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The Cryopolitics
of Reproduction
on Ice
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Kroløkke,
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PQtersen, Janne Rqthmar Herrmånn,
Anna
Sofie Bach, Stine Willum Adrian,
Rune
Klingenberg
and Michael Nebeling Petersen
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The Cryopolitics of Reproduction
on Ice
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EMERALD STUDIES IN REPRODUCTION,
CULTURE AND SOCIETY
Series Editors: Petra Nordqvist, Manchester University, UK and
Nicky Hudson, De Montfort University, UK
This book series brings together scholars from across the social sciences and
humanities who are working in the broad field of human reproduction. Repro-
duction is a growing field of interest in the UK and internationally, and this series
publishes work from across the lifecycle of reproduction addressing issues such as
conception, contraception, abortion, pregnancy, birth, infertility, pre- and post-
natal care, pre-natal screen and testing, IVF, prenatal genetic diagnosis, mito-
chondrial donation, surrogacy, adoption, reproductive donation, family-making
and more. Books in this series will focus on the social, cultural, material, legal,
historical and political aspects of human reproduction, encouraging work from
early career researchers as well as established scholars. The series includes mono-
graphs, edited collections and shortform books (between 20-50,000 words). Con-
tributors use the latest conceptual, methodological andtheoretical developments
to enhance and develop current thinking about human reproduction and its sig-
nificance for understanding wider social practices and processes.
Further titles
in this series
Pam Lowe, Sarah-Jane Page,
Anti-Abortion Acth sm in the UK. Understanding
Religion, Gender and Reproductim Rights in the Public Sphere
Christina Weis,
Coinunercial Surrogacy and Migration in Russia
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Editorial Board
Asia Pacific
Professor Mark Andrejevic, Monash University, Australia
Professor Rod Broadhurst, Australian National University, Australia
Dr Akane Kanai, Monash University, Australia
Dr Monique Mann, Queensland University of Technology, Australia
Dr Brady Robards, Monash University, Australia
Dr Campbell Wilson, Monash University, Australia
Europe
Professor Ross Coomber, University of Liverpool, UK
Dr Rutger Leukfeldt, Netherlands Institute for the Study of Crime and Law
Enforcement, Netherlands
Dr Adrian Scott, Goldsmiths, University of London, UK
Professor
Majid
Yar, Lancaster University, UK
North America
Associate Professor Michael Adoijan, University of Calgary, Canada
Professor Walter DeKeseredy, West Virginia University, USA
Professor Benoit Dupont, University of Montreal, Canada
Associate Professor David Maimon, Georgia State University, USA
Assistant Professor James Popham, Wilfrid Laurier University, Canada
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The Cryopolitics of
Reproduction on Ice:A New
Scandinavian Ice Age
CHARLOTTE
KROLØKKE
University of Southern Denmark, Denmark
THOMAS
SØBIRK PETERSEN
University of Roskilde, Denmark
JANNE
ROTHMAR HERRMANN
University of Copenhagen, Denmark
ANNA SOFIE BACH
University of Southern Denmark, Denmark
STINE WILLUM
ADRIAN
Aalborg University, Denmark
RUNE
KLINGENBERG
Roskilde University, Denmark
MICHAEL, NEBELING
PETERSEN
University of Southern Denmark, Denmark
-;
I
PUBLISHING
United Kingdom — North America — Japan — India — Malaysia — China
emerald
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Emerald Publishing Limited
Howard House, Wagon Lane, Bingley BD 16 1 WA, UK
First edition 2020
Copyright C authors, 2020. Published under an exclusive license.
Reprints and permissions service
Contact: [email protected]
No part of this book may be reproduced, stored in a retrieval system, transmitted in
any form or by any means electronic, mechanical, photocopying, recording or
otherwise without either the prior written permission of the publisher or a licence
permitting restricted copying issued in the UK by The Copyright Licensing Agency
and in the USA by The Copyright Clearance Center. Any opinions expressed in the
chapters are those of the authors. Whilst Emerald makes every effort to ensure the
quality and accuracy of its content, Emerald makes no representation implied or
otherwise, as to the chapters' suitability and application and disclaims any warranties,
express or implied, to their use.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
ISBN: 978-1-83867-043-6 (Print)
ISBN: 978-1-83867-042-9 (Online)
ISBN: 978-1-83867-044-3 (Epub)
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Contents
List of Tables
About the Authors
Acknowledgments
Introduction
.Ni
xiii
1
3
3
7
13
15
19
19
21
26
27
28
30
31
34
35
36
37
39
40
43
44
45
1.
2.
3.
4.
Scandinavian Legal Cryo Landscapes.,
The Scandinavian Welfare States
Freeze and Re-Animate. A Cryopolitical Framework
Reproductive Imaginaries and Methodological
Entanglements
5. Chapter Overview
Chapter 1 The Market in Ice
1. Introduction
2. The Legal Framework
2.1. The Development
of
Private Cryopreserved Sperm
Banking in Scandinavia Up To 1997
2.2. Challenging Heteronormativity Through the Market
2.3. Fron?.
`Business
-to-Business" to `Business-to-Constnner":
Danish Cryo-sperm Goes Global
2.4. The Story of Why the Cold North Kept the Eggs at Home
Theorizing .the Market in Ice
4. Imaginaries of Travelling Sperm
4.1. Nature and Safety
4.2. Kinship and the Best Interests of the Child
4.3. Commercialization
5. Imaginaries of Domesticated Eggs
5.1. Nature and Safety
5.2. Kinship and the Best Interests of the Child
5.3. Commercialization
6. Summary
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Viii
Contents
47
Chapter 2 Disease: On the Use of Freezing on Medical Indication
1.
2.
3.
4.
Introduction
The Legal Framework
Theorizing Disease
Imaginaries of Medical Freezing
4.1. Imaginaries of Progress and Possibility
4.2. Medical Freezing and the New Regime of
Risk Prediction and Management
4.3. Cryo-insurance and the Imaginary of Reproductive
Futurity
4.4. hnaginaries of "Normal" Womanhood and "Potent"
Masculinity
5. Summary
47
49
52
55
55
57
62
66
70
73
73
76
78
81
81
83
85
88
88
90
93
95
Chapter
3
Delay: On the
Use of Freezing for
Non
-
Medical Reasons
1.
2.
3.
4.
Introduction
The Legal Framework
Theorizing Delay
Imaginaries on Freezing for Non-Medical Reasons
4.1. hnaginaries of Reproductive Autonomy
4.1.1. Egg Freezing as a
Tool
to Strengthen
Women's Individual Autonomy
4.1.2. Delay as Socio-Cultural Coercion and
Market Exploitation
4.2 Imaginaries of Rightly Timed Kinship
4.2.1. Kinship Temporalities and the Best Interests
of the Child
4.2.2. Kinship Temporalities and the Best Interests
of (Older) Women
5. Summary
Chapter 4 Death
and Destruction
1.
2.
3.
4.
Introduction
The Legal Framework
Theorizing Death and Destruction
Imaginaries of Death and Destruction
4.1. Dr Frankenstein's Monstrous Technologies
4.2. When Death No Longer Does Us Part. Imaginaries of
Families Forever
95
96
98
101
102
104
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Contents ix
4.2.1. From the Deposit with Love
4.2.2. Latent Siblings, Liminal Life
5. Summary
Chapter 5 Disturb
104
107
111
113
113
114
117
121
122
124=
127
128
135
138
1. Introduction
2. The Legal Framework
3. Theorizing Disturbance
4. Imaginaries of Disturbance
4.1. Disturbances of Reproductive Tifne — Old Mothers
4.2 Disturbing the Generational Kinship Order
4.3. Disturbing Gendered Reproductive Categories
4.3.1. From Sickness to Reproductive Citizenship
in the Welfare State?
4.3.2. Where Is the Mother? Troubling
Reproductive Categorization
5. Summary
Conclusion
139
142
146
149
155
175
1. Scandinavian Repro-Cryopolitics
2. Final Thoughts on Methodology
Appendix: Empirical Work
Bibliography
Index
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List of Tables
Table 1. Scandinavian Legal Cryo Landscapes
I
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About the Authors
of Culture at the University of Southern Denmark. She holds a PhD degree
in
Sociology from the University of Copenhagen and has published her work in soci-
ology and gender studies journals. Her current study on ovarian tissue cryopreser-
vation cuts cross gender studies, feminist Science and Technology Studies (STS),
and medical sociology.
Charlotte
Kroløkke
is a Professor with special responsibilities in Cultural Analy-
ses of Reproduction in the Department for the Study of Culture at the University
of Southern Denmark. Her work has been published indifferent journals within
cultural studies, feminist and gender studies while her latest book
Global Fluids.
The Cultural Politics of Reproductive Waste and Value
was published in the Fertil-
ity, Reproduction and Sexuality special series in Berghahn Books in 2018.
Janne
Rothmar Herrmann
is a Professor with special responsibilities in Health
Anna
Sofie
Bach is a Postdoctoral Researcher at the Department for the Study
Law and Technology at the Faculty of Law at the University of Copenhagen. She
is a Governor of the World Association for Medical Law, serves as a member on
the Danish Dataethics Council by appointment by the Minister for Justice and
has previously served on the Nordic Committee on Bioethics by appointment by
the Nordic Council of Ministers. '
Michael Nebeling
Petersen,
PhD, is an Associate Professor in the Department
for the Study of Culture, University of Southern Denmark. Has worked exten-
sively
with gay culture and citizenship, new technologies of reproduction and kin-
ship, and digital media and mediated cultures of intimacy. His research centers
questions on culture, power, and identity, and he is interested in the intersections
between gender, sexuality, kinship, race, and nation.
Rune
Klingenberg
is a Postdoctoral Researcher at the Department of Commu-
nication and Arts at Roskilde University. He holds a PhD in Philosophy and
Science Studies from Roskilde University and has worked on various issues
in practical ethics, including ethical vegetarianism, punishment ethics, and
neuroethics.
Stine
Willum
Adrian is an Associate Professor in Techno-Anthropology at Aal-
borg University. She holds a PhD in Feminist STS and Cultural Analysis from
Linkoping University. Adrian's work has always been interdisciplinary focusing
on reproductive technology, gender, intersectionality, feminist materialisms, ethics
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xii
About the Authors
of technologies, and ethnographic methods. Adrian has previously done compre-
hensive ethnographic studies on fertility clinics and sperm banks in Denmark and
Sweden, and she is currently engaged in researching masculinity, reproduction,
and kinship when men freeze and deposit sperm. She has published articles in
journals like
BioSocieties, European Journal of Womens Studies and Distinktion:
Journal of Social Theory.
Thomas Søbirk Petersen (TSP) is Professor with special responsibilities in Ethics
at Roskilde University, Department of Communication and Arts. TSP primar-
ily focuses on Criminal Justice Ethics. TSP has published a number of books
and articles in international journals dealing with topics like adoption, assisted
reproduction, doping, organ donation, neuroethics, criminalization theory, and
theories about the quality of life. TSP is a former member of the Danish Council
on Ethics and the Danish Centre for Animal Welfare and received the Danish
Ministry of Research and Information Technology's Research Communication
Prize in 2013.
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Acknowledgments
The research that has gone into this book was supported by the Independent
Research Fund Denmark's collective grant: "Ice Age. Entangled Lives, Times,
and Ethics in Fertility Preservation" (grant #7013-00042B). As we identified
sociotechnical imaginaries as a fruitful platform for interdisciplinary analyses,
Professor Sheila Jasanoff and her Fellows at Harvard Kennedy School's Pro-
gram on Science, Technology, and Society hosted a valuable research seminar
which enabled us to discuss early thoughts. We also owe a special thank you to
the Danish-Norwegian Cooperation Fund who awarded us a week long writing
retreat at Lysebu, to Schæffergaarden for hosting our second writing retreat as
well as the Law School at the University of Copenhagen for providing us with
inspiring spaces to write as well as the empirical. venues that so generously ena-
bled our access to patients as well as 'ethnographic studies: Thank you to the
Lab of Reproductive Biology in Copenhagen, Cryos International, the 30 sperm
deponents that generously shared their stories of having deposits, the 508 Danish
students that participated in a survey study, the
11
anonymous women who gener-
ously shared their reflections
and
feelings about the cryopreservation of embryos,
and the 41 women who willingly 'accounted for their experiences with ovarian
tissue freezing and transplantation. Thank you to the Library of the Danish
Parliament for granting its access to their archives.
A special thank
you
to our generous colleagues some of whom volunteered to
read and comment on earlier 'drafts of this book: Kathrine Carroll, Karin Ham-
marberg, Marcia Inborn, Sheila Jasanofl', Venetia Kantsa, Ori Katz, Thomas
Lemke, Liå Lombardo, Guido Pennings, Joanna Radin, Aviad Raz, Julie Smith,
Ole Sohn, Zvi Tiiger, and Catherine Waldby. Valuable insights were gained from
our many collaborations with practitioners from the reproductive field and politi-
cians with special''yinterests in the arena. Thank you to: Claus Yding Andersen,
`May-Britt Kattrup, Stine Gry Kristensen, Peter Reeslev, Maria Salomon, Ole
Schou, and Soren-Ziebe. Thank you also to Yael Hashiloni-Dolev, Caroline Wraa
Rasmussen, and Amit Kaplan who helped facilitate a survey study of Danish
students' attitudes on the cryopreservation of reproductive cells. We were incred-
ibly fortunate to have Caroline Wraa Rasmussen provide us with expert research
assistance throughout the writing of this book. We greatly appreciate the work
of the two special series editors of the Emerald Studies in Reproduction, Culture,
and Society: Nicky Hudson and Petra Nordqvist, the constructive comments
made by an anonymous reviewer as well as the Emerald Publishing team led by
Jen McCall.
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xin Acknowledgments
We need to extend a special thank you to our families and friends whose sup-
port and understanding have made the writing process easier as well as our uni-
versity colleagues, administrators, and friends located at Roskilde University,
the University of Copenhagen, University of Southern Denmark and Aalborg
University.
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Introduction
This book is about the Scandinavian ice age of reproduction. The ability to freeze
reproductive cells, tissue, and embryos is fundamentally changing our under-
standing of what it means to be a reproductive citizen and of the ways
in
which
reproductive matter gains mobility and value. This book is concerned with cryo-
technologies and what we refer to as the development of a cryogenic reproduc-
tive culture, as they come into play in the Scandinavian welfare states. Centering
Scandinavia is especially interesting, we argue, because reproductive technologies
and welfare state ideologies have historically come together to ensure particular
citizens free access to reproductive technologies, all countries are pronatalist and
the welfare state support of free health care combined with emerging markets of
private fertility care are unique. Of the Scandinavian countries Denmark stands
out. Although the country has sought to limit the monetary market in oocytes,
Denmark has for years been one of, if not the country in the world, with most
children born after the use of assisted reproductive technologies including IVF
and sperm donation (De Guyter et al., 2018). Denmark has moreover become the
fertility hub of Scandinavia as private sperm banking and private fertility clinics
has emerged and developed with comparatively cheap prices, and a strong medical
industry on the side.
Because understanding the cryopolitics of reproduction demands a collabora-
tive approach, in this book, we cut across the arenas of bioethics/law, practices/
experiences, and culture/commerce. We engage in interdisciplinary scholarship in
an attempt to answer questions such as: How does cryo, in the welfare state, help
mobilize particular understandings of reproductive time, reproductive rights,
and reproductive well-being? What values are embedded within Scandinavian
laws that seek to regulate cryotechnologies? What are the moral arguments for or
against certain freezing technologies and the many possible ways in which they
can be used to create new offspring? What is the moral and legal status of frozen
tissue that once was living elsewhere but is now in cryotanks? How is cryo enacted
in clinical settings and how do the women and men who freeze experience the
preservation of reproductive parts? What cultural configurations and imaginaries
of cryo appear in popular culture and how are frozen cells and tissue, in inter-
views with freezers, transformed into frozen assets? In this book, we seek to make
a significant academic contribution to interdisciplinary scholarship, engaging a
The Cryopolitics of Reproduction on Ice: A New Scandinavian Ice Age
Emerald Studies in Reproduction, Culture and Society, 1-18
Copyright
© Authors, 2020
doi:10.1108/978-1-83867-042-
920191002
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2
The Cryopolitics of Reproduction on Ice
wide range of empirical data as well as enabling scholarly public policies, ethical
debates, and law on preservation.
In responding to these questions, we build upon the existing research within
reproductive medicine, law, ethics, sociology, and cultural studies in order to
develop an interdisciplinary lens with a view to conducting integrated analyses
of empirical materials that normally pertain to discreet scientific fields of repro-
ductive studies. For example, while some bioethicists have pointed to concerns
related to reproductive autonomy and the potential harm to the resulting child
(Harwood, 2009), others have argued that the possibility of cryopreservation
can increase reproductive autonomy and equality between the sexes (Goold &
Savulescu, 2009). Sociology scholars have shown that preservation, in the case
of women's eggs, enables women to reconcile their reproductive desire with
their careers, relationships and health (Waldby, 2014, 2019) and, in the case of
reproduction after death, blurs boundaries between life and death
(Kroløkke
&
Adrian, 2013), potentially affecting inheritance and bringing family law into play
(Simpson, 2001). As echoed in Waldby's (2019) latest book, the cryopreservation
of women's oocytes ensures that reproductive material does not "go to waste"
(p. 127) enabling women's reproductive cells instead to enter what Waldby (2019)
refers to as the "global oocyte market" (p. 73). Anthropology scholars have noted
how freezing technologies assist in making reproductive fluids transcend national
borders, yet they also remind us that these technological developments must be
situated in particular localized contexts (Melhuus, 2012). Meanwhile, and from
the perspective of cultural studies, the ability to postpone or synchronize bio-
logical matter draws upon normative understandings of ageing as an individu-
alized yet also, rhetorically at least, reversible and manageable process (Carroll
—
&
Kroløkke,
2017). Tn combination, these scholars suggest that the attraction
of freezing lies precisely in its promise to re-animate and re-entangle biological
matter, turning (old) aging bodies into enhanced (younger) bodies while also con-
stituting interesting entanglements between reproductive medicine, transplant
surgery, regenerative medicine, and business opportunities.
Whereas the existing scholarship has made crucial analytical and theoretical
incisions in the ways that cryopreservation changes our understanding of repro-
duction and the making of kin, in this book, we extend this work in several ways.
Going beyond the cryopreservation of reproductive cells, we theorize and empiri-
cally investigate the preservation of both reproductive cells (sperm and eggs) as
well as that of ovarian and testicular tissue. Moreover, we employ the notion
of sociotechnical imaginaries to engage in an interdisciplinary quest drawing
upon different cryo-relevant empirical material including ethical guidelines, legal
documents, interview and observational studies, a survey study as well as popu-
lar accounts and clinical marketing material (see the Appendix). Also, in situat-
ing our empirical material in light of the term "cryopolitics" (Radin & Kowal,
2017), we explicitly interrogate how ciyo-technologies come together with cul-
tural concerns related to the reproduction of new Scandinavian children/citizens
as well as contributing to academic discussions on the state of the Scandinavian
repro-cryopolitics. In this introduction, therefore, we first turn to a discussion
of cryopolitics as the general theoretical framework for the book, situating it in
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Introduction 3
the Scandinavian welfare state, and we outline some methodological reflections/
points of departure for interdisciplinary analyses in the subsequent chapters.
1. Scandinavian Legal Cryo Landscapes
Scandinavia is, in many ways, a homogenous region. During the period from 1397
to 1523, Denmark, Norway, and Sweden (including the territories of Finland,
Greenland, the Faroe Islands, the German state of Schleswig-Holstein, Orkney
Islands, Shetland Islands and Iceland) formed the Kalmar Union headed by a
single monarch. Not long after Sweden left the Union in 1523, Norway remained
under the Danish Crown until 1814 when Norway was ceded to the Swedish
crown due to its defeat in the Napoleonic Wars. A failed attempt at independence
subsequently forced Norway into a Union with Sweden before it gained inde-
pendence in 1905. Thus, a common history and culture has existed for centuries.
In the 1800s, the ideological movement "Scandinavia-ism" supported the idea of
a unified region based on a common language, culture,, and heritage. A modern
form of "Scandinavia-ism" reemerged decades later in a number of guises, for
example, through formalized legal collaboration in private law in the early 1900s,
the formalized political structure for inter-parliamentary collaboration (The Nor-
dic Council), the national appointment of Ministers responsible for Nordic col-
laboration, the establishment of the then Scandinavian state-owned Scandinavian
Airlines System and a common Nordic football league tournament.
The Scandinavian countries are all welfare states based on a socialist model,
as shown in more detail below. A number of conventions secure flee movement
within the Scandinavian territory; including the right to live, study, and work, the
right to social security and the right to speak your own language in other Scandi-
navian countries. Nevertheless, there are considerable differences in the regulation
of assisted reproductive technologies and cryopreservation.
As the table below demonstrates, both regulation and regulatory instruments
vary a great deal. As a result, different cryo-pathways have formed in Scandina-
via; one related to sperm and treatment of single and lesbian women centered in
Denmark and another pathway involving travel to Sweden for egg freezing.
2. The Scandinavian Welfare States
In choosing to specifically focus our research on the Scandinavian context, we
argue that the Scandinavian region is especially unique as regards the ice age of
reproduction. While we, throughout the book, highlight the ways in which the
welfare state both enables and constricts reproductive practices, it is worth giv-
ing a brief overview of what a Scandinavian focus contributes. Notably, politi-
cal dreams of a welfare state appeared in the Scandinavian countries during the
1920s and 1930s. During that time, Denmark and Sweden began to develop wel-
fare state societies. Although the same political ideas were found in Norway, it
was not until the mid-1960s and early 1970s that Norway truly became a welfare
state: Having been an active opponent of the German invasion, Norway faced
a long period of rebuilding in the wake of World War 2 (WW2), unlike neutral
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Table 1. Scandinavian Legal Cryo Landscapes.
4-11
Eggs Non
-
medical
Eggs Medical
Sperm
Embryos
The Cryopoliticsof Reproductionon Ice
Denmark
Cryopreservation
5 years
Requirements to destroy
Woman's death
Woman turns 46 years old
Cryopreservation
Until woman's 46th birthday
in case of serious disease
(woman or partner)
Requirements to destroy or
donate
Woman turns 46 years old
Serious illness in woman or
partner no longer-present
Woman's death
Age limit for use
Under 46 years
Cryopreservation
As long as it is in the interest
of the woman and medically
sound
Cryopreservation
Indefinitely
Cryopreservation
5 years
Requirements to destroy
Man's death unless
written consent to
posthumous use
Requirements to destroy or
donate
Separation
Divorce
Woman's death
Man's death (unless written
consent to posthumous use)
Age limit for use
Woman under 46 years
Cryopreservation
5 years
Norway
Age limit for use
Under 46 years
Cryopreservation
Not allowed (but amended
legal framework is expected
that would allow self-financed
cryopreservation with an
upper age limit for use)
Requirements to destroy
Requirements to destroy or
donate
Woman's death
Age limit for use
None
Cryopreservation
Allowed on medical
indication
Storage limit indefinite,
but use requires marriage
or stable relationship
Requirements to-destroy
Man's death
Requirements to destroy or
donate
Woman's death
Man's death
Man or woman no longer able
to consent
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Age limit for use
Age limit for use
Age limit for use
Age limit for use
Sweden
Cryopreservation
Indefinitely
Requirements to destroy
None, but sperm from
a dead donor cannot be
used for insemination
of women who did not
-know the donor
Age limit for use
Age limit for use
Age limit for use
None in legal framework (but None in legal framework (but None in legal
regional Councils have set in regional Councils have set in framework (but
place age limits for the public place age limits for the public regional Councils have
sector of 37-41 years)
set in place an age limit
sector of 37-11 years)
of 55 years for the
public sector)
None
General guidelines on
assisted reproduction state
that woman must be over
25 and under 39. Can be
derogated from based on
medical and psycho-social
assessment of the couple.
Reasonable age.:difference
between man and woman
Cryopreservation
Indefinitely, 5 years if the egg
has been subject to somatic
cell nuclear transfer.
Requirements to destroy
If an egg, which' has been
subject to somatic cell'
nuclear transfer, has been
used in experiments
None
None
Cryopreservation
Cryopreservation
Indefinitely
10 years, with a possibility to
prolong.
Requirements to destroy Requirements to destroy
If an embryo has been used in
experiments
Age limit for use
uotlo)lpo.11ul
t-n
None
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6
The Cryopolitics of Reproduction on Ice
Sweden and Denmark, which had been a "protectorate" with an official policy of
"reasonable collaboration," at least until 1943 (Elting, 1981).
In the Scandinavian welfare states, the (re)production of families is a major
focal point for different reasons. In Denmark, reproduction became vital as the
notion of a welfare state providing free education and healthcare took shape as
a political project in the 1920s, especially in terms of controlling the "quality" of
the individuals who would potentially pose a "burden" to society and the pub-
lic purse.
Lene
Koch has demonstrated how, in Scandinavia, eugenic practices .
were adopted by parliamentary majorities on the initiative of the Labour (Social
Democratic) parties and enjoyed widespread scientific endorsement (Koch,
2006). Koch's doctoral thesis evidences how eugenics as a political ideal became
an integral part of Danish healthcare and social welfare policies, but also how the
practical implementation of this ideal was complex and included both 'elements
of coercive legal measures and elements of liberalization of reproduction. The
welfare state project and its adoption of eugenic policies marked the first success-
ful liberalization of abortion and sterilization. Even though this liberalization,
which made some abortions legal (in Denmark and Sweden with the adoption of
the first Abortion Acts in 1938), was motivated by societal concerns, it neverthe-
less constituted the very first legal recognition of the individual's own control of
reproduction. Simultaneously, the falling birth rate was seen as a national crisis,
and in Denmark, a population commission was therefore tasked with considering
social programs relating to motherhood (Brondum, 2012).
The commission's recommendations lead to few changes in practice compared
to Sweden. In Sweden, the issue of population control was equally pivotal. Abor-
tion on eugenic grounds had been legalized in Sweden in 1938 and eugenic steri-
lization laws had been adopted in 1934 as well as in 1941. It was, however, the
wider issue of population control (combined with the Scandinavian-wide social
democratic ideology) that encompassed the political ideal of the welfare state.
In Sweden, a fear of population decline drove several pronatalist welfare initi-
atives in the area of reproduction, including the adoption of a marriage loan
reform intended to lengthen the fertile period of women within marriage by mak-
ing earlier marriages economically feasible. A maternity relief reform provided
economic assistance to childbearing women in need and programs of improved
housing for large families were intended to indirectly affect fertility by upgrad-
ing conditions for families that were to serve as examples of appropriate fam-
ily patterns
(Kalvemark,
1980). In this way, the programs were also intended as
social engineering projects and these intrusions into private life were justified by
an instrumental rationalism. To produce more than one child was seen as rational
behavior just like good dental hygiene and was thus actively promoted for this
reason (Freiburg, 1993).
In Norway, just after WW2, all parties had announced a common program
that would introduce a rights-based welfare state model focusing on equality as
opposed to social welfare dependency on handouts and alms. But unlike most
European countries, rationing continued well into the 1950s, demonstrating a
prolonged period during which the Norwegian economy and country as a whole
were rebuilt. Major welfare state legislation came with the introduction of social
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Introduction 7
security in laws of 1964, 1966, and 1971. Support for unmarried mothers followed
in 1981 and paid maternity leave followed between 1987 and 1993. Having been
established decades later, and not in the context of a perceived national crisis
related to falling population numbers, the underlying message of the Norwegian
welfare state is not about encouraging women to have more children, but rather
about creating the necessary societal framework to support women/couples in
having the number of children they choose to have
(Sørum,
2019).
However,
in
her new year's address to the Norwegian people in 2019, the Norwegian Prime
Minister called for Norwegian women to have more children in order to counter-
balance the increase in the number of pensioners, so that the weight of the welfare
state might be distributed across a greater number of shoulders. Thus, even in
2019, reproduction in the welfare state relates to collective and societal interests.
The Scandinavian welfare states are redistributive and provide a wide range
of benefits and services as citizens' entitlements with the aim of creating more
egalitarian societies (Leira, 2002, p. 32). This includes, but
is
not limited to, paid
parental leave, free health care, affordable childcare, and child support to single
parents or lower-income families: typically parents are entitled to up to one year
of parental leave to share between them, with the state providing an income based
on previous salary (often capped at the same level as unemployment benefits,
with some employers providing the remainder of the normal salary for some of
the months). Prenatal care, birth, and child/parent medical check-ups following
birth in the home are flee, as is fertility treatment subject to certain conditions.
Childcare is heavily subsidized, meaning that parents pay approximately $300
a month for childcare, and most families receive å cash financial subsidy from
the state with single parents receiving more. For example, in Denmark, a couple
would receive an annual cash subsidy of $2,760 for a child aged between 0 and
2 years, reducing to $1,700 for 17 year-olds, whereas single parents receive a fur-
ther $5,500 annually.
While the Scandinavian welfare states historically have created a framework in
which economic stratifications are cushioned, in the welfare state, women must
nevertheless dutifully manage their reproductive abilities in order to reproduce
not only the family but, in fact, the nation. Below, we present our cryopoliti-
cal framework and delineate our decision to analytically focus on Scandinavian
imaginaries on the ice age of reproduction. We then present our empirical data
and give a brief overview of the chapters in this book.
3. Freeze and Re-Animate. A Cryopolitical Framework
The ability to freeze is nothing new. Indeed, freezing parts of, or even whole bod-
ies, can be traced back to the emergence of cooling technologies and the use of
increasingly sophisticated techniques undertaken, following the Cold War period,
within the general field of cryobiology. Initially employed in the animal breeding
industry (Clarke, 2007), cryopreservation is today common practice and big busi-
ness involving freezers, shipping companies, laboratories, and biological banks,
all of which play a part in the transnational exchanges of biological material
(Parry, 2004). Importantly, the ability to freeze and bank parts of the body has
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8
The Cryopolitics of Reproduction on Ice
enabled body parts to be used for new purposes. Joanna Radin (2017) illustrates
this, when she traces how the freezing of blood mobilized biological material and
helped it gain relevance in new contexts:
It is the ability to hold still biological substances at various degrees
of low temperature that has enabled such materials to become
incredibly mutable and mobile, able to be manipulated, relocated,
and recombined to answer questions other than the ones for which
they were initially extracted from the body. (p. 3)
In this book, we align ourselves with this thinking and we position the ability
to freeze as a key biopolitical tool of the twenty-first century (Radin & Kowal,
2017). Consequently, we turn to cryopolitics as an overall theoretical frame for
understanding the cultural imperative of putting reproduction on ice.
The concept of cryopolitics emerges from debates on the geopolitical impor-
tance of the Arctic and climate change policies. Coined by Michael Bravo and
Gareth Rees (2006), cryopolitics was initially concerned with ecological poli-
cies and the melting ice in the Arctic. However, in his later work, Bravo (2017)
redefines cryopolitics to include "the productive agency of natural and artificial
`material frozen states"' (p. 33). He makes a point 'of stressing the interconnec-
tions between the cultural need for cold storage and the melting ice in the Arctic:
The more the economy grows, the more cooling is needed, and the more likely
global warming is to continue to be a problem. Charis Thompson (2017) makes
a similar observation, when she notes that we "live in a world chronically short
of ice in nature, not in culture" (p. 339). We agree with Radin and Kowal's (2017)
decision to view cryopolitics as an intervention in the politics of low temperatures
as well as an overall framework for understanding the cooling efforts undertaken
in the field of cryobiology. In contrast to Radin and Kowal's (2017) decision to
focus on the freezing of blood, DNA, interspecies, and animal conservation, how-
ever, in
The Cryopolitics of Reproduction
we apply the cryopolitical framework
to tease out the practices and the performance of cryo within the field of human
reproduction within the Scandinavian welfare states. This includes, for example,
how cryogenic reproduction unfolds in media accounts, in legal deliberations, in
public debates, in commercial settings, and in various clinical contexts. Conse-
quently, we are interested in the ways that cryopreservation animates different
possibilities and understandings of reproduction, kinship, morality, reproductive
citizenship, life, and death.
In
The'Ciyopolitics of Reproduction,
we view cryopolitics as an overall theo-
retical framework that addresses the ability to freeze whole or parts of bodies
such as reproductive cells and tissue. In many ways, cryopolitics bears a strong
resemblance to Michel Foucault's (1979) notion of biopolitics. By assembling
bio
and politics, Foucault analyzed the ways in which the body, the subject, and
populations became the object of intensified political attention in modern soci-
eties. Famously, Foucault argued how power changed from a sovereign power
characterized by the right to kill to a modern biopower characterized by the crea-
tion, maintenance, and control of life; thus, biopower refers to ways in which
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Introduction 9
individual citizens' lives, bodies, and reproduction are regulated to fit dominant
norms and how these regulations are internalized by citizens, whom biopower
takes as its subjects. Thomas Lemke (2014) aptly captures this dynamic, when
he positions liberalism as a key framework in biopolitics and as a particular way
of governing individuals. According to Lemke (2014), in liberalism, individuals
are governed through self-imposed estimations of risks and a "permanent fear
of failure" (p. 67). In particular, fear also has a "segregatory function," ,(P. 68)
dividing individuals according to particular risk assessments. This is seen in terms
of egg freezing, for instance, where blood tests and an ultrasound examination
on current egg count and fertility potential come together to estimate the so-
called "risks of infertility." Meanwhile, Alexander Friedrich (2017) maintains
that cryopolitics is not simply biopolitics in disguise. Rather, cryopolitics seeks to
intervene in how freezing not only transforms our understanding of life but also
becomes a way of cheating death — a biopolitics of freezing of sorts (Friedrich,
2017; Radin & Kowal, 2017).
Importantly, cryopolitics intensifies the biopolitical notion of to "make live and
let die" with the cryopolitical statement of "make live 'acid
not
let die" (Kowal &
Radin, 2015, p. 63). In this way, freezing becomes a biological as well as an affec-
tive time machine. It produces what is referred to as forms of
latent
life (Luyet
& Gehenio, 1940; Radin, 2013). Latency has, as Radin (2013) successfully shows,
several meanings. Not only does it refer to the technoscientific efforts needed to
keep biological material available for the future, it also turns frozen matter into
future informational and affective resources, enabling some reproductive citizens
to extend their reproductive years or perhaps avoid reproductive death altogether
(Radin, 2013). In the case of Radin's (2013) research object "The Human Genome
Diversity Project," for instance, frozen blood became a method used to strategically
ensure future access to long lost indigenous communities. She notes (Radin, 2013,
p. 488) that latency, became a way for the scientist to gain "new knowledge about
biological variation. In a similar vein and in an analysis of cryonics as a form of
science fiction, Grant Shoffstall (2010) points to the intersections of latency and
futurity when he states: "Like science fiction, cryonic suspension and the claims of
its advocates dwell primarily in the realm of
possibility:
the
what
if
or the
what could
be
of a given future" (p. 287). As a term, then, latency refers both to the ability of
biological matter to be frozen in time and space but importantly also, as it has been
employed in feminist scholarship, as "part of the apparatus of postcolonial medical
infrastructure" (Radin, 2013, p. 488).
Whereas latency refers to the ways that cryopreservation pauses the develop-
ment of (cryogenic) life, throughout this book, we use the concept of liminality
to help reveal the other aspects of moral dramas that cryopreservation produces.
Based on Victor Turner's understanding of liminality as an in-between state of
being, feminist science scholar Susan Squier (2004, p. 5) develops an understand-
ing of liminality that frames marginalized lives as both "symbolically privileged
and troublingly unstable." While Squier (2004, p. 9) empirically relies on select
case studies in the fields of science and literature, she argues that liminal lives
exist at the boundaries of life and death, becoming at times "marginal to human
life" yet simultaneously holding "a rich potentiality for our ongoing biomedical
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10
The Cryopolitics of Reproduction on Ice
negotiations." Whereas Radin (2013) uses latency to situate cryopreservation
in particular historical contexts, liminality, as evidenced in the work of Squier
(2004), assists in theorizing the in-betweenness produced within the context of
cryopreservation and as it unfolds in a variety of empirical accounts.
Thus, the notion of cryopolitics with its attention to latency and liminality
sets out to critically explore what can be seen as the transgressed boundaries of
life and death. Freezing produces both a new form of latent biological matter as
well as matter that exists in a "state of suspended animation" (Radin, 2013, p. 8).
Klaus Hoeyer (2017) similarly turns to suspense and suspension as especially pro-
ductive terminology when discussing cryopreservation. According to Hoeyer, sus-
pense has several meanings: Biological bits and parts — once frozen — are put on
hold, suspended from the bodies they came from, resulting in a suspension of life
and death. Cryo, however, heightens the drama and creates yet another form of
suspense: "The suspension of biological decay creates a space ,for åction in which
new social forms are built, new property managements emerge, and new hopes
and concerns can flourish" (p. 209). While Hoeyer (2017) focuses on the ( role of
biobanks,
throughout
The Cryopolitics of Reproduction,
we widen the notion of
suspense to additionally include the ways that cryopreservation creates drama in
ethical and legal debates as well as in popular accounts and in the narratives of
freezers. We agree with Hoeyer (2017) when he eloquently points to the intersections
between ice, law, monstrous imaginaries and drama and says:
In the hold of cold, hot dreams and chilly nightmares of the future
evolve. The depth of the drama reflects not only the legal trans-
gression between person and thing, but also the imaginary space
in which ideas about self and other can be transgressed. (p. 209)
While in
The Cryopolitics of, Reproduction
we advance an interdisciplinary
approach, we pay 'particular attention to work conducted within Science and
Technology Studies (STS). STS 'scholars have been successful in showing how
cooling technologies change our very understanding of what it means to be bio-
logical while also situating new technological developments as sites of practice
highlighting the ways that human and non-human actors come together (Friese,
2013; Landecker; 2005). For example, Carrie Friese (2013) discusses how nature
is being potentialized through cloning technologies central to the development
of endangered species. Similarly, fertility preservation — as egg freezing is com-
monly referred to in the United States — is, in the clinical practices and in the
cultural imaginaries, turned into future investments and self-donated seeds, (Car-
roll &
Kroløkke,
2017) upholding what feminist scholars have termed seed-based
thinking, re-naturalizing the genetic connection as essential in the making of kin
(Rothman, 1989). In this way, STS scholars situate freezing technologies in con-
crete material practices while simultaneously highlighting how freezing changes
our very understanding of what it means to be biological (Landecker, 2005). We
agree with Hannah Landecker (2005) who states that freezing has influenced our
understanding that to be biological today means to be "suspendable, interrupt-
ible, storable, freezable in parts" (p. 4).
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Introduction 11
Importantly, a focus on the cryopolitics of reproduction means recognizing
the ways in which cryopreservation radically challenges and re-calibrates tempo-
ralities. As noted by Zerubavel (1981), temporalities are embedded within tem-
poral techniques like calendars and watches, techniques that inculcate "hidden
rhythms" and form a temporal experience that appear natural and feel like "my
inner clock" (Freeman, 20 10) and work to orient people in specific ways (Adams,
Murphy, & Clarke, 2009). This means, that the way time feels and structure life,
not simply is, but rather could be understood as a sociotechnical imaginary which
is naturalized and structure bodies and lives according to technological and nor-
mative scripts. In this line of thought, reproductive temporalities are not under-
stood as natural, bodily, or given structures of life. Rather, they are understood
as effects of cultural hegemonies and capitalism (Zerubavel, 1981). In his book
In
a Qtteer Time and Place
(Halberstam, 2005) on queer and subcultural temporali-
ties, Halberstam turns to heteronormative temporalities, which he understands
in three levels: First, "the time of reproduction," which is "ruled by a biological
clock for women and by strict bourgeois rules of respectability and scheduling for
married couples." Second, "family time [which] refers to the normative schedul-
ing of daily life (early to bed, early to rise) that accompanies the practice of child
rearing." And finally,
the time of inheritance [which] refers l to an overview of genera-
tional time within which values, wealth, goods, and morality are
passed through family ties from one generation to the next. It
also connects the family to the historical past of the nation, and
glances ahead to connect the family to the future of both familial
and national stability. (Halberstam, 2005, p. 5)
In
The Cryopolitics of .Reproduction,
we argue that the cryopolitics of repro-
duction involving when, how and if to have children, are embedded within such
cultural temporalities, that are not biological, though they might appear or feel
biological. Rather, they are normative and performative. For example, whereas
the ability to freeze biological material allows the synchronization of parts of dif-
ferent generational and time development ages, it also creates new understandings
of frost as a dating technology allowing especially younger women to use their
frozen egg cells as a reproductive, romantic, and familial investment. Meanwhile,
in the case of ovarian tissue freezing, for example, frost allows women to put
their reproductive abilities on hold — synchronizing women's fertile time with
treatment protocols and in this manner, securing their reproductive futures at the
onset of disease. In the scientific imaginary, however, ovarian tissue may also re-
emerge as a cold remedy for women's hot flushes. This is especially the case, when
ovarian tissue transplants are imagined as remedies used to postpone menopause
(Kroløkke
and Bach, in review).
Here, cryopreservation enables biological parts to be apparently paused, while
other parts paradoxically continue living. In this case, cryopreservation synchro-
nizes reproduction, not only with reproductive intent but also with the realities of
increased life expectancy and reproductive aging. For example, in scientific texts,
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12
The 0yopolitics of Reproduction on Ice
menopause is particularly equated with increased health concerns and, within the
welfare state, increased healthcare funding costs. In sharp contrast, ovary trans-
plants are framed as a cost-efficient and even resource-wise way of managing
women's ovaries. Whereas the ovaries of a newborn girl contain an average of one
million eggs, in these scientific accounts, close to 99.9% of follicles undergo decay
or are, one might say, wasted during a woman's lifetime. While many of these fol-
licles may not be suitable for reproduction, in these medical texts, scientists specu-
late that they can be used for the purposes of oestrogen enhancement. As noted
by
Kroløkke
and Bach (in review), what may appear as a "radical" option, then, is
retold into an "efficient" management of women's ovaries. In these stories, freezing
is translated into a rescue mission ending degeneration and reducing healthcare
costs. As a result, ovarian tissue freezing becomes a "reproductive conservation
method."
Cryopreservation is a future-oriented strategy and frequently embedded within
temporal techniques. It is consequently not surprising that fertility clinics in North
America rely heavily on the visual imagery of the clock in which women are
reminded that their fertility is "running out," has already reached its "prime," or
it is metaphorically and perhaps also literally "five minutes to midnight." Within a
cryopolitical framework, the imagery of the clock is interesting in several ways. The
clock — rather than other technological innovations — has been considered by soci-
ologists as the key machine of the industrial age. Time periods became, as noted by
John Hassard (1990), the central planning feature. -And`the clock, and along with
it, the ability to synchronize production and engage in high levels of coordination
was deemed necessary in the desire to enhance productivity. Consequently, time, as
exemplified through the clock, has gained economic value. And it similarly plays
a role in putting reproduction on ice, as exemplified in commercials about social
egg freezing, where not only time but also. "optimal" time is at stake. Optimal time
in the sense that egg freezing, in .order not to be sub-optimal for the delivering of
offspring, has to be done during
the
woman's prime fertile years.
In
The Cryopolitics of Reproduction,
we problematize the ways in which the
decision to freeze is individualized as well as, at times, positioned within the wel-
fare state. A cryopolitical framework helps to reveal the normative expectations
that individuals must manage their present fertility to ensure future fertility and
the making of healthy new citizens. As noted by Rose (1999), responsibility is at
the heart of the distinction between good and bad citizens: "This responsibility
for the self to manage its present in the light of a knowledge of its own future can
be
termed `genetic prudence': a prudential norm that introduces new distinctions
between good and bad subjects of ethical choice and biological susceptibility"
(p. 134). Moreover, for a responsible reproductive citizen, cryopreservation ena-
bles a form of technological prosthesis, yet is also disciplined and managed by
the state. While cryopreservation enables for it to never be "too late to become
a mother using a cryopreserved embryo or to resurrect an individual, race, or
species" (Radio & Kowal, 2017, p. 12), the Danish welfare state, for example,
disciplines women's reproductive bodies in particular as evidenced, for instance,
in the age in which women are allowed to receive assisted reproduction (see also
Chapters 3 and 5).
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Introduction 13
In combination, cryopreserving biological matter defers and disentangles ele-
ments or parts from particular bodies and reproductive environments. Yet its
attraction lies precisely in its promise to re-animate and re-entangle biological
matter into future new or (old) enhanced bodies, landscapes, or emergent transna-
tional market exchanges. As a theoretical framework then, cryopolitics theorizes
and discusses what is at stake when biological matter is frozen in particular nor-
mative temporalities, legal, ethical, and cultural imaginaries. Clearly, the ability
to freeze and halt decay profoundly changes what reproductive matter is and in
what way it is significant. Through an affective economy involving desire and
hope, frozen matter is given new life. In short, cryopolitics, within the context of
reproduction, is a form of liminal politics (Radin & Kowal, 2017).
4. Reproductive Imaginaries and Methodological
Entanglements
In
The Cryopolitics
of
Reproduction,
we build upon — and seek to contribute to —
a set of interdisciplinary scholarly works from feminist cultural studies, medi-
cal sociology, STS, reproductive law, and applied ethics. Importantly, we use the
concepts of "imaginaries" and "entanglements" as analytical and methodologi-
cal frameworks that unite this interdisciplinary quest. The concept of cultural
imaginaries is a well-established analytical framework (Franklin, 2007; Franklin,
Lury, & Stacey, 2000). In
Dolly Mixtures,
for example, feminist anthropologist
Sarah Franklin (2007) shows how British sheep along with the genetic engineer-
ing of Dolly the Sheep are interwoven with cultural imaginaries of Britain as an
innovative and pioneering nation. Meanwhile,
Mette Svendsen
(2014) reveals how
prenatal human babies 'and piglets, in a Danish hospital and laboratory, follow
different trajectories and imaginaries of biographical and biological lives, respec-
tively In this imaginary, the research piglet becomes naturalized as mere biologi-
cal life turned into "raw material that sustains human life and health" (p. 191). To
focus on imaginaries, then, means highlighting the ways in which discursive and
material practices are connected to technological advancements (Franklin, 2007),
and focusing on what is considered good, desirable, or even natural (Jasanoff &
Kim, 2009) as well as what life becomes worthy of living
(Svendsen,
2014).
Throughout this book, we wish to pursue the notion of imaginaries as an ana-
lytical construct and turn to "sociotechnical imaginaries," as articulated by Sheila
Jasanoff and Sang-Hyun Kim (2009). Jasanoff and Kim (2009) situate imagi-
nation as both "instrumental and futuristic" (p. 123) projecting, at the national
level, "what is good, desirable, and worth attaining for a political community"
(p. 123). The concept of "sociotechnical imaginaries" reveals how technological
accomplishments are always embedded in particular practices as well as within a
"reservoir of norms and discourses, metaphors and cultural meanings" (Jasanoff
& Kim, 2009, p. 123). While Jasanoff and Kim (2009) pay particular attention to
the sociotechnical imaginaries related to the nuclear policies of the United States
and South Korea, they situate imaginaries as historically, technologically, nation-
ally, and socially constituted as well as institutionalized and practically enacted in
law and policies. Moreover, because imaginaries travel, they become integral, for
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14
The Cryopolitics of Reproduction on Ice
example, to technologies, law, national (and international) policies, popular cul-
ture, and advertising. As an analytical concept, therefore, sociotechnical imagi-
naries come together with technological progress, national policies, commercial
opportunities, and very normative constructions of how life should be lived (Jasa-
noff, 2015). In the case of
The Cryopolitics of Reproduction,
we will return to
the concept of sociotechnical imaginaries in the conclusion, but throughout the
chapters, we will highlight how discursive, affective and material practices, related
to the ability to put reproduction on ice, produce and draw upon very different
imaginaries.
