired relationships with intending parents possible. Though brokering

agencies may try to match expectations of intimacy between intending parents and

surrogate mothers, intending parents view the transaction as primarily contracted labor.

So while ideal practices of intimacy – ‘perfect journeys’ – effectively function to obscure

the commercial and labor aspects of the surrogacy process, the way the affective

economy is mediated by agencies still serves to guard against discordance in

expectations of intimacy between the two parties (Jacobson,

2016:

74–113).

Actors in ICS will also negotiate intimacies by alternately minimizing and foregrounding

the commercial exchange while subverting the inequalities. Anandita Majumdar notes

how agencies and clinics in India frame the practice in terms of patronage (by intended

parents) and gift-giving (by surrogates), wherein ‘IPs come across as generous and as

providing help to poor Indian women for whom a surrogacy contract is like a “god-

send”’ (Majumdar,

2018:

211), while surrogate mothers framed their participation as

altruistic (despite being paid) because they were providing a ‘gift’ that was ‘helping

other women’ to have families (Pande,

2014).

This patronage/gift-giving framing may

be adopted to circumvent negative, stigmatizing discourses about commodification and

exploitation in commercial surrogacy, because, as Majumdar argues, it ‘helps maintain

idealized notions of ‘what should be’’ (Majumdar,

2018:

211). But it rarely subverts the

power relations inherent in the practice: ‘. . . the surrogate is required to view herself as

both a worker-producer and a mother-reproducer. [Yet] the disciplinary project devised

by the commercial surrogacy regime exploits this production-reproduction duality’

(Pande,

2014:

64).

Reproductive justice

Such discordance in ICS’ relationships – and the ways in which it commodifies

women’s and children’s bodies (Cheney,

2018b)

– makes it difficult to argue that ICS as

currently practiced is compatible with notions of reproductive justice. More often,

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commercial surrogacy is identified as stratified reproduction (Colen,

1995),

in which

inequalities in reproductive labor are compounded by the nature of the commercial

exchange.

Laura Harrison (2016)

echoes Dasgupta and Das Gupta by detailing how ARTs like ICS

often deploy brown women’s bodies in the service of socially reproducing the white,

heteronormative, middle class; moreover, when all actors in surrogacy arrangements

concede to ‘the fiction that race is reproduced genetically’ (Harrison,

2016:

7), they not

only contribute to dominant narratives that belittle black and brown women’s

reproductive labor; they undermine decades of social science that asserts that race is a

social rather than biological fact. This has racial and class implications for the

achievement of reproductive justice. Take, for example, Pande’s work, which highlights

the irony of the Indian state policy: for decades, it forcibly controlled the fertility of poor

women, but when it realized how lucrative the ICS industry could be, India suddenly

started promoting poor Indian women’s fertility in the context of a burgeoning

international medical and reproductive tourism industry (Pande,

2014).

Even India’s

ICA ban did not alleviate inequalities, as upper-class and expatriate Indian IPs may still

utilize lower-caste surrogates – and in any case, many claim ICS still occurs

clandestinely.

As a result of such potential exploitative practices, a number of radical feminists

opposed to ICS have argued that while everyone has the right to family, ultimately

‘children are not an entitlement through which we can justify exploiting other human

beings’ (Ekman

et al., 2017:

308). Yet an abolitionist stance on commercial surrogacy

is unlikely to be effective unless universal, and it may foreclose opportunities of having

children that have only just opened up to, say, queer families (Smietana

et al., 2018).

The affective economy of reproductive technologies may seem problematic, but many

intimate relationships are often entwined with economics (Dow,

2016).

Some argue that we must look beyond the commodification of biology and genetics

and return to the emotional bases of intimate relationships (cf.

Stuvøy, 2018);

this may

provide clues for how to minimize inequalities while increasing global intimacies and

recognition of non-biological relatedness. For some, this means re-examining

reproductive desire entirely. For example, Adele Clark and Donna Haraway call for

‘kinnovation’, a radical reimagining of intimate relationships ‘generating feminist

science studies-informed pro-kin and non-natalist politics of reproductive justice’ (Clark

and Haraway, 2018:

1). Kinnovation involves a cultivation of relatedness that

emphasizes practices of intimacy over procreation (Haraway,

(2015:

161) also refers to

this as ‘making kin not babies’). Such kinning practices with other people (and other

species) may help move toward more humane and less exploitative or commodified

relationships.

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Queer kinship gives us other alternative models that allow for the expansion of notions

of family beyond the patriarchal, heteronormative, Western, and colonial (TallBear,

2018).

For these scholars, reproductive justice means exploring family making without

foreclosing the possibility of LGBTQ+ people having genetically related children

enabling exploitative practices in the name of non-heteronormative family formation

(Smietana

et al., 2018).

Possibilities include open surrogacy, multi-parent child custody,

and further detangling the biological, legal, and affective ‘grammars’ of kinship

(Gunnarsson

Payne, 2018).

So far, though, emergent laws on surrogacy have

emphasized genetic relatedness (Cheney,

2018b).

While this emphasis is crucial to

preventing baby farming and child trafficking,

it also privileges nuclear, patriarchal

family formations over non-normative ones – while the market entices non-normative

families into commercial relations as well. Moreover, such reconceptualizations will not

necessarily ameliorate power imbalances or discordant expectations of intimacy.