In order to capture sociotechnical imaginaries throughout
The Cryopolitics of
Reproduction,
we turn to entanglement as a wide-angle analytical ånd methodolog-
ical lens (Mol, 2002; Waldby & Mitchell, 2006). While entanglement in quantum
theory is used to theorize how energy and matter predictably interact, in
The Cry-
opolitics of Reproduction,
entanglement highlights how the ice age 'of reproduction
is sociomaterial, and hence consists of a set of intertwining legal, ethical, cultural,
technological and bodily relations, and clinical practices. Consequently, when
we use entanglement, we use it to reveal the ways in which reproductive tissue,
gametes, and embryos emerge through clinical practices, such as how gametes are
preserved in IVF laboratories, and thus removed from a body and stored in freez-
ing tanks. This involves movements between bodies, that is already shaped by and
shaping of cultural imaginations, marketization processes while simultaneously
located in particular kin relations, moral,-and affective 'economies of hope, uncer-
tainty, potentiality and fear (Ahmed, 2004, 2010). For example, ovarian tissue is
deeply entangled with concrete female bodies, medical expertise, family networks,
and affects of hope, yet once preserved and discovered it becomes a means to post-
pone menopause and as a remedy for osteoporosis (Andersen & Kristensen, 2015).
Clearly, not only, does cryo re-structure and entangle with temporality, cryo has
productive transformativepotential: When matter is cryopreserved, it engages new
potentialities. For example, old age is rejuvenated by frozen ovarian tissue or ovar-
ian tissue turns into a potential remedy for menopause-related ailments. To capture
the entanglements that are at stake empirically in
The Clyopolitics of Reproduction,
we pursue a wide range of empirical material through an interdisciplinary lens that
entangles legal and ethical approaches with the perspectives of sociological and
cultural studies. While we wish to address cryopreservation within a wider Scandi-
navian context, in actuality, we rely heavily on Danish empirical material. The deci-
sion to empirically foreground Denmark is done for several reasons: Not only are
we all located in Denmark and our empirical access has primarily been to Danish
clinics, sperm deposits, and laboratories, Denmark also brands itself as a pioneer
of different cryo-technologies, especially with regards to the freezing of sperm and
ovarian tissue.
Our interdisciplinary methodology included combining a legal dogmatic
method with applied ethical reasoning and qualitative methods such as in-depth
interviewing and ethnographic observations. It also includes analyses of popular
culture accounts such as those found in YouTube videos, marketing material as
well as more quantitative methods such as one large survey of Danish students'
attitudes on freezing for medical and non-medical reasons (see the Appendix
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Introduction 15
for a more detailed description of the empirical studies). The interdisciplinary
approach offers rich analysis of the complexity of the ways in which cryopreser-
vation of gametes and gonadal tissues is institutionalized and regulated in the
Scandinavian welfare state. Together, the analyses highlight key elements of how
fertility preservation, as a sociotechnical imaginary, emerges in the form of tech-
nological possibilities that are developed, organized, and negotiated in relation
to specific normative understandings, moral principles, and economic structures.
The Scandinavian legal family tends to emphasize the intent of a given regula-
tion, which makes interpretation of wording, preparatory work and parliamen-
tary comments important in establishing what the law is. Whereas Denmark. and
Sweden are members of the European Union and Norway is associated as an
EEA (European Economic Area) member state, all Scandinavian countries are
members of the Council of Europe and all are parties to the European Conven-
tion on Human Rights. As such, the dynamic, value-based style of legal interpre-
tation has also gained ground. In order to uncover the values and normativities
behind the legislation and enshrined in it, we focus on the rhetorical strategies,
tropes, and their performative effects, in particular the ways in which they seek to
naturalize particular types of family formations.
While legal documents help to contextualize cryopreservation in a particular
historical and cultural milieu, interview data and ethnographic observations pro-
vide insights into the embodied experiences of the people who cryopreserve gam-
etes and tissue and illuminate the imaginaries and practices among biomedical
professionals and
biobank
administrators (such as doctors, biologists, lab techni-
cians, sperm banks, etc.). While the overall study relates to the three Scandinavian
countries, Chapters 2 and 4 in particular draw on new empirical data from Den-
mark produced by some of the authors on; respectively, sperm deposits, embryo
storage, and ovarian and testicular tissue cryopreservation. For more details on
these studies, see Chapters 2 and,4 and the Appendix.
5. Chapter Overview
Chapter
1: The Market in Ice
Cryopreservation has facilitated and accelerated the marketization of human
gametes. This is particularly the case in Denmark, where the ability to freeze has
provided new commercial and therapeutic opportunities that cross national bor-
ders. However, the freezing and marketization of reproductive cells co-produce
a number of ethical, legal and political questions. For example, what imaginar-
ies are at play when politicians or ethical councils debate cryo-technological and
market developments? Similarly, what imaginaries unfold when discussing the
national border crossing of cryopreserved reproductive material? For instance,
why does frozen Danish sperm get to travel the world, while Danish eggs get to
stay at home? More generally, how did a monetary market for frozen sperm, but
not eggs, develop in the Danish welfare state? In Chapter 1, we unfold a number
of difficult questions related to how cryopreservation, within ethical and legal
debates, entangle with the marketplace, including imaginaries of the best interests
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16
The Cr yopolitics of Reproduction on Ice
of children, reproductive autonomy, and what should (or should not) enter the
marketplace in order to understand the making and non-making of markets in
reproductive matter in a welfare state setting.
Chapter 2:
Disease: On the Use
of Freezing on Medical Indication
Risk management, temporality, and cryopreservation intertwine in cases of freez-
ing on medical indication. This involves the freezing of sperm and ovarian tis-
sue prior to chemotherapy, that would otherwise damage the ability to reproduce
with the patient's own cells. In the chapter, we follow the imaginaries that emerge.
Scientific accounts of ovarian tissue freezing provide important insights into the
core processes of how medical developments take place and how imaginaries of
scientific progress and possibilities play an important role in this process. For
example, when doctors in Denmark, Belgium and the US started preserving ova-
ries from sick women and girls in the late 1990s, they had no clinical proof that
autotransplantation
could actually lead to pregnancies in humans, so they relied
on the transferability of animal studies and semi-successful human experiments.
As ovarian tissue freezing, in the case of Denmark, is paid for by the welfare
state, cryopreservation moreover becomes a technology of hope entangling with
normative understandings of reproductive futurity as constituting part of the
good life. Today, the growing number of children born since 2004 testifies to
the method's success in humans. A firm belief in scientific progress influences the
imaginary of ovarian tissue preservation, for example, projecting how preserva-
tion is managed and who the potentiaf freezers are understood to be. In our study
of the entanglement of cryo and disease, in this chapter, we also discuss how
freezing is practiced within quite normative imaginaries, emphasizing the promise
of "own" genetic offspring.
Chapter 3:
Delay: On the Use
of Freezing for
Non-medical Reasons
Fertility cryopreservation promises to expand and restore women's and men's
reproductive lifespan. Not only do these technologies have an impact on the
autonomy, equality and well-being of the potential parents and possibly their
children, the freezing of reproductive cells entails a potential destabilization
of the normative temporalities surrounding reproduction. In this chapter, we
develop the sociotechnical imaginaries on cryotechnology as constituting the
possibility of delay. Clearly, cryopreservation enables
a delay
or reproductive
postponement. In the case of "non-medical freezing," the aim of cryopreserva-
tion is no longer used to combat the negative effects of a disease, but rather, to
enhance the chance of seemingly healthy people having healthy children. In this
manner, cryo entangles with the desire to optimize reproduction in the storing of
young(er) reproductive cells intended for later use. Some women, for example,
may have some of their oocytes cryopreserved when they are in their mid-twenties
(to increase their chances of having children later in life). Women, as well as men,
may want to delay their reproduction because they might want more time to find
a suitable partner, time to complete education, time to mature and have their
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brtroductio» 17
career as well as secure their financial situation before embarking on parenthood.
In this chapter, we discuss the ways that legality, ethical debates, policies, clinical
practices along with the hopes and dreams of a particular reproductive future
come together, in the Scandinavian welfare states, to produce competing under-
standings of cryopreservation as constituting a form of reproductive delay.
Chapter 4: Death and Destruction
In Chapter 4, we investigate how cryopreservation radically challenges established
notions of reproductive life and death. First, we look at how cryopreservation
increases the possibility of the posthumous use of men's reproductive cells, which
clearly challenges legal, moral, and cultural understandings of reproduction. Sec-
ond, we discuss how the cryopreservation of embryos (and gametes) similarly
challenges conventional understandings of reproduction, when cryopreserved
embryos, for example, because of legal time limits for storage, are destroyed.
We understand the calibration of life and death as established within different
imaginaries: The cryo-technologies seem to, on the one hand, activate a dysto-
pian fearful imaginary about science and man taking the powers of the Gods to
make the decisions to (unethically) create/destroy life. And, on the other hand, the
technophobic dystopias are encountered by users themselves, who domesticate
and "un-monsterfy" the technologies by embedding them in a heteronormative
symbolic order of kinship, family and love. Thus, we argue that cryopreservation
holds radical destructive queer potentialities of death and destruction, yet also,
show how these potentialities, in the Scandinavian context, invariably become
domesticated and controlled by aligning cryo-technologies with imaginaries of
the traditional family.
Chapter S:
Disturb
Not only is reproductive temporality potentially restructured, cryo, as we have
shown in the previous chapters, also has transformative as well as normative
potential. In this chapter, we compare and juxtapose the different affective and
discursive threads that relate to phenomena that culturally trouble (or disturb)
normative understandings of who should reproduce and how reproduction
should take place. For example, although an adult could technically have a frozen
embryo of her dead parents implanted, and give birth to a girl that biologically
would be her daughter, yet genetically her sister, ethical and legal debates along
with clinical procedures seek to ensure that a particular reproductive temporal-
ity is still in order. Similar to the desire for a normative kinship order, monstrous
imaginaries of the elderly mother disturbs yet also animates new understand-
ings of (late) motherhood. Addressing the controversies associated with fertil-
ity preservation in relation to gender affirmation treatment, we also look, in this
chapter, at the ways in which transfertility troubles normative understandings
of who should reproduce. Disturbing the gendered categories of reproduction,
we demonstrate how, at least in the Scandinavian context, the liminal potential-
ity of Pozen fertility has called for the reorganization of specific reproductive
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18
The Cryopolitics of Reproduction on Ice
categorializations and laws in relation to fertility preservation and assisted repro-
duction more generally.
Conclusion
In the conclusion, we (re)turn to the cryopolitics of reproduction including our
method of comparative problematization (Jasanoff & Metzler, 2018) in order to
discuss the ways that the ice age of reproduction entangles with different ima'gi-
naries across the Scandinavian countries. We begin the conclusion, however, by
considering Scandinavian exceptionalism from a feminist perspective, consider-
ing
not
what makes the Scandinavian countries unique and different (for example,
the development of a welfare state), but importantly,
hoiv
narratives of Scandi-
navian exceptionalism come to function as a normative smokescreen for whom,
when and how reproduction is even allowed to take place. This chapter draws
conclusions from the four preceding chapters and highlights national differences
and core imaginaries.
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Chapter 1
The Market in Ice
1. Introduction
The fertility market is a billion dollar industry. In Denmark alone, the fertility
industry generates hundreds of millions of dollars of revenue (Toft, 2015). To
give just one example: In April 2019, having made more than $ 65 millionUS, the
Danish family behind European Sperm Bank sold two-thirds of its shares (for
an unknown but probably very substantial amount) to Axcel, a Nordic private
equity firm. While equity firms appear to have become the new financial players
in the European fertility market, according to the Allied Market Research group
(2015), the market in assisted reproduction is expected to double its growth from
2013 to 2020 (Toft, 2015). Projected as a global growth market, the business in
IVF alone includes treatments, donor gametes, hormone medication, and IVF
equipment. Rising infertility rates, trends toward later pregnancies, technological
advances in fertility equipment and services, together with rising rates of wealth
and a continued desire for genetically related children provide further evidence and
support for this burgeoning market (Allied Analytics, 2018).
It is difficult to imagine this large-scale global market without cryopreserva-
the market
in
fertility services are closely inter-
tion, as freezing technologies
twined. For one thing, 'freezing technologies make it possible to achieve, on a
grand and international scale, what was previously only possible in a small clini-
cal setting. For example, since human sperm can be frozen, sperm can be stored
and distributed all around the globe and, therefore be commodified. In addition,
with regard to today's vitrification of oocytes, eggs as well as sperm can now be
stored in large tissue banks, granting patients increased selection choice (e.g., of
who to choose as a donor) as well as enabling emergent possibilities of self-donation
involved in the freezing of one's own reproductive cells and tissue. In the process,
cryopreservation becomes a kind of insurance against infertility later in life. In
this way, freezing technologies and the fertility market are deeply intertwined.
It is perhaps not surprising that the market in human reproduction is not
like most other industries. Not only does it deal with one of the most intimate
aspects of our lives and involve the making of babies and families, the fertility
and
The Cryopolitics of Reproduction on Ice:
A New
Scandinavian Ice Age
Emerald Studies in Reproduction, Culture and Society, 19-46
Copyright
©
Authors, 2020
doi:10.1108/978-1-83867-042-920191003
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20
The Cryopolitics of Reproduction on Ice
market also tends to be tightly regulated and surrounded by ethical controversy.
In some aspects, this is perhaps particularly the case in the Scandinavian coun-
tries, where reproduction and the welfare state are closely entangled. For example,
in Denmark, the practice of freezing eggs in order to postpone pregnancy for
non-medical reasons has been met with resistance on the grounds that it is harm-
ful to women, future children, and broader societal values. At the same time,
however, Denmark is also home to one of the world's largest sperm banks,' C?yos
International,
a significant agent in the making of a global market and, as we will
demonstrate, heavily entangled in the commodification of sperm in Denmark.
The notion of a market can be difficult to pin down. On the one hand,' it is
often used broadly to signify any area in which there is supply and demand, for
example, the dating market. On the other hand, the notion of a market is often
used narrowly to signify institutions where self-interested people (individually
or collectively) exchange goods and services for money, for example, the hous-
ing market. In this chapter, we focus on the making of the
monetary
market in
assisted reproduction. It is, however, clear from previous,research that a market is
so much more; Julie Smith (2013, 2014) has, for example, demonstrated the eco-
nomic value of breast milk and breastfeeding, how its contribution can be valued
in market statistics and how the failure to account for its value in economic data
has severe impact on public policies. In his work on sperm donors in Denmark,
Sebastian Mohr (2018) has shown that the exchange of gametes for money never
solely is a question about money or payments. Rather, Mohr shows how mon-
etary exchanges are embedded and entwined within other forms of markets, for
example, affective or gift economies. We therefore use the notion of a market in a
somewhat broad sense, meaning An institution where individuals exchange goods
and services, noting that the market for sperm in Denmark more closely approxi-
mates the narrow definition of a market, 'or a monetary market, while the mar-
ket for eggs more closely approximates the broad definition. While the monetary
market in assisted. reproduction is booming, and the commercial interests at stake
were also cited by a previous Danish government as a primary reason to uphold
anonymity in sperm donation as an option (Bill L151/2016), it is also clear that
some markets in Scandinavia are very limited (e.g., egg and embryo freezing)
while others are thriving (sperm donation and cross-border reproductive care).
The aim of this chapter is to discuss and understand the making and non-
making of a Scandinavian monetary market in frozen sperm and egg cells. We
have chosen to focus exclusively on reproductive cells, because embryos as well
as ovarian and testicular tissue, within the Scandinavian welfare states, are not
currently positioned as reproductive commodities. Consequently, we first histori-
cize cryopreserved "commodities" in what is frequently understood as the "cool"
North. As noted by Schurr (2018), place and context are important. Indeed, geo-
graphically, Scandinavia can be said to be "cool." Parts of the Scandinavian terri-
tory are in the Arctic region. Land within the Arctic region has seasonally varying
snow and ice cover, in places even permafrost. Arctic seas equally contain sea-
sonal sea ice. Ice is a well-known force of nature throughout the Scandinavian
region, and ice is even seen as potentially health-conditioning, as Scandinavian
folklore sees children born in winter as stronger and sturdier. For generations,
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The Market in Ice 21
Scandinavian babies have conventionally napped outside in the cold weather in
order to improve sleep as well as health. Meanwhile, Nordic "coolness" extends to
the ways that Nordic design and products are now seen as providing sustainable
and aesthetic pleasure, connoting an inherent sense of quality as well.
Indeed, the Danish sperm bank Cryos International strategically played on
this sense of Nordic coolness, when, in the late 2000s, they marketed Danish
sperm as a Viking and quality product (Kroløkke, 2009). The "viking strategy"
also reminds us how Nordicness is embedded within a specific racial and colonial
history of Whiteness (Vitus & Andreasen, 2015). Race scholar Rikke Andreassen
has argued that the notion of Viking sperm both rekindles racial discourse akin
to that propounded by the racist race sciences of the early nineteenth century,
which were indeed very prevalent in Scandinavia, while simultaneously erasing
the racial and colonial histories and legacies of Whiteness in the Nordic coun-
tries, as consumption of (racialized) sperm is reframed within neoliberal con-
sumer logics (Andreassen, 2017, 2019). In the case of cryopreservation, however,
cold temperatures are entangled not only with cultural conventions but
also
with
regulatory responses, as slow freezing and vitrification simultaneously allowed
new reproductive techniques and markets to emerge. These various differences
have produced very different histories as regards diversity in practices and the
management of assisted reproduction.
Having considered the historical perspective, .we draw on interdisciplinary lit-
erature studies as well as empirical materials including bioethical, legal, feminist
and cultural study accounts in order to theorize the market. Because Denmark
has played a unique role in the making and unmaking of a market in the Scan-
dinavian context, we use the Danish context to describe how frozen sperm and
eggs, within the Danish welfare state, come to be understood and regulated as
commodities. We first show how cryopreservation of sperm responds to specific
concerns around safety as well as how freezing enables commodification by creat-
ing a larger pool of donors from which the recipient can choose. As sperm is left
largely unregulated, it is also allowed to "travel the world," invoking a nationalist
I
imaginary of the conquering Vikings (Kroløkke, 2009). In contrast, the freezing
of-eggs-is highly problematized, monstrositized, and limited, which precludes the
making of commercial egg banks in Denmark. In the final section of the chapter,
we bring these discursive, affective, and material elements together in order to
discuss
the making and unmaking of a Nordic market in reproduction.
I. The Legal Framework
Although the Scandinavian countries differ widely in the ways that cryopreserva-
tion is regulated, they are all welfare states. The welfare state is redistributive and
provides a wide range of benefits and services as citizens' entitlements with the
aim
of creating a more egalitarian society. Overall, the Scandinavian countries
are all successful capitalist economies, but the Scandinavian welfare state model
is also known for regulating market forces through political interventions. All
Scandinavian countries cover the cost of fertility treatment in the national health
plan conditional upon certain criteria being met such as medical indication, age,
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22
The Cryopolitics of Reproduction on Ice
marital status, etc. Typically, three cycles of IVF are offered with only a small
amount of co-payment. All the Scandinavian countries do, however, also have a
private sector for treatment in cases where criteria for access to public treatment
are not met. This is especially the case as far as bypassing waiting lists or having
more cycles than the three rounds sponsored by the State are concerned.
The use of donated sperm is thought to have existed in the Scandinavian coun-
tries since the 1920s.' In the case of Denmark, sperm banking developed and
became routinized due to entanglements with individual entrepreneurs, a distinc-
tion between public and private clinics prevalent in the welfare state, and private
fertility clinics. Globally, the market in egg cells did not develop before the emer-
gence of IVF and since the technique of sperm cryopreservation is comparatively
much simpler than that of egg vitrification, the market in sperm developed much
earlier. Even today, egg donation, in Denmark, often takes place in "fresh" (non-
cryopreserved) cycles. In this chapter, we illustrate that Scandinavian legal regula-
tion has played a significant role in the commercialization of reproductive matter,
enabling sperm to readily travel across national borders as a commodified entity,
while Scandinavian egg cells are domesticated and not marketized nor 'commodi-
fied. In Scandinavia, egg cells are exchanged in systems of donation, rather than
in systems of monetary markets.
Danish IVF history reveals interesting and unintended entanglements between
public clinics, private clinics, and an entrepreneurial sperm bank. Around the
turn of the twentieth century and during the following decades, a strong desire
among the Scandinavian governments to collaborate and form common legisla-
tive frameworks was in place. This was the case,
for
instance, in the area of family
law and led to increased legal collaborations between Scandinavian countries. In
1948, legislation in relation to reproductive assistance began to be discussed when
working groups under the Danish and Swedish Ministries of Justice considered
whether legislation on the use of insemination was needed and appropriate. At
the 1948 Nordic Meeting for Lawyers,2 what was referred to as insemination and
conception was especially highlighted as in need of
the pertinent issue of at
Nordic debate and a common Nordic legal framework (Melander, 1948). At this
time, however, neither the proceedings of the Nordic Meeting for Lawyers nor the
reports of the working groups resulted in a governmental Bill even though the
white paper given by the Ministry of Justice working group contained a draft Bill.3
'For more detail, see the historical chapter of the Swedish white paper on children
through insemination,
Sveriges Offentlige
Utredninger 1983:42 (Huvudbetdnkande
av
inseminationsutredningen), p. 31.
2
Nordic Meeting for Lawyers, "De
Nordiske
Juristmoder," have brought legal aca-
demics, practitioners, judges, administrators, civil servants, etc., from all legal institu-
tions together every third year since 1872.
3
The working group formed by the Ministry of Justice's letter of May 29, 1948 delivered
their white paper in 1953
(Betænkning
29/1953
om
en
særlig lovgivning om kunstig
befrugtning).
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The Market in Ice 23
In line with the Nordic lawyers, who saw a need to reform family law as a
result of, among other things, the insemination issue (and so-called "illegiti-
mate" children in general), the working group's draft Bill proposed regulation
of who could perform insemination (doctors), regulation of consent (treatment
of married women required consent from the husband), regulation of donor
selection (selection was made by the treating physician who was also responsible
for ensuring anonymity), regulation of paternity (the husband), and a stipula-
tion that no legal bond existed between the donor and child. However, at that
time, the feeling in the Danish Parliament was that medical issues were best
left to the medical profession to decide on, on a professional and'scientific basis,
and for that reason most medical issues should not be (and were not) addressed
by legislation. Consequently, in Denmark, no special rules or regulations gov-
erned insemination, donation, and artificial fertilization prior to 1997, when the
Act on what now became known as "artificial fertilization" was adopted. Instead
these practices were subject to sparse regulations that generally regulated medical
treatment. The general medical law framework was characterized by a high degree
of professional self-regulation and covered primarily the legal and administra-
tive framework for the healthcare system, some educational demands regarding
healthcare personnel, issues of malpractice, and the'duty to provide information
to patients.
Consequently, the practices surrounding sperm donation had been left to
develop within the healthcare system at the discretion of physicians and with-
out regulatory interference. Likewise, in Sweden, where insemination with both
partner sperm and donated sperm had been practiced at several women's clinics
and private gynaecologist practices without special rules or regulation (Sjogjerd,
2012). Following the-common Nordic deliberations on family law, the Swedish
Ministry of Justice had tasked a working group with wording a draft Bill.4 The
draft Bill was similar to the draft Bill proposed by the similar working group
under the Danish Ministry of Justice. However, the new Swedish Parental Act
deliberately did not address insemination, as the Bill stated that it was practiced
to such a small extent that no explicit regulation was needed, referring to a study
by the National Board of. Medicine showing that between July 1945 and June
1948, a total of 95 inseminations had been performed in Sweden resulting in
seven pregnancies. It was not until 1983 that one of the first legal regulations in
the world on insemination was adopted in Sweden through the Act on Insemina-
tion5 with further updates in 1985. Two significant features of this law were the
banning of private sperm banking and the insistence on using non-anonymous
donors only.
4
SOU 1953:9
Statens
Offenliga Utredninger —
Forslag
till
Lagstiftning om
Insemi-
nation avgivet
av
sakkunniga inom Justitiedepartementet. [The State's public white
papers— legislative proposal on insemination by professionals in the Ministry of Justice.]
5
Act No. 1984:1140.
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24
The Cryopolitics of Reproduction on Ice
In Denmark, the issue of regulation was revisited by a working group on
fertility treatment set up by the Minister of Health in 1992. The working group
argued that overall there was no need for special regulation because the practice
of insemination had evolved in such a way that it did not give rise to any concern:
Insemination was performed by gynaecologists and specialist doctors and as such
the working group was satisfied that the standard of care met professional medi-
cal standards and that adverse risks of transference of diseases through donation
were managed appropriately. The main theme of discussion was the fact that the
donor and the receiving couple were anonymous to each other and to the future
child. The practice of anonymity had been the norm right from the beginning
among the gynaecologists and specialists who provided fertility treatment. The
working group noted that almost all donors made the donation conditional on
anonymity, and even the clinics did not have any means of identifying the donor
at any subsequent stage. It was also, at that time, common to use sperm from
multiple donors and to recommend intercourse around the same time as the treat-
ment, thus making the actual paternity difficult to establish. The 1992 working
group remarked that it was also worth noting that in
5
-10% of marriages, the
genetic origin of the offspring was in fact not the husband. The working group
used this argument to conclude that donation was not that different from "nor-
mal" births.
,
The working group reiterated the fundamental arguments behind the practice
of anonymity in their report, since the adoption of a new law in neighboring Swe-
den in 1985 giving the child a right to any information about the donor recorded
in the medical files, meant that it was the right, time to discuss whether this was
still an appropriate principle to uphold in Denmark. The reasoning behind ano-
nymity in donation had always been three-foid. First, the purpose of providing
insemination as a fertility treatment was "to replace a natural function" and the
child's upbringing and place in the family therefore "ought to take place as close
to the normal and natural way as possible." Second, the interests of the donor
also had to be considered. It was presumed that the donor was acting for altruis-
tic reasons and not because he wanted a relationship with any offspring. Lastly,
the working group argued that the Swedish law did not carry any legal weight
anyway, since it did not place an obligation on parents to tell the child that it
had been conceived with donor sperm, and if this information was not provided
it would be hard to fulfil the right of the child which was at the center of the
Swedish law. Also, the Swedish law had resulted in fewer cases of sperm donation
in Sweden and an increasing number of Swedish women receiving treatment in
Denmark. The working group concluded by saying that it was a common fea-
ture of any regulation that by upholding certain interests, other interests would
be excluded. In this case, upholding the value of a "normal" family entails that
there can be no relation or relationship between the donor and child.
Behandling
af ufrivillig
barnløshed, en rapport
afgivet af
en
arbejdsgruppe nedsat
af sundhedsministeriet
[Treatment of involuntary infertility, a report submitted by a
working group under the Ministry of Health], Copenhagen, 1992.
6
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The Market in Ice 25
In the early 1990s, administrative guidelines began to emerge in Denmark.
The practice of anonymous donation had been adopted from the beginning by
the medical community. The early guidelines continued the conceptualization of
anonymity as the natural norm and the predominant interest became the reg-
ulation of eggs and embryos. On June 13, 1994, the Danish Board of Health
issued an instruction on the introduction of new technologies in fertility treat-
ment and a circular on doctors' notification of new treatments seeking to achieve
pregnancy. These guidelines represented the first regulation of sperm donation
with the aim of ensuring that donated sperm was free from HIV, requiring sperm
banks to notify the Board of Health of transactions and results. In this context,
cryopreservation now became seen as a safety measure and fertility treatments,
with the use of donated sperm, could now only be frozen, not fresh. This was
a
precautionary measure that would ensure sufficient testing of the sperm prior to
use, ensuring that donor sperm was free from disease (most notably HIV). But
up until that point, sperm banks had not been subject to any formal supervision
from health authorities. So, while egg cells and embryos had to be controlled in
ways that sperm did not, it was the issue of patient safety and the health authori-
ties' interest in monitoring the quality of care that sparked early regulation of an
otherwise flee market in sperm that included the use 'of fresh donations of sperm.
Consequently, up until 1984, in Denmark, assisted reproduction had not been
subjected to regulation. Instead, an imaginary of'the competent and independent
scientist had dominated the Danish case (Herrmann & KrolØkke, 2017). Medi-
cal issues were considered best left to the medical profession to decide on a pro-
fessional and scientific basis, and for that reason 'most medical issues were not
addressed by legislation (Herrmann & KrolØkke, 2017). In October 1984, how-
ever, a working group under the Ministry
for
Interior and Health published their
report "The Price of Progress" (Ministry for Interior and Health, 1984), which
recommended the establishment .,of a Council on Ethics. In 1987, the Council on
Ethics was established by Parliament, and in 1989, it published a report on the
protection of human gametes, embryos, pre-embryos and foetuses. On the topic
of cryopreservation, the Council on Ethics observed that viability was hard to
preserve and as a result recommended a time limit for cryopreservation. A major-
ity of the Council found
that cryopreservation of eggs should be allowed subject to the
same conditions applicable to sperm, i.e. that cryopreservation
should be allowed for a limited time and had to be destroyed at
the time of the banker's death. (The Ethical Council, 1989, p. 81)
However, considering the cryopreservation of sperm, the Council stated
that
it
should not be subject to any limitations except those required on medi-
cal
or
administrative grounds, provided that the sperm was destroyed when the
banker died (The Ethical Council, 1989, pp. 60-61). This requirement exclusively
addressed the time lag between deposit and fertilization, ensuring that ferti-
lization did not take place after death. Jointly, the Council on Ethics, together
with increasingly sophisticated technological developments, meant a shift in the
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26
The Cryopolitics of Reproduction on Ice
imaginary from the early legal understanding of the competent scientist to a dis-
cursive construction of the Moral State. We will return to these discursive and
affective threads in later sections and will also consider legal developments, but
now we give a brief overview of the ways in which sperm became developed and
regulated in Denmark.
2.1. The Development of
Private Cryopreserved Sperm Banking in
Scandinavia Up To 1997
While sperm donation in Sweden was already regulated from 1985, the develop-
ment of sperm banking in Denmark took place at a time where regulation was
sparse. In 1981, the first Danish commercial private sperm bank was created.
According to Ole
Schou,
the founder of the Danish sperm bank
Clyos Interna-
tional,
a nocturnal dream of "frozen sperm in ice formation" generated the idea
of a commercial sperm bank' (Gandini, 2015; interview with
Schou,
2009). It was
not until 1987, however, that
Schou
established
Ciyos,
and then, initially as a bank
for sperm deposits. It was another three years before the donor programme was
developed in 1990, with a business-to-business sales model meaning that sperm
was sold to clinics that mainly practiced sperm selection in the lab (Adrian, 2006,
2010). In the 1990s, Danish sperm banking developed, into a global industry.
At the beginning of the new century,
Cr yos
faced new competition with the
establishment of the
European Sperm Bank,
operating both in Denmark and on
the international market.
The development and intensification of the use 'of cryopreserved sperm in the
case of sperm banking and donation accelerated at the beginning of the 1990s for
several reasons. As already explained, the HIV virus had become a global health
threat, necessitating new safety measures that made using fresh sperm dangerous
and eventually illegal. Furthermore, IVF had reached a stage of routinization,
allowing a number of private fertility clinics to provide clinical hope for infertile
couples. In Denmark, where private health and fertility care was almost non-
existent at the time, the development of a private market stirred some controversy
within the community of gynaecologists and reproductive specialists, because it
marked a departure from the previous setup where the medical community had
sourced and distributed sperm within their own sector.
Sperm cryopreservation, however, was not new. Sperm banking had been
organized first through Chief Physician Lebech's sperm bank in the mid-1960s,
and since 1976, through The Central Sperm Bank ("Den
Centrale Sædbank i
Pilestræde")
established as part of the general practitioners' common laboratory
facilities in central Copenhagen. Although this sperm bank was not owned by the
state or the county council, but instead developed as an independent foundation,
the controversy of public/private treatment within the medical community had
caused the sperm bank not to sell sperm to private fertility clinics (Adrian, 2016).
In 1989, the Mermaid Clinic, which was established as one of the first private
hospitals in Denmark, wanted to offer fertility treatments, including sperm dona-
tion. However, being a private sector hospital they could not receive donor sperm
from The Central Sperm Bank, while importing sperm from the US was quite
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The Market in Ice 27
expensive. This became a business opportunity for Schou, whose challenge at the
time was to find the necessary working capital to establish the donor programme.
With a substantial order from the Mermaid Clinic, Schou was able to set up busi-
ness and establish the donor programme. With a background in business stud-
ies, he integrated a knowledge of markets, service and sales into his methods for
conceptualizing
Cryos International.
From the very beginning, he wanted a large
donor corps covering a diverse selection of phenotypes, and he was determined
to offer speedy delivery upon a sale. Within a few years he effectively supplied
the Danish market, and since then has expanded globally with sales to more than
100 countries (Adrian, 2006).
2.2. Challenging Heteronormativity Through the Market
In 1997, the Danish Act on Artificial Fertilization was adopted. The aim was to
create a legally binding framework for fertility treatment performed by doctors.
According to the preparatory work, the existing practice 'of anonymity in sperm
donation was to be continued. This meant that clinics were now legally obliged to
ensure anonymity, and as a result, sperm banks had to offer, anonymous sperm in
order to supply the domestic market. No specific reasons for codifying anonym-
ity are given in the travaux pr6paratoires, but by upholding previous practice, the
legislator endorsed the original reasons for anonymity which effectively meant
keeping the traditional heterosexual family unit intact. This reason was also given
explicitly in relation to the Act's bail on egg donation between known parties,
especially between family members, as this would create unfortunate and confus-
ing familiar relationships.
The question of donor anonymity became the predominant political issue in
relation to the market in sperm across Scandinavia. Sweden had already banned
anonymous donation in 1985, and in 2005 Norway followed suit. Meanwhile, in
2007, Finland similarly banned anonymous donations, thereby, foreground-
ing the child's right to know about their genetic origin even if it meant fewer
donations and less business for domestic fertility markets. Denmark, however,
maintained its position. In a 2006 amendment of the Act, anonymity was explic-
itly upheld, stating that there was no demand from donors or families to change
the law. Additionally, legislators raised concerns about the best interests of the
child;,which in their opinion could not be viewed as isolated from the family in
which the child was to live — legislators were concerned that it might affect the
overall welfare of the family if a third party was to be involved in the child's life.
Furthermore, according to legislators, the interests of society had to be consid-
ered as well. If anonymity were abolished, the number of donors would decline
and Denmark would face a "sperm drought" and the same problems with pro-
viding treatment as seen elsewhere in the world. The need for more complex and
costly (and state-supported) treatment such as IVF would increase if options for
simple insemination were limited in this way, and then, of course, the issue of
business interests was also at stake.
Moreover, a central issue was the question of access to treatment. In the
parliamentary debate that led up to the adoption of the regulation, one of the
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28
The Cryopolitics
of
Reproduction on Ice
discussions centered on how conception needed both a sperm and an egg, a father
and a mother, thus naturalizing the heterosexual relationship as the premise for
parenthood (Bryld &
Lykke,
2000, 2002; Nebeling Petersen, 2009; Stormhoj,
2006). During the period between 1997 and 2007, it became illegal for Danish
medical doctors to provide fertility treatment to lesbian and single women. How-
ever, since the law did not state that other health professionals were not allowed to
treat women with insemination, a midwife named Nina Stork established a'clinic,
buying sperm from
Cryos
through a doctor who acted as an intermediary. Nina
Stork's clinic, initially set up as a political protest, soon grew to be a profitable
private clinic, well-known as a clinic directed specifically at both lesbian couples
and single women within Europe. Both Stork herself, as well as the women who
succeeded in having children through insemination, challenged existing heter-
onormative understandings of family by showing picture-perfect families in the
media and being vocal in debates.
Even prior to 2007, when the Danish legislation was changed to enable medi-
cal doctors to treat women irrespective of them being single or; lesbian, several
other private clinics were established, owned by midwifes or biomedical labo-
ratory scientists, respectively. As these clinics had also marketed themselves as
offering more women-centered modes of care, they became well-known to fertil-
ity travelers from abroad and continued to develop and flourish after medical
doctors became able to legally treat single women and lesbian couples. As the
development of ICSI treatments in the 1990s brought about a fall in the num-
ber of heterosexual couples in need of sperm donation, the normative change
of what came to constitute a family can today be seen in the change of who the
sperm banks perceives to be their customers, not only in Denmark but worldwide.
While they believed 'that almost all of their customers in the 1990s were hetero-
sexual couples, this is not the case 'today, and during the 2019 symposium
Cryos
announced that single women and lesbian couples now constitute their largest
consumer group (Cryos Symposium, May 2019).
2.3. From "Business-to-Business" to "Business-to-Consumer". Danish
Cryo-sperm Goes Global
While the Danish market and legislation seemed of importance during the initial
years of the commercialization of Danish sperm, the sperm market soon took off
on the global stage. The market logic, regulations and standards of safety differ.
Notably, these logics were entangled by very mundane practices of which donors
were selected and the premise on which the selection of the donor was made.
Although a "gray" market of non-cryopreserved sperm existed, in all of the Scan-
dinavian countries, sperm donation was most common in medical settings. In this
setting, the doctor was, during this time period, in charge of the selection deci-
sions but in practice, decisions were often referred to biomedical laboratory scien-
tists. Because sperm donation had been understood as a treatment that replaced
a "natural" function and secured the heterosexual family, where the husband
was to assume paternity in every way, the phenotypes of the social father were
expected to be matched
(Rosenkvist,
1979). Conversely, in some clinics in Sweden
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The Market in Ice 29
the donor was imagined as a potential stand-in father, in view of the fact that
donor programmes relied on non-anonymous donors only (Adrian, 2006, 2010).
Consequently, it was a game changer when Cryos entered the US market. This
was a market shaped by different logics, most notably understanding the woman
or couple needing sperm as
consumers
and not as
patients.
On the US market,
Cryos'
initial "Business-to-Business"-model did not work. Here, it was expected
that the consumer (herself) would make the selection. In the US, the "business-to-
customer" market model had already existed for many years and with the advent
of the Internet all the competing sperm banks were already selling sperm based
on existing donor profiles with extended profiles, baby pictures, etc. (Adrian,
2010; Almeling, 2011; Cooper & Waldby, 2014; Daniels, 2006; Xrolokke, 2009;
Martin, 2015; Moore, 2008; Schmidt & Moore, 1999).
When
Cryos
launched their first website in the US with ice, snow, fire, and
a pregnant belly, providing donor sperm named after Vikings and marketed
to
customers overseas, there was an outcry in the Danish media (Adrian, 2006).
Although Schou, in 2001, argued that the markets were,separåte'(Adrian, 2006),
as early as the mid-2000s the new competing sperm bank,
European Sperm Bank
began selling sperm online directly to customers with 'donors having both what
they called extended and basic profiles. As neither was owned-by medical doctors,
these two sperm banks could provide treatment outsi&the'legislation (because
legislation only applied to treatment given by medical doctors). Within this con-
text, customers began buying sperm on the Internet. As several countries, includ-
ing Norway and the UK, began to prohibit the use of anonymous sperm from
the mid-2000s onward and the debate'on anonymity entered the public arena, in
2006,
European Sperm Bank
began producing and selling both anonymous and
non-anonymous sperm Iand
Cryos International
followed suit. Their product now
included both basic and extended profiles', with the latter becoming a legitimate
choice at the clinics not owned by doctors. In practice, a market for the use of
both anonymous and,non-anonymous sperm took off already in the mid and
late-2000s in Denmark, although 'medical doctors were not allowed to treat with
non-anonymous donors before the legislative changes adopted in 2012. However,
despite the logic of the Danish legislation trying to regulate a market of "Busi-
ness-to-Business," in practice, the increased commercialization of sperm moved
choices of donor selection away from the medical doctor to the patient, increas-
ingly understood as the customer. This change in decision-making in terms of
donor choice also became more visible in the clinical settings where donor deci-
sions were more vocalized (Adrian, 2019).
When Norway and the UK, in 2005, changed their legislation from allowing
only anonymous sperm donors to now allowing only non-anonymous donors,
European Sperm Bank began
sourcing sperm from non-anonymous donors. More-
over, since the midwife-owned clinics were already making special imports from
the US in order to receive sperm from non-anonymous donors,
European Sperm
Bank
followed suit and began sourcing sperm from non-anonymous donors from
the bank. After a few years,
Cryos
International
followed
European Sperm Batik,
introducing business-to-consumer sale through a developed customer-oriented
website, matching those developed by the US sperm banks.
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30
The Cryopolitics of Reproduction on Ice
The development of an accessible website for consumers led to an increas-
ing number of consumers from all over the world contacting sperm banks
to enquire whether they could receive the sperm at home. For some women,
it seemed more relaxing to carry out the insemination at home by themselves.
However, there were also a lot of lesbian and single women who, due to dis-
criminatory legislation around Europe, were not able to receive treatment locally
and for whom it was not possible to travel for treatment. Instead, they were
interested in buying the sperm directly from
Cryos International,
thereby bypass-
ing local legislation. In 2011, Cryos began to deliver sperm to private addresses
all over the world. In Europe, this was possible even in countries where sperm
donation was not legal, because the sperm changed status, no longer being cat-
egorized as
hconan cells
but as
a product
which could move freely within the
European market. However, this subversive market practice (Adrian, 2016) was
challenged by the
EU
commission, which compelled Danish legislators to review
the national implementation of the
EU
tissues directive, making it'illegal to send
sperm directly to private addresses without the involvement
of
a healthcare pro-
fessional person. In parliamentary debates, however, it was clear that the main
reason for the European Commission's wish to challenge the practice was that
many countries found the possibility of non-heteronormative families mor-
ally problematic. It was not obvious that moral arguments should influence the
Danish interpretation of the tissues directive,'since moral arguments have previ-
ously been dismissed as irrelevant in a free market context, cf. Case 159/90 —
The Society for the Protection of Unborn Children Ireland Ltd v. Stephen Grogan
and others.
Today, cross-border sales can still take place, provided that shipments
are addressed to an authorized health practitioner, such as an optician. Conse-
quently, today creative arrangements could make it possible to receive sperm for
home insemination.
2.4. The Story of Why the Cold North Kept the Eggs at Honre
At the same time as sperm began to travel and there was an increase in fertility
travel to Denmark from `all over Europe for sperm, Danish women's eggs were
and still are, kept at home (Adrian &
Kroløkke,
2018). Vitrification, which is
the successful technique used in oocyte cryopreservation, technology of oocytes,
came comparatively late to the cold north. While Spain already has a flourishing
donor market (Bergmann, 2012; Funes, 2017;
Kroløkke,
2014; Pavone & Gove,
2017; Payne 2016), in Norway, egg donation remains illegal (Aasen, 1998) and in
Denmark and Sweden, egg donation has been controversial and compensation
has historically been low. Until an amendment of the law in 2007, in Denmark,
egg donation was only allowed from women who were themselves undergoing
fertility treatment. Combined with the fact that until 2012 egg donors were com-
pensated the same amount as sperm donors (which for an entire IVF treatment
cycle translated into compensation of 500
DKK,
i.e., $85), the supply of eggs
could not meet the demand. Although compensation was raised to 2,500
DKK
in 2012/2013, this amount still did not prove sufficient to recruit donors. It was
not until the amount of compensation was increased to the same amount as seen
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The Market in Ice 31
in countries such as Sweden, Spain, and the UK (approximately €1,000), that a
change in donor numbers was seen.
At the beginning of the 2010s, vitrification was becoming a routinized technol-
ogy in other places around the world. Once again, Cryos International saw this
as a business option. Given that sperm banks were operating all over the world,
in countries with differing legislations, and given the infrastructure of cryoboxes
in circulation, and a well-organized computer system and cryotanks, it did not
seem such a big move to include eggs in the sales inventory. The Danish Act
on
"Artificial Fertilization" had barred eggs from transnational mobility, relying on
control as a key principle in safeguarding eggs that were removed from the female
body from the perceived monstrosities that ARTs could potentially give rise to.
Although a legislative change in 2012 now enabled eggs and embryos
to be
moved
across the Danish border, which until then only had been legal in the case of
sperm, Cryos faced two challenges: recruiting sperm donors with the minimum
compensation given to women going through IVF, and gaining Danish legal sup-
port to make money on the sales of the egg. In relation
to
both questions, they
faced rejections when they applied to the Ministry for the Interior and Health.
In their application, Cryos suggested a model of compensation to the donors
in which it was made possible for them to have half of the donated eggs frozen
for their own later use. However, this model
of
compensation was considered by
the Ministry of Health as too generous relative
to
the amount of financial com-
pensation the women were allowed. Furthermore, although Cryos International
was allowed to make money on sperm, women's eggs were perceived as a radi-
cally different substance, and consequently the Ministry of Health viewed sales of
oocytes as illegal. To this day, oocytes can still be stored for only five years in Den-
mark, while the regulations state that sperm can be stored forever if it is donor
sperm or even after the man's death if he has written a will. Therefore, legislation
has reduced business opportunities from non-medical freezing in Denmark as
well as the development of private egg banks.
3. Theorizing the Market in Ice
While beer, fang & Olufsen, Volvo, and Lego blocks have become well-known
"quality" Scandinavian export commodities, when it comes to the export of
Scandinavian sperm and eggs, the moral grounds for the making or unmaking
of a market become more shaky and, as we will demonstrate, highly gendered.
In this section, we theorize the making and unmaking of a market. Today, the
Scandinavian cryo-market consists of cryopreserved sperm as well as cryo-
related equipment (such as hot plates and mini incubators) along with various
mediums (such as sperm-freezing mediums, known as cryoprotectants) devel-
oped by companies such as Origio and FertilityTech, located in Denmark and
Vitrolife located in Sweden. We base our theorization of the market on an inter-
disciplinary set of scholarly articles that collectively situate reproductive sub-
stances as morally contested commodities (Radin, 1996), while simultaneously
documenting how cryopreservation has become pivotal in the market in frozen
reproductive parts.
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32
The Cryopolitics of Reproduction on Ice
At the most basic level, markets are institutions characterized by
continu-
ous, voluntm3;
and
specified
exchanges of goods and services between individu-
als or collective agents, such as businesses and organizations (Herzog, 2013;
Rosenbaum, 2000; Satz, 2010). To clarify: a single exchange is not enough to
constitute a market. Markets coordinate behavior through various mechanisms,
and they can only do this to the extent that people can adjust their behavior in
response to the anticipated actions of others, which requires continuity, (Satz,
2010). Markets are also characterized by voluntary exchanges. For example, we
may not consider it trade when someone forces two people to exchange goods.
Ultimately, only
specified
exchanges count as market transactions. We do. not
consider it trade when two people exchange gifts around Christmas, for the sim-
ple reason that the exchange in question was not sufficiently specified. If it were,
it would hardly count as the giving of gifts (Rosenbaum, 2000). Importantly,
markets can be more or less free. Take, for example, the previous sections on the
making of a sperm market in which sperm banks operated by non-medical doc-
tors existed outside, at that time, of Danish legislation. In most industrialized
nations, there are rules and regulations with regard to .who can participate in the
market. For example, one typically needs a licence in order to sell food on the
market. Another example is the sperm market again, where people must be 18
to become donors.
The rules and regulations for market exchanges can, generally, be laid out
along seven dimensions or variables (Brennan & Jaworski, 2015). First, mar-
kets can be (and are) regulated with regard to who can participate in the market.
Second, markets can be regulated with regard to which means of exchange are
allowed on the market (money, barter, bitcoins, gift cards, and so on). Third,
markets can be regulated with regard to prices, which can be fixed or flexible,
high, moderate or low, and so on. Fourth, markets can be regulated with regard
to distribution or proportion between participants on the market (how much the
different parties to the exchange get). Fifth, markets can be regulated with regard
to the mode of exchange on the market (auction, lottery, bazaar, co-op, and so
on). Sixth, markets can
be
regulated with regard to the modes of payment, such
as salaries, scholarships, tips, contributions to charity, and so on. Exchanges need
not be carried out in money that the seller receives personally. Charitable dona-
tions in the name of sellers can also function as a mode of payment. And finally,
markets can vary, in their motives for exchange. They can be for-profit, public
benefit, cost-recovery, non-profit, charitable, and so on.
In the case of the market in reproduction, altruism and gifting frequently col-
lide with market and commodity thinking. Notably, feminist scholars have pro-
vided us with sharp analytical insights into what becomes contextualized as gift
markets (Almeling, 2009; Sharp, 2000; Strathern, 1992). While donating eggs,
for example, clinical or even testimonial accounts are framed as giving some-
one-the "gift of life" (Tober & Krolokke, forthcoming). A third reason concerns
autonomy. Donors and recipients should be allowed to arrange contracts as they
see fit, insofar as they are competent adults. A fourth and final reason is harm
prevention, as legalization is understood to counteract black markets for gametes
(and exploitation of poor women around the world, a standpoint that has been
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The Market in Ice 33
complicated in studies of sex selling and surrogacy). These reasons form the main
pillars in the case for allowing the sale of gametes.
Because of the concern that paid donations will squeeze altruistic donations,
paying gamete donors has largely been resisted in the Scandinavian countries. As
long as donors are only compensated for their expenses, discomfort, and so on,
they are, ethically speaking, seen as presumably acting primarily from altruistic
motives; that is, with the intention of benefiting others. When financial incen-
tives are introduced, more egoistic motives enter the picture and potentially
begin to take over. The squeezing of altruism is primarily seen as morally prob-
lematic for the following reasons. Introducing financial incentives changes the
nature of a donation from "a public-spirited activity into a job for pay," which
can put off some potential donors, leading to a decline in quantity (Sandel, 2012,E
cited in the Danish Council on Ethics, 2013a). Moreover, there is a concern that
financial incentives are likely to attract donors, who are more inclined to hide
relevant medical information, leading to a decline in quality. The contradiction
between individual donors who donate altruistically contrasted with clinics that
gain immensely from their donation appears, in the Scandinavian countries, to
be unproblematic. In fact, Strathern (1992) highlights what may appear as a pro-
ductive tension between the gift and the commodity when she calls for an under-
standing of gift markets, while Hoeyer (2013),calls for scholars to problematize
how and when certain "things" (such as sperm and eggs) are made to appear
exchangeable. Meanwhile, feminist scholars stress that the market in reproduc-
tion is deeply entangled with late-modern forms of capitalism in which younger,
and frequently less financially secure women 'and men exchange their reproduc-
tive cells in order to partake in white, middle-class visions of the good life.
In bioethics literature, the market is understood less from the standpoint of
economics and more from the standpoint of moral objections to the buying and
selling of gametes, embryos,,and gonads. For example, a typical objection con-
cerns the notion of human dignity but also the notion of exploitation and the
squeezing of altruistic donations, which has been advanced as a concern about
the commercialization of the human body (The Danish Council on Ethics, 2013).
The issue of monetary compensation or payment to donors has, therefore, long
been a subject of ethical debate. Yet the idea of a market is here also commonly
understood as consisting of subjects who have ownership of commodities or
objects (Hoeyer, 2014).
Clearly, the buying and selling of human gametes is fraught with ethical con-
troversy. Considering the ways in which gametes, in the Scandinavian context,
enter into 'a close relationship with babies and notions of biological kinship, this
is perhaps not surprising. The primary moral reason for allowing the buying
and selling of human gametes is arguably, in bioethical literature, beneficence.
Assuming that financial incentives will increase the supply of gametes, incentives
will give people opportunities for having children that they would not otherwise
have had. To the extent that demand can already be met, an increased supply of
gametes will give people (who can afford it) more options, for example, in terms
of more healthy gametes or physical likeness with the recipient. Another moral
reason in favor of selling gametes is fairness. Donating gametes, especially eggs,
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34
The Cryopolitics of Reproduction on Ice
comes with certain costs. It is only fair, for example, that donors are rewarded for
their toil and trouble (Brandt et al., 2017). On the other hand, critics worry that
increased commercialization will lead to increased exploitation, a loss of dignity,
and less altruistic donation. The latter is seen as particularly worrying, as altruis-
tic donation promotes "social cohesion," as well as "motives and virtues that are
necessary in order to have a well-functioning society." Moreover, the squeezing
of altruistic donation is seen as morally problematic because "altruism is a good
in itself, which can be worthwhile to promote. Presumably, most people would
prefer living in a society with altruistic as opposed to paid donation" (The Danish
Council on Ethics, 2013a).
Meanwhile, anthropologists and feminist scholars call for a rethinking of the
market. Hoeyer (2013), for example, states:
We need to
denaturalize
market thinking as a transparent repre-
sentation of exchange, while simultaneously taking
into
account
how notions of markets are embedded in very
concrete
experiences
and material exchange practices and have performative effects for
them. (p. 35)
Although not specifically addressing the dynamics of cryopreservation, cryo is
necessary to make the market in reproductive substances possible in the first place.
For example, sperm is frozen and then shipped to clinics as well as private users
worldwide. Meanwhile, the market in preservation tanks, preservation mediums,
and liquid nitrogen constitute the building blocks of turning fertility preservation
into a burgeoning commercial practice. The commodity context, and most nota-
bly the effects of it, is heavily criticized in feminist accounts, however. To femi-
nist scholars, the market logic
in
reproduction reproduces gendered and raced
understandings as well as the desirability of able-bodied, flawless, "own" children
(Coleen, 1995; Ginsburg & Rapp, 1995).
Having briefly outlined theoretical perspectives on market and market think-
ing, we will now move on to two larger imaginaries, focusing on the entanglement
between reproductive cells and the market resulting in the imaginaries of travel-
ling sperm and domesticated eggs.
4. Imaginaries of Travelling Sperm
Because our interest lies in the ways that sperm, in particular, entangles with the
making and unmaking of a market in reproduction, below we outline three ana-
lytical concepts that we believe engage with the Scandinavian context. As noted
in our Introductory chapter, our empirical material primarily consists of legal
documents as well as ethical guidelines that make particular reproductive paths
possible (Adrian & Krolokke, 2018). Clearly, Danish sperm has, as also dem-
onstrated in our historical overview, become an export commodity and conse-
quently, the remaining part of the chapter focuses on sperm. We begin, however,
by discussing how the imaginary of Danish
trai,elliug
sperm can be understood
in the light of three discursive and affective elements: involved in nature and
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The Market in Ice 35
safety, kinship and the best interests of the child as well as within discourses on
commercialization.
4.1. Nature and Safety
What is nature? In the Scandinavian context, "nature" is frequently invoked in
moral debates on the market in fertility (Bryld &
Lykke,
2006). Moral philoso-
phers have traditionally been very sceptical of the entanglement between nature
and morality. And indeed, nature plays a rather murky role in these Scandinavian
debates. In Danish ethical debates, the "unnaturalness objection," is put in close
proximity to the ability to disturb (The Danish Council on Ethics, 2003; see also
Chapter 5). While we return to the notion of disturbance in Chapter 5; the general
thought behind this objection is presumably that evolution tends to lead toward
perfection, and that we should therefore not disturb what has seemingly been
perfected over billions of years. But even if nature holds a particular wisdom, it
is far from clear that this gives us any conclusive moral reasons to allow'or ban
certain treatments and services on the fertility market. More plausibly, disturbing
the so-called natural order can be offset by competing moral considerations, such
as beneficence. For example, we apparently have moral reasons to interfere with
the natural order when people get sick. Presumably, the morality of going against
the wisdom of nature, if there is such a thing, is a question of the potential gain
as well as the potential gravity of the disturbance.
To show that any given disturbance of 'the natural order is morally wrong
therefore requires a separate argument. Indeed, feminist (performative and
post-
humanist)
scholarship has already disturbed and deconstructed the distinction
between nature and culture, or between the natural and unnatural (e.g., Adrian,
2014; Bryld &
Lykke,
2000; Butler; 1993; Franklin, Lury, & Stacey, 2000; Haraway,
1985; Kember & Zylinskaj 2012), In these accounts, albeit in different ways, the
apparently obvious distinctions between nature and culture, body and technol-
ogy are deconstructed to. show that this distinction is, in fact, a cultural construct
and does not reflect any clear boundaries; rather, it produces exactly what is then
understood as nature. Central to these feminist analyses is the notion that the
production of nature is never innocent. Indeed, they are powerful manifesta-
tions of (post)colonial (Bryld &
Lykke,
2000), patriarchal (Haraway, 1985) and
heteronormative (Butler, 1993) imaginaries that favor, in particular, Western,
heterosexual forms of kinship.
It is interesting, though not surprising that the use of cryopreserved sperm
has readily been aligned with heteronormative understandings of the "natural'
heterosexual, nuclear family. Not only is the use of donated sperm in fertility
treatment a relatively old practice as well as well-established in the agricultural
breeding of farm animals prior to human use, it has also been seen as readily
replacing
a so-called natural function in order to create the "desirable" heteronor-
mative nuclear family (Bryld &
Lykke,
2006; Nebeling Petersen, 2009;
Stormhøj,
2006). As genetic kinship was already questionable in certain marital offspring
(e.g., in the case of infidelity), and the general family law framework emphasized
the marital institution rather than genetic kinship as the main constituent of
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36
The Cryopolitics of Reproduction on Ice
paternity (meaning that the husband of the woman giving birth is automatically
given paternal status), the use of donor sperm was entirely uncontroversial. We
will, as already noted, return to the notion of nature in Chapter 5 but it is worth
reiterating at this point that "nature" operates as an unquestionable argument
and one predominantly used by the Danish Council on Ethics as well as, in the
case of political debates, when medically assisted reproductive technologies are
regarded as potentially monstrous, or at the very least, "artificial."
4.2. Kinship and the Best Interests
of
the Child
The notion of "the best interest of the child" is a discourse frequently invoked
in the making and unmaking of a market (Andreassen, 2019; Nebeling Petersen,
2007). For example, "the best interests of the child" was an early element of ethi-
cal debates, together with questions on anonymity and most notably, the rights
of donor children to know the identities of their genetic parents (The Danish
Council on Ethics, 2002, 2004). In contrast, in Sweden, genetic kinship became
pivotal, and in 1985, the right of children to know their genetic parents became
the winning argument as anonymity was abolished, providing children aged
18 years or older with the opportunity to make enquiries about their conception
at public registries.
The best interests of the child appear in the ethical debates in several ways.
Whereas sperm donation itself was, as we have previously seen, uncontroversial,
the question of donor anonymity was not. For example, one argument in favor
of upholding anonymity in Denmark , when anonymous donation was banned
_
in Sweden, was that since it cannot be guaranteed that parents will tell their
children that they were conceived with donor sperm, banning anonymous dona-
tion does not in itself secure the right of children to know their genetic origins,
and, thus, within the argumentative logic, banning anonymity does not secure
"the interests of the child" which was the main argument in Sweden for banning
anonymous sperm donation.
The "best interests of the child" is a moral-ethical argument and one that is
deconstructed in contemporary feminist scholarship. From a moral-ethical per-
spective, it is not clear whether the argument succeeds. Ethicists usually view
moral rights as positive as well as negative: Positive rights presumably give people
the capacity to demand that others act in certain ways, whereas negative rights
s
give people the capacity to demand that others do not act in certain ways. That
is, negative rights are rights not to be interfered with; positive rights are rights to
be benefitted from (Narveson, 2001). Thus it may be that the right of children
to know their genetic origins is a negative right. That is to say that others have a
duty not to deny them this information, even if there is no duty (e.g., for parents)
to provide such information. If so, then it seems that anonymous donation does
interfere with children's right to know, as such donation precludes knowledge.
In feminist scholarship, however, feminists deconstructively problematize the
very notion of "the best interests of the child" and understand the notion, not
as a descriptive term reflecting pedagogical knowledge, but rather, as a rhetori-
cal construct. As such, it functions as a prism to understand a given culture's
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The Market in Ice 37
understandings of kinship, gender and children. For example, in 1997, as part
of the Danish Act on Artificial Fertilization (described above in Section 2.2), it
became illegal for medical staff to assist lesbian and single mothers with repro-
duction.7 In the parliamentary readings leading up to the adoption of the act,
the "best interests of the child" functioned as a strong guiding principle in favor
of excluding lesbian and single women. As "artificial insemination is articulated
[in the proceedings] as a substitution for intercourse, which is represented
as
`the
natural fruit of love', alternatively as `the natural' or `the normal' way of having
children" (Stormhøj, 2006, p. 139), throughout the parliamentary proceedings
"the best interests of the child" became naturalized as secured by heterosexual-
ity including clear demarcations of the nuclear family (i.e., only one mother and
only one father, who are married). Likewise, non-anonymous sperm donation was
represented as capturing the nuclear family, and the "best interests of the child"
became rhetorically staged rather to safeguard the heterosexual nuclear family
and the father than to secure the best interests of the child.
Interestingly, ten years later the law was changed, allowing medical staff to
treat both lesbian and single women (1,151, 2006, p.
37).
Now, the "best inter-
ests of the child" is not solely connected to the heteronormative family, but has
become gendered and connected to motherhood. Women's '(and not necessarily
heterosexuality's) love and nurture for children are discursively connected to a
gendered notion of motherhood. The MP JØrgen Winther, who opposed lesbian
and single motherhood in 1996, is now in favor of it, and he explains in the pro-
ceedings: "I think that it should be possible
for
two gay men to adopt legally. But
I think that a female presence is also essential when it comes to nurture, as women
are really good at looking after children."8 Although these changes in the law did
not change the ban on non-anonymity, it clearly shows, how the "best interests of
the child" can be read as a rhetorical construct, which can be analyzed as a prism
for the changing social concerns associated with ARTs.
4.3. Commercialization
As one of the Danish sperm banks grew and was named the world's largest sperm
bank by Guinness Book of Records, the market in travelling sperm came to align
itself with the historical making of the Viking nation and Danish interests in pre-
serving a national export success as well as averting the danger of sperm drought
and upholding the supply of donor sperm needed to meet demand for fertility
treatment. To Danish legislators, the sperm industry had become a national
export success, and the fact that big industry interests were at stake was even
used as
a
winning argument by the Government in a 2006 parliamentary debate
on maintaining donor- anonymity. The Danish law as well as the Parliamen-
tary debates reflected popular understandings of the Danish nation. This ideal
§3 of Act 460 of 10 June 1997: "Artificial insemination must only be given to women,
who are married to, or who live in a marriage-like relationship with a man."
$
Parliament's reading of the Bill L151, 1. beh., 2006: 19.
7
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38
The Cryopolitics of Reproduction on Ice
included the Viking nation which was made territorially great by spreading its
(male) seeds — a narrative which was widely cited in later international media
news stories under such compelling headlines as "The father's a Viking" (The
Guardian, 4.2.2011), "Invasion of the Viking Babies" (The Telegraph, June 23,
2014), "Spreading Scandinavian Genes, without Viking Boats" (New York Times,
September 30, 2004) (Herrmann & Krolukke, 2018).
In the creation of a commercial market in sperm, previous concerns relat-
ing to donor anonymity were also mentioned. Discussions on donor anonym-
ity combined, however, with the commercial interests of the state, stressing the
importance of anonymity in order to meet the demand for sperm in relation to
fertility treatment. Presumably, many donors would most probably not donate
their sperm if they did not have the option of anonymity, leading to decreased
supply and shortages. At least, this appears to have been the case in countries that
have banned anonymous donation (Bernstein, 2010; although,cf. Cahn, 2012).
Interestingly, the freezing of human sperm not only paved the way for an
international market in anonymous donor sperm from Denmark, it also pro-
vided opportunities for the selection of gametes. With regard to certain dis-
eases, this was seen as a major improvement and using frozen sperm soon
became a requirement in many countries. In Denmark, however, the selection of
gametes for non-medical reasons had already been seen.as morally problematic
for a number of reasons. Thus, Danish clinics could only disclose information
about donors regarding various physical traits that made it possible for couples
to pick a sperm donor that resembled the social father's physical appearance.
At that point in time, clinics could not disclose information about cognitive
capacities, artistic talents, or athletic prowess (The Danish Council on Ethics,
2002b). This is not surprising, considering that the use of donated frozen sperm
in relation to assisted reproduction in the Scandinavian countries had largely
been seen as a replacement of the male in the nuclear family. In this understand-
ing, frozen sperm in fact ensured that the heteronormative nuclear family would
stay intact.
As is often noted in the works of the Danish Council on Ethics, these limita-
tions are in stark contrast with the market for frozen sperm (and eggs) in the
United States. In this
way,
the US is continually referred to as an imaginary of
the limitless consumer society, a scare story on the perils of the free market. In
particular, three moral reasons have been presented in favor of limiting informa-
tion about donors. First, in the Danish context, it has been thought that disclos-
ing further information is inconsistent with a particular cultural understanding
of parenthood—that parents should welcome and love their children regardless
of their capacities. Second, it has been thought that disclosing further informa-
tion about donors could potentially lead to a problematic commodification of
sperm (and eggs), where gametes from donors with certain traits are priced higher
than others on the market. And finally, increased commodification in this domain
has been thought to be morally problematic because it could lead to social ine-
quality, as the most attractive gametes on the market would be reserved for the
rich (The Danish Council on Ethics, 2002b). However, it is not clear why dis-
closing further information about donors, but not basic information regarding
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The Market in Ice 39
appearance and ethnicity, which is commonly disclosed already, would be incon-
sistent with the understanding that children should be loved regardless of their
capacities. Moreover, it is not obvious why stratification of prices would necessar-
ily be morally problematic. For instance, such stratification could also mean that
it would be easier to recruit, for example, donors from certain ethnic groups or
non-anonymous donors, which are currently thin on the ground. Finally, it is not
self-evident that issues concerning increasing social inequality could not be fixed
via regulations such as price ceilings.
5. Imaginaries of Domesticated Eggs
In a parliamentary debate on January 25, 1994 on the topic "What are the govern-
ment's plans in relation to following, regulating or prohibiting the use of current
and future reproductive technologies?" Parliament agreed on a motion confirm-
ing that ethical assessments had to be part of the ongoing development of ARTs
in relation to both research and clinical applications. Parliament underlined
explicitly that treatment could not be introduced if the underlying research was
prohibited according to the 1991 Act on Biomedical Research Ethics Committees
and that the Council on Ethics and Board of Health should be notified before the
introduction of new treatments in order to advise on anyethical and health issues.
Furthermore, the Minister for Health was to make sure that new treatments did
not exceed what was ethically acceptable before they were introduced into clini-
cal practice. The Parliamentary motion was subsequently then transformed into
a Ministerial Order (392/1994) and guidelines (109/1994) by the National Board
of Health.
A remarkable gendered implication of the Ministerial Order was a newly
added restriction on transnational mobility. Increased mobility of human tis-
sues had at
that
time been a European political focal point for more than a
decade with, for example, the Council of Europe's recommendation no. R (79)
5 concerning international exchange and transportation of human substances
(1979) calling for member states to facilitate such exchange. Unfertilized eggs,
embryos and sperm were, however, exempt. It is not clear why the Ministerial
Order restricted transnational mobility on eggs only. However, in a decision of
March 22, 1993, the Health Ministry had denied a Danish woman to export nine
cryopreserved embryos retrieved at a private hospital in Denmark to a private
clinic in Germany where she lived and worked, citing the legislator's premise of
being able to ensure that the limitations on cryopreservation, etc. were enforced.
The decision was brought before the Ombudsperson, who noted (opinion FOU
1993.277) that the legal basis for such a prohibition was inadequate but since he
could not refute that it had been Parliament's intention that eggs and embryos
were to stay in the country for control purposes, there were insufficient grounds
for criticizing the Ministry. It is likely that the ethical concerns relating to freezing
in new reproductive technology formed the background for ensuring the control
of eggs and embryos once removed from the "safety" of the female body. In
2002, the same argument was used as the reasoning for a provision to ensure
that stem cell lines derived from embryos could only be imported into Denmark
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40
The Cryopolitics of Reproduction on Ice
if the same requirements as those applicable in Danish law had been met abroad
(2002/1 LF 209).
While sperm had unrestricted international mobility, eggs were subject to
a travel ban in order to control them. While legal literature (Herrmann, 2008)
argued the ban to be in breach of EU law which guarantees the free movement
of citizens and goods, the ban stayed in place until 2012. In the general remarks
to the Bill,9 it was noted that the ban made it impossible for a hospital to release
frozen eggs to couples who had begun treatment in Denmark and subsequently
moved abroad and wished to continue treatment there. The Government states
that in its assessment, the risk of circumvention of the Danish regulation is low,
not least because the requirement to destroy eggs and embryos-in case of death
or divorce were amended at the same time. As for the "risk" of surrogacy, it was
noted that couples could already travel for such arrangements and that in such
cases the success rate was lower when using transported (frozen) eggs compared
to fresh. Freezing, therefore, and the subsequent lower success rate it implanted
into a different woman, became a reassuring factor that would make circumven-
tion of the Danish regulation more difficult. Finally, the comments,'offer reas-
surance in declaring that lifting the travel ban for eggs does not alter the ban to
"sell, advertise sale or in any other way help the sale of eggs and embryos".
5.1. Nature and Safety
Whereas cryopreserved sperm, as demonstrated in the previous section, readily
became an export commodity, the notion of nature came to play a very different
yet quite significant role in relation to cryopreserved eggs. Meanwhile, ideas relat-
ing to "the natural". helped shape Scandinavian policies on egg donation and later
fertility preservation. For example, in Sweden, IVF was first regulated through
an Act adopted
in
1988. The Act on what was labelled "Fertilization outside
the Bodys10 prohibited the use of donated eggs because fertilization outside the
human body with the use of another woman's egg violated the process of human
life and was a technical construct to such a degree that it had the potential to
affect views on humanity and human nature. IVF could only be used with the
couple's own reproductive cells, however the law permitted the use of donated
sperm in case of insemination. Swedish legislators struggled to find good rea-
sons for this difference between eggs and sperm, as several public consultation
responses, noted
(Bill
1987/88:160, p. 11.), reflecting social and historical norms
.with regard to the importance of the mother in the nurture of children. Her nur-
turing role for the children (as opposed to the father's role as breadwinner for the
household) gave rise to the notion that the female genetic ties were more impor-
tant than those of the male. In 2002, the Swedish position on egg donation was
liberalized, allowing the use of donors.
'https://www.retsinformation.dk/Forms/R0710.aspx?id=141094
1O
Act no. 1988:711.
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The Market in Ice 41
Ideas of nature are, as evidenced in these discourses, heavily gendered. Pro-
longing the reproductive age of women into their 60s, for instance, would, in
Danish ethical and legal parliamentary debates, disturb "the natural order of
things" (see Chapter 5). The same can be said with regards to the skewing of the
usual kinship order, for example, when women use the frozen and stored eggs of
their daughters to give birth to their own genetic grandchildren (see Chapter 5).
From bioethical points of view, appeals to nature are problematic, however. For
example, one could argue that it is simply in our nature to advance our possibili-
ties through technology. This seems highly plausible, judging from the history of
human evolution and societal development. Thus, taking control of our repro-
ductive capabilities via freezing technology can in itself be seen
as
an expression
of human nature. If tinkering with the rest of nature is really what
sets
humans
apart, then it is difficult to see why postponing our reproductive age, for example,
would be unnatural. Moreover, it seems difficult to maintain that some particular
aspects of assisted reproduction are unnatural, while maintaining that assisted
reproduction is not unnatural as such. Thus the "nature" objection of inconsist-
ency threatens to generalize all forms of assisted reproduction.
Moreover, in the case of the cryopreservation of women's reproductive capaci-
ties, prolonging the reproductive age of women by freezing and storing human
eggs, in particular, has invoked monstrous imaginåries of the unnatural. For
example, it is often claimed that children are better off with younger parents (and
mothers in particular). In the words of the Danish Council on Ethics (2015), "it
is better to establish a societal practice that encourages women to have children
earlier in life, because everything else being equal, it promotes the life prospects of
children that their mothers are not too old." Similarly, in the 1994 Parliamentary
debates, a concern over the "unnatural" was featured heavily in the image of the
freezer, the ageing mother and the best interests of the child. We will return to
the best interests of the child in the next section and instead focus on the freezer
and the ageing (monstrous) mother. For example, in one proposition, a leading
Danish politician stated, in reference to the cryopreservation of embryos, that it
was offensive to have "the family in the freezer"'1 calling for a maximum two-year
cryopreservation period.
Meanwhile, the general extension of the one-year legal limit was believed to
address the concerns relating to the woman and her family, cases of illness and
the physical and mental trauma of having to undergo renewed hormone stimula-
tion and egg retrieval. The extension was meant to ensure the successful achieve-
ment of one pregnancy in accommodating further treatment cycles when the
first attempts were unsuccessful. It was noted that longer cryopreservation limits
abroad indicated that there were no safety issues involved in extending the limit.
However, the limit was not extended beyond two years out of consideration for
"Second reading of Bill L5 on 29 April 1997,
Folketingets Forhandlinger
1996-1997,
page 6352 and the proposals made during the subsequent Health Committee delib-
erations between readings [not publicly available, but made available to the authors
courtesy of the Library of the Danish Parliament].
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42
The Cryopolitics of Reproduction on Ice
the voiced ethical concerns including the Council on Ethics, which in their annual
1995 report stated that one scientific study indicated that the cryopreservation
of eggs would be likely to damage chromosomal material. Between readings, the
parliamentary Health Committee considered the Bill and members put forward
various suggestions for amendments to the Bill. Their deliberations, the mate-
rial they received in the public consultation process, and the suggested amend-
ments reflect a number of key concerns and questions: Would the technology
lead to unnecessary treatments potentially burdening the welfare state? And what
were the consequences of individualizing eggs and embryos in this way in relation
to women's rights on the one hand and disposition rights over (he material on
the other?
In this juxtaposition of the (un)natural, a clear gendered order came into
effect. Whereas male gametes had no storage limit, women's eggs have histori-
cally been restricted with regard to the number of years that they could be pre-
served in a frozen state (with a further restriction regarding their transnational
mobility added in 1994). The Council on Ethics' report formed part of the back-
ground material for the 1991 Act on Biomedical Research Ethics Committees,
which lifted the research ban on fertilized eggs in order to ensure an adequate
quality in the provision of fertility treatments. IVF was now becoming a recog-
nized treatment in clinics, which meant that research — as was the case in all other
treatments offered — was deemed integral in ensuring good quality. Article 14 of
the Act authorized the Health Minister to issue a ministerial order regulating the
donation and cryopreservation of human eggs., This included first and foremost
requirements when establishing egg banks and cryopreservation. But in reality,
the authorization was intended for the regulation not only of technical issues,
but also of a normative issue, reflected in the fact that the Government explic-
itly stated that it presupposed a maximum cryopreservation period of 12 months
for eggs and embryos, but no reasoning for the limit was given in the comments
included in the Bill (L59/1991). In this way, eggs and embryos were regulated in
ways that sperm was not. For the Council on Ethics the winning argument for
regulating storage seemed to be the preservation of viability, while the Govern-
ment did not give any reasoning for fixing the limit at 12 months in the prepara-
tory work:
In what we may view here as the "Moral Danish State," an attempt was made
to regulate the normative issue of the status of the egg as well as that of the
embryo along lines of nature and safety. Authorization was given to the Minis-
ter to regulate technical issues in a law predominantly concerned with codifying
the framework for biomedical research ethics that had previously been based on
a non-binding professional framework. The Moral State was clearly not com-
pletely comfortable with regulating medical practices, which was in line with the
general legal trend at the time — medical issues were on the whole best left to
doctors to decide on a professional basis. Between readings in Parliament as
the Bill passed to further deliberations in the relevant parliamentary com-
mittee, the Health Minister had, in a reply to question 96 from the Committee
stated that "cryopreservation of eggs is allowed when intended for later implan-
tation in the same woman or for donation: Unfertilized human eggs cannot be
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The Market in Ice 43
cryopreserved for more than 12 months" (White Paper No. 59, 1992). Since the
Act's authorization had to be interpreted in light of the scope articulated in
the preparatory work, cryopreservation was regulated accordingly in adminis-
trative practice. Despite the fact that the Ministry had received more than 100
applications from couples asking for extensions to the 12-month period due
to physical and mental problems associated with having to undergo a renewed
cycle of egg retrieval, it had been impossible to grant extensions due to the lack
of a legal basis to do so.
While the "unnaturalness" of the elderly mother was certainly a concern (see
Chapters 3 and 5), other monstrosities were also mentioned. Notably, in these
Parliamentary debates, the monstrosity of disrupting what appeared to be a nor-
mative kinship order ("twins in separate pregnancies") became pivotal. Accord-
ing to a spokesperson for the Social Democratic Party, separating "twins" became
morally suspect:
At present no eggs are frozen, but technology may catch up.
I think that 12 months is the right amount of time. To me, there is
something unethical about having embryos in storage maybe even
to have twins in separate pregnancies.
Similarly, the Conservative Party's spokesperson expressed concern when com-
paring frozen reproductive cells with what she speculated was a similarly poor
viability of frozen food:
It is the thought of the artificial that scares me ... after two or
three years in the freezer ... are the eggs in good condition? The
food we freeze has a shorter shelf life.
Meanwhile, the spokesperson for the Socialist Party reiterated the need to
tame ARTs, simply referring to the technological developments as "monstrous
research" (1996/1 LSF 5 debate). The Bill did, however, not succeed in being read
three times in the parliamentary working year because the parliamentary Health
Committee felt that there was insufficient time to debate and negotiate the Bill
and consequently it was automatically struck. Government put forward the Bill
with slight revisions the following Parliamentary year (1996/1 LSF5).
5.2. Kinship and the Best Interests
of
the Child
Interestingly, while sperm, in the legal and Parliamentary debates, escaped the
position of becoming kinship bearers, of eggs became bearers in need of state
protection. In this context, the ability to cryopreserve eggs and embryos became
technologies to be tamed. Consequently, the entanglements between Parliamen-
tary debates and Danish law produced an image of the welfare state as rightfully
controlling women's abilities to put eggs on ice. In the context of the law, in 2006,
a Bill (2005/1 LF151) sought to update the Act on Artificial Fertilization and
included new provisions on assessment of parental skills, widening access for egg
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44
The Cryopolitics of Reproduction on Ice
donation, and extending the maximum period of cryopreservation of eggs to five
years. The accompanying remarks state that both the Ministry and the National
Board of Health had continued to receive requests for dispensation in order for
couples to try for a second child with the cryopreserved fertilized eggs. It is worth
noting that, during this time period, the debates made reference to cryopreserved
eggs and fertilized eggs interchangeably.
Whereas one pregnancy had been the goal of the previous legislation, the
issue was now to secure families more time to establish a continued kinship
order and a second pregnancy. Relying upon scientific knowledge that cryo-
preservation posed no risks, the government extended the cryopreservation limit
to five years, successfully enabling the possibility of two children established
within a normative kinship order. It was stressed, however, that cryopreserved
eggs were subject to other legal limitations in addition to the length of the cryo-
preservation period, such as the requirements of destruction in case of death
and divorce, the rules on donation to other women and the requirements of con-
sent in the case of donation to research. It was to ensure enforcement of these
rules and requirements that an upper limit for cryopreservation should still be
in place. Meanwhile, no upper storage limit was in place on the cryopreservation
of sperm.
5.3. Commercialization
The ability to cryopreserve has also had a strong impact on what is today becom-
ing a market in eggs. This is seen, for example, in the ways in which the Dan-
ish law has sought to respond to cryopreservation practices. Here, the imaginary
of medicine as a scientific and commercial endeavor, in the service of the moral
good, has shifted. Notably, eggs came to be seen early on as vulnerable entities in
need of protection, in terms of limiting storage time and transnational mobility,
while no such concerns were expressed with regard to sperm. In this context, the
realm of new technology had to be tamed because of what became framed as
the risks to the patients 'and the overall ethical concerns relating to present and
future reproductive options, including the gendering of reproductive cells (see
also Chapter 3).
Today, the cryopreservation of eggs for non-medical reasons on the one
hand appears to challenge the ideas of the domesticated egg yet on the other
hand also reiterates it, as eggs are now presumably preserved for later self-
donations (see Chapter 3). Freezing for non-medical reasons, however, sup-
ports a burgeoning international market in fertility preservation. For example,
in the case of the Danish sperm bank, Cryos, cryopreservation has provided
the technological grounds for expanding their sperm bank to the US market,
enabling egg banking as well. Meanwhile, in the case of freezing for non-
medical reasons, Swedish clinics advertise their- cryopreservation services to
Danish women, encouraging them to preserve their fertility in Sweden for a
maximum period of ten years, thus bypassing the Danish five-year cryopreser-
vation rule.
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The Market in Ice 45
6. Summary
If eggs become a commodity, a global market may emerge, where
some international actors will be willing to pay large sums of
money. We do not want that. We want to meet the Danish demand
for 600 donor eggs per year so childless Danish citizens can receive
the treatment they require (Flemming Moller Mortensen, politi-
cian (S), in
Berlingske Tidende. [Ladefoged,
2016])
Throughout this chapter we have discussed how it came to be that Denmark
became a frontrunner on the international market for frozen sperm, while no
corresponding Danish market has emerged for frozen eggs. In this summary sec-
tion, we briefly outline some of the key arguments that, in the context of the
Scandinavian countries, naturalize a market in sperm yet remain resistant to the
commercialization of eggs. One apparent reason is the concern_, as echoed in
the above quote, that an international market for eggs would be detrimental
to Danish citizens in need of fertility treatment, as private corporations would
simply sell off Danish donor eggs abroad, where the potential financial gain is
greater than at home, if they were allowed to trade in eggs similarly to the way in
which they trade in sperm. In this imaginary, eggs are seen as a scarce resource yet
potentially also more financially valuable on the global market while "inherently"
belonging (unlike sperm) to the nation state.
In the above quote, the commercialization of eggs raises the question of
whether we have stronger moral obligations toward members of our own coun-
tries than we have toward citizens of other countries. There is a concern that
allowing an international trade in frozen eggs (similar to sperm) would mean that
childless citizens abroad would have better prospects of treatment, as human eggs
are a scarce resource in most countries, at the expense of Danish citizens in need
of donor eggs. The question is whether it is morally justified to reserve the avail-
able eggs for Danish citizens in need of fertility treatment, as opposed to selling
them on an international market. According to the political philosopher David
Miller, nations are shared communities, and because of this shared community
"the duties we owe to our fellow nationals are different from, and more extensive
than, the duties we owe to humans as such" (Miller, 2000, p. 27). According to this
perspective, the Danish state does indeed have a moral reason to prioritize Dan-
ish citizens when it comes to fertility treatment. But even in this relatively weak
form, nationalism remains, however, a controversial view in the field of political
philosophy (Nenad, 2018).
As noted in this chapter, the Scandinavian markets in cryopreserved eggs
and sperm follow very different trajectories. Although arguments relating to
nature, kinship, and the best interests of the child as well as concerns relating
to commercialization can be seen in legal briefs, political discussions and ethi-
cal controversies and guidelines, these arguments follow, as evidenced through-
out our discussion, very gendered trajectories. In contrast to the construction
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46
The Cryopolitics of Reproduction on Ice
of the Moral State and technologies to be tamed, notably present in the case of
cryopreserved eggs, imaginaries of market opportunities and Danish sperm that
"naturally" transgresses nation states and becomes an export commodity guide
the ways in which sperm becomes regulated, in effect creating what more closely
approximates a (thriving) monetary market for sperm than for eggs. While this
chapter has taken a wide perspective in outlining the making and unmaking of a
market in Scandinavia, it underlines the ways in which this market entangles with
cryopreservation technologies as well as the ways in which it comes to be narrated
in the light of gendered as well as national concerns relating to the exceptional
welfare state.
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Chapter 2
Disease: On the Use of Freezing on
Medical Indication
1. Introduction
This chapter concerns fertility preservation in the context of disease, or what is
often conceptualized as "medical freezing" or freezing on "medical indication."
A standard example of medical freezing is the cancer patient who freezes repro-
ductive cells or tissue before going into chemo- or radiation therapy. However, as
we will demonstrate in this chapter, the demarcation of "medical freezing" and its
connection to the notion of disease is not necessarily clear, nor- absolute. Rather,
the rationales and logics behind what comes to count as medical freezing as well
as who are seen as "worthy" candidates for medical freezing serve as important
sites for investigating the normative frontiers of biomedical achievements and
sociotechnical imaginaries associated with fertility preservation.
The development of programmes for "medical freezing" is entangled with the
developments in especially the treatment of cancer. With rising survival rates,
more attention has been directed at the late complications of, for instance, cancer,
including fertility-related difficulties (Woodruff, 2007; for cancer statistics in the
Nordic countries see NORDCAN, 2019). In fact, this concern has laid the ground
for the development of oncofertility as a separate field within reproductive medi-
cine that specializes in fertility preservation in cancer patients (Woodruff, 2007).
With the increased awareness and understanding of how specifically chemo- and
radiation therapy as well as certain diseases (also non-malignant diseases such as
Cryptorchidism, Turner syndrome, or Lupus) affect future fertility, attention has
been directed at technologies for storing reproductive matter outside of the body
"before it is too late"; at protecting the capacity to reproduce, rather than offering
assisted reproduction afterwards with poor results.
Currently, cryopreservation is positioned as the most promising method for fer-
tility preservation. However, other technologies are also available. In a 2014 article
detailing clinical guidelines for fertility preservation, one of the leading fertility
experts Sweden, together with an American colleague, outlined several different
in
The Cryopolitics of Reproduction on Ice: A New Scandinavian Ice Age
Emerald Studies in Reproduction, Culture and Society, 47-71
Copyright © Authors, 2020
doi:10.1108/978-1-83867-042-920191004
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48
The Cryopolitics of Reproduction on Ice
options for fertility preservation that should be considered (Rodriguez-Wallberg &
Oktay, 2014). Besides from cryopreservation, Rodriguez-Wallberg and Oktay
(2014) suggest to always consider shielding of testis or ovaries from radiation if
possible. Another option is "ovary transposition" which involves surgically mov-
ing the ovaries and fallopian tubes to the abdomen wall away from pelvic radiation
areas. They also mention, but reject, the possibility of using hormone-suppressive
drugs in females which some biomedical professionals believe to have a protective
effect by putting the cells "to rest." It is a contested practice (see, for instance,
Blumenfeld, 2014), and our field observations show that, at least in Denmark, go-
called GnRH agonist is often given in combination with cryopreservation of eggs
or ovarian tissue. In males, the overall viewpoint internationally 'is that hormonal
approaches to conserving fertility have so far not proven useful or only to be of
limited value (Picton et al., 2015).
Bodily differences between testis, sperm, ovaries, and oocytes (eggs) enable
and disable particular practices regarding fertility preservation in ill patients.
As also described in the previous chapter, cryopreservation of sperm has been
in place longer than other techniques. Likewise, embryo freezing proved to be a
robust technique to be offered, also in the Scandinavian countries, long before the
freezing of oocytes was successful. Embryo freezing is, however; only an option
for women who have time for egg retrieval and access to sperm to be used for
fertilization. In the context of disease, this leaves out large numbers of women
who are either in too much in a hurry to start treatment or single (and unwilling
to use donor sperm). Additionally, neither are options for prepubescent children/
adolescents who cannot have eggs retrieved nor ,produce viable sperm samples.
Consequently, in the 1990s, selected clinics'in Sweden (1995) and Denmark
(1999), on an experimental basis, started preserving ovarian tissue from cancer
patients (Oslo University Hospital, Norway followed in 2004; c£ Rodriguez-Wall-
berg et al., 2016). Additionally, new vitrification techniques improved the freezing
of unfertilized eggs in the early 2000s (Gook, 2011), which made oocyte freezing
an option in many of the university hospitals in the Scandinavian countries in the
following decade (Rodriguez-Wallberg et al., 2016). However, despite the techno-
logical possibilities, the Scandinavian fertility doctors recognize that far from all
patients whose fertility can be compromised by treatment or their condition are
offered fertility preservation (Rodriguez-Wallberg et al., 2016). As we will discuss
further in this chapter, alternatives to sperm cryopreservation, if the testis are not
mature, are still limited and highly experimental.
This chapter reveals how the material differences of procedures and biologies
matter to the ways medical freezing emerges as an offer to patients as well as to how
cultural norms shape the procedures and experiences of fertility preservation. Time
and risk assessments are important elements. For instance, the retrieval of eggs
requires hormonal stimulation over a few weeks to ripen multiple eggs. A single
cycle stimulation, however, only produces a limited number of eggs which might
not be enough to enable a full-term pregnancy, less not several. In contrast, the
preservation of sperm and gonadal tissue can be performed from day to day and
involves thousands of sperm and egg cells. However, tissue preservation requires
surgical procedures and is in this sense a more extensive and risky procedure.
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Disease: On the Use of Freezing on Medical Indication 49
In what follows, we engage with how these differences enable diverse visions
of "medical freezing," entangling technologies, materialities, and imaginaries of
future families as we ask how socio-technical imaginaries unfold in the practices
and visions of cryopreserving reproductive material from ill people in the context
of the Scandinavian welfare states. Empirically, the chapter focuses on the Danish
case, as it builds on ethnographic fieldwork on ovarian tissue freezing and sperm
depositing conducted in Denmark. Drawing on observations, document analyses
of medical journal articles and websites as well as interviews with both biomedi-
cal professionals and patients who have frozen, respectively, sperm and ovarian
tissue in relation to serious disease (see Appendix), the chapter seeks to demon-
strate how "medical freezing" is conceptualized, envisioned, and experienced (for
more details on the empirical data, see also the Appendix).
The chapter begins with a section contextualizing cryopreservation practices
on medical indication within the regulatory frameworks of the different Scandi-
navian welfare states, though the empirical analyses centers the Danish case. To
situate our discussion of medical freezing further, we then turn to a theorization
of the notion of disease. In the empirical section,
we
analyze and discuss four
elements central to the way fertility preservation emerges
in
the context of dis-
ease and is imagined by biomedical professionals as well as among the people
who are freezing. We first look at the biomedical imaginary of progress in which
fertility preservation emerges as a new and promising, yet challenging, remedy
for optimization and risk management. Afterward; we demonstrate how fertility
preservation is experienced as a type of cryo-insurance, illuminating specific affec-
tive economies of hope and fear that medical freezing is entangled in. In the last
section, we examine the gendered imaginaries that unfold in the patients' accounts
of cryo-insurance, demonstrating how fertility preservation is not only a matter of
protecting one's reproductive capacity but also tied to the restoration of norma-
tive bodies and gender identities. The chapter concludes with a brief summary in
which we also take=up the discussion of how the notion of "medical freezing," in
contrast to "social freezing" (see also Chapter 3), is interwoven with larger discus-
sions about prevention medicine as well as ethical and economic prioritizations in
the welfare state.
2. The Legal Framework
The Scandinavian countries all have legal frameworks that are permissive toward
medical freezing. The guidelines of the Swedish Society for Obstetricians and
Gynecologists note that the distinction between "social" and "medical" freezing
is not always easy to determine, but highlights the distinction as important since
the categorization can bear upon whether the cost is covered by the public health
care system or paid out of own pocket (SFGO, 2015). In 2012, Danish law was
changed to better accommodate medical freezing and now authorizes the physi-
cian to extend the 5-year freezing limit on eggs and embryos if medical reasons
exist for doing so, implicating that freezing can be extended for as long as the
medical reason for doing so exists, and as long as the upper age limit of 45 years
is observed. Clearly, the imaginary of motherhood as a positive future option
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SO
The Cryopolitics
of
Reproduction on Ice
overrides, in the case of medical freezing, initial concerns of prolonged freez-
ing while still maintaining the imaginary of the monstrosity associated with late
motherhood which dominated the initial law-making process as discussed in
other chapters (see the discussion in Chapters 1, 3, and 5). In Denmark, sperm
can be stored indefinitely, and even be used after the death of the patient which
we discuss in more detail in Chapter 4.
Sweden offers both egg and sperm freezing without storage limits, but' limits
embryo freezing to 10 years. Interestingly, Norway allows egg freezing solely on
medical indication and with no storage limitations per se (but limits use in terms
of age and relationship requirements). Meanwhile, in Norway, embryos cannot be
stored for more than five years despite medical indication and the patient has to
comply with the overall conditions for embryo freezing, for example, being in a
stable relationship (NGF, 2019). Long term freezing of sperm is available on medi-
cal indication only and performed at public hospitals for men suffering from dis-
eases or undergoing treatment that affects fertility Use of stored sperm for assisted
reproduction must comply with the condition of having been in astable relation-
ship for more than two years or being married (see Introduction for more details).
Meanwhile, ovarian tissue freezing is offered in Denmark, Sweden, and Norway.
In comparison, Denmark has been most successful in terms
of
the number of chil-
dren born following the procedure (14 out of the 17 children that had been born
in the Nordic countries in 2016 were born in Denmark. The Danish centre has
also cryopreserved and transplanted much more tissue than in the other countries,
Rodriguez-Wallberg et al., 2016, pp. 1019-1020). On the other hand, as we will
return to later in the chapter, Sweden has pushed the agenda on whom medical
freezing can be offered to. In Sweden, ovarian tissue from young girls with Turner
Syndrome is cryopreserved, as are eggs (or even ovarian tissue) in relation to gender-
corrective surgery, regarding it as freezing on medical indication (SFGO, 2015).
We will not discuss fertility preservation in transgender individuals more in
this chapter, but return to the topic in Chapter 5 when we discuss the normative
imaginaries that affect 'and delineate how transgender people have (or have not)
become eligible and intelligible subjects of fertility preservation. The conceptu-
alization of fertility preservation in relation to gender-affirming surgery is com-
plicated, and differs significantly between the Scandinavian countries, relating to
the more overall understanding of transgender healthcare which has undergone
significant change in the past decade in all three countries.