I remain skeptical that any kind of intimacy or ethics of care overcome the inequalities

of market-mediated reproductive transactions. But if we can expand our notions of

relatedness as we keep the issue of reproductive justice at the forefront of the

discussion, we can better recognize the broader contexts, histories, and relations of

power into which we enter when we make certain decisions to expand our families. And

if we can hold the industry to standards that uphold reproductive justice, hopefully this

will lead to ever more ethical, inclusive, and nonexploitative reproductive practices.

Funding

The author received no financial support for the research, authorship, and/or

publication of this article.

Notes

Genetic parentage differs from biological parentage in that in a surrogacy

arrangement, a child may have a

genetic

relationship to one or more intending parent

(and many laws concerning surrogacy require a genetic link) and a

biological

relationship with their surrogate mother, in that she gestates them in her womb.

This is particularly true following several countries’ passage of marriage equality

laws.

Israel revised their domestic surrogacy law in 2018, expanding it to allow single

women to utilize domestic surrogacy. Though gay men are still prohibited, the Israeli

government continues to assist gay men and couples who go abroad for international

commercial surrogacy (ICS) by helping them attain Israeli citizenship for the resulting

children.

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In India, the conservative government restricted the use of surrogacy to

heterosexual couples in 2014, and further to domestic and altruistic surrogacy in 2016

(Majumdar,

2018:

210).

Confirmed by delegates to the Africa regional consultation on surrogacy hosted by

International Social Services at the University of the Western Cape, Cape Town, South

Africa, 19 August 2019. See also, for example,

https://www.vinsfertility.com/surrogacy-

in-kenya/.

Gay fathers are far more likely to disclose a child’s surrogacy origins to them at an

early age because of the conspicuous absence of a mother and the need for the child

to explain their unconventional family to friends and schoolmates.

Adolescence is a typically a difficult period of identity exploration, but it can be

particularly so for adoptees and donor-conceived people – and by extension, surro-

children. Many grapple especially with the exchange of money around their

birth/adoptions. This aspect might be even more difficult for surro-children, given that at

least a portion of the money paid by intending parents does go to the surrogate mother.

Moreover, the UN Special Rapporteur on the Sale and Sexual Exploitation of Children,

Maud de Boer-Buquicchio, stated in her 2018 special report on surrogacy that in some

instances, commercial surrogacy could constitute ‘the sale of children’ (United

Nations

Human Rights Council Special Rapporteur on the Sale and Sexual Exploitation of

Children, 2018).

Though it is acknowledged that more research about surrogate-born people’s

perspectives is needed, many of them – particularly those born through ICS – have not

yet come of age, and so it can be difficult to gain access to them as children: Perhaps

the circumstances of their births have not yet been disclosed to them, and/or adult

gatekeepers fear that the outcomes of such studies could reveal uncomfortable truths

or moral questioning of their choices and actions. It can be similarly difficult to access

the bio-children of surrogates in countries where stigma around surrogacy practices

persists. Some children may have been too young to remember or may not otherwise

have known that their mothers have acted as surrogates. Some governments, such as

in India, Cambodia, and Thailand, have moved to more tightly control or even ban ICS

due to alleged corruption and exploitation, including trafficking of women and children –

a fact to which they do not want to draw attention. In other countries where the industry

is openly active, it may still tightly control access to women acting as surrogates –

either currently or in the past – so they may be reluctant to be interviewed, or to allow

researchers access to their own families.

Discussed at the panel ‘Children’s Rights in the Age of Biotechnology’, at the

conference ‘Celebrating 30 Years of the Convention on the Rights of the Child’, Palais

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des Nations (United Nations), Geneva, Switzerland, 19 November 2019.

10.

Surrogate mothers’ identities are often completely erased from the documentation

of a child’s birth. Either the birth certificate is

never

issued with the surrogate mother’s

name on it, or it is replaced by one with the intending parents’ names once the child is

transferred into their custody. Until recently, gamete providers’ identities were largely

anonymous, but donor-conceived people have pushed to require gamete donation to

be non-anonymous because of genetic implications like inherited disease and public

health concerns such as preventing people conceived from the same donor sperm

(effectively half-siblings) ending up dating, married, or procreating together.

11.

Cf.

https://www.huffpost.com/entry/why-indias-new-surrogacy-bill-is-bad-for-

women_b_57c075f9e4b0b01630de83ad

12.

Without the requirement of a genetic link to at least one commissioning parent,

there could be an explosion in the gamete market to make ‘designer babies’ and/or in

baby farming, which is already taking place (cf.

https://www.aljazeera.com/programmes/africainvestigates/2015/12/nigeria-baby-

farmers-151202123224095.html).

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Author biography

Kristen E. Cheney

is Associate Professor of Children and Youth Studies at the

International Institute of Social Studies in The Hague, The Netherlands. Her current

research focusee on orphanhood, adoption, surrogacy, and adolescent sexual and

reproductive health. Cheney was the organizer of the 2014 International Forum on

Intercountry Adoption and Global Surrogacy and currently serves on the international

surrogacy expert group drafting guidelines for international surrogacy arrangements.

You can read more about her work at iss.academia.edu/KristenCheney.

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