While fertility `preservation is free of charge in the Scandinavian countries,
when done on medical indication, access to medical freezing relies on specific
estimations of the likelihood of future infertility which are made by cancer and
fertility specialists (Rodriguez-Wallberg et al., 2016). Some drugs and treatments
are known to be specifically damaging, but in principle the risk of each patient is
evaluated on the basis of the treatment procedure, the age of the patient, the like-
lihood of survival and the time available before treatment has to start. In women
with cancer, the official Danish guidelines, for instance, state that the risk of los-
ing fertility has to be >50% (Jensen et al., 2017). However, risk is hard to predict,
especially in cancer patients as treatment plans often change over time or in the
case of relapse. Importantly, the reproductive material has to be extracted and
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Disease: On the Use of Freezing on Medical Indication 51
preserved before too much chemo has been distributed in the body. Here, the
context of the Scandinavian welfare state matters as doctors, who do not have to
worry about the patient's medical expenses or insurance plans, are able to apply a
"better safe than sorry" approach offering fertility preservation to an increasing
number of patients whose chances of survival appear high.
Finally, age is an important inclusion criterion for fertility preservation, espe-
cially in women. In Norway, ovarian tissue freezing is not offered to women above
the age of 35 years, while egg and embryo freezing can be offered until the age of
39 (NGF, 2019). In Denmark, medical freezing in females is overall regulated by
the age rule that restricts assisted reproduction to women below the age of 45, but
above the age of 35 ovarian tissue freezing is only offered to women whose ovarian
reserve is regarded as good enough by the fertility specialists (Jensen et al., 2015).
The same age criteria do not apply to men. In Denmark, we have come across, in the
public sector, men in their 60s having established sperm deposits paid by the public.
Though tissue preservation is the new and promising possibility, it is important
to emphasize that within the Nordic region, the freezing of sperm is stilt the most
common type of fertility preservation (Rodriguez-Wallberg et at., 201b, p. 1024).
Compared to the retrieval of eggs or gonadal tissue, sperm is also much easier to
deposit. Based on data from the public fertility centers in the Scandinavian region,
it is estimated that for every patient who preserves eggs,, embryos, or ovarian tis-
sue, three patients deposit sperm (Rodriguez-Wallberg et al., 2016, p. 1024).
Viewed through the lens of this chapter, medical freezing in the Scandinavian
welfare states raises a number of interesting ethical questions. Notably, medical
freezing raises ethical questions related to the prioritization of scarce financial
resources within the healthcare system, as we will also return to throughout the
chapter. There are several trajectories of this debate that relates to the notion
of cryo-insurance which we introduce later in the chapter. One aspect, however,
concerns how to balance public finances in relation to the overall low utilization
rates of frozen gametes and tissues documented by previous research. Studies on
the usage rates of cryopreserved sperm among cancer patients have showed the
return rates to be between 5% and 10% (e.g., Carcia, Herrero, Holzer, Tulandi, &
Chan, 2015; van Casteren, ;van Santbrink, Van Inzen, Romijn, & Dohle, 2008) and
among men with other types of disease around 30% (Carcia et al., 2015). Belgian
studies found the return rate for embryo freezing in female cancer patients to be
23% (Dolmans, De Ouderaen, Demylle, & Pirard, 2015) and for ovarian tissue to
be as low as 2.3% (Dolmans et al., 2013). In Denmark, the return rates for ovarian
tissue is also less than 10%, however, the Danish team expects the return rate to
increase as many young patients come of age (the youngest patient was around
six months old). A second aspect is, as we also discuss further in the chapter, the
success rates in terms of how high (or low) the likelihood of actually producing
viable pregnancies is. While the statistics differ between different techniques and
'It is important here to note that this estimate does not include Danish data on sperm
cryopreservation which is not centralized in Denmark in the same way as in the other
Nordic countries.
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The Cr yopolitics of Reproduction on Ice
materialities, ethical questions about whether fertility preservation is giving the
patients false hope influence the development of the field as well as the way that
fertility specialists work together with the doctors treating the original condition
making "medical freezing" relevant in the first place.
Overall, the discussion of prioritization and, thus the conceptualization of
medical freezing, relates to changing notions of illness and infertility. In the fol-
lowing section, we turn, however, to social scientific theorizing of disease.
3. Theorizing Disease
In this section, we theorize freezing for medical reasons in light of biomedicali-
zation theory (Clarke, Shim, Mamo, Fosket, & Fishman, 2003), social scientific
theorizing of risk, and surveillance medicine (Adams, Murphy, _& Clarke, 2009;
Clarke et al., 2003) while simultaneously situating freezing for medical reasons as
a hope technology (Franklin, 1993, 1997). Overall, we approach fertility preserva-
tion as it emerges as infertility prevention offered to patients. That is, individuals
whose fertility might be compromised by the medical treatment they are receiving
or by a medical condition. However, we also wish to demonstrate how fertility
preservation, as a new type of preventive medicine, illuminates a more overall
transformation of the ways biomedicine operates
in
the welfare state. This trans-
formation has overall been captured in the notion_ of "biomedicalization" (Clarke
et al., 2003; Rose, 2007). The term biomedicalization grasps how "biomedicali-
zation practices emphasize transformations of such medical phenomena and of
bodies, largely through sooner-rather-than-later' technoscientific interventions
not only for treatment but also increasingly, for enhancement" (Clarke, Shim,
Mamo, Fosket, & Fishman, 2010, p. 2).
First, however, we turn to a brief discussion of the ways that infertility is con-
ceptualized as a "disease to highlight the ways that biomedicine and cultural norms
associated with fertility entangle. Arguably, the advancement of medical freezing
is co-produced with a more general turn toward the biomedicalization of infertil-
ity. Clearly not a life-threatening condition in itself, infertility is frequently, how-
ever, conceptualized as a chronic disease with severe psycho-social effects and thus,
regarded as a condition that should be prevented if at all possible. This is in spite
of the fact that within Western biomedicine, in general, disease has traditionally
been conceptualized as biological or physiological malfunctions or deviations. Yet,
this understanding has become contested as too narrow and simplistic and not
taking into account the psycho-social dimensions of health and well-being (The
Danish Council of Ethics, 2016). For example, this understanding is reflected in
the constitutional work of the World Health Organisation (WHO) who already in
1946 defined health as "a state of complete physical, mental and social well-being
and not merely the absence of disease or infirmity" (WHO, 1946, p. 2).
In similar ways, the understanding of infertility has developed. While still defined
as a disease, the definition has expanded from a defect in the reproductive organs to
a broader understanding of being "unable to establish a pregnancy" without assis-
tance (Zegers-Hochschild et al., 2017). This understanding takes the psycho-social
dimension into account, while also extending fertility care to (fertile) partners as
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Disease: On the Use of Freezing on Medical Indication 53
well as to non-heterosexuals. This understanding can be found, for instance, in
The International Glossary of Infertility and Fertility Care from 2017 which estab-
lishes that infertility is: "A disease characterized by the failure to establish a clinical
pregnancy after 12 months of regular, unprotected sexual intercourse or due to an
impairment of a person's capacity to reproduce either as an individual or with his/
her partner" (Zegers-Hochschild et al., 2017, p. 1795). While the political signifi-
cance of calling infertility an impairment can be debated (e.g., Brown, 2018; Lo &
Campo-Engelstein, 2018), the overall aim of the definitory work has, according
to a group of leading fertility specialists, been to provide more people with access
to fertility treatment/care (Zegers-Hochschild et al., 2017, p. 1787). Arguably, this
also reflects what The Danish Ethical Council, in a report called "what is disease?",
terms the humanistic disease model (Danish Ethical Council, 2016, p. 9). Here the
understanding of disease is connected to the idea of a "condition" as something
that affects the person's "capacity to act" and "to live their lives in accordance with
the values and projects the person subscribes to and has chosen to build their way
of life around" (Danish Ethical Council, 2016, p. 9 — translation by authors).
Describing the changes of biomedicine especially with regard to (bio)techno-
logical innovations, Clarke et al. (2003) highlight how biomedicalization involves
an increased focus on being and remaining healthy rather than diagnosing and
treating existing symptoms. Health becomes an individual goal as well as a social
and moral responsibility (Clarke et al., 2003, p. 17I ). This orients medical attention
toward risk prediction and surveillance medicine, which are mutually constitutive
practices. As Clarke et al. (2003, p. 172) emphasize: "Risks are calculated and
assessed in order to rationalize surveillance, and through surveillance risk is con-
ceptualized and standardized into ever more precise calculations and algorithms."
In the context of disease, then, fertility preservation comes to rely on practices
of prediction and risk assessment and they entangle with the management of
contemporary treatment protocols. Fertility preservation is, in that sense, an act
of anticipation (Adams et al., 2009) of predicting in the present that infertility
might likely occur in the future either due to a bodily condition such as cryptor-
chidism in young boys or due to invasive cancer treatment, known for its damag-
ing effects on reproductive cells. As we will also discuss in this chapter, the new
medical regime of prediction and prevention seems to be exceeding the classic
boundaries of somatic medicine as more attention is directed toward environ-
mental risk, such as the effect of radiation from mobile phones on sperm quality
(Gorpinchenko,
Nikitin,
Banyra, & Shulyak, 2014), the effects of chemicals from
cosmetics (Rehfeld, Dissing, & Skakkebwk, 2016) as well as to age and the perils
of hormone deprivation
(Kristensen
& Andersen, 2018). Consequently, enhanced
focus on prevention means that medical freezing could be regarded as an offer
which should include, at least in theory, many more people whose future fertility
is
at
risk. Thus, the biomedicalization of (in)fertility challenges a clear demarca-
tionbetween medical and social freezing, which is a foundational rationale of the
Nordic welfare states where "medical freezing" is offered for fine, while "social
freezing" is privatized or restricted (Chapter 3).
Moreover, fertility preservation practices involve a specific entanglement
of biomedicalization and cryopreservation as cold storage is currently the
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54
The Ciyopolitics of Reproduction on Ice
driving technology in establishing programmes for protecting patients' fertil-
ity. As
Kroløkke
& Bach (in review) argue the ability to freeze not only involves
imaginaries of prevention and optimization, but also specific ideas about the
(re)synchronization of (sick) bodies with normative life trajectories, for exam-
ple, through the restoration of reproductive capacities, the induction of timely
puberty around the beginning of adolescence and the postponement of prema-
ture menopause. Embodying a specific form of cryomedicalization
(Kroløkke
&
Bach, forthcoming), fertility preservation involves the management of bodily
time, including aging, as well as it becomes an orientation toward reproductive
futurity (Edelman, 2004). Not only is reproduction encouraged, reproductive
desire is also taken as a given as captured by Franke (2001) in the notion of
repronormativity. Furthermore, as much critical feminist scholarship has demon-
strated, this entails a strong cultural connection between the ideal of "building
one's own family" and notions of the good and happy life. Consequently, follow-
ing Edelman (2004) and Ahmed's (2010) work, the childless life is then always
already positioned as an unhappy and undesirable life. In his conceptualization
of reproductive futurity, Edelmann further criticizes the strong moral imperative
to participating in the reproduction of society through the production of new
citizens. Following also Rose (2007) and Carroll and Krolokke (2017), medical
freezing can then be understood as a specific technology of the pronatalist wel-
fare state to uphold, and thus manage, the reproductive biocitizenship of patients
despite their illness.
Freezing can, however, also be aptly understood as a hope technology, as Sarah
Franklin termed technologies for assisted reproduction in her early work on IVF
(Franklin, 1993, 1997). Not only does frozen 'reproductive material promise a
chance of genetic offspring, it also orients the sick patients toward a normative
future. The child, even the prospective child, can be seen as what Ahmed (2014)
calls a token of futurity.
By
overcoming specific age- and time-related issues, the
preservation of sperm, ovarian and testicular tissue extends this hope to groups
of sick people for whom preserving cells and tissue might likely be the only chance
(for genetic children). As Delvecchio Good, Schaffer, and Lind (1990) and Brown
(2015), among others, have demonstrated, cancer treatment is already in itself
entangled with the production and surveillance of hopefulness and optimism.
Not only are doctors and scientists preoccupied with providing better treatments
which will increase the likelihood of survival, "hope is a crucial element within
the therapeutic armoury of nursing for patients with life-threatening illnesses"
(Rose, 2007, p 135). Describing the introduction of "hope scales" and "hope
indexes" in the clinical practices, Brown (2015) further points to the emerging
interest of biomedicine to metricise the emotional states of sick individuals, espe-
cially cancer patients, as hope is also increasingly seen as central to being cured,
or at least responsive to treatment. Hope surveillance is, as Brown argues, not just
a measure of emotions already existing in the individual, but part of an institu-
tional and disciplinary discourse that produces "modes of self-management and
affective decorum" (Brown, 2015, p. 121).
This theoretical section shows how freezing for medical reasons has to be
contextualized within the more overall biomedicalization of infertility as well as
seen in light of risk and surveillance theories along with being situated as a hope
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Disease: On the Use of Freezing on Medical Indication 55
technology. In the context of disease and in the specific case of the Scandinavian
welfare state, cryopreservation is co-constituted not only as a desirable repro-
ductive technology, but as an integral part of the welfare state management of
sick people who can engage with the prospects of future reproduction, and thus,
become cured citizens with reproductive potential.
4. Imaginaries of Medical Freezing
In the analytical sections that follow, we highlight the discursive, material,;and
affective configurations associated with freezing for medical reasons. While we
primarily draw upon interviews with women and men who, in the face of serious
disease, have had their reproductive cells or tissue preserved (see Appendix), our
point of departure will often be the Danish context. Several reasons exist for this.
For one, and as will become apparent in the analysis, Denmark considers itself at
the forefront of tissue preservation while already having established a world-wide
reputation for its sperm bank business (see Chapter 1). In our analysis, we will
discuss the ways that our empirical material engages with different imaginaries
such as discourses associated with progress and possibility, risk prediction and
management as well as the ways that freezing turns into a cryo-insurance in the
imaginary of future fertility.
4.1. Imaginaries of Progress and Possibility
Fertility preservation is of high priority to many of these patients
and planning for it may provide some emotional comfort and
assurance while going through often harsh chemo- and/or radia-
tion therapy, knowing they may regain menstrual cycles and cre-
ate their own family onee they have recovered from the disease.
Not only will they possiblyy.be able to have children after otherwise
sterilizing treatment, but they may even be able to avoid hormone
replacement therapy and not go through premature menopause.
(Andersen, Silber, Berghold, Jorgensen, & Ernst, 2012,
pp. 128-129)
Stories of medical progress and scientific achievements are dominant imaginaries
on medical freezing. No matter whether the medical narrative of cryopreserving
reproductive material from sick patients reflects on the freezing of sperm, eggs,
ovarian
or
testicular tissue, fertility preservation is a story of discovering new
methods and providing better options for more people and new groups of patients
who can now be (more) hopeful about future procreation. The plotline of progress
and optimism is by no means new or unique to cryopreservation. In her early work
on
IVF, Franklin (2002) shows how the scientific imaginary of progress drew heav-
ily on images of pioneering scientists "embarking upon an expedition or voyage
of discovery" (p. 12). These narratives and the imaginaries involved are shaped by
how differently the technologies have emerged in time and history.
Overall, the emergence of "medical freezing" is infused with scientific hope-
fulness and an optimistic belief in (future) progress. Technological optimism is
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56
The Cryopolitics of Reproduction on Ice
especially visible in the practices of tissue preservation, as they have been devel-
oped in the attempts to offer fertility preservation to prepubescent children (and
others) who cannot produce sperm samples or have eggs retrieved. In the cases
of both testicular and ovarian tissue freezing, the advancement has been pushed
forward by experimental doctors (and willing patients) driven by strong beliefs
in scientific achievements being just around the corner. This was, for instance,
the case when the ovarian tissue preservation programmes were established in
Sweden in 1995 and in Denmark in 1999, before any clinical evidence proved that
the procedure would enable pregnancies in humans (Rodriguez-Wallberg et al.,
2016). For instance, in 1999, as a group of fertility specialists from the University
Hospital in Copenhagen, Denmark, approached the Ministry of Health asking
for legal clarification around ovary transplantation, they wrote:
A number of animal-experimental studies conducted abroad have
recently demonstrated that it is possible to freeze ovarian tissue,
and restore fertility after thawing and implantation of the tissue,
in the spot from where it was removed. Both mice and sheep have
given birth to normal and fertile offspring after this procedure, and
the results are now so promising that a number of clinics abroad
have started to preserve ovarian tissue from women to, if possible,
implant it again at a later point with the aim of restoring fertility.
Also, a number of patients have approached us to inquire about the
possibility of freezing their ovarian tissue in Denmark. It concerns
women who suffer from a disease which requires treatment which is
likely to damage the eggs in the ovaries and, thus, render them sterile.
If these women could-have their ovaries or parts of them removed
and frozen to, at a later point, have them implanted, they would
probably be able to preserve/restore fertility and give birth to their
own genetic children. (Andersen, Byskov, Andersen, & Ziebe, 1999)
As the quote shows, at this point in time, the Danish doctors were relying
on-exemplary experimental animal models, especially sheep whose ovarian size
and structure resembles that of humans (Gosden et al., 1994). The quote further
illustrates that not only were the doctors hopeful and embarking on a scientific
voyage, they also had patients who were desperate to preserve their genetic mate-
rial, and who believed enough in future achievements to take part in experimental
'treatment. Today, ovarian tissue preservation is an established procedure in all of
the Scandinavian countries, though it is primarily the clinics in Copenhagen and
at Karolinska in Stockholm that have been successful as far as children later born
following the procedure (Rodriguez-Wallberg et al., 2016).
In contrast, the establishment of programmes for preserving testicular tissue
in young boys currently causes discussions among biomedical professionals as, at
the moment, it is not possible to put the tissue to work. In Denmark, however,
parents to baby boys who have been diagnosed as cryptorchid are nevertheless
offered cryopreservation of testicular tissue as part of the surgery conducted
on the testis. Believing the technology will be in place as the boy grows up, the
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Disease: On the Use of Freezing on Medical Indication 57
fertility doctors and the lab involved with cryopreservation strongly recommend
this option to the parents while they additionally wish to include other groups of
boys in order to provide them with the best future fertility chances possible. Simi-
lar to ovarian tissue, testicular tissue preservation counseling relies on a belief in
future progress to be made.
Interestingly, the narrative of progress and optimism is infused with stories
of national exceptionalism. In Sweden, they pride themselves with being first-
movers on both oocyte freezing and ovarian tissue and they also include patient
groups which others do not (e.g., Rodriguez-Wallberg et al., 2015; and fieldnotes
from observations at scientific events). Similarly, the Danish impact on the sci-
entific achievements is often celebrated. In 2016, a new breakthrough, involving
the Danish team, hit world news as a 24-year-old Moaza Al Matrooshi became
the first to have a baby after having her ovarian tissue preserved before going into
puberty. Testifying to the possibility of preserving fertility in prepubescent girls,
the story about the nine-year-old who had ovarian tissue frozen in 2001 in the
UK to return at the age of 23 to have it implanted by Danish specialists in New
York made headlines such as "Woman has `miracle baby' using ovary frozen in
childhood" (Oriti, 2016). To the Danish website Videnskab.dk (science.dk), Claus
Yding Andersen, professor at the Laboratory of Reproductive Biology in Copen-
hagen, said about this new achievement to which he contributed:
When we started preserving the ovaries of these girls 15 years
ago, we were not certain we would be able to restore their fertility
later in life, but this proves that we can. (Sjogren, 2017, author's
translation)
Andersen further emphasizes the Danish team as central to the breakthrough, as
he is quoted for underlining; "We are world-leading on this area, which was the
reason why the British contacted us regarding Moaza Al Matrooshi" (Sjogren,
2017). While we return to Scandinavian exceptionalism in our concluding chap-
ter, Andersen's comment here reveals the ways that progress narratives come
together with a naturalization of the "exceptionally" technologically progressive
Scandinavian .welfare states.
While more and more options are developed, it is important to note that fertil-
ity preservation also involves biomedical practices of risk prediction and manage-
ment; practices that have developed in allignment with the specific way healthcare
is organized in the Scandinavian welfare states. In the next section, we turn to a
closer exploration of how worthy and qualified candidates for medical freezing
are produced.
4.2. Medical Freezing and the Neiv Regime
of
Risk Prediction and
Management
Counseling a breast cancer patient regarding her options for fertil-
ity preservation should include several important factors other than
just the impact of chemotherapy on ovarian reserve. The age of the
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58
The Cryopolitics of Reproduction on Ice
patient, the number of children desired, concerns regarding type
of tumor, presence of BRCA mutation, hormone sensitivity, and
concerns regarding the possibility of pregnancy after treatment for
breast cancer may vary greatly between patients, so there is no "one-
size-fits-all" approach. (Rodriguez-Wallberg & Oktay, 2014, p. 111)
Medical freezing does not exist in a vacuum, but is entangled with the achieve-
ments within other medical arenas and treatment options for severe medical condi-
tions and an overall turn toward risk prediction and management (Clarke et al.,
2003; Rose, 2007). As the likelihood of survival and recovery from' serious disease
increases, such as with childhood leukaemia or lupus, or the understanding of
the psycho-social implications of a medical condition such as Turner syndrome
changes, the need for fertility preservation grows. Importantly, the belief in pro-
gress in itself has a significant effect on who comes to be imagined as in need of
medical freezing as well as on how fertility preservation becomes a tool to manage
risks associated with specific conditions. As noted by Langstrup (2007) in a study
on stem cell research, the users of technology should be regarded as
an effect
of
innovation processes rather than an already existing and given identity group. This
is an important point in terms of understanding' who comes to be understood as
candidates for freezing on medical indication and also in terms of discussing how
"medical freezing" is established in relation to "social freezing" (see also Chapter 3).
While cancer patients have been regarded as obvious cryogenic agents, and
thus a primary target group for fertility preservation, some forms of cancer
cause controversy which can enlighten us on how risk is understood and man-
aged. While the freezing of sperm, eggs, and embryos are considered riskless in
terms of cancer, the preservation of tissue involves a different type of risk. This
applies to ovarian and testicular cancers, but also to, for instance, leukaemia,
cancer of the blood, and to breast cancer patients with BRCA genes which is not
only inheritable, but also increases their future risk of ovarian cancer. Nonethe-
less, founded in the belief in fixture achievements, from the beginning ovarian
tissue from leukaemia patients has been stored in the hope that new technologies
and -knowledge would develop before the patients would need it. Illuminating
how timely consideration and optimism entangle, in 2015, the Norwegian ovary
preservation team wrote:
We are not aware that transplantation of ovarian tissue in patients
with leukemia has ever been performed (13). However, in very
young patients the tissue can be stored for decades in the hope that
methods for in vitro growth of follicles, safe xeno transplantation
to immunosuppressed animals or techniques for purging of malig-
nant cells from the cryopreserved ovarian tissue, may become
available. (Tanbo et al., 2015, p. 940)
The quote illuminates how the ability of cold storage to preserve the reproduc-
tive material for a long time, enables hope to be kept alive through the latency
of the stored tissue. This destabilization of time not only allows for future (re)
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Disease: On the Use of Freezing on Medical h7dication 59
synchronization of the infertile leukaemia survivor with the normative life course
of procreation, it also opens up a window for scientific accomplishments to be
made and thus offers opportunity for improved risk management.
Arguably still controversial, the Danish team is currently transferring frozen-
thawed tissue to women who have suffered from leukaemia or who carry BRCA
genes which involves increasing their risk of ovarian cancer. Based on new stud-
ies, they do not find evidence that enough leukaemia cells persist in the tissue to
present a significant risk. In BRCA patients, the team has also developed a tech-
nique to remove the tissue once the woman has had a baby or after a few years if
the attempt to become pregnant is unsuccessful (see e.g., Kristensen et al., 2017).
These practices, declared too risky by other biomedical professionals, testify to
how, at least in the Danish context, the assessment of risk is interwoven with a
strong ideal of protecting and enabling genetic kinship relations.
In the realms on non-benign diseases, candidates for medical freezing emerge
through changing conceptualizations of their conditions, and, as we will show,
through a changing understanding of what it means to be at risk. In Sweden,
for instance, ovary preservation is now offered to patients with Turner syndrome
(SFGO, 2015). Infertility is a known problem in this group, but recently it has
been discovered that they are born with an ovarian reserve similar to other
infants which, for unknown reasons, decreases at a rapid speed. Co-produced by
a changed understanding of the psycho-social effects of Turner, a disease that has
been associated with mental immaturity and non-fitness for motherhood, women
with Turner syndrome are frequently offered fertility treatment. Thus, young
Turner girls are now also becoming obvious cryogenic agents. In Sweden, they are
already considered as good candidates for donor eggs, but early age cryopreser-
vation of ovarian tissue provides them the opportunity for genetic parenthood
(Hovatta et al., 2006).2
Another example of how optimism works and affects the negotiation of risk
and of what it means to be a "worthy" candidate concerns the autoimmune dis-
ease lupus. Causing controversy in the same way as leukaemia, Danish doctors are
currently promoting to offer fertility preservation to this group of patients (who
are often treated with chemotherapy) as new progress seems to have been made
in finding a cure for lupus. As observed at a conference held by the International
Society for Fertility Preservation in Vienna in 2017, this is a debated position.
In fact, other doctors consider the prognosis of Lupus too severe, the patients
too unwell and the cure too far away to support reproduction through fertility
preservation. This discussion highlights an important ethical discussion around
whether the optimism in offering fertility preservation to an increasing number of
people with diverse conditions could potentially create "false hope." The notion
of "false hope" is interesting, especially when interweaving with risk manage-
ment, since hope is always connected to potential outcomes rather than certain-
ties. Similarly to the case of leukaemia, the argument among Danish biomedical
similar progress is taking place around Klinefelter syndrome, another chromo-
somal defect in boys that also causes fertility problems.
2
A
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60
The Ci yopolitics of Reproduction on Ice
professionals is that reproductive material from Lupus patients (or other high-
risk groups) can always be frozen without the promise of future use. Again, the
logic of "better safe than sorry" says that if nothing is frozen and a cure is found,
these women will not have a very limited chance to have (more) genetic children.
Another dimension of this discussion relates to how much risk patients end
up being willing to take in terms of realizing their dream of genetically related
offspring, once you have first preserved their chance. From an ethical perspective,
there is also always the future child to think about, like with all types of assisted
reproduction
(Pennings,
1999). In this case, especially the risk of losing the par-
ent early due to recurrence of cancer due to the reintroduction of malicious cells
becomes a relevant matter. We go into more depth with this issue in Chapter
5, but here it suffices to note that in such discussions there is always a tension
between the welfare of the future child and a parent's rights to _procreate, invit-
ing different ways to strike a balance between these competing concerns. With
regards to patients wanting to have children, a concern could be if their wish
for a genetically related child may obscure their judgement of the potential risks
and rewards. However, as pointed out by Coggon and Miola (2011), people are
generally allowed great freedom when it comes to their medical decisions, even if
circumstances are pressing in various ways.
A third example of how new cryogenetic agents emerge in the entanglement
of scientific progress and biomedicalized risk management is the increase of
commercialization of sperm deposit facilities, not least the globally operating
company Give Legacy. What is particularly interesting about Give Legacy is the
way they challenge the distinction between medical and non-medical freezing.
Although situated in Switzerland, Give Legacy draws on the feel of the cold
North and Viking mythology, emphasized through their logo of a shield with
the web of wyrd a letter or "rune" in the old Nordic language of Norse. With a
painted face of a man having an, aura of the ancient Greeks and thus having an
important legacy, they write on their front page of their webpage: "Protect your
most valuable assets. We founded Legacy to protect men like you." Founded by
Harvard graduates that had a friend whom fell ill with cancer at a young age, the
risk of illness and disease threatening male fertility became apparent. Developed
at the Harvard Innovation Lab in Cambridge in the US, this sperm bank arguably
targets men identifying with a socioeconomic and educational elite. Give Legacy
offers, men a practice of securing their fertility into the future. Visually developed
to appear, as discreet and secure as a Swiss banking facility, the exclusive service
provider, .on their website, explains the need for protecting your assets:
"Give Legacy was founded to ensure that forward-looking men can lock in
their future and store their healthiest sperm discreetly and with a trusted provider.
The fact is the modern man faces many risks, from the chemicals in his food to
the radiation from his mobile phone to the diseases that others carry. There is a
reason why male fertility has declined so drastically in the past 40 years. At the
same time, humanity is undergoing a fundamental transformation that brings
us closer to the singularity each day. Google's chief futurist — Ray Kurzweil —
believes that the day when humans live forever could arrive by 2029. Yet men
produce a new genetic mutation every 8 months and DNA fragmentation leads to
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Disease: On the Use of Freezing on Medical Indication 61
damaged sperm DNA. By taking a snapshot of your healthiest, highest-quality
genetic material today, you are protecting yourself from risk today while opening
the door to the scientific advances of tomorrow..." (https://www.givelegacy.com,
accessed on October 24, 2018).
In this tale, sperm depositing is promoted not only in order to secure reproduc-
tion in time, rather, it is to "lock in one's future" and to secure one's "legacy" (here
conceptualized as one's sperm) from the risks of illness and disease. It enables the
"better I" to live forever through banking one's seed safely, even in a discrete man-
ner. This idea of banking sperm forever draws upon both technological progress of
potential eternal life as promised by the imaginaries evoked by the movement of
singularity, at the same time as it is promoted as an answer to the challenge of the
Anthropocene. Here, the technological hazards of life are captured in the formula-
tion of "modern man" facing an onslaught of risks associated with chemicals and
radiation disturbing the genetic inheritance, constituting a threat to his sperm. The
figure of the "Swiss bank" is paradoxically both a story of technological quick, fixes
and progress as the threat of the Anthropocene becomes a challenge'for male legacy
of the elite. The risks of illness of male infertility may be fixed by storage, at a young
age, ensuring "quality children" (the highest-quality genetic material) forever.
This understanding of risk management does not only emerge in the commer-
cialized tale of Give Legacy; the importance of the securing of sperm and fertil-
ity is likewise at stake in the interviews with Danish men having sperm deposits
in a Danish sperm bank. Considering the biological easiness in which men can
produce sperm compared to the surgery involved in the freezing of eggs and ovar-
ian tissue, it is interesting that the biomedicalization of the freezing of sperm in a
larger scale has yet to evolve. Ivan, who deposited sperm due to testicular cancer,
had tried to convince his brother to freeze sperm and told his friends and family
that he would give his son a deposit when the time came. He explains what he told
his brother turning 18:
I told him I thought he should have it done. It does not cost
100,000 Danish Kr•oners to store (approx. 15,000 USD). It is more
like 4,000 for 5 year's (approx. 650 USD). The gain or what you
may call it, if you face not being able to have children, is that you
would still be able to have your own children because you did that
act. I would not keep that information away from him. That is why
I told him to do it (Interview with Ivan, 2019).
Ivan 'does, moreover, reflect that this information potentially could be dis-
persed to all men at one point or another. Freezing for medical reasons made him
aware of the potential of the cryotechnology. In line with Give Legacy, he points
to the promise of securing fertility for men in a much broader scale, not the least
his friends and close family ("I would not keep that information away from him").
Overall, the numerous fertility preservation strategies signal a shift from sim-
ply disease treatment and management toward an increased biomedical attention
to the "quality of life" of the (cured) patients, including the management of late
complications such as infertility. In this way, the imaginary of "medical freezing"
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62
The 0-yopolitics of Reproduction our Ice
is based on the idea of fertility preservation as a way to enable cancer survivors,
especially children, and chronically ill people to live "normal lives." In this imagi-
nary, the notion of "normal lives" includes the envisioning of genetic procreation
as especially important. In the next section, we turn to patients' stories about
preserving reproductive capacity to illuminate not only how fertility preservation,
in the context of disease, is experienced as an insurance against future infertility,
but also, how it turns into a life insurance offering a glimpse of the future which
has been compromised by severe illness.
4.3. Cryo-insurance and the Imaginary
of
Reproductive Futurity
I just thought it was like an insurance. That's what I was think-
ing, what we were thinking. Rather be safe and not be on the
other side and realise that we should have done it or ... you never
know which priorities you have on the other side. (Interview
with
Helena, 2017)
,
In this section, we explore the ways that fertility preservation is given meaning as
a type of cryo-insurance, as exemplified in the above quote from an interview with
Danish Helena who had ovarian tissue preserved before starting breast cancer
treatment. We are especially interested in demonstrating how the imaginary of
fertility preservation as an insurance is entangled with what cultural critic Sara
Ahmed (2010, 2014) terms affective economies of hope, fear and happiness as
well as in calling attention to how the prospective child works as a token of futu-
rity in the context of disease. In this sense, we wish to demonstrate how patient
experiences share the technological optimism with the biomedical imaginary of
progress analyzed before, but also how fertility preservation becomes an orienta-
tion device (Ahmed, 2006; Franklin, 2013), (re)synchronising bodies and identi-
ties with normative life temporalities and ideas about the good life.
Conceptualising fertility preservation as insurance targets an important tem-
poral dimension of the procedure of freezing one's reproductive material. As an
act of anticipation, of reacting in the present on the prediction of a high risk
of infertility in the future, fertility preservation involves what Adams and col-
leagues (2009) have talked about as speculative forecasting. The patient might
never.need the tissue for reproductive purposes, either because their reproductive
organs were not damaged badly or because they do not want (more) children — or
eventually because they die. As already mentioned, many clinics observe that the
majority of the patients never return for their preserved gametes or tissue. Con-
sequently, fertility preservation is a practice of preparing for
potential
trauma in
the future. Like with other types of insurance, it is about securing oneself, in the
current trauma, in the event of a future reproductive crisis.
However, unlike, for instance, car insurance, fertility preservation provides no
guarantee that the patient will have the reward (the child) in case of the "accident"
(infertility) taking place. This has made some doctors and bioethicists question the
insurance terminology, especially with regards to oocyte freezing (e.g., Mertes &
Pennings, 2011). In fact, the chance of a take-home-baby is rather low, though it
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Disease.- On the Use of Freezing on Medical Indication 63
varies depending on the type of matter stored, the age of the patient at the time
of cryopreservation etc. Dutch and Canadian studies have found the live birth
rate of cryopreserved sperm from cancer patients to be between 50% and 62%
(Carcia et al., 2015; van Casteren et al., 2008). At the moment, ovary preservation
is estimated to give a chance of around 30% (Jensen et al., 2015). The chance of
pregnancies is harder to estimate in the case of embryo and oocyte freezing since
it depends on the number of frozen oocytes/embryos as well as the ability of fro-
zen oocytes to fertilize (as demonstrated by, e.g., Meniru & Craft, 1997). A small-
scale study on female cancer patients from Belgium found the live birth rate with
frozen embryos to be 44% (Dolmans et al., 2015). A larger US-based, non-cancer
related study found, however, that both embryo and oocyte freezing leads to live
births in only 25% of the cases (Ho et al., 2017). Arguably, freezing from only one
cycle does not give a very high chance of having a child (Meniru & Craft, 1997).
As we discussed above, there is no technological solution to plat testicular tissue
from prepubertal children to use at the moment.
For several of the men having faced illness such as cancer, however, the possi-
bility of a sperm deposit was likewise perceived as an insurance. Ludwig explains:
It is an insurance or savings in the bank, a child savings (bØrneop-
sparing), because it can be of use. I have stored it for the family.
The day I need to have it cashed, I know it is there and I can go to
the bank to have it consigned. (Interview with Ludwig, 2019)
Most of the men interviewed use the notion of 'insurance to describe why they
had a deposit established in the sperm bank. It is in order to secure the possibility
of having genetically related children later in life that the deposit is underscored
as central for them. However, the sperm deposit did not seem to work as a "happy
object" (Ahmed, 20 10) that enabled hope during treatment, it was, to these men,
central due to keeping the potential of a family after the treatment was over. In
the case of these interviews, this was especially important when seen as a compen-
sation for the prospects of sterility.
-- Although all of the men interviewed had deposits, several reported that they were
misinformed during treatment, or there had been malpractice involved in the estab-
lishment of the deposits which could have had consequences for their reproductive
future. For instance, Bent had not been offered to have a deposit established in the
waiting time before treatment, and did not have his sperm stored until after chemo
had begun. However, he had, by chance, kept his fertility, and had a child after treat-
ment without the use of his cryopreserved sperm. Meanwhile,
Laurids,
who prior
to his cancer treatment had stored sperm both at a private sperm bank and a public
clinic, explained how the obligatory blood testing, which is needed in the private
clinics to handle the sperm during treatment, was not carried out in relation to the
deposit he had stored privately.
Laurids
and his partner had only been able to use
the sperm for treatment, as he also had deposited in a public clinic, where the neces-
sary testing had been done in relation to these deposits. Sterile due to the treatment,
Laurids
realized that he could have been facing false hopes by having had sperm
stored, thus challenging the idea of insurance enabling future reproductive security.
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The Cryopolitics of Reproduction on Ice
hi practice, the notion of insurance likewise becomes disturbed in the case of
Pelle, who also had his sperm preserved prior to cancer treatment. However, just
like Bent, he had a child without the use of reproductive technologies. Unfor-
tunately, the pregnancy damaged the body of his partner so much that the doc-
tors did not recommend for her to go through another pregnancy, and a few
years later their only child died due to cancer. Pelle now has sperm stored, but
whether the sperm will be of use is questionable, as this would demand involve-
ment of a surrogate. Instead the possibility of adopting a child and reconfiguring
kinship was, in the interview, increasingly becoming a plausible alternative. He
explains how he and his wife are in the process of rethinking .the question of
genetic kinship:
What is it about these genes? It is just a look, but is it important
that the kids look like me? Maybe it is more important that the
values you have are brought forward to society, to the
world,
-to
faith, to hope. When we talk [he and his wife], we are leaning
towards the idea that maybe it is not the genes that are necessary
(..) what is important may instead be the values of the family that
you want to pass on. (Interview with Pelle,`-2019)
In the context of disease, fertility preservation is not only about preserving
the capacity to bring new (genetically related) life into the world. As a producer
of hope, the latent vitality of the frozen tissue revitalizes the patient in several
ways (for a discussion on latency, see also Chapter 4). In some cases, however,
frozen gametes may challenge the notion of conceiving more genetically related
children. Similarly to what
was
found in medical evaluations of the procedure (for
instance, Hoeg et al., 2017 and Lotz et al.,'2016), interviews with Danish women
who have frozen ovarian tissue ,show, how the freezing of tissue functions as a
more overall reorientation toward life. When asked about her decision to freeze,
23-year-old Agnes, who had one of her ovaries frozen at the age of 22, states that:
My mum said I should do it, because I had to survive. So I had to get it out, so
I-would have, in some way, a future. Agnes'recollection displays how the prospect
of a reproductive future becomes a way to imagine having a future at all, for the
patients as well as their relatives. Helena, who was cited above, spoke about how
it felt somewhat out of place to be confronted with the question of having more
children during a conversation about scanning her lungs for metastasis. Nonethe-
less, like Agnes, she explained how talking about future fertility simultaneously
felt like a confirmation that the doctors believed in her survival. If not, why would
they spend money on preserving her fertility, as she put it.
The way that reproductive futurity and hope entangles is even clearer in the
narrative of Carol who found that fertility preservation affected the very way she
dealt with being sick. 27 years old when freezing ovarian tissue due to aggressive
breast cancer, Carol a few years later explained:
You have something to fight for. I mean, there always is, I guess,
but something extra. And when I had done all this (freezing), and
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Disease.- On the Use of Freezing on Medical Indication 65
I really wanted it then ... I have to get out on the other side. And I
will live life again. So I think that kept me going. (Interview with
Carol, 2017)
In Carol's narrative, the frozen tissue turns into what Ahmed (2010) would
call a happy object; an object sticky with hope. The proximity of the prospective
child, the extra, completes Carol's envisioning of living not only life, but a'happy
family life, which enables her to remain optimistic and oriented toward the future
during the invasive treatment. In the end, Carol needed egg donation and IVF,
but the tissue still reversed the menopausal condition her body
was
in after treat-
ment and, in her account, relieved her from a lot of discomfort.
These stories illustrate how fertility preservation comes to function as an ori-
entation device (Ahmed, 2006), a way of being turned toward specific objects (the
prospective child) and landmarks (survival). This process is further illuminated
in
the interview with Jane, who already had a young child when' she was diagnosed
with aggressive breast cancer and never has returned
to have
her tissue trans-
planted. Where most of the interviewees immediately accepted fertility preserva-
tion when offered, Jane was in doubt and almost declined it. About her change
of heart she explains:
I think it was also because I was just thinking but I have to decide
about something that has to do with... the future and right now
I am critically ill. I mean, I did that a lot; because I remember
I was reading the information material
a
million times. And I
was thinking, do I really put my body through all this because
of something that is not really possible? ( ... ) I remember that we
walked out from that conversation with the doctor (fertility spe-
cialist) completely like ... high, you know, because it was such an
awesome ... also because a lot of what he talked about had to do
with a life after. And that was just so hard to see when you have the
whole thing ahead of you, right? Well, okay, so there is a chance
that you will get out on the other side of all this. And that there is
a life and that
you
will have all your options back. (Interview with
Janne, 2018)
Janne's account clearly demonstrates how cryopreservation of reproductive
material, 'despite the lack of guarantees, comes to symbolize a life insurance in
multiple, ways as it enables them to be optimistic about the future. Another note-
worthy aspect of Janne's reflections is also the empowering aspect of regaining
reproductive autonomy in the sense that fertility preservation provides Janne
with the choice should she want more children. This aspect has to be understood
as shaped by how being diagnosed with cancer often involves feelings of losing
power and control over one's life course (Frank, 2013; Jain, 2013). You just have
to jump on the train, as Janne says, referring to how it felt having a treatment plan
laid out. The interviews illustrate how fertility preservation, at the time of fertility
counseling, is experienced as a small window in which a bit of control is regained
f.
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66
The Cryopolitics of Reproduction on Ice
through the prospect of choice both in terms of whether you want to preserve
ovarian tissue at all and if you want (more) children in the future.
Meanwhile, the emphasis on having a (reproductive) choice needs to be situ-
ated as a configuration of fertility preservation within the more overall cultural
imaginary of personal autonomy. Not only a cultural value of the neoliberal soci-
ety as, for instance, discussed by Carroll and Kroløkke (2017) in relation to egg
freezing, reproductive autonomy is also a dominant imaginary of the individu-
alized Scandinavian welfare state. Cryo-insurance becomes a self-management
technology through which a sense of control and personal autonomy can be
restored and this is in spite of the lack of guarantees provided by contempo-
rary cryo technologies. In this manner, cryopreservation sutures the (reproductive)
identity of the neoliberal citizen who, in the biomedicalized society, needs to be in
control of their own health and secure having as many options as possible to live
the good life (Clarke et al., 2003).
In practice, the imaginary of fertility preservation as cryo-insurance is 'thus
both circulated as well as enacted among the patients. The notion of insurance is
additionally reconfigured when the imaginary of technological fixes is challenged,
when bodies act surprisingly or when malpractices take place. The attempt to pre-
serve fertility is, however, important not only to the ways patients move forward
in their lives, but also in terms of how they understand themselves. To develop
the aspect of identity production more, we now turn to how gendered imaginaries
affect the experiences with and conceptualization of fertility preservation.
4.4. Imaginaries of "Normal" Womanhood and "Potent" Masculinity
In this last analytical section, we explore how the imaginaries of preserving and
restoring fertility entangle with the (re)production of gendered identities. As
enactments of cultural norms, narratives of (in)fertility are produced differently
by men and women: Importantly, the entanglement of fertility and gender is
not restricted to the accounts of the patients. In the scientific writings about
the advancements of ovarian tissue preservation, especially with regards to its
ability to restore the hormonal cycle, Danish fertility specialists, for instance,
state that:
Restored hormone production may even be the desired effect
rather than fertility restoration in some patients (10), and a more
appealing alternative to pHRT for some women. In Denmark
around a dozen young women who entered menopause due to
cancer treatment have had frozen/thawed tissue transplanted only
to become a "normal woman" again and avoid menopause. (Kris-
tensen & Andersen, 2018, p. 2)
The connection between having a cycle and feeling like a "normal woman"
is, however, also echoed in the interview material. Not only can the menopau-
sal condition of the body, caused by loss of ovarian function, entail different
types of discomfort such as hot flashes and vaginal dryness, several of the
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Disease:
017
the Use of Freezing on Medical Indication 67
interviewees also voice how having an ovary extracted or losing the ovarian
function felt like being deprived of womanliness. Invoking a narrative of gen-
der identity loss, Sandra says about the experience of regaining her cycle after
transplantation:
It was ... (laughing) it sounds a bit crazy, but suddenly I was happy
to have my period, right. I mean ... and actually it was ... it was, it
sounds a bit; but it was like becoming a woman again. I had really
missed it, this thing about feeling the body react in all kinds of
ways. (Interview with Sandra, 2018)
Sandra's hesitation indicates that she finds it a bit odd to connect 'the bodily
experience of monthly changes she experiences after having her cycle restored to a
feeling of womanliness. Besides from a bodily sensation of vitality, which Sandra
associates with normality, normality is also achieved in the practicalities;of hav-
ing hormonal cycles: "now I also have to go to the store to buy sanitary napkins,"
Sandra adds.
One of the younger women who had ovarian tissue transplanted without
much effect talked about how the failed attempts to restore her cycle, which
has also been attempted with hormone replacement therapy, have left her
feeling rather "genderless" as she doesn't have enough estrogen in her body.
Zenia, another young women who had tissue transplanted for non-reproduc-
tive purposes, similarly recalls how her hormone-deprived body left her feel-
ing out of place:
Before it started working, I had sort of a feeling that...not to
be; I recall the feeling of being somewhere between a man and a
woman. Or like being nervous about whether not having a cycle
meant that I was about to become more of a man than a woman.
And I didn't like that because would I begin to grow a beard or
something? I mean before it began to work again, I was nervous
about the consequences if I didn't get my hormones up and run-
ning again. And I found that annoying, also with regards to what
men would think about that. I was single at that time and found it
stressful: Since then it has been fine, but it was some kind of inse-
curity about my femininity, I think. (Interview with Zenia, 2019)
Zenia's account not only shows how the deprivation of hormones destabilizes
her sense of gender identity. In contrast to the other interviewee who felt "gen-
derless," Zenia speaks of a fear that she will eventually have masculine features
("would I begin to grow a beard or something."). Zenia's account further dem-
onstrates how her sense of womanliness, as well as her fear of appearing "manly,"
is produced within a heteronormative framework where womanliness becomes a
matter of being attractive to men.
The matter of being an attractive partner is similarly present among other
interviewees a bit older than Zenia. In their stories, however, heterosexual
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68
The Cryopolitics of Reproduction on Ice
attractiveness re-entangles with childbearing. Illustrating a joy similar to Sandra's
about regaining her period, Leila, for instance, recounts:
Leila:
Well normally you hate having your period, right
(laughing), but this time you are just so happy and I
was thinking yes! You have become a woman again.
So it is wonderful in that situation.
Interviewer: Did you not feel like a woman before?
Leila:
but ... it's more like when you think about the fact
that you do not have your period, that you might not
be able to have children, then you can feel that you are
not woman enough. It's more like that I think. You
are not fertile.
As the exchange reveals, Leila's sense of value as a woman is associated with
being fertile ("that you might not be able to have children"). The feeling of hav-
ing less value as a partner is also reflected in the interview with Sandra, when
talking about not dating for a period of time after she went through cancer
treatment, she says: "I mean, what do I have to offer? I can't even assure you
that you can have children if you are to be in a relationship with me." Some of
the women who already had partners, similarly spoke about feeling like failures
because they might not be able to "give my partner children." While also reflect-
ing about how producing a baby is often seen as the ultimate love exclama-
tion of the heterosexual couple, as described by, for instance, Bryld and
Lykke
(2002), these stories also reproduce a rather traditional image of a complemen-
tary heterosexual love relationship in which the primary role of the woman is
to be fruitful.
For several of the men, having a sperm deposit was likewise related to mas-
culinity. This was not least underscored in the stories of how the sperm deposits
came to be. Ivan, who had his deposit made prior to cancer treatment, explains
how he experienced the visit to the sperm bank as very awkward, as producing the
necessary sperm ejaculation is a sexualized act:
I think I walked back and forth on the pavement several times, I
walked around for ten minutes, back and forth. It was by a bus
stop, and there were a lot of people, and you had to enter this
doorway, where it said SPERM BANK with big fat letters ....
It was weird to walk in there, like "000hhh, what do people
think." And the silly thing was that I had been at that bus stop
several times before, but I have never noticed that anyone has
entered that door. [ ... ] and then I entered and it was exactly
what I had expected. It was white walls, glass and a white desk,
white gowns, and a waiting room, and you could have some
water — it was just like you had gone to any other place, and
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Disease: On the Use of Freezing on Medical Indication 69
now you were waiting for your turn. Then I went to the desk ...
I was pretty cool, but I recall that I was pretty nervous. My
hands were cold, because I was a bit anxious in regards to the
situation, because ... this has something to do with sexuality
and fertility, and it is not a topic where you just stop people on
the street and talk to them about it, it is a private matter. (Inter-
view with Ivan, 2019)
Moreover, it is also a situation where the sperm quality, which is associated
with masculinity, is assessed.
I saw myself walk around like a confused chicken without my
head, into the room and the booth and out of the booth again and
over to deliver the plastic cup, and it was transparent, everyone
could see "well that was not much there" or "wow, this is too much
it is almost spilling all over." (Interview with Ivan, 2019)
The transparency of the cup and the situation of handing over the sperm to
the lab technicians was, by several of the men, described as a situation that was
difficult because of the fear of being assessed as producing too little. This fear
was amplified in the interviews with men who had become sterile due to chemo-
therapy. For example,
Laurids
explained, when asked whether becoming sterile
had impacted on his masculinity:
Maybe a little bit, but it is not like how it would be as a woman to
lose one of her breasts: It is nothing I am ashamed of, or hold back,
and I know it is silly. Maybe it has taken a few per cent, a little sting
in one's sense of masculinity. (Interview with
Laurids,
2019)
Although sterility, as he explains it, has made only a small impact on how
he perceives himself, he also underscores that he was close to dying during his
treatment. Thus, the question of sterility was not what had been in focus, rather,
that of vital importance in his account was the deposits that had enabled him
to have children afterward.
Laurids
had, however, interestingly been one of the
men that suggested that all men should be told about how easy and relatively
inexpensive setting up a sperm deposit is. To him, sperm depositing becomes a
rational act, albeit conflicting with the awkwardness of providing the sample.
This awkwardness or rather the act of masturbation, conceptualized here as a
sexual act, raises the question by
Laurids
of, why don't men just do it before they
have a diagnosis?
In the biomedical as well as patient accounts, preservation enables the re-enact-
ment of heteronormative gender identities. As noted by Oudshoorn (1994), in her
archaeology of sex hormones, hormones became sexed (understood as uniquely
"belonging" to feminine or masculine bodies). As revealed in this section, the
freezing of ovarian tissue along with sperm deposits reiterates this understanding
of normatively gendered bodies.
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70
The Cryopolitics of Reproduction on Ice
5.
Summary
In this chapter, we have shown how cryotechnological achievements entangle with
optimism and belief in future progress and have shaped the development of what
has become conceptualized as medical freezing, that is fertility preservation pro-
grammes for people who are already enrolled in the healthcare system and, con-
sequently, understood as patients. Through the examples of the development of
ovarian and testicular tissue freezing, we have illuminated how an overall belief
in future scientific achievements has pushed forward the establishment of fertil-
ity preservation programmes before there has been any proof that the preserved
material will work to produce human babies.
Drawing on the notion of cryo-insurance, we have shown how the ability to --
preserve the possibility of having children produces hope among doctors as well--
as patients and their relatives. Through the examination of patient accounts, we
have also revealed how cryo-insurance, as an orientation device toward a reproduc-
tive future, has a normalizing function as it allows the patients to go on with the
life they imagined and planned for, which most often includes having (more) chil-
dren. We have highlighted how cryo-insurance, in the context of disease, involves
a specific kind of future orientation as the prospect of future children allows the
patients to even imagine a future, an image often compromised by the potential
death threat of a cancer diagnosis. Through the proximity to the child, as a token
of futurity, the patient is, however, reinstalled as closer tolife than death.
Throughout the chapter we have discussed how the development of different
kinds of medical diagnoses such as cancer, Turner syndrome or Cryptorchidism,
has turned an increasing number of patients into cryogenic agents whose repro-
ductive citizenship is in need
of
immediate protection. As we have demonstrated
in the chapter, fertility preservation involves very specific biomedical practices
of risk assessment and risk management. Not only should the risk of future
/o),
infertility meet certain criteria (e.g., >501 which can be hard to predict in the
context of illness, both the chance of survival and the chance of reproductive
success, which in the scientific imaginary correlates strongly with age, also have
to be sufficiently high for, it to be worthwhile. In this way, numerous processes
of speculative forecasting (Adams et al., 2009) shape which patients are offered
which kind
of
fertility preservation as well as who can have, for instance, ovar-
ian tissue transplanted afterward. Illustrated through examples of the contro-
versy created
over
certain types of disease such as leukaemia and Lupus, we have
showed how there are significant differences between the Scandinavian countries
and the medical teams in terms of when the hope for a baby outweighs the risk of
going through surgery or of reintroducing malicious cells.
Importantly, we have also demonstrated how the latent potentiality of the fro-
zen tissue entangles with the production of embodied gender identities. For both
the
men
and women interviewed, the ability to restore fertility, either very physi-
cally in the sense of regaining menstrual cycles or in the capacity to engage in
genetic reproduction, shapes how they are able to understand themselves as men
and women. Several of the men mentioned that the prospect of infertility affected
their sense of masculinity, illuminating how virility and fatherhood are important
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Disease: On the Use of Freezing on Medical Indication 71
elements of contemporary Scandinavian manhood. Similarly, the women talked
about feeling deprived of femininity when they went into early menopause. Not
only did regaining their hormonal cycles, through ovarian tissue transplantation,
suture their bodily sense of normality, the prospect of being able to procreate
restored their sense of value as attractive partners, reiterating rather traditional
gendered structures of meaning in which a woman's value is closely connected to
reproduction.
Clearly, medical freezing practices have to be understood within the context of
the Scandinavian healthcare system in which treatment is flee. This allows for doc-
tors to work within a logic of "better safe than sorry," because they do not have
to take the financial situation or insurance plan of the patient into account. Yet,
the limited, and highly debated, budgets of the public healthcare
system
also co-
produce the need of categorical demarcation and prioritization. With increased
attention toward prediction and prevention, which is foundational to the way
medical freezing is performed in the Scandinavian countries, clear distinctions
between "medical freezing" and "non-medical freezing" collapse. With only few
of the so-called medical freezers returning to use their stored reproductive mate-
rial, it is, from an ethical point of view, relevant to ask why scarce public resources
are employed. Nevertheless, cryopreservation of reproductive cells or tissue, in
the context of disease, is conceptualized as a valuable insurance against future
infertility. In contrast, the freezing of eggs for "non-medical reasons" is, however,
also often, in the Danish public debate and among bioethicists (see e.g., Mertes &
Pennings,
2011), positioned as something closer to a lottery ticket than an insur-
ance (Notes from field observations).
in
the next chapter of the book, we turn to
an exploration of freezing for non-medical reasons in the Scandinavian countries,
highlighting the normative and heavily gendered imaginaries as well as the legal
and ethical discussions affecting how Swedish women have obtained access to
self-paid egg freezing,
while
the Danish and Norwegian women have not.
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Chapter 3
Delay: On the Use of Freezing for
Non-Medical Reasons
1.
Introduction
In 2009, 564 egg freezing cycles were performed in the United States for non-
medical reasons. Meanwhile, in 2016, according to a recent news account, the
number had risen to 8,892 cycles (Sussmann, 2018). Similarly,
in
the United King-
dom, there has been a dramatic increase in the number of egg freezing cycles for
non-medical reasons from 395 cycles in 2012 to 1,170 in 2016 (Sussmann 2018).
Today, throughout the Western world, an ever-increasing number of human eggs
reside in cryotanks. This rise is, in part at least, due 'to the fact that egg freezing
is no longer considered experimental. In 2012, the European Society for Human
Reproduction and Embryology, together with the American Society for Repro-
ductive Medicine, removed the experimental label, enabling the preservation of
human eggs to become a widely available technology. Although it has become a
burgeoning business in the United States, Australia, the United Kingdom as well
as Spain, the practice has yet to become established in the Scandinavian coun-
tries. This is despite the fact that Scandinavian fertility doctors consider advanced
child-bearing age to be one of the primary reasons for later fertility problems in
the region and think that cryopreservation promises to synchronize reproductive
potential with that of educational, financial as well as romantic realities (e.g.,
housing costs, educational, and career demands).
In this chapter, 'entitled Delay, we discuss sociotechnical imaginaries asso-
ciated with what we refer to as "non-medical freezing." The chapter has been
deliberately called "Delay in order to show how the imaginary of delay, in the
Scandinavian context, entangles with cryotechnologies and appears in popular
cultural,
clinical,
ethical and legal accounts. In short, "delay" is often associated
with the negative consequences of intentionally postponing reproduction. As ech-
oed in the 2016 Copenhagen campaign "Have you counted your eggs today?" the
fact that women with higher education levels
delay
pregnancy is directly, in these
accounts, correlated with later fertility problems. Criticizing the concept of delay,
The Cryopolitics of Reproduction on Ice: A New Scandinavian Ice Age
Emerald Studies in Reproduction, Culture and Society, 73-94
Copyright© Authors, 2020
doi:10.1108/978-1-83867-042
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920191005
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The Cryopolitics of Reproduction on Ice
however, Inhorn (2019) instead suggests the term "waithood." Initially developed
by Singerman (2007), to understand the cross-national trend in the delaying of
marriage, Inhorn (2019) uses the concept of waithood to explain why highly edu-
cated women, in metropolitan areas in the United States, use cryotechnologies to
secure their reproductive potential. As exemplified in her work, women do not
wish to delay reproduction, rather they seek to secure a future chance of repro-
duction by cryopreserving their eggs. Waithood, rather than delay, is similarly a
theoretical concept in sociological research on singlehood (Lahad, 2012). Here,
temporality and waiting come together to identify singlehood as an
unanticipated
form of delay (Lahad, 2012, p. 163) yet simultaneously a collective and relational
experience. According to Lahad (2012, p. 165): "Waiting is often associated with
fear and anxieties about the future, yet it can also be a time of anticipation, hope=
and excitement." Thus, waithood constitutes an interesting and potentially less
stigmatizing theoretical concept from which the cryopreservation of reproductive
cells for non-medical reasons can be understood.
However, throughout this chapter we use "delay" as a concept, and the reason
for doing this is to acknowledge the Scandinavian context in which the imagi-
nary of delay has a stronghold as well as to problematize the concept of delay
itself. In the Scandinavian context, delay becomes both conceptualized in light of
what appears a collective female biological (alarm) clock and individualized as a
woman's own responsibility. As noted by one informantin the survey of Danish
students' attitudes toward egg freezing _for non-medical purposes, whose com-
ments echo the sentiment of several others:
If she waits until her egg quality is too low to have children, she
should have prioritized it more. Even as a single woman, it is possible
to have kids. Kids are not a right, they are a gift. (ID36, 22-year-old
female Danish medical student, see the Appendix for details on the
survey study)
Consequently, while women who freeze their eggs for non-medical reasons, as
echoed in Inhorn's work, may not refer to delay as a motivation for freezing, as an
imaginary, delay figures prominently in the Scandinavian ethical, popular culture,
as well as in the survey material.
Similarly, our choice to use non-medical freezing can be called into question.
While also referred to as "social freezing," "elective oocyte preservation" (Inborn,
Birenbaum-Carmeli, Birger et al. 2018b; Inhorn, Birenbaum-Carmeli, Westphal
et
al.
2018a), "planned" cryopreservation (ASRM, 2018), or "self-donation,"1 we
have deliberately chosen the term "non-medical" freezing. We have done this for
'The Carl von Linn6 Clinic located in Uppsala Sweden advertises itself as one of the
largest fertility clinics in the Scandinavian countries outlining the cryopreservation of
own gametes as a type of self-donation: http://wwwlinne.se/aggfrysningegendonation?
lang=en&fbclid=IwAROnaPObCNe7M W26aeDXdSGoPxSwOxzI4BxCcelrNrAu3H_
org7bkzU-QKI.
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Delay: On the Use of Freezing for Non-Medical Reasons 75
several reasons: Not only do the terms "social," "elective," or "planned" mask
the fact that not everyone can afford to participate in cryopreservation, they also
infer a certain intentionality. As already described in the previous chapter on
cryopreservation within the context of disease (Chapter 2), gamete cryopreser-
vation has been advanced to assist women and men suffering from diseases such
as cancer with fertility preservation. Consequently, in the Scandinavian welfare
states, political and ethical imaginaries of freezing have become closely,entan-
gled with whether freezing is viewed as being for medical or non-medical rea-
sons. This labeling also resonates with the empirical material that is emerging
from the Scandinavian countries. For example, in the aforementioned survey
study of Danish students' attitudes toward the cryopreservation of human eggs,
it is apparent that students strongly support freezing for medical reasons, yet
remain split as far as freezing for non-medical reasons is concerned. Moreo-
ver, cryopreservation has raised general ethical concerns about the autonomy
and well-being of the women and the child (Petersen, 1999, 2004), the alleged
unnaturalness of the procedure or the worry that medical freezing gives women
false hope (Mertes & Pennings, 2011a). In the Scandinavian countries, there is
an overwhelming political and general consensus in favor of moral and legal
support of freezing for medical reasons, yet the same cannot be said for freezing
for non-medical reasons.
While to some extent arbitrary, the discursive split between the "medical" and
the "non-medical" context is also interestingly evident
in
existing ethnographic
research. For example, Martin (2010), in her mixed methods approach, examines
discourses on egg freezing for medical and non-medical reasons in the United
States. Whereas, as was made clear in Chapter 2, women who freeze for medical
reasons are positioned in a sympathetic imaginary as the "worthy cancer patient,"
for example, Martin (2010, pp. 533-535), she reveals how women who freeze for
non-medical reasons are frequently
cast
as putting their own selfish needs first.
Martin further notes: ,
The healthy young woman's decision to freeze eggs is portrayed
as_ a selfish move, unlike the altruism of the cancer patient who is
willing to subject her body to invasive treatments to fulfil future
family obligations. (Martin, 2010, pp. 536-537)
In the Scandinavian countries, preservation of fertility on medical grounds is
undisputed as not only legal but in fact desirable. The juxtaposition between
"medical" 'and "non-medical" is also echoed in the large survey study of Danish
students'. As noted by one student in reference to the state's obligation to pay for
preservation:
I do not think that it is the state's job but the woman's if she wants
children in the future. If, however, she has health problems that
make it difficult for her to currently become pregnant, then the
state should finance it. (ID69, 23-year-old female Danish medical
student)
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The Cr))opolitics of Reproduction on Ice
Consequently, while, in this chapter, we acknowledge the ways in which medical
and non-medical reasons at times overlap, such as in the case of women who
freeze in the anticipation of future disease and infertility, throughout this chapter
we consistently use the term "non-medical" freezing to describe core cases of
what is considered to be non-medical freezing, that is, freezing that is done not
because of a medical condition such as cancer.
This chapter highlights competing imaginaries associated with freezing for
non-medical reasons. While this certainly could include the freezing of both eggs
and sperm as well as embryos, our focus rests primarily with the burgeoning
interest that the freezing of women's eggs for non-medical reasons has attracted.
Moreover, in what follows, we first contextualize non-medical freezing within the
context of the Scandinavian welfare states. We then theorize freezing for non-
medical reasons, specifying the temporal and anticipatory logics associated with
delay
prior to identifying and critically discussing key imaginaries. Our primary
investigation lens is directed at clarifying imaginaries concerning non-medical
preservation in the Scandinavian countries. This includes 'critically discuss-
ing some of the moral values that appear in the Scandinavian countries, such
as concerns around reproductive autonomy, gender equality, the interests of the
child and the interests of women as well as what appears as self-interest in older
women. We empirically focus on the Scandinavian context, but simultaneously
situate it within larger international debates as well as venturing, at times, into
more empirical detail about how these imaginaries unfold in a Danish context.
2. The Legal Framework
The legal framework for freezing for non-medical reasons (delay) relates, in the
Scandinavian context, both to the storage time of gametes and embryos and
the regulation of their subsequent use. A relatively liberal legal framework for
the preservation of eggs is a prerequisite, not only for the emergence of a mar-
ket in egg freezing, but also for women to feel that non-medical freezing is an
attractive option. This is especially prevalent in the United States as well as in
Australia, where egg freezing is heralded as the new equalizer, enabling women
to wait for "Mr Right" while taking "control" over their fertility.2 As outlined in
Chapter 1 and in contrast to countries such as the United States and Australia,
the Scandinavian countries have responded differently to cryo technologies, with
Denmark and Norway adopting. liberal limits for cryopreservation of sperm yet
strict time limits for the cryopreservation of eggs. As a result, freezing for non-
medical reasons
is
limited in Denmark due to the five-year cryopreservation rule.
Nevertheless, it is now offered by Danish clinics. Meanwhile, Norway explicitly
prohibits non-medical egg freezing, as the legality of cold storage depends on
medical indication (see Table 1 in the Introduction), which is consistent with the
A example of this type of marketing can be found at the Egg Freeze Center lo-
cated in Richmond, Australia. Retrieved from https://www.numberleggfieeze.com/.
Accessed on February 2019.
2
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Delay: On the Use of Freezing for Non-Medical Reasons 77
fact that sperm donation is allowed but egg donation prohibited according to the
Norwegian Biotechnology Act. Interestingly, in Sweden the freezing period of
gametes is decided by an individual medical assessment and legal regulation is
limited to the cold storage of embryos (see Table I in the Introduction). Perhaps
not surprisingly, therefore, Sweden is the Scandinavian country with the most
developed market in freezing for non-medical purposes. Meanwhile, none of the
countries offer egg freezing as part of the national health package, and thus,'egg
freezing is exclusively offered by private clinics.3
Compared to the other Scandinavian countries, in Denmark the potentiality
of ART to delay
female
reproduction became a key concern in the legal response
to assisted reproductive technologies. As mentioned in Chapter 1, the first Dan-
ish regulatory interest in 1993 came in the form of guidelines` which focused on
controlling eggs,
both in terms of their cryopreserved storage as well as the degree
to which they could be used to delay reproduction. Mirroring what was described
as women's "natural" ability to bear children, the Danish political responses high-
lighted a gendered concern and reason for the more restrictive guidelines which
deemed fertility treatment to be illegal in women beyond, their 46th birthday and
set a cryopreservation limit of five years. Bearing in mind that the ability to have
children could end prematurely in some women, publicly funded IVF was only
to be offered to women up to 40 years of age. On account of what was framed
as the maintenance and upbringing of the child, in Denmark, 45 years was to be
the upper limit for women to legally receive ART within the private sector. Mean-
while, no age limit existed for men. In a response to the parliamentary Committee
for Health, the Minister added that the increased'risk in pregnancy and during
childbirth for older women was also to be considered when setting the upper limit
at 45 years. The guidelines clearly invoked gendered imaginaries and normative
understandings related to the appropriate age of motherhood as well as the desire
to control women's eggs in terms of storage and delayed use. In setting an upper
age limit, the Danish law mirrored traditional and welfare state views of women's
role in the family (Pateman, 1989) emphasizing the importance of the female (and
not the male) presence in upbringing and caring for the child.
In -an explicit quest to
tame
the chilling potential outcomes of ARTs, the
adopted Danish Act continued to include what was discursively positioned as an
"objective" age limit of 45 years for women in replacement of the Bill's suggested
subjective limit of 40-45 years. This was based on an individual assessment of
the woman's reproductive capacity and whether or not it has ceased because of
I'1
1`~
3
The price of egg freezing is estimated at 3,000 euros
(DKK
23,000) at the Stork clinic
(this excludes medicine and the expenses associated with freezing and subsequent
thawing). At The Carl von Linn6 Clinic, the price of egg freezing is approximately
2,400 euros
(SEK
25,000) and excludes the annual storage fee (beyond the first year).
°
Directive No. 15,120 of 22 December 1993 on physicians' use of artificial fertilization
and other forms of fertility-enhancing treatments. Shortly followed by Directive No.
109 of 13 June 1994 on the introduction of new treatment methods in assisted repro-
duction and the Health Board's circular No. 108 of 13 June 1994.
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78
The Cryopolitics
of
Reproduction on Ice
age or the onset of menopause. While this assessment was initially intended to
apply to both men and women, in reality it became gendered. A public outcry
in the media made by several men caused all parties to abandon the initial age
requirement relating to men and highlighted the fact that men could reproduce
"naturally" until old age. As the Bill became the first comprehensive Act regulat-
ing assisted reproduction, the female age limit of 45 years was codified. However,
within the public health care system the regional providers of healthcare have set
the limit for access to publicly funded fertility treatment at 40 years for women.
Swedish law does not include an age limit for the delayed use of gametes and the
final decision is subject to individual medical assessment, with county councils
recommending an age range of 37-41 years for women receiving IVF treatment
in the public healthcare system but subject to individual assessment. As demon-
strated in the above section, the Scandinavian countries differ in the legal frame-
works relating to cryopreservation for non-medical reasons, although all three
countries rely on gendered regulation. Prior to framing key competing sociotech-
nical imaginaries in the Scandinavian countries, we turn now to a theorization
of delay which emphasizes the temporal and anticipatory logics associated with
cryopreservation.
3. Theorizing Delay
In this section, we view the concept of -_delay
within
cultural analytical schol-
arship on the temporal politics of anticipation and biopreparedness as well as
within feminist science and technology scholarship. Delay engages with a tempo-
ral or anticipatory logic requiring acting in the present by freezing one's fertility
potential, the medicalization and technolo'gization of gamete freezing, and an
orientation to the future (van de Wiel, 2015, p. 119). Freeman (2010) theorizes
this temporal and normative logic in developing the twin concepts of chrononor-
mativity and chronobiopolitics. According to Freeman (2010), chrononormativ-
ity illustrates how time organizes "individual human bodies toward maximum
productivity" (p. 3). Chrononormativity involves institutional techniques (clocks,
calendars, schedules) that make the movement of individual as well as collec-
tive groups of bodies appear desirable, even natural, biological, and somatic. By
emphasizing temporalities as norms and politics, Freeman (2010) draws our atten-
tion to time as
.a
performative and powerful technique orienting, regulating, and
disciplining bodies in synchronized rhythms to normative modes of production
and culture, including gender, kinship and identity as well as powerful rhythms
that are naturalized and re-appear as "hidden rhythms" (Zerubavel, 1981). Simi-
larly, the preservation of one's own material becomes, as also noted by Waldby
(2019), a private investment directed at ensuring generational normativity.
In this theorization of delay, non-medical freezing can be seen as an act of
anticipation. It becomes a temporal state of being oriented to the future and thus
acting in the present while being reflective on the past (Adams, Murphy, & Clarke,
2009; Waldby, 2014). As noted by Adams et al. (2009, p. 248), the past and the
future collide when "the future increasingly not only defines the present but also
creates material trajectories of life that unfold as
anticipated by those speculative
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Delay: On the Use of Freezing for Non-Medical Reasons 79
processes"
(authors' italics). While the notion of delay entangles with this antici-
patory logic, it similarly draws upon the speculative and promissory industries
involved in vitrification, banking and thawing (Thompson, 2004; Waldby &
Mitchell, 2006). Freezing for non-medical reasons can then be theorized as not
exclusively an individual decision to anticipate future infertility. Rather, it is both
a burgeoning commercial practice as well as a way to manage one's reproductive
desires, including that of heterosexual coupledom (Inborn et al., 2018a) while
also ensuring generational lineage (Waldby, 2019).
In this way, cryopreservation entangles with market and kinship needs when,
as noted by Adams et al. (2009, p. 252): "anticipation is a mode of both creating
markets and responding to projected needs." Similarly, in the development of bio
-
preparedness as a concept, cryopreservation becomes an embodied preparation
of women's bodies (through hormone injections and egg retrieval) that enables
genetic parenthood (Waggoner, 2015). These forms of biopreparedness reinforce
freezing as a technology that maintains the desire for a heterosexual, nuclear fam-
ily while simultaneously drawing upon conventional notions of kinship in which a
gestational and genetic relationship between parents and children remains desir-
able (van de Wiel, 2014, pp. 7-8). Moreover, when positioned within a neoliberal
context in which individuals are responsible for 'optimizing their own reproduc-
tive futures, freezing for non-medical reasons becomes enacted as a "responsible"
preparation of the body for a likely (and perhaps desiråble) future (Carroll &
Kroløkke,
2017).
However, it also becomes an anticipation of securing the family line. Based on
notions of "thick time" (Neimanis and Walker, 2014), Waldby (2019) develops
a different temporal perspective; to more adequately understand her interviews
with egg freezers. She states that; "The term thick time evokes the sense in which
the entire genealogy of the species and ancestry is played out in the real time of
lived life" (Waldby, 2019, p. 33). Thick'time, then, cements the promise inherent
in cryopreservation technologies. It recognizes the individual woman's desire for
a future child as well as, importantly, the ways in which cryopreservation enables
the continuation of kinship lines. As echoed in Waldby's (2019) text, oocytes turn
into family investment material or elements that echo an indebtedness that these
women have to their own families.
While women discipline and control their reproductive bodies through what,
in this theoretical framing, can be seen as an anticipatory risk-management
logic, delay can also be theorized in the light of optimization and bioprepared-
ness. Cryotechnologies enable women and men who can afford it to bank their
"optimal" genetic and reproductive material. Although not addressing cryo-
technologies specifically, in the opinion of Rose (2007), optimization frequently
includes biomedical and technological efforts aimed at securing the best possible
futures. In the case of gamete freezing, freezing promises to hold still what at that
point in time are viewed as the highest-quality reproductive cells. Cold storage
enables not only delay and reproduction at a later (more optimal) time, but also,
when understood as an optimizing technology, enables the depositors who can
afford it to bank their "optimal" genetic and reproductive material. Rose (2007)
states that: "the old lines between treatment, correction and enhancement can no
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80
The Cryopolitics of Reproduction on Ice
longer be sustained" (p. 17). The key feature of optimization, therefore, is its for-
ward focus, whereby acting in the present (such as freezing now) promises a more
successful (future) reproductive outcome. Hannah Landecker (2004) comments
on this development, when she notes that reproductive technologies change what
it means to be biological.
In the existing scholarship, delay is strikingly gendered. Women are framed
as doubly responsible for managing their reproductive time and for enacting
responsible reproductive citizenship through the anticipation of future infertil-
ity (Carroll & Krolokke, 2017). In her discussion of Dutch and British media
accounts of egg freezing between 2000 and 2012, van de Wiel (2014), for exam-
ple, illustrates this theoretical framing, when she highlights the gendered impli-
cations that these accounts have of the ageing female reproductive body. Egg
freezers are, she notes, both lauded for taking matters into their own hands, yet
are also frequently criticized as "lifestyle freezers" whereby choosing to 'freeze
one's eggs is not cast as the solution but rather becomes indicative of the woman
being too picky, wanting it all, naively awaiting "Mr Right" instead of settling
for "Mr Good Enough" (van de Wiel, 2014, p. 10). Similarly, Martin (2010)
notes how women who freeze for non-medical reasons become stigmatized while
risk-managing their reproductive future in .the quest 'of genetically related
children. She states that:
As a tool of risk management, egg freezing is a technomedical
displacement remedy, ameliorating fears of childlessness and
the reproductive and genetic unknown at the same time as put-
ting women's bodies and bank accounts at risk. (Martin, 2010,
p. 540)
Key to the theoretical debate, therefore, are the ways in which delay seeks to opti-
mize and risk-manage women's reproduction while ensuring the ability to parent
what becomes prefaced as one's "own" genetic offspring (Franklin, 2007; Ussher,
2006).
This theoretical section reveals how delay engages temporal and anticipa-
tory logics as well as being situated within a general cultural logic of optimi-
zation. Importantly, theorizing delay allows us to situate cryopreservation for
non-medical reasons in the light of larger (chrono)normative Scandinavian
practices associated with child-bearing and the making of families. Cryopreser-
vation becomes, in this context, a synchronizing technology that tries to ensure
reproductive possibilities despite the biological realities of reproductive ageing,
for example. Within the anticipatory practice of reproductive delay, therefore,
freezing for non-medical reasons engages synchronization strategies by turn-
ing reproductive cells into future self-investments, optimizing depositor bodies
while also preparing them for future genetic parenthood together with the con-
tinuation of the family line. We turn now to some of the sociotechnical imagi-
naries that, in the context of the Scandinavian countries, surround freezing for
non-medical reasons.
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Dela})'
On the Use
of
Freezing for Non-Medical Reasons 81
4. Imaginaries on Freezing for Non
-
Medical Reasons
In the following section, we will first present some of the central imaginaries,
often evoked as discourses or affective configurations and arguments, for and
against freezing for non-medical reasons. While we draw upon popular media
accounts, interviews and survey studies (see Introduction), our point of departure
will often be the Danish Council on Ethics and its Scandinavian counterparts. In
our analysis, we will try to both unfold and critically discuss the imaginaries that
focus on normative evaluations concerning the legalization of freezing for non-
medical reasons.
The ethical discussions related to the non-medical freezing of eggs are of
particular interest to us. There are several reasons for this. First of all, ethical
discussions often center around women's reproductive cells and are therefore
frequently gendered. Notably, ethical discussions about the cryopreservation of
sperm for non-medical reasons are far less heated than ethical discussions about
women's reproductive cells. Whereas an emerging scientific and business interest
argues in favor of the cryopreservation of both female and male reproductive
cells (in order also to ensure men's chances of genetic parenthood), ethical dis-
cussions about the non-medical cryopreservation of sperm do not take up much
space compared to the parallel discussion on eggs. Moreover, what is seen as
men's reproductive ability to deliver "fresh" sperm (regardless of age) combined
with the fact that no legal cryopreservation time limits exist on the preserva-
tion of sperm, have made men's reproductive choices appear limitless. Second,
we have also deprioritized the freezing of embryos for non-medical reasons. In
part, this discussion consists
of
complex ethical issues and arguments surround-
ing the moral status of embryos, including when it is morally permissible or
should be legal to destroy embryos that are cryopreserved for non-medical rea-
sons. Moreover, clinical evidence suggests that women prefer to have their eggs
(not embryos) preserved for non-medical reasons (Goold & Savulescu, 2009).
The desire to preserve eggs rather than embryos therefore partially contributes
to embryos having a higher moral status than eggs, or even the same rights as
people_, or may lead to women postponing the decision about with whom to cre-
ate an embryo. When women freeze eggs rather than embryos, they also steer
clear of complications that may arise if they later disagree with their partner
about what is to be done with this reproductive material. Consequently, in the
following sections, we investigate some of the central imaginaries that surround
egg freezing for non-medical reasons in the Scandinavian countries.
4.1. Imaginaries
of
Reproductive Autonomy
We have been successful at liberating women from pregnan-
cies, but we have never been successful at letting women have
children, when they want them. (Interview excerpt with David
Keefe, Head of NYU Langone Fertility Center, repeated in Vest-
ergaard, 2014)
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The Cryopolitics
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Reproduction on Ice
Egg freezing promises to grant women more reproductive choices. Not only can
women now, with the assistance of the birth control pill, control
idiether
they
want to be pregnant, the development of cryotechnologies has, in this medical
(and frequently also clinical) imaginary, afforded (some) women the chance to
decide
tivhen
they want to be mothers. As yet another reproductive technology,
therefore, egg freezing purports to revolutionize women's reproductive lives. As
noted by Herrmann and
Kroløkke
(2018), egg freezing purports to extend the
reproductive choices afforded by the birth control pill, thus granting women `the
autonomy to synchronize their "biological clock" with the rest of their lives.
In fact, some of the obvious arguments in favor of freezing for non-medical
reasons are based on values such as reproductive autonomy and increased
gender equality (Danish Council on Ethics, 2015, pp. 3-5). However, in order
to understand how the non-medical freezing of gametes is understood in a
Scandinavian context, we need to consider how different conceptualizations of
women's reproductive autonomy coproduce differentiating imaginaries of egg
freezing as respectively contributing to women's emancipation or reproducing
suppressive societal structures.
Women's reproductive autonomy has become a moral axiom in Western
culture (Harwood, 2009; McLeod, 2002; Petersen, 2004, 2015; Robertson,
1994) and maybe even more so in the Scandinavian context. Thus, in Scandi-
navia, reproductive autonomy arguments extend to women's eggs, including
who owns them and who should decide what happens with them. This notion
is echoed in the Danish Council on Ethics (2015, p. 11) accounts, when the
Council recognizes that an important moral value that should be taken into
account when the regulation of, assisted reproduction is discussed is that "...
the woman herself or her family, as a 'point of departure, should decide for
herself what should be done with her eggs." Similarly, the Swedish National
Council of Medical Ethics (2013, p. 148) emphasizes the ways in which auton-
omy and temporality come together when it writes about egg freezing and
autonomy: "The technique can increase the reproductive autonomy of women,
as it can increase their' possibility to decide when and with whom they will have
a child,.'_' And in Norway, members of The Norwegian Board of Technology
mention that
[ ... ] freezing of eggs at a young age will increase the freedom of
choice and the possibility to pursue other goals in life, without
renouncing the possibility to have children later in life. (The Royal
Department of Health and Care, 2016-2017, p. 30)
As will become clear in our forthcoming analysis, concerns relating to repro-
ductive autonomy are prominent in the Scandinavian context. In Scandinavia,
cryotechnologies become both an individualized empowerment tool as well as
problematized as a form of gendered exploitation when women become norma-
tively oriented toward having a reproductive future. In the following section, we
discuss both of these conceptualizations of reproductive autonomy as they come
into play in the Scandinavian welfare states.
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Dela),.- On the Use of Freezing for Non-Medical Reasons 83
4.1.1. Egg Freezing as a Tool to Strengthen Women's Individual Autonomy.
I like it. Without new children, we have no future. But women
deserve a career as much as men do. (I13107, 22-year-old female
Danish medical student)
In both the clinical marketing material as well as in individual user accounts, egg
freezing is stipulated as enhancing women's reproductive autonomy. Respond-
ing to the question "should the Danish welfare state or the employer pay for egg
freezing," the medical student quoted above expresses agreement on both counts,
equating cryotechnological developments with children and the prospects of hav-
ing a future in the first place ("without children, we have no future"). Within the
imaginary of cryotechnologies as technologies that strengthen women's auton-
omy, women may want to freeze their eggs for many different reasons. They may
need to have more time to find a suitable partner or believe that they cannot find
a suitable partner before their biological clock runs out. They may need 'time to
complete their education, time to mature and have a career and secure their finan-
cial situation before embarking on parenthood. This is echoed in Inhorn et al.'s
(2018a) large interview study of North American and Israeli women's reasons for
cryopreservation. Inhorn et al. (2018a, 2018b) document that freezing for non-
medical reasons is complex, yet all of their female interviewees reify the desire
for heterosexual couplehood. Thus, the-fact that women have no male partner
appears at the heart of the decision to preserve, conceptualized by the authors
as "the male deficit problem" (Inhorn et al., 2018a, 2018b). Accordingly, in this
imaginary, if women want to cryopreserve their eggs for non-medical reasons,
they should then be allowed to freeze their eggs for as long as they want to.
In the imaginary of reproductive autonomy, egg freezing transgresses overall
structures of oppression such as exploitation of traditional gendered norms. This
is reflected in the marketing of egg freezing in the United States. When the latest
egg freezing clinic, Trellis, in New York City re-situates the clinic as a "fertility
studio," it simultaneously promotes egg freezing within a rhetoric of "options
now, possibilities later." In the process, freezing for non-medical reasons turns
into a wellness regimen in which young, attractive, seemingly successful, well-
dressed and smiling women gladly turn to the fertility clinic now re-aestheticized
as a designer furniture homey space in order to secure their future chances of
motherhood. Trellis Fertility Studio encourages women to "own" their fertility,
when they say: "Take charge of your fertility" (https://www.trellishealth.com/
2018). Similarly, on March 8, 2018, International Women's Day, Extend Fertility
(also located in Manhattan) conceptualized egg freezing as following in the foot-
steps of the birth control pill in granting women reproductive choices:
Egg freezing allows a young woman to make choices for herself —
whether those choices are to focus on her career, pursue higher
education, travel, date without pressure, or any other activity that
doesn't involve having babies right now — while preserving the
option to have children when she's good and ready. (https://extend-
fertility.com/blog/egg-freezing-gender-equality, 2018)
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84
The Cryopolitics of Reproduction on Ice
In the above cases, reproductive autonomy is aesthetically presented in the
shape of young, attractive, well-dressed, urban women. While fertility preserva-
tion appears to be the goal, the visual material de-emphasizes pregnancy and
children and instead re-centers on the young, attractive, fit, individual, autono-
mous woman.
Although autonomy is also strongly present in media and ethical accounts
on egg freezing in the Scandinavian countries, interestingly Scandinavian clinics
do not rely on this discourse in their commercial practices. Rather, outlining the
possibilities of egg freezing, the Stork clinic, located in Copenhagen, aestheti-
cally uses a photo of a white pregnant woman wearing a wedding ring, to explain
that egg freezing is an option to help women delay their family-making plans
(https://www storkklinik.dk/en/treatments/egg-and-sperm-donation/egg-freezingo.
In this representation, pregnancy and egg freezing visually collide, turning egg
freezing, aesthetically at least, into a viable reproductive planning option.
Meanwhile, the Nordic Egg Bank, located in Gothenburg in Sweden, situates
itself as a Nordic frontrunner and refers to egg freezing as a "fantastic opportu-
nity to preserve fertility ( ... ) if pregnancy isn't an option in their present social
situation" (https://www.youtube.com/watch?v=-brHAOtE_w8 2018). Similarly,
Livio, located throughout Sweden as well as in Norway, situates egg freezing as
an ability to help women or couples who want a later pregnancy (https:Hlivio.se/
behandling/aggfrysning/ 2019). In Livio's online presence, egg freezing is aestheti-
cally presented in the middle of a sunny Scandinavian corn field (https://Iivio.se/
behandling/aggfrysning/ Retrieved January 2019). Thus, unlike the commercial
clamor for reproductive autonomy that is evident in the commercial practices of
clinics in the United States, in the Nordic clinical advertisements, egg freezing for
non-medical purposes is situated within a more nationalized, collective, albeit
autonomous, Scandinavian desire for family planning. This planning involves
fairly heteronormative and white, family values, such as that of marriage visually
portrayed through the wedding','riing,5 multiple children and, as evident in the
Swedish flags portrayed in The ,Carl von Linne Clinic video,6 national pride.
While the Scandinavian countries have a reputation for focusing on women's
autonomy and gender equality, as far as reproductive rights are concerned,
these concepts are still debatable. In fact, not only autonomy but gender equal-
ity appears at the heart of the issue, when, for example, the Danish Council
on Ethics (2013, p. 5) situates egg freezing as potentially contributing to more
gender- equality. The law on cryopreservation widens the gap between women's
and men's possibilities of reproducing later in life. This is especially the case in
storkklinik. dk/en/treatments/egg-and-sperm-donation/egg-freezingn
6
In this presentational video, The Carl von Linne Clinic portrays itself as one of
Sweden's oldest IVF clinics (the male scientist gestures proudly and displays two
Swedish flags) and as a skilled gardener (visually showing the healthy growing of
various different plants throughout the video) including acquiring knowledge on
how best to individualize growth and development. Retrieved from http://www.linne.
se/?lang=en. Accessed on February 2019.
5
(https://www.
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Delay: On the Use of Freezing for Non-Medical Reasons 85
Denmark and Norway where, in the absence of clinical and medical reasons,
women can only cryopreserve their eggs for five years. The structural differences
between women and men in the labor market and in the educational system
make it easier for men — or so the argument goes — to make not only long-term
family plans but also career plans. These differences would not necessarily dis-
appear if women had the same opportunity to cryopreserve as men, but could
nevertheless increase the equality of opportunities between men and women in
important areas of life. In this argument, liberalization of the Danish and Nor-
wegian regulation would benefit women in countering the effects of structural
inequality and normative pressures. Thus, in these pro-egg freezing accounts,
individualized solutions are seen as better than no solutions
at
all while also
offering more women the chance to enter the workplace or enhance their careers
when they want to.
4.1.2. Delay as Socio-cultural Coercion and Market Exploitation.
I do not think that the employer should intervene. The offer
should only be present if the state pays. If an employer inter-
venes in circumstances like that, it could lead to a risk of dis-
crimination of women in the workplace because a woman might
feel that she owes the employer something. The power relation-
ship will accordingly be disproportional between employer and
employee (more than it already is). (ID163, 24-year-old female
Danish law student)
Whereas cryotechnologies, in the previous section, are seen as supporting ideas of
women's reproductive autonomy, we now 'discuss the ways in which cold storage
entangles with Scandinavian concerns around capitalist exploitation of women's
reproduction. In response to the question of whether Danish employers should
be allowed to include egg freezing in their benefit packages, the Danish female law
student quoted above disagrees. While she, in her response, in fact remains open
to the !Danish welfare state funding non-medical egg freezing ("the offer should
only be present if the state pays," she situates cryo-employer benefits as adding
fuel to an already unequal relationship and potential exploitative practices. ("The
power relationship will accordingly be disproportional.") In her response, as well
as in the responses of other informants, cryopreservation entangles with a capi-
talist market and `most notably concerns around unequal power relationships.
In this section,~we discuss the ways in which freezing for non-medical purposes
entangles with concerns around capitalist exploitation. To do this, we turn to the
Danish Council on Ethics and delineate arguments made against freezing for non-
medical reasons as well as concerns present in the large survey study. Here, auton-
omy comes to be understood within an imaginary of coercion. For example, the
former chair of the Danish Ethical Council,
Gorm Greisen,
argues against freez-
ing eggs for non-medical reasons and The Danish Council on Ethics situates repro-
ductive autonomy not within individualized forms of empowerment but rather
within a larger context of exploitation and coercion. He states: "Women may
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86
The Cr))opolitics of Reproduction on Ice
experience that they are coerced to delay their reproduction" (Nobel, 2017, p. 3).
According to Greisen, autonomy must be understood as freedom from coercion
from family, work or other institutions. Similarly, in Norway, the Norwegian
Council of Biotechnology connects women's reproductive autonomy with societal
pressures when it writes that: "With increased reproductive autonomy through
egg freezing, may follow a social pressure to delay having children, because of,
e.g. career reasons" (The Norwegian Biotechnology Advisory Board, 2019,
p. 1). Concerns around the ways in which autonomy and larger societal pressures
come together are also present in the survey of Danish students. For example,
and although recognizing the potential of freezing for non-medical reasons, one
student expresses concern, when she says:
I am worried that it (freezing for non-medical reasons) might lead
to an expectation that women will take the offer (to 'freeze her
eggs). It could then create a culture in which it is not only an offer
but in fact a requirement to keep your job, get the'same,pay and
have the same positions as men. (ID66, 24-year-old male Danish
medical student)
Here, reproductive autonomy conversely entangles with., gender equality identi-
fied by this student as equal pay and equal job 'opportunities as well as freedom
from collective forms of coercion ("a requirement to keep your job").
In the feminist scholarly debates on fertility preservation a similar understand-
ing of autonomy as "freedom from coercion" can be found. Complicating the
discussion, feminist scholars have emphasized how autonomy must always be sit-
uated within larger cultural contexts (Martin,-20 10). According to Martin (2010),
freezing for non-medical reasons medicalizes women's bodies while simultane-
ously situating .child-bearing and genetic relatedness as key to a healthy family
life. As noted by Martin (2010, p. 540): "On top of the reproductive imperative
can now be laid the genetic imperative." In this account, autonomy is understood
as freedom from the normative pressures framed as healthy family life. Similarly,
Lombardi (2018) contextUalizes egg freezing for non-medical reasons in an Ital-
ian context and situates cryotechnologies in the light of larger gender inequalities:
"If the choice of freezing eggs at 25-30 years of age and to defrost them at the
age of 40 or 50 is, forced by unfavorable social conditions, then we cannot speak
of `free choice' but rather of a choice that goes against women and not to their
benefit," she says (Lombardi, 2018, p. 225).
In further criticism of non-medical freezing in this material, cryotechnologies
become imagined as individualizing technologies available only to the women
who can afford them. For example, sceptics such as Cattapan et al. (2014) have
argued that reproductive autonomy becomes stratified. Thus, supporting freez-
ing for non-medical reasons (e.g., by making it legal or by letting companies
pay for it) may, in this imaginary, undermine the autonomy of the many. The
individual use of cryotechnologies is seen as potentially shifting attention away
from important and lasting changes of the societal structures (e.g., in the work-
place) that distinctly disadvantage women. If these changes, for example, are
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Delay: On the Use of Freezing for Non-Medical Reasons 87
implemented in the workplace (e.g., more flexible working hours, paid paren-
tal leave, equal pay, etc.), in this discourse, women become less restricted by
structural changes and more autonomous. Thus, instead of spending time and
resources on what here becomes constructed as an overly optimistic biotech-
nological and individual fix through structural changes, Scandinavian ethical
debates suggest that a collective effort is required. Lombardi (2018) echoes this
argument as well, when she situates freezing for non-medical reasons not within
delayed motherhood but rather within a precarious job market which makes
motherhood difficult in the first place. Similarly, Cattapan et al. (2014) argue
that shifting the burden to individual women to accommodate the traditional
employment model (by using egg freezing) is not preferable to changing the
model itself.
In this imaginary, and within the context of the Scandinavian countries, repro-
ductive autonomy becomes heavily entangled with more general moral concerns
related to women's autonomy as a whole. The imaginary of autonomy therefore
becomes key in the ethical accounts relating to how women's autonomy should
be understood. In this imaginary, the fact that patriarchal employment models
favor men does not necessarily lead to a call for egg freezing to be illegal (Goold
& Savulescu, 2009). Instead, in pro-egg freezing ethical accounts, individualized
solutions are seen as better than no solutions at all, while also offering more
women the chance to enter the workplace or enhance their careers. Furthermore,
in this imaginary, even if activism for social change in the labor market is prefer-
able to individual accommodations to this market, activism for social change is
not necessarily eliminated, undermined or overshadowed by allowing access to
technology that might remove some of the constraints that women face in the
labor market or in their lives as a whole.
As we have seen the argument for liberalization within this critical imaginary
of autonomy, is complicated
by
feminist researchers who have argued that freez-
ing for non-medical reasons will increase the inequality between privileged and
unprivileged women and their families (Cattapan et al., 2014). This latter argu-
ment is entangled with the cost of freezing and depends on whether cryopreser-
vation for non-medical reasons is supported by the social health care services or
exists in a free market. While in Denmark, preservation for non-medical reasons
is currently paid out of pocket, Swedish companies are increasingly following the
example of companies in the United States and offering IVF and freezing for non-
medical reasons as employee benefits (Lindroos, 2017). According to Benify, a
Scandinavian company that helps companies put together employee benefit pack-
ages, "modern" companies may offer fertility packages to their employees includ-
ing not just IVF but freezing for non-medical reasons (Lindroos, 2017). While
the employer packages may be controversial, the survey study of Danish students
found less resistance to welfare state-funded packages exists. A welfare state
might consider funding cryopreservation as part of the public healthcare system.
In that case, the inequality between the financially privileged and less financially
privileged would not be widened, but the burden on the welfare state to fund egg
freezing would become stronger. Conversely, if freezing for non-medical reasons
is limited or even illegal, then only financially privileged Scandinavian women
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The Cryopolitics of Reproduction on Ice
(notably in Denmark and Norway) can afford to travel to have their eggs cryo-
preserved in countries (e.g., Sweden) where it is legal. In this way, understandings
and arguments around how and whether non-medical freezing enhances or limits
reproductive autonomy must be assessed and discussed within Scandinavian con-
figurations of what autonomy or equality might even be.
4.2. Imaginaries of Rightly Timed Kinship
When I was 12, I made myself a list. A kind of life plan. I should
have an apartment before I was 22. I should meet the man of my
life when I was 24. He was supposed to propose when I was 26,
and we would marry when I was 281/2. Because according to
the statistics that I had read, this was the time when it was the
least probable that you would then divorce. (Penny Wayne Claire
Kembba in Baby on Ice https://www.nrk.no/dokumentar/xU
forbudt-eggfrysing- 1. 14508790)
I
Whereas the then 12-year-old Norwegian Penny Kembba envisaged having her first
child at the age of 29, the documentary
Baby on Ice
reveals the trepidations and
concerns related to anticipated future infertility tincluding the cross-national repro-
ductive pathways (Adrian &
Kroløkke,
2018) involved when Penny travels from
Norway to Sweden. In this section, we suggest that freezing for non-medical reasons
can also be understood within imaginaries of rightly 'timed kinship. Cryotechnolo-
gies enable another reproductive temporality' not only are women able to postpone
motherhood such as in the case
of
frozen gametes that can become a child twenty
years later, these non-normative reproductive temporalities come to appear morally
wrong, as they upset a particular normative temporality and thus produce anxieties
about the frozenness of the matter. In what follows, we begin by specifically high-
lighting the concerns related to the best interests of the child and those of women
as aptly understood within an imaginary of the (right) temporality of kinship. Con-
cerns about the potential harm to children and too old mothers are key to Scandina-
vian medical and ethical debates on cryopreservation for non-medical reasons. We
end by returning to the kinship temporalities that, in stories like Penny Kembba's,
stress chrononormative understandings of freezing for non-medical reasons.
4.2.1. Kinship Temporalities and the Best Interests of the Child.
In Scandinavia, the best interests of the child play a big role in discussions about the
ability to freeze and postpone reproduction
(Kroløkke
& Adrian, 2013). Feminist
scholars have, however, shown how arguments about the best interests of the child
function as a smokescreen for the reiteration of more conservative cultural val-
ues Baird, 2008; Hosking & Ripper, 2012;
Kroløkke
& Adrian, 2013; Liljestrand,
1995). The interests of the child become what Baird (2008, p. 29 1) calls an "imper-
meable category," "iconized" as well as "fetishized" (Baird, 2008, p. 293). Based on
Swedish empirical material, Liljestrand (1995) points out how what are presumed
to be the interests of the child replace children's actual experiences, when she says:
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Delay: On the Use of Freezing for Non-Medical Reasons 89
The "child's best interests" became a powerful argument serving
this purpose because of its ambiguity and because it capitalized
on existing social values of social solidarity and the social value
of the child. (p. 297)
In this section, we discuss the ways in which the best interests of the child unfold
in the context of freezing for non-medical reasons. The age of the mother, is also
a key element in this discussion.
The concern around the best interests of children is frequently divided into
two separate issues. One issue is
direct
and concerns the effect that the process
of freezing and thawing will or can have on the health and well-being of the
future child. Specifically, will cryopreservation increase the incidence of birth
defects (Danish Council on Ethics, 2015, p. 8, see also the Swedish National
Council of Medical Ethics, 2013, pp. 147-149). The other issue is
indirect
and
concerns the alleged harm (often psychological or social in nature) that may
follow when children are born to older than average mothers/parents who have
delayed having children until they are in their forties or fifties. This issue has to
do with the idea that older parents are not as "good" parents as younger par-
ents (e.g., because they may not have the same energy, etc. as younger parents),
or that children born to older parents are harmed because they will not have
their parents for as long a time as children born to younger parents (Danish
Ethical Council, 2015, p. 7). Similarly, the Swedish National Council of Medi-
cal Ethics 2013, for example, writes that it speaks against allowing older women
to have children because "the risk of a problematic upbringing is increased due
to the fact that older women are at a higher risk of death related to disease."
In these accounts, the woman's age entangles with concerns related to disease
and possibly even premature maternal death.
However, with regard to the more direct concern, the entanglements between
cryopreservation and child health contrast with clinical evidence (Noyes et al.,
2009). Clinical evidence suggests that children born from cryopreserved eggs do
not have more birth abnormalities compared to "spontaneous" pregnancies and
birth (Noyes et al., 2009). The results from the Noyes et al. (2009) study involving
936 children born from cryopreserved eggs reveal that only about 1.3% of these
children had birth defects. (This should be compared with the observation that
children with birth defects account for approximately 3% of all live births in the
USA.) Additionally, medical evidence suggests that cryopreserving several eggs
.during a woman's most fertile years could minimize the risks of genetic abnor-
malities in the potential child even if she uses them much later in life (Gould &
Savulescu, 2009). Consequently, current clinical evidence supports the idea that
children born from cryopreserved eggs have fewer genetic abnormalities than
children born after spontaneous conception. Moreover, because the preserved
eggs are "younger," fewer genetic abnormalities may exist when they are later
retrieved and used by an older woman. This is notably evident in the clinical
advertisements, where "younger" eggs are equated with a "healthier" outcome.
As noted by the Stork clinic, located in Copenhagen, "freezing eggs can increase
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The Cryopolitics of Reproduction on Ice
the chances of becoming pregnant at a later date, as healthy eggs are removed and
stored as early as possible. ))7
The material also addresses the concern that children born from cryopreserved
eggs may be indirectly harmed by having an "old mother." Adrian,
Kroløkke,
and
Herrmann (forthcoming) show that older Danish mothers are frequently posi-
tioned within an imaginary of monstrosity, according to which older women hav-
ing children become morally problematic. The monstrous old mother narrative
may, however, be problematic from an empirical as well as a moral point of view.
For example, Shaw and Giles (2009) document that the well-being of children
born to women over the age of 45 is actually better than the well-being of children
born to younger women. Women over the age of 45 usually have abetter income,
greater job security, and are seen as more prepared and more committed to being
a parent (Shaw & Giles, 2009). Moreover, women's increased life expectancy, may
mean that a woman who brings a child into the world when she is 50 years old will
be alive to care for her child for many years. In the Scandinavian countries, aver-
age life expectancy for women is over 80 years. However„although it is reasonable
to expect that a woman who gives birth to a child when she is 50 will live until her
child is well into adulthood, normativities related to the "ideal" age of childbirth
still prevail. Similarly, in the large survey study of Danish students, one informant
echoed the opinion of several others when she writes: "It is a good choice to have
if the woman prioritizes her career, however I don't think women should be older
than 40 when they have a child" (ID 105,-Danish law student). In the next section
and in Chapter 5, we present and discuss in greater detail imaginaries that connect
to older women (i.e., women over 40) wanting and having children. Because of the
ways in which these normativities are gendered, we turn now to the treatment of
age and the best interests of what appears as self-interested women in the material.
4.2.2.
Kinship Temporalities and the Best Interests of (Older) Women.
What exactly is it that we (in reference to women over 40) are sup-
posed to do in all these years from when we are 40 till we are 80?
(Interview with Rita, 2012)
We argue that the concerns that ageing mothers express can aptly be understood
as embedded within the imaginary about rightly timed kinship. The workings of
this imaginary are, for example, discussed and analyzed within queer literature on
reproduction and temporality (Edelman, 2004; Halberstam, 2004). In this litera-
ture, temporality constitutes a powerful orientation device in which reproduction
by older mothers appears monstrous, that is, experienced as morally problem-
atic. The best interests of the child therefore come to be understood within a
7
The
Stork clinic offers egg freezing to its clientele positioning eggs from younger
women as more attractive than eggs from women over 35: Retrieved from https://
www.storkklinik.dk/en/treatments/egg-and-sperm-donation/egg-freezing/. Accessed
on February 2019.
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Delay: On the Use of Freezing for Non-Medical Reasons 91
normative imperative and drive toward young motherhood. In contrast, "old"
mothers and especially women over the age of 50 become situated as entering
their "grandmother" years.
We argue that the concern about "too old" mothers is rather a concern around
Scandinavian women being out of sync with temporal norms of motherhood.
Once they become "grandmother potential," they (unlike their male counter-
parts) cease to be positioned as having reproductive potential. As noted'in the
survey study and in response to the ability to cryopreserve eggs:
I think it's a personal choice everyone should be allowed to make,
but of course, there are some important factors to keep in mind
such as the age. I don't think it's fair to have a child when you are
100 years old. (ID 142, 22-year-old female Danish law student)
These concerns are also evident when Danish medical expert and professor Lone
Schmidt says:
It is deceiving people to tell them that women in their mid-30s can
freeze their eggs and later on have a child. Only a very small por-
tion of the eggs will result in a live child. (Sorensen, 2013)
Likewise, Karin Erb, Head of the Danish Women's Society, a non-governmental
agency, reiterates this concern, when she says:
Social egg freezing deceives women that 'they can have children at
42 years of age or when they feel ready. It creates a false sense of
security, and the woman will have wasted all of her fertile years,
because she thought she was secured.
(Kvindesamfund,
2017)
This criticism is combined with the desire for information to help women (as
well as men) to make what is referred to as "informed choices" about the proper
chances of having a child at a certain age. In this context, information is sought
to secure that no one sees ciyopreservation for non-medical reasons as a complete
cryo-insurance (see Chapter 2).
Within this context of ageing mothers, delay itself produces a potentially
'unhealthy temporal order. For example, an older pregnant woman is put in
close proximity to health problems (e.g., Jacobsson, 2004; Molina & Pace, 2017).
According to fertility experts from the General Hospital in Copenhagen, mater-
nal mortality increases roughly fourfold over the age of 40 (to 20.6 deaths per
100,000) including higher rates of ectopic pregnancy. A second, and more psy-
chological, concern among fertility experts is based on the fact that because the
chances of conceiving a child decrease with the age of the women, failing to
achieve a pregnancy may have negative psychological consequences. While these
medical concerns are based on clinical research, the ethical concern that older
women endanger their own physical as well as psychological health is simulta-
neously rooted in an understanding of reproductive temporality as following a
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The Cryopolitics of Reproduction on Ice
particular order. Similarly, from cultural analytical perspectives, old motherhood
destabilizes normative understandings of what older women should or should
not do. Once women are older; their reproductive desire becomes queer perhaps
even, culturally translated, unhealthy.
The imaginary of older mothers and rightly timed kinship can, however; also
be contested from moral perspectives that have to do with the acceptance of
health risks. The ethical scepticism toward cryopreservation may provoke the fol-
lowing moral question: How much medical and psychological risk should the
welfare state accept in order to accept the use of this technology? From an ethical
point of view, one way to answer this question is to see how much risk the wel-
fare state already accepts in the area of medicine and reproduction. First, while
women over 40 certainly have children as well as access to assisted reproduction,
even if this involves an increased risk for women's health, then it seems to fol-
low that the state should also, morally and legally, accept egg freezing for non-
medical reasons. Furthermore, if women are informed about the medical and
psychological risks and are competent decision-makers and they accept this risk,
in accordance with the imaginary of the autonomous woman, then it seems like
a good rule of thumb that they are the ones to decide whether or not the risk is
acceptable. This is already a common and accepted practice in the Scandinavian
countries, when people are asked whether they want an operation or treatment in
the healthcare system.
With regard to the imaginary of rightly timed kinship, Scandinavian women
like Penny Kembba, in the introductory quote to this section, may go to Sweden
in order to freeze their eggs and get their reproductive opportunities "back on
track" (Kumano-Ensby, Falch-Nilsen, & Ebrahimi, 2019). In these types of cryo-
and reproductive pathways (Adrian & Kroløkke, 2018), Scandinavian women
turn egg freezing into an act of "involuntary childlessness. ,8 For example, this is
the case for "Andrea," a Norwegian woman who at the age of 35 and because she
had no male partner; decided to go to Sweden to have her oocytes cryopreserved.
In the news article, Andrea re-naturalizes egg freezing for non-medical reasons
by, in a similar way to the Scandinavian clinical advertisements, stressing the
attractiveness and naturalness of pregnancy: "It is something that I really felt
like doing. For me it means a lot to have fairly good odds of becoming pregnant
later in life" (Arrestad & Jevne, 2014). By positioning herself as "involuntarily
childless," Andrea makes a claim for legitimacy as far as access and availability of
treatment is concerned by repositioning the temporal order as one that provides
her with "fairly good odds" of a "later" pregnancy. Similarly, Penny Kembba, in
the documentary
Baby on Ice
considers that the possibilities of freezing for non-
medical reasons offer her an option of later genetic motherhood, highlighting
the injustices involved in having to travel to Sweden: "I can freeze my eggs but
not in Norway. I do not understand why this is not my right" (Kumano-Ensby
et al., 2019).
Retrieved from https://www.nrk.noAivsstil/_-bor-fa-fryse-ned-egg-i-norge-1.11613007.
Accessed on January 2019.
$
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Delay: On the Use of Freezing for Non-Medical Reasons 93
The imaginary of "rightly timed" kinship is, as this section has shown, present
in ethical debates, clinical advertisements, popular and student accounts and is
also challenged by Scandinavian women who travel to Sweden for freezing. Spe-
cifically as far as the Scandinavian countries are concerned, the quest to engage
with an anticipatory logic involves responsibly managing, in the welfare state,
one's reproductive future, including the prospects of anticipated future infertility
and normative constructions of (good) motherhood (Carroll &
Kroløkke,
2017;
Martin, 2010).
5. Summary
In this chapter, we have shown how, in the Scandinavian welfare states, two over-
all sociotechnical imaginaries unfold, focusing on reproductive autonomy
as
well
as the rightful timing of kinship. In the case of the imaginary on reproductive
autonomy, autonomy takes on two very different directions' the individualized
woman's right to choose contrasted with the collectivized'rights of women to have
state protection against what, in this latter imaginary, are seen as inappropriate
social pressures. Meanwhile, as evidenced in our second imaginary, the timing of
kinship follows very normative understandings of reproductive timing, producing
monstrous figures and concerns around the interests of the child and the women
in order to discipline women into having children early instead of freezing their
eggs. However, the re-labelling of non-medical freezers
as
involuntarily childless
seeks to secure a new position that is both compatible with the interests of the state
while also positioning motherhood at the core
of
the good welfare state citizen.
While this chapter has prioritized freezing for non-medical reasons, it is con-
tinuously, in the empirical material, understood in light of its counterpart, that
is medical freezing. In contrast to medical freezing which aims to "restore" the ill
body and prepare it for the normativities involved in pregnancy and motherhood
(Kroløkke
& Bach, in review), freezing for non-medical reasons disrupts what can
be seen as an already overburdened Scandinavian universal health care system.
As noted by the Danish Council on Ethics (2001, p. 18), medical expertise should
only be used to fight disease and not to finance elective procedures. As infertil-
ity is internationally conceptualized as a disease (Zegers-Hochschild et al., 2017,
p. 1795), the battle over non-medical freezing of eggs as a way to preserve fertility
highlights the normativities of reproductive ageing and timeliness that together
produce the societal response to
anticipated
involuntary childlessness, especially
in women. Unlike more neoliberal economies such as that of the United States,
in Scandinavia, non-medical freezing finds itself in an entanglement between the
welfare state, growing commercial interests, the realities of women's and men's
reproductive lives coupled with developments within cryotechnologies that pro-
vide women (and men) with opportunities to "chill" their reproductive desires.
As illustrated in our theoretical section, the notion of chronobiopolitics
focuses our attention on how entire populations are managed and synchronized
"not only with one another but also with larger temporal schema" including the
ways in which "properly temporalized bodies" are linked to "narratives of move-
ment and change" (Freeman, 2010, p. 4). Reproductive delay is an example of
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94
The Cryopolitics of Reproduction on Ice
chronobiopolitics. As evidenced in this chapter, when delay becomes deliberate,
from the perspective of the welfare state, it transgresses what are viewed as desir-
able forms of reproduction and instead becomes a potential moral disruption of
reproductive time. Freezing for non-medical reasons can, however, also be theo-
rized as individualized attempts to synchronize one's life and body to, for exam-
ple, capitalist temporalities (Zaretsky, 1986) along with normative reproductive
(Edelman, 2004; Halberstam, 2005) or even romantic temporalities (Carroll &
Kroløkke,
2017; Inborn et al., 2018a). Hence, the legislative and ethical "hur-
dling" of non-medical egg banking that takes place in Denmark and Norway can
be understood as Scandinavian biopolitical attempts to control technology, to
restabilize and reinstall reproductive timeliness within a gendered framework of
women's "natural time for childbearing" as well as, in the examples of reproduc-
tive pathways to Sweden, chrononormative attempts to re-synchronize reproduc-
tion to fit that of family planning and genetic motherhood.
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Chapter 4
Death and Destruction
1. Introduction
In this chapter, we investigate how cryopreservation radically challenges estab-
lished notions of reproductive life and death. The aim of this chapter is two-fold.
We turn first to how cryopreservation increases the possibility of the posthumous_
use of men's reproductive cells, which clearly challenges legal, moral, and cultural
understandings of reproduction. Second, we discuss how the cryopreservation
of embryos (and gametes) similarly challenges conventional understandings of
reproduction, when cryopreserved embryos, for example, because of legal time
limits for storage, are destroyed. As already reckoned by Radin and Kowal (2017),
the potential of cryopreservation lies exactly in its ability to
not
let die. In this
light, we wish to discuss the affective economies
in
which destruction takes place
and cast light on what happens when the potentiality of suspended life is demar-
cated by welfare state regulation.
We start the chapter by outlining the Scandinavian legal landscape including
legal controversies related to posthumous
use
of sperm as well as the Scandina-
vian regulation on cryopreserved embryos. We then turn to a theoretical pres-
entation highlighting the concepts of latency (Kowal & Radin, 2015; Radin,
2013) and liminality (Squier, 2004) while situating death and destruction in lieu
of queer perspectives (e.g., Berlant, 2007; Butler, 2004, 2009; Edelman, 2004).
Based on our empirical material (interview studies and ethical arguments), we
analytically center two imaginaries: We term the first imaginary the imaginary of
Dr Frankenstein's monster. Echoing Mary Shelley's famous 1818 novel about the
scientist, who invents life and bypasses death with devastating consequences, we
show how the technologies of cryopreservation, especially the potential to pro-
create after death and to store or destroy life in the freezer, are problematized
and feared, most notably by the lawmakers and the Danish Ethical Council. The
second imaginary, which we will call the imaginary of families forever, counters
the first imaginary of Dr Frankenstein's monster by associating the technolo-
gies of cryopreservation, not with monstrous hubris of science gone too far, but
with family-making, kinship, and heteronormative order. This imaginary is most
The Cryopolitics of Reproduction on Ice: A New Scandinavian Ice Age
Emerald Studies in Reproduction, Culture and Society, 95-112
Copyright
©
Authors, 2020
doi:10.1108/978-1-83867-042
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The Cryopolitics of Reproduction on Ice
typically employed by individual cryogenic agents to legitimize or, rather, to make
sense of their use and/or storage of either, in this case, sperm or embryos: The
cryo-technologies seem to, on the one hand, activate a dystopian fearful imagi-
nary about science and man taking the powers of the Gods to make the decisions
to (unethically) create/destroy life. And, on the other hand, the technophobic dys-
topias are encountered by users themselves, who domesticate and "un-monsterfy"
the technologies by embedding them in a heteronormative symbolic order of
kinship, family, and love.
We discuss how these two imaginaries come into play when, for example,
Danish men, who have cryopreserved sperm for potential use after- their death,
narrate the potentialities in light of "future families" as well as when cryopre-
served embryos are affectively embodied by Danish women who have embryos
stored in cryo-tanks. By including queer cultural theories (Chen, 2012; Edelman,
2004), we argue that cryopreservation holds radical destructive queer potentiali-
ties of death and destruction, yet also, show how these potentialities, in the Scan-
dinavian context, invariably become domesticated and controlled by aligning
cryo-technologies with imaginaries of the traditional family.
2. The Legal Framework
When the first Danish Comprehensive Act of 1997
on
assisted reproduction
was worded, it was done in prohibitive language. The Act clearly intended to
regulate a number of potential "monstrosities" made possible by reproductive
technologies. These monstrosities included suspended life in the freezer as well
as posthumous reproduction. In terms of the requirement to destroy frozen
embryos, the act simply followed in the footsteps of the 1991 act on Biomedical
Research Ethics Committees which had presupposed a maximum cryopreserva-
tion period of 12 months for embryos without giving a reason for the limit (L59
23 October 1991). In reports by the Danish Council on Ethics leading up to
the 1991 Act, however, eggs and embryos had been positioned discursively as
vulnerable entities in need of state control and protection.' Consequently, the
first Bill introduced on Assisted Reproduction included a provision on cryo-
preservation, which codified this limitation on the cryopreservation of embryos
to 12 months.
According to the first version of the Bill, the National Health Board would
have the possibility to grant permission to extend cryopreservation "in special
cases, where the woman's health or other critical grounds" spoke in favor of an
extension.' Meanwhile, no upper storage limit existed in regard to the cryopreser-
vation of sperm. The spokesperson for the Social Democratic Party said: "I find
12 months to be right. To me, there is something unethical about having embryos
'As explained in Chapter 1, the Danish legislator used the terms "eggs" and "embry-
os" interchangeably. The early legislation often uses the word "egg" when it actually
seeks to regulate embryos. The first regulation of cryopreservation regulated the freez-
ing of embryos, since the freezing of oocytes was not technically possible at the time.
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Death and Destruction 97
in storage maybe even to have twins in separate pregnancies" (1996/1 LSF 5
debate). The monstrosity of disrupting what appeared as a normative kinship
order ("twins in separate pregnancies") became pivotal in these debates. The Con-
servative Party's spokesperson admitted that it was difficult to provide a rational
reason for the 12-month limitation,
it is the thought of the artificial that scares me ... after 2 or 3 years
in the freezer ... are the embryos in good condition? The foods we
freeze have a shorter shelf life. (1996/1 LSF 5 debate)
In this manner, the freezer's potential for uninhibited storage capacity became
questioned.
The perceived monstrosity of posthumous reproduction, in the Danish
legal debates, related to posthumous use of stored gametes, posthumous
transplantation of ovaries from a deceased donor to a living recipient; and
a widowed partner's use of stored embryos, consequently featured heavily in
the Act's listed prohibitions, along with other perceived monstrosities, such as
inter alia, reproductive cloning, and the creation of human—animal chimera.
Relying on nature as a key organizing principle, 'the Danish Act sought to
align the use of ART with what was perceived as the "natural" reproductive
time, and set in place a requirement to destroy gametes upon the death of the
depositor.
This understanding of reproduction as taking place within the lifetime of an
individual came under siege in a highly profiled 2010 case. Heard by the High
Court of Eastern Denmark in 2010 (judgment no. B845009 of 16 December
2010), the case subsequently sparked regulatory change. The judgment granted a
widow access to her deceased husband's sperm even though the Act on Assisted
Reproduction'in its prohibition on posthumous reproduction made the view of
the legislator quite clear. However, since the woman's husband had made the
deposit as a security deposit in a private sperm bank before embarking on cancer
treatment (and not in a hospital), the deposit was not considered to be the start
of or a
part
of an ongoing fertility treatment. Consequently, his deposit fell out-
side the scope of the Act: Because the deposit was made for insurance and not to
embark on fertility treatment at the time of the deposit, the depositor had been
free to enter into a contract with the sperm bank and consent to posthumous
storage and use by contract or written will. The judgment was soon after given
as the primary reason by the Minister for abolishing the Act's prohibition on
posthumous reproduction.2 The government expressed a desire for uniformity in
the regulation of reproductive technology, which is reflected in the amendment
Act's broader scope of application, which meant that tissue centers and sperm
banks were now also subject to the Act, as opposed to medical staff only. Danish
2
Paragraph 2.4.2 of the general comments for Bill L138 proposed by the Minister
for Health on 12 March 2012, https://www.ft.dk/ripdf/samling/20111/lovforslag/
1138/20111 _1138_som_fremsat. pdf
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The Cryopolitics of Reproduction on Ice
law had previously excluded certain health professionals from the Act, which had
meant that at a certain time when lesbian women and couples were excluded from
treatment performed by medical doctors, a midwife could legally perform insemi-
nation at her clinic.
The Danish government has subsequently legalized treatment of sin-
gle and lesbian women and sought to regulate ARTS uniformly, irrespective
of which health profession was the provider. However, as a natural continua-
tion of this ambition and in light of the judgment handed down by the High
Court of Eastern Denmark it was seen as a logical step to amend the Act in
terms of posthumous reproduction. Interestingly, however, this possibility is
gendered, as it enables only men to deposit their reproductive cells to be
rised
posthumously.
While our empirical point of departure, in this chapter, focuses on Denmark,
briefly, in the case of Norway and right from the adoption in 2003 of the Nor-
wegian Biotechnology Act, sections 2-11 and 2-17, the Norwegian Act required
the destruction of gametes and section 2-16 the destruction of embryos upon
the death of the depositor. The Swedish Act on Genetic Integrity prohibits use
of sperm or eggs from a deceased person. However, following a case with the
same facts as in the Danish judgment of 2010, the Swedish Medico-Ethical
Council was in favor- of allowing use of sperm from a deceased partner if he
had consented prior to death,3 however the social authorities and the govern-
ment found that further deliberations were needed and that it was not the time
for regulatory change yet (Lagrådsremiss, 2018). This is in spite of the fact
that the Swedish council emphasized good social parents and that the child was
informed about its origin. In this manner, the Scandinavian regulation varies in
important ways, yet, as will become clear throughout the remaining part of this
chapter and in large part due to the legislation on the posthumous use of sperm,
the Danish case is especially interesting. While Denmark strictly regulates the
storage of eggs and_embryos, sperm can be stored indefinitely and even used
posthumously.
3. Theorizing Death. and Destruction
As already noted in our Introductory chapter, Foucault's framing of biopoli-
tics can aptly be re-theorized in a time of cryopreservation as "cryopolitics."
While the concept of biopolitics theorizes the politicization of the body in
modern times, which makes modern power most effective when embracing life
and not killing, cryopolitics reveals the dramatic impacts that cryopreserva-
tion has of making life and not letting die (Kowal & Radin, 2015; Radin &
Kowal, 2017). The ability to cryopreserve destabilizes, as echoed in science
technology scholarship, the distinction between life and death, the living
and the non-living (Radin, 2013, p. 488; Radin & Kowal, 2017). Not only
have cryopreservation technologies become critical tools in the management
3
http://www. smer. se/wp-con ten t/upload s/2013/02/Smer_rapp o rt_2013_ 1_webb. pd f
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Death and Destruction 99
of medically assisted reproduction, the ability to cryopreserve promises to
postpone aging and the eventual death of reproductive cells and material.
Cryopreservation can be understood, as also reckoned by Kowal and Radin
(2015, p. 68), as a deferral strategy in which cold temperatures become a "tem-
poral prosthesis, promising it is never too late to revive an individual, race, or
species." In this section, we present theoretical perspectives relevant to analyz-
ing the ways that cryopreserved sperm and embryos come to exist in latent
or liminal states. Cryopreserved sperm and embryos have the potential, as we
will show, to challenge cultural understandings of death and destruction. We
begin by presenting the twin concepts of latency and liminality, derived from
science and technology scholars, prior to discussing the insights that queer
cultural analytical perspectives on life and death add to the understanding
of cryopreserved reproduction, death, and destruction in the Scandinavian
welfare states.
The concept of latency theorizes the ability to pause and interrupt the devel-
opment of biological cells and matter (Kowal & Radin, 2015; Radin, 2013, 2015;
Radin & Kowal, 2017). Whereas cryobiologists such as Luyet and Gehenio
(1940) initially flamed latency to refer to the ability to pause and restart the
growth of cells and tissues (Kowal & Radin, 2015; Radin & Kowal, 2017), Kowal
and Radin (2015, p. 74) additionally use latency to critically frame how preserva-
tion produces understandings of rightful or wrongful death. In their case study
of the preservation of Australian indigenous blood, latency manifests itself
as the ability to preserve as well as a justification to let die. As noted by them
(Kowal & Radin, 2015, p. 74) and in reference to preserved Australian indigenous
blood: "Either the latent life of samples can be harnessed in ways that generate
knowledge to benefit those from whom this material was derived, or the sam-
ples should be stewarded towards a satisfactory death." Frozen blood, Kowal
and Radin (2015) argue, moves between these two different cryopolitical states:
"Latent life" which echoes the need for preservation, and "incomplete death"
which naturalizes destruction. In the first cryopolitical state, latency enables the
making of new temporalities, creating an understanding of the body as plastic
(Landecker, 2005, 2007). With cryopreservation, as Kowal and Radin (2015, p.
69) pose, an `_`_ability to bring biological material "back to life" in another time is
made possible, the potentiality that would otherwise ebb with the passing of time
is preserved and even intensified." This is, as we will show, readily exemplified in
the context of frozen embryos in which the time of reproduction entangles with
generational logics embedded in our kinship systems. This includes, for example,
the ability to use sperm after the provider's death.
In Squier's (2004) work, liminality is exemplified through the embryo which
achieves human status when "adopted" by intended parents as well as, at times,
potentiated as distinctly non-human yet instead "rescue material" such as in
the case of the stem cell and rejuvenation industries. Liminality entangles with,
Squier (2004, p. 26) notes, a
biological and social state of transition from a world in which
human beings had a characteristic and predictable life course to a
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The Cryopolitics of Reproduction on Ice
world in which neither the beginning of life, nor its flow, nor even
its end has a foreseeable structure.
In the case of the cryopreserved embryo, embryos are "repurposed" and, by
embryo adoption agencies in the United States, animated as "frozen orphanages"
(Cromer, 2018, p. 362). As noted by Cromer, in the rhetoric of pro-life accounts
in the United States, putting embryos in the cryo-tanks becomes problematized
as it denies them their "optimal" storage; namely, that of the warm environment
of the uterus. Although not using liminality as a theoretical concept, Cromer's
(2018) research aptly illustrates the ways that the frozen embryo is animated
between life and (almost) death. In the aforementioned accounts, cryo exists in
close proximity to death.
Queer scholarship has been especially apt at questioning the seemingly clear
distinctions between life and death. While some theories departing from Lacan-
ian psychoanalysis argue that
queerness is
a symbolic position of death in oppo-
sition to reproductive futurity, the normative imperative of life, to "be fruitful
and multiply" (Edelman, 2004). Other queer theories depart from biopolitical
theorization (e.g., Agamben, 1998; Berlant, 2007; Butler, 2009; Foucault, 2003;
Lemke, 2009; Mbembe, 2003). In these theories, life is not simply considered an
ontological fact in opposition to death. Rather, life is understood as a political
matter, that can be given and taken not by bodily killing but as recognition of life.
The living dead in the death worlds (Mbembe, 2003, p. 40) or the
zoe
or naked life
of Agamben (1998) are conceptualizations of living matter not
living.
In opposi-
tion to
bios,
naked life is living matter not politically recognized and thus not
understood or deemed to be fully human, and thus not in need of state or other
forms of protection.
Most famously, Judith Butler (2009) has theorized life, and she argues, that
"there is no life and no death without a relation to some frame" (p. 7). In this,
she points out that what is considered a life is not the same as what is living
(Butler, 2009, p. 8). The production of life and populations is to Butler a politi-
cal matter that encompasses the (global) organization of life, violence and death.
We included these theorizations of life to make the theoretical argument that
the ethical, moral, or ontological status of embryos or gametes should not be
understood as already given, rather, the status must be understood as an effect
of the affective ånd discursive in the embryonic and gametic matter. How we
frame, give value to and conceptualize matter encompasses what kind of mat-
ters we understand as living, and, thus, what kinds of material are worthy of
protection and affective nurture. Importantly, the demarcations between life and
death are troubled by cryopreservation, as Kowal and Radin (2015, p. 68) argue,
"biopolitical assemblages make life and let die, cryopolitical ones reveal the dra-
matic impacts of mundane efforts to make life and not let die." That surely is
the case of the posthumous use of sperm, while the Danish 5-years-rule for
cryopreserved embryos complicates the cryopolitical mandate of not letting die.
Rather, if the embryos are considered living matter, the 5-years-rule relates to the
sovereign power of "making death." As noted by postcolonial scholar Achille.
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Death and Destruction 101
Mbembe (2003), modern biopower also contains the sovereign power of killing,
and making death. According to Mbembe, the biopolitical production of bodies
and populations are closely intertwined with the necropolitical power of expos-
ing other bodies and populations to symbolic and concrete death.
In the two cases explored in this chapter, the posthumous use of cryopre-
served sperm and the cryopreserved embryos, we draw on these insights by
asking how life and death are cryopolitically calibrated in the Danish context:
How and when does the cryopreserved matter obtain a status of life? And does
the cryopreserved matter enable (gendered) calibrations of living and dying
for donors? In order to analyze how matter becomes animated to life, we in
particular turn to queer scholar Mel Y. Chen (2012), who investigates how we
linguistically animate signs and matter, and how words create life and human/
non-human entities. Rather than thinking of life/death or human/non-human
as fixed material categories, Chen develops the concept of animacy hierarchies
to critically investigate how we linguistically and affectively animate entities in
a life hierarchy, where humans are at the top, stones at the bottom — and plants,
animals, organic material, and indeed cryopreserved embryos, are somewhere in
the middle — left for cultural negotiation and anxieties. By moving the analysis to
the very local and micro level, we will show how sociotechnical imaginaries are
embodied, lived, discussed, negotiated, and changed, also in the very everyday
lives of people. In the following, we investigate how these negotiations and anxi-
eties are played out in the ethical debates as well as in narratives and affective
registers of freezers.
4. Imaginaries of Death and Destruction
Cryopreservation raises 'important ethical and cultural questions. Clearly, the
routine destruction of human reproductive material invokes debates. Whereas we,
in our analysis prioritize the ways, that cryogenic agents negotiate having repro-
ductive cells "on
ice,"
we briefly turn to the ethical controversies which are, we
believe, at the heart of notably the construction of the monstrous Dr Franken-
stein imaginary.
As routine
as
the destruction of embryos or reproductive cells may be, it contin-
ues to be fraught with ethical controversy (Steinbock, 2011). This is particularly
the case when 'destroying gametes and embryos either against the wishes of the
prospective parents (so-called unwanted destruction, e.g., Douglas & Savulescu,
2009;
Pennings,
2002), or in the cases of embryo destruction (Cromer, 2018).
Notably, the destruction of gametes and especially embryos is, at times, consid-
ered morally problematic, not only because it runs counter to the autonomy of
prospective parents, but due to the alleged moral status of the reproductive mate-
rial itself (Wallach & Robertson, 1987). Echoing this concern, members of the
Danish Council on Ethics argue that embryos have "full moral standing"; that
is, "the same standing as other humans" (Danish Council on Ethics, 2003, see
also 2014). As noted in our theoretical section, life and death categories are not a
priori
given but rather, life and death categories become animated or calibrated to
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The Cryopolitics of Reproduction on Ice
uphold particular cultural values. This is notably the case when embryos are con-
sidered persons (Douglas & Savulescu, 2009). When considered persons, embryos
are seen as endowed with special moral rights, claims, and interests. In this imag-
inary of "embryos as persons," embryos are afforded the same protections as
the rest of humanity and thus, the seemingly routine destruction of embryos
becomes problematized (Douglas & Savulescu, 2009; Tonti-Filippini, 1999).
But even if embryos do not have (full) moral standing by virtue of being poten-
tial persons, from the perspective of moral philosophy, in the ethical debates,
other reasons for granting them moral status exist. One common suggestion,
in the debates, is that embryos are humans. The idea here is that, even though
embryos do not have the mental characteristics that usually ground the special
moral status of humans such as rationality, merely being a member of a rational
species is considered sufficient for having some degree of moral standing (Doug-
las & Savulescu, 2009; Finnis, 1995). This idea seems to be well in line with the
view expressed by some members of the Danish Council on Ethics, yet it remains
unclear why mere membership of a species is sufficient to possess certain' rights,
when it is clearly not sufficient to possess all rights. After all, children are humans,
but they do not have the same rights as human adults, only those that pertain to
their particular capacities. Of course, even if embryos neither have moral stand-
ing by virtue of being potential persons nor by virtue of,,being humans, it might
still be considered morally problematic to destroy them, similarly to how it is
normally considered morally problematic to kill a healthy non-human animal
(Douglas & Savulescu, 2009).
Concerns related to the moral status of embryos have, not surprisingly, been
at the center of reproductive rights and anti-choice activists. In Cromer's (2018)
ethnographic study, she reveals how the nearly one million leftover embryos, in the
United States, are brought. back into life by anti-choice organizations such as the
Snowflake Embryo Adoption and the Blossom programs. When embryos become
conceptualized as "orphans in need of adoption" (Cromer, 2018, p. 374), cryo-
preservation tanks themselves are made to appear monstrous, potentially storing
the embryos indefinitely and thus risking, as Cromer (2018) reveals, the chances of
frozen embryos becoming born. In this context, it becomes morally problematic
to deprive beings of
the potential
of having a (good) Christian future. While the
question of morality or human status is integral to the ways that the destruction
of. cryopreserved material is managed and debated, it is also fundamental to the
formulation of monstrous imaginaries such as the Dr Frankenstein technologies
imaginary to which we now turn.
4.1. Dr Frankenstein's Monstrous Technologies
It is an interruption of the peace of the grave and it can appear a
bit morbid. (Birkler, 2012)
With headlines like "When the husband is in the grave and the sperm is in the
bank," the Chair of the Danish Council on Ethics painted, in 2012, a monstrous
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Death and Destruction 103
picture of the posthumous use of sperm. As reckoned in Krolokke and Adrian's
(2012) analysis of Danish and Australian bioethical debates on posthumous
reproduction, when the widow transgresses "natural" procreation stories by
using her dead husband's deposited sperm, her reproductive agency becomes
problematized ("it can appear a bit morbid"). Whereas the grieving widow,
Krolokke and Adrian (2012) show, in the case of Australia and through her
enactment of grief, achieves a certain degree of reproductive agency, in the case
of Denmark, posthumous reproduction evoked, during this time period, fears
related to the image of an orphaned child as well as that of the necrophilic
mother ("it is an interruption of the peace of the grave"). In his debate article,
Birkler (2012) puts cryopreservation technologies not only in close proximity
to the necrophilic mother; rather; Birkler (2012) uses the imaginary of necro-
philia to reposition cryo-technologies as "artificial." In this formulation, male
reproductive autonomy is even at stake, when Birkler (2012), in reference to
a separation between desire and reproduction, says: "Today, sexuality has, to
a large extent, become separated from desire and reproduction. If we main-
tain this distinction, it would obviously be impossible for a man to fertilize a
woman after his death" (Birkler, 2012, p. 273). While Birkler maintains a rather
gendered notion of reproductive agency of the man fertilizing the woman, he
simultaneously reinvigorates the heteroseuxal nuclear family. Consequently, the
Danish ethical debates, in their ability to destabilize generational and life/death
temporalities, cryo-technologies become positioned as potential Dr Franken-
stein's monstrous technologies.
The imaginary of Dr Frankenstein's technologies is by no means new. It has
consistently involved any kind of technology that threatens to change what has
come to be seen as "natural" (Bryld, 2001; Lederer, 2002; Waldby, 2002). For
example, in a 1995 report on assisted reproduction, members of the Danish
Council on Ethics (1995, 6.2.2) argued that cryopreservation, used as an instru-
ment to support assisted reproduction, was inherently wrong. At that time, the
mere existence of the technology raised difficult ethical and legal questions
about who should be entitled to these gametes and embryos if the parents were
to-divorce or die. By not accepting cryopreservation at all, however, the diffi-
cult questions centering" the use of posthumous gametes and embryos would
be avoided altogether. This worry became reiterated in a report by the Dan-
ish Council on Ethics (2004, p. 28) which centered the concern that the use of
posthumous gametes and embryos would change our understanding of what a
family is 'like. As noted by Herrmann and Krolokke (2018), cryopreservation
produces, in the context of Denmark, monstrous imaginaries related to the dis-
ruption of genealogical order as well as the imaginary of the nuclear family that,
in the case of posthumous reproduction, becomes disrupted. We turn now to
another_ reading that reveals the elasticity of the Frankenstein narrative when
women themselves negotiate reproductive temporality to not threaten but rather
strengthen the family. As echoed in the work of feminist scholars such as Susan
Lederer (2002), the Frankenstein narrative is highly elastic and supports "multi-
ple, even conflicting, interpretations" (p. 46).
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The 0yopolitics
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Reproduction on Ice
4.2. When Death No Longer Does Us Part. Imaginaries
of
Families
Forever
In this section, we turn to how cryogenic agents with sperm deposits or embryos
in the bank reflect on the possibility of making use of their gametes and embryos.
In turning to these cryogenic agents, we seek to privilege the individuals who
have gametes or embryos in the bank. Notably, we highlight the ways in which
sperm deposits become latent with affects of love and reproductive futurity while
embryos are animated as siblings. While our two cases illustrate very different
types of deposits as well as cryopreserved material, they share an imaginary of
family formation captured by us in the formulation of families forever.
4.2.1. From the Deposit with Love.
It becomes philosophical now. If I had endless resources, I would
send my sperm into space in a space probe, not aiming it at any-
thing in particular.
Then I would know that it could travel around the universe for
a billion years and maybe get caught by an unknown species for
further examination. (Interview with Lange, 2018)
As outlined in our legal section, in Denmark, it is legal for women to use sperm
from a deceased male partner, in cases where they had written a will. Through
interviews with 30 men who all have a sperm deposit in Cryos International (see
Appendix), we turn now to their reflections, if any, of what should happen with
their gametes after death. Interestingly, most of the men interviewed were not
aware that they can make a will that will enable their partner(s) to use the sperm
after they have died. However, most of them are positive toward the option and
various imaginaries 'of life after death emerge as the men reflect on the continu-
ation of having their sperm stoned and used post-mortem. The imaginaries that
appear are very different from the imaginaries of Dr Frankenstein's monstrous
technologies as seen in the media debates. Instead they are entangled in love, life,
and legacy, and reflect on the making of kin now and in the future. In particular,
men who had cancer mentioned that writing a will stating the opportunity for
their partner to use the sperm post-mortem would have been an option that they
would have liked to have used, not least in case they had not survived the cancer.
Bjarne who had cancer, and had a child, explains:
I think it is a good option. I can definitely see the point, and I believe
there was no legislation at the time I began my chemo-treatment. If
the development had been negative in relation to the treatment, and
I had been given a negative prognosis of survival, I think I would
have done it back then.
Stine: Made a will?
Bjarne: Made a will for my wife, yes. (Interview with Bjarne, 2018)
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Death and Destruction 105
As echoed in Bjarne's quote, a sperm deposit and a will becomes a desirable
option. The situation of having cancer evokes in itself a situation of liminality.
More than becoming an extension of Bjarne, the latency of the sperm deposit,
in this quote, becomes a possibility for the wife to still have children with
Bjarne, in case cancer treatment failed. In this case, the frozen deposit enables
both an imagined and material continuation of their relationship after death.
This perspective is also echoed in interviews with men who, albeit not facing
serious disease, had made a sperm deposit. While some of these men, for one
reason or another, wanted to secure their fertility over time, some had a vasec-
tomy performed and wanted to secure their reproductive abilities in case they
regretted their sterilization. For example, Thøger had deposited sperm because
he wants to have a vasectomy in the future. To him, a will would also enable
his wife to have more children with him in case he died. Death was re-animated
during the conversation, as he had just, prior to the interview, lost two of his
friends suddenly. This experience impacted on how he reflected on death and
posthumous reproduction:
For a person like me, I think it is [the deposit] a way of a lifeline. i think it is
smart.
G..)
My current wife would be able to have a child if I died, and this
may happen on my way home. You never know. One of my friends
was on the train on the second of January from Fuen to Copenha-
gen [the train that was cut open in an accident with many casual-
ties and deaths]. His funeral took place last Friday. It was not fun.
And a great colleague, I have spent a lot of time with him, skiing
and so on, his burial is today or tomorrow. I will not go, it will
be crowded, but it is things like that you think about. In this way
I perceive Cryos and the 'deposit as a space of time, a pocket of
time where you are indecisive. I think it is smart. It is technologi-
cally smart and may remove doubt and questions about whether I
should do it [the vasectomy] or not. (Interview with Thøger, 2018)
With a sperm deposit, Thøger is allowed what he describes as a space of time
or a pocket of time. It enables both liminality and latency. As he describes, the
deposit allows him a space to be "indecisive" in his decisions. With a deposit
he can keep his fertility and control his reproduction. Moreover, the latency
of cryopreservation that is inherent in the depositing of sperm enables him
to begin to remove his doubt regarding whether he should have carried out
the vasectomy that he hopes to have done in the near future. Moreover, the
deposit does something to time, as not only does it secure fertility after steril-
ity, it even enables his fertility after death. A potential of his wife having more
children. A death that, as he is very much aware, is uncontrollable. Not least the
above-mentioned catastrophic train accident where his friend died, which had
illustrated to him the fragility of life, and which may be overcome partly by his
sperm in the freezer.
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The Cgopolitics of Reproduction on Ice
Eric, who had already had his vasectomy carried out, had, in contrary to
Thøger,
been well aware of the option of writing a will, enabling posthumous reproduction.
He explains that he was not clearly told by Cryos, but as he has a background in law,
he realized the option as he read through the standard conditions of the contract:
No, I don't think most people would know. I was not told or
informed by Cryos directly, but you know how lawyers are. Before
I decided to have a deposit at Cryos, I read the standard conditions
as I decided to set up the deposit at Cryos, and I saw there was an
option of establishing a will in case death would take place. Other-
wise sperm or what they call gametes would be destroyed. I read it
and thought about it and thought: "Okay, what do I want in case I
die?" I know of course most people when they die, they know they
will not have more children. But since I have frozen my sperm, I
will not force anyone, but if the women who are close to and loved
by me wish to have children, I find it a good opportunity to give it
to them, as it is both ethically and legally possible, why not do it?
(Interview with Eric, 2018)
Eric had decided to have the vasectomy as he found it was his only way to
control his reproduction, deciding not to have children.] He was, as illustrated,
very engaged in setting up the will. As he had two women he loved, who did not
know of one another — and should not know about each other — he had paid for
two deposits at Cryos to secure both of them
the
possibility of having children
with him in case he died. A possibility he found should not be missed as it was
"both ethically and legally possible" and could be a help to the women in case
they wanted children. Asked why he wanted children in case he died but not as
he lived, he replied:
I am an atheist. I believe when we die we are dead. There is no more.
So after my death, to be honest, it is not very important to me what
happens after my death. I think it is more in relation to them [the
women]. They will not know anything before I potentially die. I just
make
the
possibilities of them having the choice at a later time, if
something, would happen .... But to me it is really not .... If what
you
think of is — I can answer you directly, I have no need to think
that my genes need to be passed over to the next generation, it is not
at
all
my motivation. (Interview with Eric, 2018)
At the same time as Eric wants to control his reproduction through a vasec-
tomy, having a sperm deposit enables having children either if he changes his
mind, or after his death. With his death, he would not have to care for the chil-
dren and be faced with responsibilities, however the technology could at this time
enable the women he loved to have children with sperm from his deposits. This
understanding of the sperm technology reconfigures his views on kinship as a
result of his atheist understanding of life and death. It is his atheist perception on
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Death and Destruction 107
life and death that makes posthumous use of his sperm possible and more relevant
for him, than reproduction in life, where he would face paternal responsibilities.
Being a (literally) dead dad would, on the contrary, not involve his presence but
show care for his two lovers. In this way, the latency of the deposit becomes a gift
of life for the women that may dream of children that Eric in life had refused them.
Eric's perception of death and posthumous reproduction did, however, differ
significantly from most of the men, who did connect the sperm with their4egacy
and preferred fathering of children alive. Several mentioned, that if they were not
alive, they did not think the use of their sperm would be in the interest of .their
partner. They hoped she instead would find another loving man,to have children
with. Posthumous use of sperm was, however, not only about leaving.matter for
love. Some of the men had imaginaries of how their sperm could be used posthu-
mously in the development of personalized medicine. Sperm cells were, to several
of the men, particularly important cells. Lauge, as mentioned in the introduc-
tory quote, moreover does not reflect upon the potential of posthumous children,
instead, he situates his cryopreserved sperm as potentially transgressing not only
temporal but spatial boundaries. ("Then, I would know that it could travel around
the universe for a billion years and maybe get caught by an unknown species for
further examination.") In this manner, posthumous use of sperm after death, as
here described by Lange, extends beyond the making of children into the legacy
of the deceased man making marks in the universe across time and space. Time
and space that is already altered through thecryopreservation of sperm stored in
Cryos' banks.
In summary, interviewing men with sperm deposits about posthumous use of
their sperm evoked a number of imaginaries. The latency enabled by the cryo-
technologies is central in how imaginaries emerge. However, while Dr Franken-
stein's monster is a prominent figure in debates on posthumous reproduction in
the media, the imaginaries' that are evoked by men having sperm in the freezer are
quite different. They mainly focus on love, kinship, and legacy, in relation to the
potentiality of having children after- death. However, the rich imaginaries of how
sperm in the future could be used through scientific investigations, even in outer
space, are making an even more potent narrative of a hu(MAN) life after death.
4.2.2. Latent Siblings, Liminal Life.
It Js like instant noodles... I have like this, that it is a mini child
laying there. It is like a little seed in a pot of earth, it just needs a
little water, then it is a new life. (Interview with Karen, 2018)
Turning to the experiences of Danish women, who have cryopreserved embryos,
all of the interviewees had extra embryos after having had at least one child as a
result of the treatments. As noted in the introductory notes, the interview study
included interviews with 12 women. It specifically sought to understand what
kind of moral and ethical status the embryos have, including how women felt
about the embryos? Whether embryos are, from their perspectives, living matter?
And why or when should they be destroyed, if ever?
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The Cr),opolitics of Reproduction on Ice
When we asked if the women considered the cryopreserved embryo as alive or
holding any value in itself, all the women quite rapidly, in different ways, answered
that the embryos are only cells with no moral value as life in itself. In Denmark,
abortion is generally seen as a fundamental reproductive right and very few peo-
ple oppose free abortion. Raising the concern about the status of the embryo acti-
vates arguments from debates about abortions, as the moral status of the embryo
has historically been used in anti-abortion arguments and campaigns, and to
consider the embryo as holding a special value seemed to remind the women of
this. All women very vocally opposed anti-abortion and positioned their opinions
about their frozen embryos as different to their opinion about abortion.
But when asking the women to unfold the ways they thought about the
embryos, the narratives became more complicated and ambivalent. On the one
hand, they all rationally understood the material as "only cells, nothing but
cells" (interview with Louise), but as the story of Karen, who after one success-
ful pregnancy had one cryopreserved embryo left, reveals, _there is something
more going on:
j
I got pregnant and got Valentin and after that the embryo has just
haunted me! [ ... ] I feel like this, when I look. at Valentin, I often
think, oh my, you have a twin brother or sister waiting for you [ ... ].
(Interview with Karen, 2018)
j
In the quote, Karen is trying to make sense of the latency of the embryo. On
the one hand, it is nothing in itself, but a seed or a given set of possibilities. As
echoed in the beginning of this section, Karen also animates the frozen embryo
as being close to life. The embryo only needs "a little water" before becoming a
new life. It's like "instant noodles," already made and fixed. The liveliness of the
embryo is already kinned, as the new life is put into kinship as the latent twin sis-
ter or brother of her already born child. In this way, Karen is also navigating and
making meaning of the liminality of the embryo, that is how the embryo is both
"a mini child" and nothing but a "seed" at the same time.
-Reading this animation of the embryo through the concept of animacies
(Chen, 2012; Cherry, 1992), we notice that the embryo is animated linguistically:
In the first sentence of the quote, Karen tells us that the embryo haunts her. Lin-
guistically, the embryo becomes the subject of a transitive verb, which means that
the embryo not only becomes the subject who can do something ("to haunt"),
it can also haunt
someone,
which means the embryo's actions has effects on the
other subjects (which linguistically are objects). In this way, the embryo is given
life, or rather, becomes animated as not only a vibrant matter (Bennett, 2010),
but a matter with agency. The matter seems to almost have a will of its own, and
thus, -the embryo moves up the "animacy hierarchy" (Chen, 2012, p. 26) as it
becomes more human. We can notice the same linguistic animation in the words
of Dorte, when she says, albeit metaphorically, that the embryo "is calling [her]
in the night."
It is also worth noting how the embryos are animated not only through gram-
matical transitivity, but also
affectively
through the kinning of the embryo from
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Death and Destruction 109
matter into family. The linguist John Cherry (1992) has noticed how we, across
different languages, animate in hierarchies, meaning that we linguistically animate
adults over non-adults, male over female, higher/larger animals over smaller ani-
mals and insects. And familiar (kin/named) over unfamiliar (non-kin/unnamed).
In the quote by Karen, we see how Karen kins the embryo as a twin sibling to her
already born child and thus, she animates the embryo up the animacy hierarchy
as a family member. As noted by Sara Ahmed, the investment of affect in differ-
ent objects makes affect circulate and accumulate much like the accumulation of
value in Marxist theory (Ahmed, 2004, pp. 45-48). In this way, we can see how
the kinning of the embryos enables an affective investment in the;embryonic mat-
ter, which circulates affect between the matter and the subjects `and makes the
embryonic matter increasingly effectively charged, and even moves position fiom
the (material) object to the (kinned) subject. The matter is animated linguistically,
through kinning, affectively and by circulation of affective investment.
In the case of the interviewee Karen, she is economically and socially not able
to have another child, and due to the Danish legislation, which only'allows the
cryopreservation of embryos within five years, she is forced to choose between
destroying the embryo or donating it to science. When asked about what she
would do, she answered:
Because I have all these feelings for it [the cryopreserved embryo],
it would be very difficult for me, that it would-be used for ... in
some laboratory somewhere, where they should do something to
it .... Actually, I think it would be gruesome and crazy [laughs] [...].
Because I have feelings for it! It is Valentin's brother or sister! I
really feel like that. (Interview with Karen, 2018)
Michael continued to ask Karen about the status of the cryopreserved embryo,
if the logic of her feelings was that the cryopreserved embryo should be regarded
as life and thus morally, if not legally, protected. She answered:
I don't think it is a'child. Rather I think it is a precursor of a child.
What I also keep thinking about is that the doctor, she said, it is a
really strong and good blastocyst. It wasn't one of those at the low
scale, it was all the way at the top! It was the same with Valentin,
he, was also like that.
I
really feel it is a little gold egg laying up
there [at the hospital]. When I cycle by the hospital, I usually wink
to it. (Interview with Karen, 2018)
As noted by Thompson (2004, p. 265), the categorization of embryos as "good"
or "bad" by the medical staff in the clinics and hospitals positions the embryos as
either life or waste. In Karen's story, the categorization of the embryo as "strong"
seems to equate the characteristic of her already born child, as he is also "strong."
The metonymic connections between the laboratory categorization of the embryo
(now cryopreserved) and the characteristics of the child (already born) remind us
of how the embryos are further animated by the re-categorization from simple
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The Cryopolitics of Reproduction on Ice
cells to latent life in the clinic, and as noted by Thompson (2004, p. 265) and Chen
(2012, p. 44), this animation and re-categorization are biopolitically invoked by
a more "sentized mapping of normalities" (Chen, 2012). This means that the
promise and latency of a normal future free from "abnormalities" seems to ani-
mate, whereas the presence of "undesired conditions" seem to de-animate the
embryonic matter to waste.
The circuits of animation through linguistics and affects, through humaniza-
tion and kinning, escalate in Karen's story. The animation of the matter leads
to affective accumulation, which further animates the embryonic matter up the
animacy hierarchy from cells to vibrant matter, to matter with agency, and to
kin/child.
Women are habitually reminded of their decision to potentially destroy
the
-
frozen embryos. The women who have embryos cryopreserved at private clinics
often get a letter every year asking them if they want to keep the embryo cryopre-
served or if they want to "destroy" the embryo. The women who have embryos
cryopreserved in public clinics do not get such a letter every year, but they are very
well aware of the five-year limit. Mette, who was pregnant with twins at the time
of the interview, said:
Dagmar, the child I have now, she is two ,years old, and she was
the second egg. The first egg didn't stick. And then they looked at
my eggs, and those that were good, they asked; should we freeze
them? At that moment, I thought, I am just having Dagmar, so
whatever! Just freeze. Then I think one first realises when you
get the letter, once a year, and the letter says, `should we destroy
your eggs or should we continue to freeze themT I think you get
a feeling of ownership. I thought: `hell no, you must not destroy
my children!' [ ... ] And h feel like that way of formulating it... I
actually think that was what triggered it for me [to want to have
another child]: The letter and the wording of destroying. I mean,
I see it as my children or some kind of finished creatures, just on
frost. (Interview with Mette, 2018)
Later in the interview, the interviewer returned to the letter and asked how
Mette felt about abortion when she articulated embryos as being little humans.
She responded:
it
,'
I think the unborn life becomes more precarious when you are in
fertility treatment. Because you need so many little miracles. It is
a fragile process, you think, just the egg, you are like uuuuuuh! All
this, you don't think about it in an ordinary intercourse. Then it is
just menstruation. In treatment, it becomes very biological, very
chemical, you feel like a ... it's very laboratory-like. I mean you
can see it all on the monitor! `Now we take one more egg.' And
when you have the egg inserted again: `Look! Here's the egg.' It is
all petit-small. You just get this... human precarity in a completely
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Death mad Destruction III
different level when you are in fertility treatment. (Interview with
Mette,
2018)
Mette
is articulating the ways in which the embryonic matter becomes ani-
mated and affectively charged. First, the letter sent from the clinic about destruc-
tion seems to intensify the animation of the matter.
Mette,
as well as many other
interviewees, do not like the word "destruction" in relation to the embryos. The
alignment of not using the eggs and the word "destruction" seem to activate a:
feeling of responsibility to the embryos, which pushes the women to want another
pregnancy, rather than destroying the embryos. The letter further reminds the
women about the 5-year time limit which also seems to accelerate
the
feeling of
time and the investment in not destroying the embryos. Interestingly,
Mette
also
reflects on the different ways the embryo becomes a valued matter of life: It is
the treatments which remind
Mette
about how difficult it is for her to become
pregnant as well as the disaggregation of the eggs and embryos from the full
pregnancy process (Nebeling Petersen, 2019). The eggs ,are counted, monitored,
categorized, and visually enlarged, both when retrieved and when inseminated.
These visual technologies, combined with the medical and categorizing technolo-
gies, animate the eggs as precarious matters of life.
It is in the context of these various circuits of animation that we are to under-
stand the cryopreserved embryonic matter. The women are trying to fixate mean-
ing to the liminal matter, to categorize it
as
either purely matter (as in the case of
abortion) or as latent valued kin (as in case of the cryopreserved embryos). The
meaning seems to slide between matter, objects 'and subjects, which accumulate
even more meaning and affect to the matter. The "good" embryo holds a prom-
ise of a desirable future; in which the embryonic matter is categorized as latent
life and linguistically and affectively animated by the medical staff and potential
parents.
5. Summary
Lee Edelman (2004) reminds us that the promise of the future is held symbolically
by the child. The social order of reproductive futurity is affirmed and authenti-
cated by the child remaining "the perpetual horizon of every acknowledged poli-
tics,-the fantasmatic beneficiary of every political intervention" (Edelman, 2004,
p. 3). In this queer line of thought, the future is organized as reproductive futu-
rity in which desire and queerness are domesticized and made conservative in the
sense that'reproductive futurity maintains social order above all and eradicates
any transgression of normality. If we think of the valuation of the embryonic
matter into a child in this vein, we could wonder if the embryonic matter is ani-
mated to a child to avoid the queerness of the future. That is, the liminality and
latency of the embryonic matter appear as a queer intervention into temporality:
The matter seems to fold both the past (the making of the embryo fixated in the
past by the cryopreservation) and the latent future (what the embryo might be
when no longer cryopreserved) into the present (in which the women are asked to
make sense of the matter).
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The Cryopolitics of Reproduction on Ice
Further, cryopreservation seems to make a queer intervention into kinship:
Is the frozen matter a twin to the child? Can one be related to what is not yet a
human? Can I give birth to what was conceived a long time ago? In this way, cryo-
preservation of embryos seems to destabilize the heteronormative structure of
reproduction (that reproduction is the natural fruit of heterosexual intercourse).
Following Edelman (2004), these queer interventions into temporality and kin-
ship are fundamentally destroying or, rather, queering the social order. And thus,
we might feel a strong normative desire to annul these interventions into nor-
mality and social order by effectively ordering the chaos in the futurity of the
symbolic child. Whereas Edelman would advocate destroying the child, to stay
in the queer presence, the interviewed women with stored cryopreserved embryos
are stressed by the threat of destruction and the liminal presence of queerness.
In this way, the liminality of cryopreserved embryos between living/non-living,
purely matter/vibrant matter, past/future is felt as a queer destabilization of the
symbolic order, or it is felt and discursively framed in the ethical and legal debates
within the imaginary of Dr Frankenstein's monster, like the posthumous use of
sperm.
But in the life of the cryotanks, the liminality of the cryopreserved matter
is tamed and domesticized and thereby un-queered by affectiYely charging the
matter and embedding it within a heteronormative social order of reproduction:
The sperm cell is safely placed in the marriage, and becomes a will of the continu-
ation of the heterosexual marriage and `its fruits." Likewise, in the case of the
women with stored cryopreserved embryos, the liminal matter is domesticated
by the latency of the matter to become a kin, a sibling, a child. The cryotanks'
discursive and affective reframing of the matter from being embedded within the
imaginaries of Dr Frankenstein's technologies to one of (latent) families forever
enables the freezers to make sense of the liminality of the cryopreserved matter
and to reorganize the queer potentialities of cryopreservation "back" to heter-
onormative symbolic order, even though the technologies continue to destabilize
exactly that order. However, briefly returning to the ethics of destruction, even if
embryos do not have moral standing by virtue of being potential persons nor by
virtue of being humans, it might still, as also evidenced in our empirical material,
be morally problematic to destroy them (Douglas & Savulescu, 2009). The sup-
posed right of embryos (and gametes) against being destroyed, however, would
seemingly have .to be weighed against other competing rights or considerations,
such as the rights of prospective parents. Unless, of course, the right of embryos
against being destroyed trumps all other rights, but this is implausible consider-
ing that embryos, at least in the Scandinavian context, do not qualify as persons.
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Chapter 5
Disturb
1. Introduction
As cryopreservation technology disrupts reproductive temporality and enables
various forms of delay, fertility preservation at times disturbs
or,
at
a
minimum,
challenges the very way we think about or imagine the possibilities of human
reproduction. In this chapter, we will focus on three possible areas of disturbance.
The three areas are: 45+-year-old mothers, the reorganization of generational
time, and finally, fertility preservation in transgender individuals, which trans-
gresses traditional conceptualizations of gender and parenthood. We are well
aware that there are many more uses of cryopreservation technologies that have
caused and probably will continue to trouble the way we think about and act
towards assisted reproduction.
In this chapter, we place at the center what historian Susan Stryker (2006,
2007) calls the "transgender phenomena." Originally defined as "anything that
disrupts or denaturalizes normative gender, and which 'calls our attention to the
processes through which normativity is produced and atypicality achieves vis-
ibility" (Stryker, 2007, p. 60), the concept has been broadened to concern matters
that have the potential to radically alter our beliefs about, for instance, embodi-
ment, kinship, and motherhood (Stryker, Currah, & Moore, 2008). Importantly,
it is not the trans* phenomena or the 45+-year-old mother that we wish to call
attention to as always already being disturbing. Rather, our focus is on how
such transgressing phenomena become disturbances and how the controversies
around them can be used to illuminate the normative structures and institutional
boundaries within which fertility preservation is coproduced as an emerging
sociotechnical option
(Styrker,
2006, p. 3). We have chosen to include the three
examples of ageing, generational relationality, and gender, as these social catego-
ries are part of imaginaries central to the ways in which assisted reproduction
is organized and regulated in the Scandinavian countries. Through our analy-
ses, we illustrate how these sociotechnical constructs are shaped in and through
the entanglements of technology, politics, ethics, and biological matter. Our
The Cryopolitics of Reproduction on Ice: A New Scandinavian Ice Age
Emerald Studies in Reproduction, Culture and Society, 113-138
Copyright
© Authors, 2020
doi:10.1108/978-1-83867-042-
920191007
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The Cryopolitics of Reproduction on Ice
examples include the ethical debates on reproduction in which women over the
age of 45 become pregnant and give birth as well as the ways that cryopreserva-
tion has the potential to disturb the generational order including the ability, for
instance, for a woman to give birth to what is genetically speaking her grandchild
or her sibling. Finally, we turn to the ways that fertility preservation emerges as
an option for transgender individuals to discuss the disturbance of normative
understandings of who can and should procreate as well as of the gendered con-
notations of gametes.
In what follows, we continue with a short description of the Scandinavian legal
landscape and then turn to a theoretical overview including an interrogation of
our choice of terminology, specifically how and why we use the term "disturb" to
characterize these cryopreservation practices. In the three sections udder Section
4, we present and discuss some of the imaginaries connected to each of these
examples of "disturbance" and end the chapter with a brief summary reconnect-
ing the three examples.
2. The Legal Framework
The potential for cryopreservation to disturb
what
is perceived as "natural"
boundaries in reproduction was a key concern in the first Scandinavian regula-
tory instruments. In particular, Danish regulation initially capped cryopreser-
vation of embryos at 1 year in order
to
"control retrieved eggs," although no
reasons for this limit were initially included iri the wording of the law but presup-
posed in the comments included in the Bill (L59/1991). As the cryopreservation
limit was codified in the 1997 Act on Artificial Reproduction, parliamentary
debates demonstrated a safety concern as well as revealed the concerns about
the potential of -cryopreservation to disturb. The parliamentary discussions
over the
coming
years demonstrated a persistent and perceived monstrosity
connected to the "unnatural' both in terms of it being biologically unnatural
for women to conceive in middle-age and it being unnatural for parenting to
come at an age where there was an increased risk of the parent dying before see-
ing-the child through to adulthood (Adrian, Kroløkke, & Herrmann, 2019). As
a result, Danish law prohibits the use of ART for women over 45 years of age
(see Table 1 in the Introduction). In contrast, Danish men are able to reproduce
even posthumously with prior consent (as also discussed in Chapter 4), demon-
strating a very gendered perception of what comes to count as a disturbance of
reproductive age. As also demonstrated in Table 1 in the Introduction, maternal
age is also addressed in Norway and Sweden, although here rather framed as
a medical issue left to individual medical assessment rather than a normative
legal limit.
Danish parliamentary debates and regulation technologies also invoked other
monstrosities. The Parliamentary debates recognized that cryo produces a poten-
tial disruption related to which generation gives birth to which generation. This
was, however, understood as a monstrosity disrupting what appeared to be a nor-
mative kinship order ("twins in separate pregnancies"). This concern became in
fact pivotal (Herrmann & Kroløkke, 2018). In a parliamentary debate in 1995, a
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Disturb 115
spokesperson for the Social Democratic Party viewed separating "twins" as morally
suspect, even though no reasons were given for why it seemingly appears unethical:
At present no eggs are frozen, but technology may catch up. I find
12 months to be right. To me, there is something unethical about
having embryos in storage, maybe even to have twins in separate
pregnancies. (Bill no. 22/February 23, 1995)
In a proposition, another leading Danish politician stated in reference to the cry-
opreservation
of embryos that it was offensive to have "the family in the freezer,"
calling for a maximum two-year cryopreservation period.2
Not only age and kinship order but also fertility preservation in transgender
individuals has to be understood in light of the way in which transgender is and
has been understood and conceptualized both socially, culturally, and perhaps
especially medically. Because fertility preservation in trans youth and 'adults is of
particular interest in this chapter, we go into more detail outlining its legal and
historical context within the Scandinavian countries. The access to (or lack of)
fertility care cannot, however, be separated from the'ways in which the concepts
of "transsexualism," "gender incongruence," "gender dysphoria," and the like
have been produced by Western biomedicine since the late nineteenth century. As
part of a general medicalization of gender and sexual "deviance," "transsexual-
ism" (along with "homosexuality") emerged as a psychiatric
disease
in the first
half of the twentieth century. As described by historians such as Stryker (2017),
medicalization in general involved a decriminalization of gender non-conforming
people (however, as described by Holm, 2017, p. 232, from 1913 to 1967 "cross-
dressing" was criminalized in Denmark where "men" who wore what was per-
ceived as women's clothes in public could be arrested). However, medicalization
also comes at
a
price. As argued by many trans rights activists, the psychopatho-
logical stigma contributes to the deprivation of self-determination and, especially
in the Scandinavian welfare states, to the restriction of access to healthcare (e.g.,
Amnesty International, 2016; TGEU, 2019b). In 1965, "transvestism," an early
term for -what is today often conceptualized as transgenderism or gender incon-
gruence, was incorporated into the section on mental disorders in the ICD-8,
the international classification manual of the WHO (in ICD-9, 1975, "transves-
tism" was replaced by "transsexualism." cf. Drescher et al., 2012).3 Similarly, the
American Psychiatric Association adopted the diagnosis of transsexualism in the
Debate on Bill no. 200 of 23 February 1995 printed in
Folketingets Forhandlinger,
p. 4055, http://webarkiv.ft.dk/?/samling/19951/lovforslag_oversigtsformat/1200.htm
D
Debate on Bill no. 200 of 23 February 1995 printed in
Folketingets Forhandlinger,
p. 4055, http://webarkiv.ft.dk/?/samling/19951/lovforslag_oversigtsformat/1200.htm
3
A described by Drescher et al. (2012), until Hirschfeldt in his influential work from
the 1920s started distinguishing between homosexuality and transgenderism, these
were often conflated. Thus, homosexuality features in the ICD-6 from 1948, but was
removed from the ICD-10 which was launched in 1980 (Dresner et al., 2012, p. 570).
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The Cryopolitics of Reproduction on Ice
Diagnostic and Statistical Manual of Mental Disorders (DSM-III) of 1980, also
using the term Gender Identity Disorder. In DSM-V from 2013, the diagnosis
was changed to "gender dysphoria."
In the Scandinavian region, gender affirmation surgeries have taken place since
the late 1940s, with world-famous American Christine Jorgensen being the first
known to undergo successful surgery in Denmark in 1949.4 Characteristic of the
Scandinavian countries, gender affirmation treatment has been centralized in the
public health system. In Denmark this, for instance, resulted in the monopoliza-
tion of trans healthcare in the Sexological Clinic, which was established in 1986
within the psychiatric chapter at the University Hospital in Copenhagen. Accord-
ing to Bremer (2011, p. 26), Sweden became the first country in the world to grant
trans people a right to publicly funded gender affirmation treatment in 1972.
However, with the new access to treatment followed a castration requirement in
order to obtain a legal sex change (Bremer, 2011). In Denmark, the castration
requirement had been applied to
tranagender
individuals since 1951 (Holm, 2017,
p. 37), and in Norway administrative practice had set the same requirement (Nor-
wegian Directorate of Health, 2015). Importantly, sterilization and castration
laws also reflect a darker side to the history of the Scandinavian welfare states
in which eugenic sterilization laws were formulated and widely used. From 1929
in Denmark and 1934 in Sweden and Norway, the state was allowed to sterilize
citizens who were understood as unfit for parenthood, for instance, due to low IQ
(a new biomedical tool of the early twentieth century) or mental illness (including
sexual offenders) which in reality correlated with being poor (see, for instance, the
work of Koch, 2014, for more on the Danish case)."
However, in 2013, as we elaborate
on
in Section 4.3, after several proposals to
change the law, the Swedish regulator decided to remove the castration require-
ment. This meant that neither was surgery needed to apply for a legal sex change,
nor was being diagnosed as mentally ill required (though still necessary to have
the surgery in Sweden at the time). Similarly, Denmark removed the castration
requirement in 2014 (Act 752/2014), and Norway in 2016 (74 L 2015-2016).
became world-famous when Christine Jorgensen, a former US marine, un-
derwent a so-called sex change in Copenhagen. As one of the first successful operations
in the world, Jorgensen had the world press watching as she returned to the US after
the procedure was done (Holm, 2017; White, 1952). As Jorgensen became an inter-
national celebrity, Denmark was granted a place in
tranagender
history even though
allegedly Jorgensen originally planned to go to Sweden where the procedure had been
attempted before (Danmarkshistorien.dk). According to Holm (2017, p. 36), follow-
ing the public attention, the Danish Ministry of Justice in the following years received
numerous applications from foreign nationals, as well as from an increasing number
of Danish citizens, even though the option had immediately been removed for non-
Danish citizens.
"In Denmark, both men and women who were regarded as promiscuous and men-
tally underdeveloped were institutionalised on small and isolated islands, Sprogo
and Livo. One of the only ways to leave the islands were to be sterilised (Holm, 2017,
p. 203).
4
Denmark
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These changes preceded a 2017 judgment from the European Court of Human
Rights that found castration, as a condition to legal gender recognition, a viola-
tion of human rights
(A. P., Garcon and Nicol v. Fiance,
2017). With the castration
demand removed, Sweden in 2014 began to offer fertility preservation in relation
to gender affirmation treatment to both transwomen (sperm) and transmen (eggs,
embryos, or ovarian tissue). As we will describe in more detail in the analysis this
followed several years of debate. Today, in Denmark and Norway, only sperm pres-
ervation is possible for reasons we will elaborate on in the analysis.
In 2017, as the first country in the world (Holm, 2017), Denmark removed
the diagnosis of "transsexualism" from the list of psychiatric disorders. A similar
change has since taken place in WHO's ICD-11, launched in 2018, where "trans-
sexualism" is deleted from the section on mental health disorders and the diagnosis
of "gender incongruence" has been added to a new chapter on "sexual health condi-
tions" (WHO, 2018). To secure access to the public healthcare
system,
in Denmark,
the diagnosis was replaced by two new diagnostic codes intending to be non-
stigmatizing (DZ768E1-4 which specifies "contact due to tr'ånsgenderism" and "due
to gender identity conditions," cf. The Danish Ministry of Health, 2017): Following
this re-conceptualization, trans healthcare has been re-established outside of psychi-
atry in The Centre for Gender Identity and new guidelines have been issued. Impor-
tantly, where the former guidelines mentioned options for fertility preservation in
transmen, the new guidelines state that there are currently no options. In 2018, as
part of a longer process adopting principles of informed consent in Denmark, it was
further decided that as of 2018 in relation to castration due to gender affirmation sur-
gery, permission no longer had to be obtained from the Danish Health Board (Act
1688/2017 and the preparatory remarks listed in L60/2017).
Having sketched the socio-legal contexts in which 45+-year-old women and
transgender individuals emerge as cryogenic agents as well as the framework that
regulates "intergenerational reproduction" in the Scandinavian countries, we now
wish to turn to the notion of disturbance. In the next section, we discuss what we
mean when we use the term "disturb" and why we find it important to include
analysis of the way cryopreservation technologies cause controversy.
3. Theorizing Disturbance
Because our analyses in this book is founded in law, ethics, cultural studies, femi-
nist studies and STS, what comes to be regarded as disturbing or problematic
is not given nor static. Rather, assisted reproduction, including the use of cryo-
technology, is a stellar example of how ideas and perceptions change over time
as well
as
of the ways that moral standpoints co-exist and entangle in everyday
practices around cryo-technologies.
Due to the interdisciplinary approach of the book, we discuss disturbances
from several angles. From a bioethical and cultural analytical point of view, dis-
turbance is often connected to revulsion, which can be a central element in moral
judgement. This is because strong emotional reactions arise to activities or peo-
ple that is found to be disgusting or disturbing, a perspective also investigated by
feminist scholars such as Sara Ahmed (2014). While feminist affect theory is more
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The Cryopolitics of Reproduction on Ice
concerned with the performativity of disgust, and what disgust does, in critical
bioethics, the central question concerns how disgust distorts and unduly exacer-
bates moral judgement. This is a central issue in relation to understanding how
cryo-technologies disturb and, as we will demonstrate throughout the chapter, have
continuously caused controversy. These debates are central to the technologies that
have been applied and developed — perhaps especially within the public healthcare
systems of the Scandinavian welfare states. We will elaborate more on the matter of
disgust as we theorize the bioethical concept of the yuck factor later in this section.
In light of the framework of sociotechnical imaginaries and our concern with
how fertility, preservation practices have developed in the entanglements between
cryo-technologies, cultural values and the socio-political contexts of the Scandi-
navian welfare states, we first turn to deconstructivist thinking to theorize how
cryo-technologies cause controversy and usually also yuck responses. From this
perspective, disturbance spurs from practices and possibilities that challenge 'fun-
damental structures and conceptualizations of reproduction including the trou-
bling of social categories central to the social organization of family life. Consider,
for instance, as mentioned in Chapter 4, creating children using gametes of a
deceased spouse, giving birth to your own grandchildren (or a biological sibling),
or having a "family in the freezer" (Herrmann & Kroløkke, 2018).
Feminist thinking invites us to examine how social categories such as "old
mother," "brother" or "transsexual" are produced and become part of the social
forces through which subjects come to live and in relation to which practices, such
as fertility preservation, are conceptualized and organized. As Staunæs (2004)
has highlighted in her work on gender• and ethnicity, social categories are a sort
of tool we use to orient ourselves. They are sorting mechanisms used to con-
nect and disconnect, to include and exclude the appropriate and the deviant and,
thus, they are central to the production of normative hierarchies (Staunæs, 2004,
p. 60). This means that social categories, such as man, woman, old or infertile
cannot be approached as "a consequence of the body," nor as a solid and sta-
ble variable. Rather, social categories are social products with a fluid and chang-
ing content. Importantly, social categories are also productive and have material
consequences on human lives working as structuring principles for human inter-
action and the social organization of our societies. Consequently, in this per-
spective, we approach the controversies evolving around fertility preservation as
cryo-technologies destabilize central social categorizations of age, generation and
gender, and not least the notion of what is natural.
In particular, the work of Foucault has centered on destabilizing the regimes
of thought by turning to historical and genealogical analyses of how a phenom-
enon has been made meaningful and understandable within broader contexts in
a specific historical moment or period of time. Indeed, Foucault has argued that
the work of an intellectual is:
to question over and over again what is postulated as self-evident, to
disturb people's mental habits, the way they do and think things, to
dissipate what is familiar and accepted, to re-examine rules and insti-
tutions. (Foucault, cited from Foucault & Kritzman, 1988, p. 265)
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Disturb 119
To Foucault and the genealogical method, the object of an analysis has often been
to destabilize our habitual ways of thinking. The task has been essential to not only
poststructuralist thought but also to, for example, bioethicists and STS scholars.
Either by revealing what forms of meaning have been left out of the discourses
due to the hegemony of other systems of meaning (Laclau & Mouffe, 1985), or by
using troubling concepts to move the analysis in surprising ways. Within feminist
poststructuralist studies, the habitual analysis within a given field can be troubled
by using concepts from other fields (e.g., using words from biology to understand
the production of meaning like the Deleuzian concept of rhizome) or by exclud-
ing overdetermined words/concepts like man and woman in the analysis, like
SØndergård has done in her work on gender (Søndergdrd, 2000, 2002). ,
Deconstruction is, thus, fundamentally about troubling: Rather than examin-
ing a phenomenon in itself, deconstructionism invites us to look at the meaning-
making of a phenomenon by including its binary opposition. That means that
a sign is never self-referring, but always haunted by its opposition. To Derrida,
meaning is structured in binary oppositions which are always hierarchized. For
example, heterosexuality is only meaningful in relation to homosexuality, what
is heterosexual is what is not homosexual (Fuss, 1991). And this relation of signs
both hierarchize heterosexuality over homosexuality, as well as it leaves heterosex-
uality always troubled by the haunting nature of its opposition. The deconstruc-
tion of the hetero-homosexual binary has greatly inspired queer theories which
have studied the continuous construction of sexuality and normality. Likewise,
in her seminal book
Gender Trouble,
Butler (1999) troubles our ways of thinking
about gender by suggesting a radical other framework, including the deconstruc-
tion of the binary opposite gender and sex. Butler (1999) shows how "it would
make no sense, then,; to define gender as the cultural interpretation of sex, if sex
itself is a gendered category" (p. 11).
Troubling, is not solely' an analytical strategy. It can also be an empirical phe-
nomenon that occurs differently than expected or differently than the empirical
patterns. When, for example, Butler troubles our ways of thinking about gen-
der, she additionally, through her own readings, suggests a subversive strategy
for- change. She asks us to see how apparently marginal ways of doing gender
(like the drag queen) reveal how gender is being construed in a more general way.
Similarly, we suggest that applying a deconstructivist perspective on how cryo-
technologies "disturb" opens up for new perspectives which may interfere in the
very way fertility preservation comes to be imagined and conceptualized, politi-
cally, legally as well as socially.
While feminist and queer scholarship have been concerned with the processes
through which certain technologies and their interrelated subject positions are
shaped, including how they become problematized and stigmatized, moral phi-
losophy applies a different take on disturbances. In the field of bioethics, it has
been theorized that new biotechnology often causes disturbances by evoking dis-
gust responses, in particular, with regards to perceived transgressions of the natu-
ral. In this way, it has been theorized that disgust responses often drive, guide,
and distort moral judgements, often in disguise of other professed moral reasons
(Kelly, 2011).
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Distca•b 121
alone, such as vaccinations, smartphones, and public transportation. Similarly,
there are many things that are arguably natural yet morally objectionable, such as
adultery, infanticide, and murder. In short, no direct relationship between nature
and morality can, from these perspectives, be made (Moore & Baldwin, 1993;
Ridge, 2018). Even if there was such a direct relationship, one could argue that
there is nothing more natural for human beings than using technology to trans-
form the human experience.
To sum up, we suggest, in this chapter, that the cases to which we now turn
tell us something about the potential of cryo-technology to disturb naturalized
social categories as well as our moral sensibilities. Consequently, in what follows,
we turn to the ways that cryo-technologies trouble societal understandings of
motherhood, kinship, and gender. Going into three examples, we re-emphasize
that these are examples are chosen, not because the practices or individuals them-
selves are disturbing. Rather, the conceptualization and the organization of fertil-
ity preservation, for instance, in relation to women who give birth at the age of
50, highlight central sociotechnical imaginaries concerning parenthood and how
gendered bodies have raised responses that find novel use of cryo-technology dis-
turbing. Conversely, while incorporating law material, 'ethical council guidelines
as well as individual experiences, the Chapter aims to de-center specific individu-
als as always already figures of disturbance. This is done in order to re-center the
normative structures of fertility care and the systems of meaning and categories
on which it is founded as what is being disturbed (Raun, 2014; Staunæs 2004,
p. 71; Stryker, 2006).
4. Imaginaries
of
Disturbance
In the following sections, we discuss three different empirical settings in which
controversies around what should be allowed have occurred. The controversies
highlight important aspects of how cryo-technologies and fertility preservation
come together to disturb core imaginaries about the correct as well as "natural"
connection between age and reproduction, generation and kinship and gender,
disorders and parenthood. We first turn to a discussion of the ethical debates
around post-menopausal women having children with the use of cryopreserved
eggs or embryos. We then examine the ethical dilemmas connected to the pos-
sibility inherent to cryopreservation of reorganizing generational time. Due to
the lack of Scandinavian examples tied to the strict legal regulation in the region
(see introduction), we turn to a Canadian example in order to illustrate how
kinship disorder is produced and ethically delimited. The last, and lengthier,
example concerns transgender fertility and how (some) transgender individu-
als came to be seen as reproductive citizens within the Scandinavian context.
We delineate how central aspects of the legal framework regulating reproduc-
tion and family life are significantly challenged by depathologization along with
easier access to legal gender recognition. In this final analytical case, we discuss
how the acknowledgement of trans people's reproductive rights invites for new
terminology and categorization around fertility preservation and reproduction
in general.
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4.1. Disturbances
of
Reproductive Time — Old Mothers
Cryopreservation enables postmenopausal women to reproduce, using their
own reproductive material, as gametes and embryos can be cryopreserved over
several decades. There is no doubt that when especially older women (defined in
Denmark as 45+ years of age) give birth, motherhood becomes represented as
disturbing, yucky, or even monstrous (Adrian et al., 2019). The Danish Council
on Ethics (1995, section 6, p. 6) has, for instance, argued that it is against the
interest of the child to have a mother that is 45+ at the time of birth, as the child
then cannot expect to have its mother around for as many years as children ,with
younger parents. In 2018, for example, a public furore arose, when Benedikte
Kimr, a Danish politician and mayor of the city Elsinore, announced that, at
the age of 48, she was pregnant with her second child conceived with embryos
that had been stored in Spain to avoid the restrictive Danish system (see also
Chapters 1 and 3). Benedicte Kimr has been very public about how she had met
a lot of resistance due to her age. For instance, she received a letter in which a lot
of negative comments were written, such as: "we recommend that you immedi-
ately abort the child. A woman shall absolutely not conceive a child at that age."
(Iversen, 2018).
It is tempting to interpret such resistance as arising (at least partly) from feel-
ings of disgust or yuck responses that have simply not caught up with the tech-
nological reality. Motherhood in old age has been associated with disease and
illness. Although medical advances such as egg donation or the cryopreservation
of one's own reproductive cells exist, the imaginary of the old mother continues
to evoke feelings of disgust and; generate moral judgement. In sharp contrast,
media representations of older fathers emphasize their virility underlining their
desire as well as naturalizing their reproductive choices. As noted by one such
father identified as a 56-year-old male with "wind in his hair": "we have children
because we can" (Munch, 2017). In the imaginary of the disturbing old mother,
we trace two arguments that are especially salient in the Danish context; namely,
that of the interest of the child and the best interests of women themselves.
The interests of the child figure prominently in the Danish Council on Ethics.
To the Danish Council on Ethics, the interests of the child speak in favor of not
letting women over the age of 45 have access to assisted reproduction in Denmark
(see also Chapter 3 for other references to this worry). More specifically, it speaks
against the interest of the child to have a mum that is 45+ at the time of birth, as
[ ... ] it is in the interests of the child to grow up under the best
possible circumstances, and this implies that ... the child will have
the best possible chance of its parents being alive until at least
adolescence. (The Danish Council on Ethics, 1995, section 6, p. 6)
Although this is the only passage in which the Danish Council on Ethics, in their
many reports and papers, mention and try to argue in favor of the age limits for
women using assisted reproduction, there are, of course, other imaginaries in the
debate. However, before presenting them, a few critical remarks are in order.
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First, if we take the argument at face value, an age limit should also exist for
men, as this would increase the chance that the child will have parents that are
alive during its childhood and adolescence. Alternatively, one could also argue
for the idea that we could have a combined age limit, according to which the age
limit for a couple may not override, say, 90 years for a couple of two. But, to our
knowledge, no one has argued in favor of this proposal. However, among the
Scandinavian countries it is only Sweden that has an age limit for men (no access
to ART if you are above the age of 56). Furthermore, one could just as well argue
for the view that the age limit for men should be lower than for women, as the
Lf
average lifespan of women, in the Scandinavian countries, is longer than that of
men. But again, we have neither heard of a politician nor a member of an ethics
council who has convincingly argued that men's legal access to assisted reproduc-
tion, because of age limits, should be narrower than women's. Second, it follows
from this way of reasoning, that it would be better for the child if the parents were
15 years of age than if they were 25. As by having parents
as
young
as
possible,
it will increase the chance that one of the most important things in terms of the
interests of the child is fulfilled. Namely, that its parents
will
be alive until at least
adolescence (Petersen, 2014).
Another example of combining the interests of the child with a rejection of
letting women over 50 have legal access to assisted reproduction is the former
chair of the Danish organization "The Interests of Children" (BØrns
Vilkår),
John
Halse,
who has argued "[...] with -all respect it is only very few [women]
at the age of 50 who have children who have the same energy as a parent who
is at the age of, for instance, 30 years"
(Halse,
2007). This type of argument is
flawed in several ways. First of all, the important thing child rearing is not that
you, in order to be a good parent, should have the energy level like the average
person at the age of 30. The important thing is that you have sufficient energy
to take care of your child and that
you
prioritize the energy you have, so that
your child benefits from the energy you have. Second, if it is the energy level
of parents that is decisive for getting access to assisted reproduction, then lazy
or people low on energy compared to the energy level of the average 30-year-
old person, should not have access to assisted reproduction. However, nobody
would argue in favor of such severe state intervention. Moreover, the energy
of parents is not all that matters when we take into account the interests of
the child. As we mentioned in Chapter 3, the parent's job and financial situa-
tion is typically more secure and their level of education and self-knowledge
is typically better when they are older, than when they are in their 20s. Finally,
if a parent has a higher than normal risk of dying before their children have
reached adulthood, it should then be made illegal for healthcare professionals
to help people at risk of early death with assisted reproduction (such as smok-
ers, obese individuals, or soldiers). Unlike age, however, none of these risk
categories produce legal restrictions in terms of ART. Finally, even if children
born by women above 45 years (or between 15 and 25 years) had worse lives
than children born by mums between 25 and 35 years (which there is some
evidence for), they would still have lives that are well worth living (Myrskyla
& Fenelon, 2012).
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Interestingly, a more positive attitude toward letting women 45+ years old
have access to assisted reproduction can be observed in the Swedish National
Council on Medical Ethics (SMER, 2013) when they write that "the Council
finds it inappropriate to state a general age limit for people seeking assisted
reproduction, as people age individually" (p. 201). Here, aging becomes an
individualized experience enabling, in this imaginary, some women (women
who do not act or look their age) access to ART. Similarly, Adrian et al.
(2019) highlight how
"not
looking one's age" enables women older than 45
an escape from yuck responses or monstrosity in clinical practices. And
complicating this perspective, in the biomedical imaginary, risk assess-
ments are bountiful. The risk of pregnancy complications increases, in this
imaginary, with age, raising the potential for yuck responses associated with
(pre-eclampsia, ectopic pregnancy and perinatal diabetes, see, for example,
Vincent-Rohfritsch, 2012). In this biomedical imaginary, then, pregnancy
complications are combined with a low live birth rate for women over 40 who
through IVF use their own eggs to have offspring. At 41 years, the chance of
giving live birth is 9.5% per cycle, while it decreases to 2.7% per cycle when
the women reach 45 (Lockwood, 2012). However, as we argued in Chapter 3,
it would be a fallacy to let this biomedical imaginary determine that women
over 45 should not have legal access to assisted reproduction. For even if the
above-mentioned risks are higher for older mothers than for younger moth-
ers, it may still be preferable for older women to accept these risks compared
to the imaginary of having no children.
As noted, the monstrous imaginary that old mothers find themselves in
entangles with various yuck responses. One indication of this is that the
judgement of elderly mothers, for example, through the imaginary of the best
interests of the child, does not seemingly rest on consistent moral beliefs, but
rather appears to be an ad hoc rationalization. Of course, much more could
be said in the discussion above, but it would surely not be the first time moral
judgement against women was rooted in biases, as Martha Nussbaum (2009)
reminds us.
4.2.
Disturbing the Generational Kinship Order
Another potential disturbance, or potential cause of yuck responses, relates to
the cryopreservation time period and the generational order in which reproduc-
tion is seen as "naturally" taking place. For instance, cryopreservation technolo-
gies make it technically possible for a woman to give birth to a child that can
be seen as her own child and at the same time also her sibling, for example, if
she uses frozen embryos of her parents. By the same token, cryopreservation
technologies also make it possible for a woman to give birth to a child that is
in some sense older than herself, for example, if the embryo was created and
frozen before the woman was born. While legally not possible in the Scandi-
navian countries, such arrangements raise feelings of disturbance and/or cause
yuck responses. Cryotechnologies materialize what may have, at earlier times,
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appeared as fictional imaginaires of someone giving birth to the brother of her
own grandparent or someone fathering the daughter of his own great-grand-
mother. Disrupting generational order produces uneasiness. In this section, we
unfold the ways that generational orders may be disrupted by yuck responses
and turn to a rather exceptional Canadian story, which made headlines in the
Danish media (e.g., "Canadian girl may give birth to her own half-sister"; Ytzen,
2007), highlighting how normative understandings of kinship can be disturbed
by cryopreservation.
In its broadest sense, kinship refers to the myriad of ways individuals are
related to each other through descent and affinity. Kinship is, however, not a
unified term. On the one hand, kinship can be seen as something "given by birth
and unchangeable." On the other hand, however, it can also be, as reckoned in
social scientific theorizing, seen as "shaped by the ordinary, everyday activities
of family life, as well as the `scientific' endeavours of geneticists and clinicians
involved in fertility treatment or prenatal medicine"
(Carsten,
2004, p. 6). To
showcase how the frontiers of cryopreservation technologies shape, as well as dis-
turb, imaginaries of kinship, we turn to a case from outside Scandinavia, which
aptly shows some of the concerns about "genealogical bewilderment" that are
bound to rise from various uses of cryopreservation in the coming years. With
increased access to cryopreservation technologies, and increasing trends of fertil-
ity migration, we take it that this case is a sign of what is to come in terms of how
cryopreservation will challenge and disturb notions of generational and kinship
order in the future.
In the above mentioned Canadian case from 2007, a mother received per-
mission from the Canadian ethics committee to donate her frozen eggs to her
seven-year-old daughter. The daughter suffered from Turner syndrome, which
among other things destroys the eggs, leading to early menopause. Due to dif-
ficulties preserving the daughter's own reproductive material (in part related to
the daughter's age), the mother therefore wanted to help her daughter by giving
her the option to use her eggs in the future, and thus potentially give birth to
a child that was then, in a more traditional biological understanding, her own
half=sister or -brother (Fleming, 2007; Gidoni et al., 2008). The case naturally
stirred debate and controversy. Whereas the ethical committee noted that the
mother donated her eggs out of love and that she was guided through altruistic
intent, they also noted that it would be up to the daughter and future part-
ner whether the eggs should be used, which they considered sufficient to secure
the daughter's autonomy in the deliberation. Moreover, the committee used a
speculative argument when they remarked that "ethical considerations change
with time. Who knows what the ethics will be in 20 years from now" (Roberts,
2007, p. 26)?
In contrast to this more liberal approach, critics were worried that the psycho-
logical welfare of the future child had not been taken sufficiently into account.
According to Roberts, an ethics professor: "Such a baby would be a sibling of the
birth mother at the same time as the direct genetic offspring of the grandmother
donor." Continuing, "in psychiatry we are hearing more and more of children
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The Cryopolitics of Reproduction on Ice
suffering from identity problems, and specifically a condition called `genealogical
bewilderment.' Could it possibly get more bewildering than this?" (Roberts, 2007,
p. 26). Thus, the critics align confusion and identity problems with the disruption
in kinship genealogy, establishing an imaginary in which "bewilderment" is both
undesirable as well as problematic.
Thus, critics invoked the recurring imaginary of the best interests of the child.
That is, critics argued that the psychological welfare of the future child would be
endangered by this disturbance of the usual genealogical relations. Whether this
would be the case is, of course, an empirical question combined with a view on
what constitutes a sufficient or acceptable level of welfare for the future child.
However, even if this indeed would endanger the psychological welfare of the
future child, this does not necessarily mean that it would be morally wrong. From
a moral perspective, the question remains about how much (or little) risk of harm
we should accept when it comes to future children?
Briefly, within bioethics, three moral principles have been suggested in this
regard: the maximum welfare principle, the minimum threshold principle, and
the reasonable welfare principle (Pennings, 1999). Because the maximum wel-
fare principle suggests that we should only bring children into the world under
optimal circumstances, this principle seems to rule out arrangements such as
the above. It also seems to rule out many other instances of fertility treatment
that are usually considered acceptable, such as helping poor or disabled parents
to conceive children. In contrast, on the minimum threshold principle, a lot
more risk of harm can be accepted. As long as the child has a life worth liv-
ing, there is no problem from a moral point of view if we accept the minimum
threshold principle. This implies that whereas children should not be brought
into the world with 'debilitating diseases, there is no moral problem as long as
they would not have been better off having never been born. Contrary to the
maximum welfare principle, then, the minimum threshold principle appears to
be much too wide, in the sense that it allows too much. Consider, for instance,
someone who has the choice between conceiving now and possibly having a
child with a birth defect, or conceiving in six months and having a child with
a much lower risk of any abnormalities. On the minimum threshold principle,
there would be no moral grounds for waiting six months, assuming that the
birth defect in question would not make life outright unbearable, but this seems
like the wrong answer.
The reasonable welfare principle has been proposed as an intermediate princi-
ple that can avoid the counter-intuitive implications of the principles above. On
the reasonable welfare principle, circumstances do not need to be optimal in order
for someone to bring a child into the world. It is enough that the circumstances
are reasonable — in the sense that the child will have a life that is reasonably happy.
On the other hand, prospects for the child should be better than a life just barely
worth living. Although this idea is difficult to spell out more precisely, it is not
difficult to understand. In order to live a reasonably happy life, some scholars
emphasize "the abilities that are required for an individual to enjoy a normal
range of opportunity in his society," while others refer to a life adequate in the
"major respects that generally make human lives valuable and worth living," or
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Disturb 127
"some conception of [...] normal functioning"
(Pennings,
1999, p. 1148). These
descriptions are all fairly vague, but they seemingly capture some important core
in a happy life.
The genealogical bewilderment that the Canadian case so aptly illustrates is,
by the Canadian Ethical Council, resolved through an imaginary of love (for the
ill child) as well as firm belief in technological progress narratives. Meanwhile, the
critics upheld a maximum welfare perspective reiterating the interests of the child,
an imaginary which has also traditionally enjoyed a prominent role in discussions
on the frontiers of fertility treatment by the Danish Council on Ethics. As already
noted in Chapter 4, the interests of the child are frequently co-opted to naturalize
particular, and frequently quite normative, world views. In this regard, it is also
worth recalling that yuck responses have seemingly driven a range of discrimina-
tory policies throughout history, often disguised as benign and genuine moral
judgement.
4.3. Disturbing Gendered Reproductive Categories
In this chapter's last example, we turn to a more detailed analysis of fertility
preservation in transgender individuals.6 While transgender people's (lack of) access
to healthcare has increasingly been debated in the Scandinavian "region for the past
decade and the regulatory framework has changed significantly, as described in the
beginning of the chapter, reproductive rights and sexual health have not gained
much public interest. And in contrast to especially (cisgendered) women's attempts
to preserve their change of motherhood later in life (see this chapter and Chapter 3),
fertility preservation in transgender individuals has not received much social scien-
tific scholarly attention. Internationally, however, biomedical professionals working
on transgender- healthcare have called attention to the issue (e.g., Coleman et al.,
2011; De Sutter., 2009; De Sutter, Kira, Verschoor, & Hotimsky, 2002; Greenman,
2004). As we will demonstrate in this chapter, fertility preservation has also been a
topic in the political debates on the creation of a new legal framework for transgen-
der people in the Scandinavian context.
In the international guidelines for Standard of Care from WPATH, World
Professional Association 'for Transgender Health, which the Scandinavian coun-
tries all follow to some extent, reproductive health is highlighted as an important
6In this book, we work with a wide concept of transgender. Consequently, transgender
is not a specific identity, nor a specific bodily state. As a concept, transgender refers
to people who do not identify with the gender they were assigned by birth. Impor-
tantly however, how trans people live their lives, dress and identify differs. Similarly,
trans identity cannot be reduced to a wish of hormonal or surgical treatments. Not
all transgender individuals want hormones or surgeries. Importantly, following the
work of Stryker (2017), we do not understand transitioning as a movement from one
specific point (or gender) to another. However, since the topic of this chapter is fertil-
ity preservation, the context of our discussion is primarily one of gender affirming
treatment, and this means that we primarily discuss trans in relation to hormones and
surgeries as they impact on (future) fertility.
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The Cryopolitics of Reproduction on Ice
aspect of transgender healthcare (Coleman et al., 2011, pp. 196-197). While
not all transgender or gender non-conforming people wish to have children, the
effects of treatment on fertility need to be discussed, Coleman et al. (2011) argue,
in order to make an informed choice. Notably, both hormonal treatment and sur-
gery have effects that can be irreversible. However, research has indicated that the
ovaries seem to be less sensitive to testosterone than the testicles are to oestrogen
(e.g., Coleman et al., 2011, p. 197; Weirckx et al., 2012). While most transmen
experience regaining their menstrual cycle if they stop taking hormones, many
transwomen have trouble producing viable sperm samples when going on oestro-
gen. Besides this, many transgender individuals also experience a significant dis-
comfort, and even dysphoria, related to coming off of hormones (e.g., Armuand,
Dejhne, Olofson, & Rodriguez-Wallberg, 2016). This can also be enhanced by
inducing other types of hormones (e.g., oestrogen to increase the maturation
eggs necessary for fertility preservation). As highlighted in the Standards of Care
(Coleman et al., 2011) as well as by Swedish healthcare professionals (Armuand
et al., 2016), this speaks to the importance of discussing fertility preservation with
transgender patients
before
they start any treatment.
Technically, fertility preservation techniques do not as such differ between
cisgendered and transgendered individuals. The fact that only certain trans peo-
ple are offered to preserve fertility speaks, however, to the politicized nature of
the topic. It is only in the Swedish context that transgender fertility preservation
is actively conceptualized as "medical freezing" (see SFGO 2015), even though
the freezing of sperm is also free in relation to gender affirmation treatment in
both Denmark and Norway (The Danish Health Ministry, 2017, The Norwe-
gian Ministry of Health and Care Services, 2017). In the following section, we
examine the imaginaries that enabled specific practices and disabled others, pay-
ing specific attention to the national differences between Sweden, Denmark and
Norway. Thus, comparing the Scandinavian countries reveals how specific and
national understandings and regulations of gender and kinship produce norma-
tive boundaries regulating who becomes eligible for fertility preservation and
whose reproductive citizenship is supported and protected by the welfare state.
4.3.1. From Sickness to Reproductive Citizenship in the Welfare State?
The patients are pouring in and I don't believe we have seen the
top yet. If so, you can wonder if quite a few people have lived in
hiding and shame, where, today, they dare to come forward, to
a greater extent, and say `here I am'. Before, many people have
probably gone under the radar and have sought help abroad.
(Dr
Med
Astrid Hojgaard, Centre for Gender Identity, in
Demark,
in
Kristeligt Dagblad,
Shelde, 2019)
These types of experiences are also increasingly documented on YouTube in so-called
Vlogs in which the experiences of transitioning and living as a trans person is docu-
mented, shared and discussed (see also the work of Raun, 2012, 2014).
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Disturb 129
As outlined in the section on the medico-legal landscape of transgender rights
and healthcare (Section 2), the laws regulating medical and legal transition have
changed significantly in the past decade in Sweden, Denmark, and Norway. Fol-
lowing the above-mentioned legal changes, all of the Scandinavian countries have
seen a significant increase in the number of individuals who seek trans-related
health care services. As illustrated in the introductory quote from the head of
the Centre for Gender Identity at Aalborg University Hospital, Denmark, this
increase in the number of patients is ascribed to a more general de-stigmatization
of transgender people in Danish society. Despite the fact that the Scandinavian
healthcare systems have been heavily criticized by trans activists and in Denmark
also by Amnesty International (2016) for monopolizing trans healthcare and
restricting access by applying narrow and very binary understandings of what
it means to be transgender, a wider imaginary of inclusion exists as well. This is
further mirrored by the way Denmark, for instance, has been written into inter-
national transgender history by being the place where US citizen Christine Jor-
gensen in 1949 went through what became known as "the world's first, successful
gender affirmation surgery" (Holm, 2017; Stryker, 2017; White, 1952). Likewise,
the award-winning Hollywood drama The Danish Girl (2015) is about a Danish
girl called
Lili
Ilse
Elvenes,
better known as
Lili
Elbe, who was among the first to
receive gender affirmation treatment, including surgery, in Germany in the 1930s.
Unfortunately,
Lili
Elbe died from complications in relation to the experimental
treatment that aimed to enable her to become pregnant (Holm, 2017, p. 285).
In the Swedish context, the offer to preserve fertility in transgender people,
especially in transmen, is similarly positioned within a storyline of Sweden being
progressive. For instance, in an abstract for the 2014 conference of the American
Society for Reproductive Medicine, a team
of
Swedish doctors' motives in their
presentation of
a
'study of oocyte freezing in transmen are as follows:
OBJECTIVE: Lesbian, gay, bisexual, transgender (LGBT) rights
in Sweden have been regarded as some of the most progressive in
Europe. In 2013, a previously valid requirement of sterilization
for legalization of gender change was ruled unconstitutional in
court. Hence, transsexuals may now be included in clinical pro-
grams of fertility preservation (FP) before sex-reassignment sur-
gery. Our aim is to report a pilot experience with counseling and
performance of FP in transsexual men, as standards of care for
FP, in this clinical setting are lacking. (Rodriguez-Wallberg et al.,
2014, p. e 160)
Emphasizing the frontrunner status of Sweden, both in terms of its LGBTQ
rights and their own contribution to providing the first clinical standards of care,
Rodriguez-Wallberg et al. contribute to the production of the positive storyline
not only of themselves as medical pioneers, but also of a more overall move toward
inclusion of transgender people and other LGBTQ minority groups into Swedish
society. However, as emphasized by feminist scholars such as
Jaspir
Puar (2007)
and Michael Nebeling Petersen (2012) in their discussions of homonationalism,
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The Cjyopolitics of Reproduction on Ice
such narratives of "exceptionalism" are also political tools which are often used
to render invisible other suppressive policies and the marginalization of minority
groups (see also our Conclusion). Notably, fertility preservation in transgender
individuals cannot be disconnected from the Scandinavian histories of forced
sterilization and their origins. As demonstrated, the Swedish abstract does
acknowledge the previous sterilization requirement. However, the narratives of a
contemporary national exceptionalism readily make invisible how the castration
requirement has been normalized and sought to be upheld by many politicians,
also in Sweden. Notably, the Swedish government, in contrast to Danish and
Norwegian States, has publicly pardoned and offered a financial compensation
to transgender individuals who underwent forced sterilization between 1972 and
2013 (Kammarkollegiet, 2018). Nevertheless, the narrative of Scandinavian pro-
gressiveness downplays the normative imaginaries of gender and kinship that still
affect the regulation and organization of trans fertility. Especially, it overshadows
the difficulties with putting preserved material to use within the Scandinavian
laws on assisted reproduction which is, arguably, the main argument not to pre-
serve eggs from transmen in Denmark and Norway.
One aspect of how these normative imaginaries of gender operate can be illu-
minated through a closer look at an evaluation of the 1972 Act on Sex Change
(which gave access to publicly funded gender affirmation treatment) that was
ordered by the Swedish government in 2006 (SOU 2007:16). Interestingly, despite
advising to uphold a sterilization requirement, the _ report recommends that
transgender individuals obtain access to fertility preservation. About upholding
the sterilization requirement the commission writes in the summary, that they:
find it to be reasonable to demand that a person who is assigned
female does not have male sex glands and vice versa. Even though
it appears to be an extreme exception, we want to obviate the
possibility that a person registered as male gives birth to a child.
(SOU 2007:16, p. 15)
Arguably, in this framework in which transgender reproduction becomes imagi-
nable through the proposal of fertility preservation, the sterilization requirement
works as a way to uphold a normative order between gender categories and repro-
ductive capacities: men should not be pregnant.
Moreover, in legitimizing the sterilization requirement, which has been heavily
criticized as inhumane, the commission annotates that from their point of view,
"in principle all of transgender individuals" wish to have their sex glands removed
(p. 15). Also, they add that, from a medical point of view, it can be risky to keep the
original gonads when starting on hormonal treatment (SOU 2007:16). In this way,
sterilization is constructed as an obvious part of transitioning, which, of course, it
also is for some people. Yet, the assertion that all transgender individuals wish to
have their glands removed is founded in a binary understanding of gender that is
also sought to be maintained through a specific ordering of transitioning bodies so
that they can still be sorted into boxes that fit a normative understanding of "men"
and "women." In this understanding, which has shaped the organization of trans
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Disturb 131
healthcare in the region in general, being transgender always involves being born
"in the wrong body" and therefore wishing to belong to "the opposite sex." How-
ever, as emphasized by much trans scholarship, this is not always the case and there
are many ways to identify as transgender which affect to what extent one wishes
to medically and/or legally transition (e.g., Gottzen & Staube, 2016; Stryker, 2017;
Stryker et al., 2008).
In their extensive report, the 2006 committee proposes that while the original
intention with the castration requirement was that transsexuals should not have
"their own children" after transitioning, as this would cause "a disturbance of
the kinship structures" (p. 170), their wish to uphold the requirement is not based
on a wish to deny transgender individuals children. Rather they (re)produce a
family-building imaginary as they emphasize that:
building a family and living with children - biological or not is for
many people an important part of life. The right to build a-family
is, in accordance with domestic laws, also included in the list of
rights and freedoms covered by the European Convention. This
right has already in the past years been expanded in the Swedish
law in comparison to 1972. ( ... ) With the demand that today exists
in the act on sex change, some individuals are forced to renounce
future parenthood solely because of their gender identity. In our
view, this is unsatisfactory. (SOU 2007:16, p. 184)
Again, activating an imaginary of progress, the 2006 committee, in this way,
reinstalls transgender individuals as citizens with reproductive rights, pointing to
fertility preservation as a way to secure this right to reproduction. In emphasizing
this re-conceptualization; the 2006 committee also notes how, in the 1972 com-
mission's preparatory work, transgender reproduction was not only undesired,
transgender fertility was also imagined as "a theoretical and peripheral issue"
(SOU 2007:16, p. 181)2 because all transgender individuals were expected to dis-
play heterosexuality after tr~ansitioning (meaning that they would not engage in
sex that could enable pregnancies). The 2006 committee further annotates how,
in the imaginary of the 1972 commission, already having children also made a
person's "transsexualism" questionable. Positioning this as an old-fashioned view,
the 2006 committee importantly conceptualizes transgender fertility within an
imaginary of same-sex desire as normal and natural as they write:
However, it has turned out that among transsexuals, exactly like
in the general population, are heterosexuals, bisexuals and homo-
sexuals. Thus, it is not uncommon that a transsexual is together
with a person who belongs to the same sex as he or she does after
the sex change. (SOU 2007:16, p. 18 1)
In this way, the 2006 committee actively disconnects transgenderism from a
previous connotation of being a sexual perversion and abnormality. Notably, the
diverse couplehood relations that can be imagined also call for considerations in
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The Cryopolitics of Reproduction on Ice
relation to how to practice fertility preservation, especially in light of new repro-
ductive technologies. The 2006 committee highlights that there might be some
issues in using the stored gametes that could collide with, for instance, the regula-
tions on double donation and/or surrogacy (pp. 187-188). However, in contrast
to the Danish and Norwegian contexts, to which we turn shortly, this does not
cause the commission to discourage the cryopreservation of eggs from transmen,
but rather to suggest some important precautions, especially in terms of parental
categorization which we will return to in the next section. In comparison with
Denmark and Norway, as we also discussed in Chapters 1 and 3, Sweden has in
general had a less restrictive approach to egg freezing and performed egg freezing
more extensively and from an earlier point in time (Rodriguez-Wallberg et al.,
2015). This is a technological aspect which cannot be disregarded, as this also
means that egg freezing in general is less available in the Danish and Norwegian
context.
Turning to the Norwegian and Danish context, we wish to highlight, how it
is primarily fertility preservation in transmen that is perceived to be particularly
troubling. That is, after the castration requirements were abandoned ;in, respec-
tively, 2014 and 2016, the preservation of sperm in relation to gender` affirmation
treatment quickly became an offer alongside gender affirmation treatment (and,
thus, publicly funded) in both countries (The Danish Ministry of Health, 2014;
The Norwegian Ministry of Health and Care Services 2017, p. 33). Interestingly,
in the first guidelines that were issued in Denmark after the castration require-
ment was abolished, preservation of eggs was also listed as an option to be dis-
cussed in relation to a more overall discussion with the patient of the effects of
treatment on fertility (The Danish Health Ministry, 2014).
However, shortly after, in the updated version of the guidelines that followed
the reconstitution of trans health outside of the psychiatric system in 2017, this
possibility disappeared. In accordance with the WPATH Standards of Care
(Coleman et al., 2011), the patient information sheets, however, still inform about
the effects of treatment on fertility, including hormonal therapy, but the guide-
lines now state that "currently no offer to preserve eggs for later is available" (The
Danish Health Ministry, 2017). The interesting aspect is that while it is techno-
logically possible, even though our fieldwork shows not a lot of unfertilized eggs
are preserved in the Danish health care system, egg freezing in transmen does not
count as medical freezing in the Danish context. Illustrative of this point, in an
email correspondence we had with the Centre for Gender Identity, egg freezing
is framed as expensive and the correspondence notes that currently, only women
with cancer are offered the chance to preserve their eggs. It is further mentioned
that egg freezing might not be necessary since the ovaries are easy to stimulate,
even after many years on testosterone, meaning that if a transman keeps his
reproductive organs, he will be able to have children later in life — even with state-
financed assisted reproduction as we will return to. Finally, the correspondence
highlights the matter of the (il)legality of surrogacy that the Swedish committee
also pointed to. While altruistic surrogacy is not illegal in Denmark, it is not sup-
ported by the legal framework. For example, a notion of intended parents, and,
important in relation to trans fertility, it is not legal for healthcare professionals
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Disturb 133
to assist in gestational surrogacy @ 13 Act on Assisted Reproduction). While the
Danish law was changed in 2018 to allow double donation on medical indication
(Act 1688/2017), the overall point is that the current framework does not support
transmen becoming genetic parents using preserved eggs.
The Norwegian case is further illustrative of how the normative understanding
of kinship and gender shapes the practices of assisted reproduction and comes
to shape transmen's access to assisted reproduction. Already in 2012, a few years
before the abolishment of the castration requirement, the Norwegian Biotech-
nology Advisory Board wrote to the Norwegian Ministry of Health. After a
dialogue with one of the influential Norwegian trans organizations, the board
unanimously recommended to offer transgender individuals cryopreservation of
gametes before gender affirmative treatment. In highlighting fertility preservation
as a matter of equality, they write:
The Biotechnology Advisory Board regards it as self-evident that
no individual is discriminated against because of 'their sexual on
entation or gender identity. Paragraphs 2-11 and 2-17 of the 'Act
on Biotechnology regulates the storage of gametes (gender cells
in Norwegian). Sperm can be stored without limitations other
than that it cannot be used for reproduction after the death of
the depositor. Egg cells and ovarian tissue can be stored
in case a
woman has to go through treatment which can damage fertility,
and
gender corrective surgery must be said to fall within these circum-
stances. Transsexuals have the same right to medical treatment as
any other person, and this dictates that transsexuals should be able
to store their gametes before treatment that can reduce their repro-
ductive capacity. (The Norwegian Biotechnology Advisory Board,
2012, p. 1)
Again, we see how, through progressive principles of equal rights to healthcare,
the Norwegian Biotechnology Advisory Board positions transgender individuals
as obvious candidates for fertility preservation. Additionally, they conceptualized
fertility preservation in transgender individuals as belonging to the category of
medical freezing (see Chapter 2 for a more detailed discussion of the notion of
medical freezing).,
Following this statement, the advisory board turns to the matter of the castra-
tion requirement. First, they point out that "for many years, transsexuals have
met prejudice and discrimination" (p. 1) and that this is, among other things, is
connected to what is experienced as an obligation to have surgery to obtain legal
transitioning. In emphasizing that they look forward to an upcoming debate on
castration practices following an approaching law proposal on discrimination of
transsexuals, the Biotechnology Advisory Board then, surprisingly, points out
that the castration requirement is actually not stated by Norwegian law. Instead
it is "based on a custom at the national register" (p. 1) indicating that, in similar
veins as in the Swedish case, castration is used to uphold a specific order between
legal gender categories and the reproductive capacities of bodies.
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The Cryopolitics of Reproduction on Ice
Notably, on the one hand, the Norwegian Biotechnology Advisory Board
problematizes the restriction of transgender people's reproductive rights, yet
simultaneously emphasizes specific limitations as to how this right can be realized,
at least for some trans individuals. The problem is, as the letter states, that some
"reproductive strategies require the participation of a third party, for instance,
a donor or a surrogate" (p. 2) and that these strategies are not legal in Norway.
Thus, while initially supportive of fertility preservation, they conclude:
To the extent that transsexuals are dependent upon a type of
assisted reproduction which is illegal in Norway, cryopreservation
of gametes and tissue should be defined. Cryopreservation should
also be denied even if the law might be subject to change during
the storage time. (p. 2)
Similar to the 2006 Swedish committee, the Norwegian Biotechnology Advisory
Board does not want fertility preservation in transgender individuals "to'contrib-
ute to a legalization of surrogacy" (p. 2).
In 2016, the same year as Norway changed the practice on legal gender rec-
ognition, the Norwegian biotechnology law was evaluated by the Norwegian
Ministry of Health and Care Services (The Norwegian Ministry of Health and
Care Services, 2017). In the evaluation, the government proposes to uphold that
sperm can be stored in relation to gender affirmation treatment, a practice that
had been instigated by the Directorate of Health by means of interpreting the
Biotechnology Act (The Norwegian Ministry of Health and Care Services, 2017,
p. 33). While the matter of preservation of eggs in transmen is not directly men-
tioned, the evaluation addresses how the lift of the castration requirement has
an impact on how to interpret § 2-2 of .the biotechnology act which states that
assisted reproduction can only
be
performed on
immen
(who are married or liv-
ing in a stable relationship). In spite of the recommendations of a majority of
the Biotechnology Board to ease trans reproduction, the government suggests
upholding that assisted reproduction is done on the basis of the legal sex (The
Norwegian Ministry of Health and Care Services, 2017, p. 33), which means that,
in Norway, transmen who legally transition are excluded from assisted reproduc-
tion, even if they do not medically transition. In contrast to this, the Danish
Parliament decided to amend the health legislation so trans individuals would
still have access to gender specific healthcare (such as breast cancer screening,
etc.), including upholding the access to insemination and IVF through defining a
woman
as
a person with a uterus or ovarian tissue (Bill 198/2014). However, the
prospect of pregnant men also caused controversy among some politicians who,
in the debates, pointed specifically to the troubling of reproductive categorization
as a reason not to change the law.
The examples illustrate how securing options for genetic parenthood after
transitioning are limited for transmen in Denmark and Norway, while Sweden,
at least in principle, allows them to preserve eggs. That is, a more recent Swed-
ish evaluation report, problematizes that the Swedish clinics only offer fertility
preservation to patients who are diagnosed with "transsexualism," disregarding
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Disturb 135
that a number of other trans diagnoses exist in Sweden (SOU 2017:92, p. 586). In
contrast, preservation of sperm is less complicated, testifying to the argument we
made in Chapter 1, that frozen sperm is more easily imagined as mobile as well
as easier to be disconnected from the social category of fatherhood (e.g., in the
case of donor sperm). While this previous section has highlighted the ways that
transmen and women emerge, in the welfare states, as reproductive citizens, in our
next section, we elaborate on how the cryopreservation of trans fertility reorgan-
izes parental categorization and how this troubles the normative gendered order
of reproduction in the Scandinavian welfare state.
4.3.2.
Where Is the Mother? Troubling Reproductive Categorization:
If a person, who has gone through a sex change, becomes the par-
ent of a child after transitioning, he or she will be denominated in
accordance with the current law, despite whether he or she con-
tributed with sperm or egg. (Preparatory work for a new Swedish
law, SOU 2007:16, p. 187)
As illustrated in the previous section, an important aspect of regulating
transgender reproduction, especially in the Swedish'context, has involved uphold-
ing, and thus reorganizing specific categorical orders of reproduction. Arguably,
frozen sperm from transgender women has been less problematized as all coun-
tries already have rather permissive frameworks for donor sperm and increasingly
also for assisted reproduction among non-heterosexual couples. This means that
transwomen can use their sperm with a female partner or "donate" it to another
%
woman whom they wish to parent with. However, as the Swedish 2006 evalua-
tion points out, transgender reproduction requires a new attention to parental
categorization. As the quote above suggests, it will be necessary, in order to avoid
disturbing kinship structures, that a transgender individual who becomes a par-
ent using preserved sperm will be parentally categorized according to their legal
sex. According to the Swedish report, this is easy with transwomen, as the legal
framework already includes the category "parent" which is used for the non-bio-
logical mother in a lesbian couple (SOU 2007:16, p. 188). Similarly, it is asserted
that if a transman provides the egg for a pregnancy in another person, a solution
that, as emphasized, was not legal in Sweden at the time of the evaluation, the
transman should be categorized as the father (SOU 2007:16, p. 187). Since then,
a new law in Sweden has, as of January 2019, made double donation and embryo
donation legal (SOSFS 2009:30), which should, at least in principle, ease genetic
parenthood of transmen who have cryopreserved eggs.
Besides curtailing surrogacy, an important issue in the Swedish 2006 evalu-
ation was also, as already mentioned, to prevent a future in which men would
become pregnant (SOU 2007: 16). To some this is, of course, an overall dystopian
scenario following a more liberal approach to legal gender recognition. Follow-
ing Staunws (2004), the pregnant man can be regarded as a border figure, that is,
someone who challenges the fundamental ordering of meaning and transgressing
social categorization that is fundamental to our social practices. On the political
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The Cryopolitics of Reproduction on Ice
and cultural level, the pregnant man demonstrates the ambivalence of what is
natural, as well as, from a moral perspective, what is right. Additionally, this
disturbance illuminates the social production of the gendered structures along
which our societies are arranged.
In 2008, the image of a pregnant man troubled the heteronormative categories
of reproduction as international headlines broke that US citizen Thomas Beatie
had announced that he was pregnant in the US LGBT magazine The Advocate
(Beatie, 2008). Within a sensationalizing narrative, Beatie is often ascribed to be
the first man in the world to become pregnant, which arguably made invisible that
transmen have always had children, though not being legally recognized as men.
Nevertheless, Beatie's bold act to go public with his story created a lot of public
attention. Having transitioned a few years earlier, Beatie had not had modifying
therapy on his reproductive organs since this was not important to his sense of
self and because he always wanted children. Initially intending to use a surrogate,
Beatie ended up deciding to carry the pregnancy himself as'his,partner Nancy
could not because she had had a hysterectomy due to 'endometriosis a decade
earlier. In his own account, Beatie (2008) describes how their choice to have him
carry the pregnancy caused a lot of confusion in people as well as how it made
medical professionals reject them, apparently activating the yuck factor.
Following the abolishment of the castration requirement, similar stories have
surfaced in the Scandinavian context. Since the removal of the castration require-
ment, both Denmark and Sweden have seen several cases of people with male ID
numbers who have become pregnant. In the context of the Scandinavian welfare
state, male pregnancies cause a specific kind of problem as the public healthcare
system is organized around a social security number that, in all of the countries,
is gendered. Through having a digit that signals whether you are male or female,
transgender men have had problems with being registered within the prenatal
care system, as this only allows for female ID numbers (e.g., Carlen, 2015; Dam,
2018; Erichsen, 2018). Overall, the Scandinavian healthcare systems have been
found not to be specifically inclusive of people who do not adhere to conventional
norms of heterosexuality and nuclear families (e.g., The Aids Foundation, 2017;
Klittmark, Garzon, Andersson, & Wells, 2019; Rondahl, Bruhner, & Lindhe,
2009;
Tved,
2019). As the following quote from
Mikkel,
a transman, illustrates,
it is not necessarily easy to be a pregnant man in the Danish health care system:
My experiences with the healthcare system have been mixed. I
have met a doctor who was insecure and scared when he talked to
me about the pregnancy, and then I am treated with respect and
curiosity by the midwife who follows me. And curiosity is perfectly
fine, if it means that you ask questions and do not treat me like a
freak. I understand that I am different from what they are used
to. But I still want to be treated with respect.
(Mikkel,
in Danish
Newspaper Politiken, Erichsen 2018)
Mikkel's account illuminates how the pregnant. man is often infused with a
monstrosity, in similar ways as the 50+-year-old woman who becomes an old
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Disturb 137
mother using cryopreserved eggs. Pregnancy in men also challenges the very fun-
damental connection between gender and birth as it fundamentally destabilizes
the cultural imaginary that everyone has a mother — an imaginary already desta-
bilized through gay men's surrogacy practices. However, trans fertility imposes
a new situation in which a baby can have no mother, and also
not be born
of a
woman — to rephrase the title of Adrienne Rich's (1976) influential feminist book
on motherhood.
Until 2019, where Sweden, again as a first in Europe, changed its law, all of
the Scandinavian countries have ascribed to the
mater senper certa est
principle
(TGEU, 2019x, The Swedish Justice Department, 2018). Not specifically aimed at
transgender people, this principle states that the woman giving birth is always the
mother of the child (ACT 1981-04-08-7 (NO); Act 1257/2018).8 As also pointed
out by Bremer (2011, p. 192), this means that, according to the law, a pregnant
man is not possible and trans people have been categorized as parents in relation
to their reproductive organs. The trans exclusive nature of these 'conceptualiza-
tions has already been problematized by several trans people who have brought
action against both the Danish and the Swedish states to have their; legal gen-
der recognized by the state in relation to their children. _Interestingly, in Swe-
den, where the gender trouble trans reproduction would produce was recognized
already in the 2006 evaluation, there has not been political support to change this
part of the legal framework until 2018 (brought into effect in 2019).
The debates around parental categorizations testify to how, even though trans
fertility destabilizes specific relations between gender and reproductive capacities,
transgender reproduction can rather easily be legally reorganized to fit norma-
tive frameworks of kinship in which men are fathers and women are mothers.
As long as trans reproduction is practiced in relation to a binary understanding
of gender, it does not as such challenge the gendering of parenthood, though
it does disturb certain notions of the normal and the natural. Entangled with
cryopreservation, trans fertility clearly also holds a normalizing potential where
transgender individuals become culturally intelligible through their participation
in reproduction (Dahl, 2018; Edelman, 2004). On the other hand, as a cybor-
gian border figure, the reproductive transgender person is also, as Staunaes (2004)
points out, a resource of imagination that enables the reimagination of a field.
As cryopreserved eggs come to constitute genetic fatherhood, and frozen sperm
is stored to be used in a future female partner, the gendered connotation of gam-
etes will be significantly challenged. Notably, in the Scandinavian languages, gam-
etes are often referred to as "gender cells," which, according to Holm and Bulow
(2011), is interrelated with the role early endocrinologists in the Scandinavian
countries believed them to have in the hormonal production. As also highlighted
by Armuand et al. (2016) in their aim to establish new standards of care for fer-
tility preservation in transgender individuals, the reimagining of trans people as
$
Obviously, the
mater semper certa est
principle also impacts the use of surrogacy
in the Scandinavian countries, that consequently do not operate with the idea of
intended motherhood.
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138
The Cryopolitics of Reproduction on Ice
reproductive citizens calls for a new language of reproduction and the bodily
parts and processes involved. Transgender reproduction can be disturbing to soci-
etal norm, but being enrolled in the cisnormative structure of fertility care can
also be disturbing to the trans individual. In order to ease the gender dysphoria
and distress related to this, Armuand et al. (2016) stress that:
it is important to use non-gendered words as far as possible, such
as "bleeding," "gametes" and "pelvic examination" instead of
"menstruation," "eggs" and "gynaecological examination," and to
use the right pronoun. The latter can easily be achieved by simply
asking the individual which pronoun is preferred. (p. 388)
In this way, the biomedical community is taking part in the reconceptualizing and
de-gendering of the social world of reproduction and fertility preservation.
5. Summary
In this chapter, we have discussed how cryopreservation technologies come to dis-
turb specific social categorizations and moral understandings of how the world
ought to be. By centering phenomena that transgress the normative boundaries
of age, generational kinship order, and gender, we have sought to tease out the
normative frontiers of cryopreservation technologies and fertility preservation.
Through examples that cause controversy and ethical debate, such as reproduc-
tion in postmenopausal women or women
who
preserve embryos to enable their
children to have children, we have illuminated and critically discussed how vari-
ous cultural values and biases render these practices meaningful or wrongful in
various settings.
Through our discussion
bf
transgender fertility, we have further tried to under-
line how these disturbances of the social order are not only producing judgement
and regulation, but also creating a space where reordering and re-conceptualizing
takes place. This points to how the ability to reorganize reproductive time offered
through cryo-technologies has monstrous potentiality, destabilizing and chal-
lenging our sense of what is (un)natural, of what is morally acceptable and who,
from a legal point of view, should have access to fertility treatment by means of
cryopreservation.
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Conclusion
We conclude by returning to the Scandinavian sociotechnical imaginaries on cryo-
technologies and the cryopolitics of reproduction, as they unfold in our material
and within the Scandinavian context. As noted in our introductory chapter, the
concept of sociotechnical imaginaries helps reveal how technological accomplish-
ments are always embedded in particular practices as well as within a "reservoir
of norms and discourses, metaphors and cultural meanings" (Jasanoff & Kim,
2009, p. 123). To highlight the ways that Scandinavian cryo-practices
(law,
ethics,
clinical practices, popular culture, marketing material, user accounts, and medi-
cal expertise) entangle to produce different sociotechnical imaginaries, we return
to our introductory quest and highlight our response to the following question:
How do the values embedded within our empirical material produce different
sociotechnical imaginaries on cryo-technologies in the Scandinavian countries?
While the Scandinavian countries share a somewhat common history, the
responses to cryo-technologies have, as we have shown, by no means been uni-
form. In the case of Denmark and Norway, for example, the cryopreservation
of Danish and Norwegian women's egg cells for non-medical reasons, as we
have explained in Chapters 3 and 5, continues to evoke troublesome imaginaries.
Meanwhile, in the case of disease or, in the exporting of Danish sperm, cryo
evokes national pride and protection (see Chapters 1 and 2). Moreover, contin-
gencies in the regulatory developments establish very different reproductive prac-
tices and pathways. In the case of Denmark, regulatory developments initially
only sought to regulate the medical clinical practices and inadvertently, there-
fore, made room for the development of commercial sperm banking and global
exporting (Chapter 1). Meanwhile, Norway has continued to reiterate, in its strict
legal framework, a technology to be tamed perspective (Melhuus, 2012). Thus,
Scandinavian nation state responses to reproductive technologies reveal very dif-
ferent sociotechnical imaginaries framing and shaping how reproduction should
or should not take place. Throughout this conclusion, we first provide a brief
summary of our key findings and then, engage in the ways that cryo invokes
different national imaginaries and collective responses.
But first, a brief outline of the ways that cryo-technologies and frozen matter,
in the five chapters, achieve value. Clearly, cryo-technologies engage, as we have
shown, Scandinavian imaginaries very differently. In Chapter 1, we revealed how
The Cryopolitics of Reproduction on Ice:
A New
Scandinavian Ice Age
Emerald Studies in Reproduction, Culture and Society, 139-147
Copyright
©
Authors, 2020
doi:10.11081978-1-83867-042-920191008
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The Cryopolitics of Reproduction on Ice
a gender-stratified market in cryopreserved reproductive cells has emerged. In
sharp contrast to cryopreserved Danish "Viking" sperm, which has emerged as an
export commodity, Scandinavian women's eggs are kept "at home," domesticated
and at times even disciplined as inherently belonging to the woman that they
come from (notably in the case of Norway). Scandinavian women's egg cells are
regulated differently than men's sperm cells, enabling Danish sperm, unlike Dan-
ish women's eggs, to entangle with globalized consumer logics. For an overview of
the time limits set for reproductive material, according to the different laws of the
Scandinavian countries, see Figure 1 in the Introduction to this book.
Whereas Chapter 1 delineated the legal and cultural normativities involved in the
making and non-making of a market in cryopreserved reproductive cells, includ-
ing the ways that a global market in cryopreserved sperm has been produced in
Denmark, in Chapter 2 we turned to fertility preservation as a cryo-technological
response to disease. The chapter featured analyses of both the old cryo-technologies
of sperm depositing, as it is undertaken by primarily Danish men, as well as
new technological practices involved in the cryopreservation of young girls' and
women's ovarian tissue. Narrated within imaginaries of technological progress
and possibilities, sperm deposits and frozen ovarian tissue became a form of
cryo-insurance, positioning the individual as having a (reproductive) future and
reinstalling their reproductive choices. In this 'chapter, what we discussed as "the
good life" got interwoven with new biomedical practices of anticipation and risk
prevention as well as with normative understandings of always working toward
having a reproductive future. While frozen cells and tissue have reproductive
potential, the frozen matter additionally, in Chapter 2, gained potentiality when
seen as (re)establishing particular gender identities such as that of "feminine"
women and "masculine men: As exemplified in Chapter 2, cryopreserved ovar-
ian tissue and reproductive cells entangle, with normative understandings of indi-
viduals desiring future genetic offspring, and thus, cryopreservation becomes an
anticipatory and gendered practice associated with reproductive futurity.
In Chapters 2 as well as 3, we critiqued yet, paradoxically perhaps also main-
tained the distinction between medical and non-medical freezing. While we,
in _large part, considered this distinction problematic (see Chapter 2), and in
many ways in itself a sociotechnical imaginary, we nevertheless argued that this
division, within the Scandinavian welfare states, is a productive and important
analytical distinction. Whereas freezing for medical reasons is paid for by all of
the Scandinavian welfare states, freezing for what is seen as non-medical rea-
sons is, at times, conceptualized as "unnecessary," becoming instead animated,
in particular, in the case of Denmark and Norway, as an individualized repro-
ductive (consumer) choice. As such, freezing is, in the context of Denmark and
the preservation of eggs, limited to a five-year cryopreservation period while,
in the case of Norway, not possible at all. In Chapter 3, we in fact prioritized
the imaginaries that freezing for non-medical reasons invoked, such as under-
standings of reproductive autonomy as well as concerns related to market
coercions that might capitalize on women's reproductive desires and uncertain-
ties. While we chose to label the chapter "Delay," we also remained critical of
this terminology and discussed the ways that the cryopreservation of women's
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Conchision 141
reproductive cells deconstructs a normative temporal kinship order. Not only
may older women, if they have cryopreserved their oocytes, opt for mother-
hood at an advanced (potentially monstrous) age (see also Chapter 5), in the
imaginary of rightly timed kinship, women who freeze were seen as bringing
their reproduction "back on track." In this manner, traveling to Sweden (where
egg freezing for non-medical reasons is not illegal), for example, to freeze one's
oocytes becomes exemplary of engaging in a reproductive and perhaps even
responsible anticipatory logic.
Our final two chapters centered, in more detailed ways, on the ways that cryo-
technologies, in the Scandinavian context, become cryopolitical interventions.
Cryo-technologies enable individuals to preserve the latency of reproductive tis-
sue and cells yet simultaneously, also coproduce various forms of disturbances
which we illuminated through the legal, political, ethical and social controver-
sies they cause. Notably, in Chapter 4, cryo-technological interventions were
discussed in light of the use of sperm posthumously as well as in the case of
the destruction of cryopreserved embryos. While the chapter discussed how life
and death, through the lens of these two cases, become calibrated, 'Chapter 4
also highlighted how sociotechnical imaginaries of Dr Frankenstein, in practice,
reconfigure imaginaries of families in the freezer. Meanwhile, Chapter 5 elabo-
rated on the notion of disturbance and how fertility preservation challenges
central social categorizations with respect to reproductive age, the generational
order of kinship and gender. Through an elaboration of the discussion of repro-
duction in postmenopausal women (also addressed in Chapter 3), the chapter
highlighted the ethical arguments that have shaped the Scandinavian attempts
to restrict assisted reproduction within a woman's "natural" reproductive life-
time. Similarly, the chapter examined the legal and ethical discussions that form
the basis for prohibiting generational kinship disorder enabled by the ability of
cryo-technology to, for instance, allow a mother to preserve embryos for her
own children to cu.ry.,While reproductive aging and generational disorder have
been contained in the Scandinavian context, in Section 4.3 of Chapter 5, we
delineated how transgender individuals have emerged as reproductive citizens in
need of fertility preservation. This is in spite of the imaginaries in which trans
reproduction destabilizes the symbolic order between gendered categories and
reproductive practices. In critically discussing how imaginaries of progressive-
ness and reproductive autonomy have supported the conceptualization of trans
individuals as cryogenenic agents, within the Scandinavian welfare states, we
further highlighted the values and normative regulations that have eased the
preservation of sperm from transgender women. The regulations concerning
the preservation of eggs and ovarian tissue from transmen are, as we revealed
in this chapter, complicated and even restricted in Denmark and Norway. As a
consequence, in Chapter 5, we argued that while much of the legal and concep-
tual work undertaken around transgender reproduction has sought to restore
normative binary logics of gender and parenthood, transgender reproduction
also subverts the traditional meaning of important social categories in ways
that significantly destabilize traditional imaginaries of "natural" correlations
between gender, reproductive cells, and parenthood.
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142
The Cr yopolitics of Reproduction on Ice
Having briefly summarized our key findings, we turn now to a discussion of
Scandinavian reproductive cryopolitics including the ways that cryo, in particular,
entangles with Scandinavian ideals on family formation.
1. Scandinavian Repro
-
Cryopolitics
As noted throughout this book, cryopolitics engages in a "critical reflection"
(Radin & Kowal, 2017, p. 4). It involves contextualizing cryopreservation in lieu
of the "intensification of the management of life" (Kowal & Radin, 2015, p. 68)
and what Friedrich (2017) calls the "economy in cold" (p. 65). This involves cryo-
therapy chambers, cooling containers, transportation networks; liquid nitrogen,
dry ice, clinical expertise as well as the circulation of global capital and the devel-
opment of biobanks (Bravo, 2017; Friedrich, 2017; Parry, 2004). These are tech-
nologies that help produce modern and "cooled states" (Bravo, 2017, p. 29) along
with markets and cultural imaginaries of ice as rescue technologies. For exam-
ple, cryopreserved gametes enable IVF treatments to unfold without the delicate
synchronization of provider and recipient bodies, while cooling technologies are
at the core of the global trade in reproductive cells, organs, and tissues. As evi-
denced throughout the different chapters, however, the Scandinavian countries
differ- in important ways. In this first part of the section discussing Scandinavian
cryopolitics, we return to the key distinction between freezing for medical and non-
medical reasons, and then continue our discussions with considerations related to
an imaginary of family formation.
In the moral distinction between freezing for medical and non-medical pur-
poses, medical freezing becomes articulated as morally more important than freez-
ing for non-medical reasons. In :line with this way of thinking, people who suffer
from an illness are culturally understood
as
worse off than others through no fault
of their own. Within the context of the Scandinavian welfare states, this gives these
individuals a claim to compensation on account of "justice," a claim which those
who are not sick do not have access to. As argued by, for instance, Lamont and
Favor (2017), in a welfare context, people who are worse off than others, through
what gets framed as at no fault of their own, have a claim to compensation. Con-
sequently, people who need fertility preservation for medical reasons are seen as
not themselves responsible for the risks associated with losing their fertility. This is
in contrast to people who do not currently have what, in this imaginary, becomes
a medical reason `to preserve their fertility. In contributing to the reiteration of
this distinction to be meaningful, the Danish Council on Ethics (2015, p. 7) states
and in reference to what they see as non-medical freezing: "It is to a larger extent a
matter of personal choice" compared to freezing due to sudden disease.
In this Scandinavian imaginary, the state is seen as having a stronger obliga-
_tion to help patients as opposed to non-medical freezers. However, from a moral
point of view, this does not preclude that the state could have some obligation to
aid non-medical freezers. Especially considering the fact that in a welfare state
with publicly funded ARTs, people who opt for "non-medical" freezing, and end
up using their frozen eggs in fertility treatment down the line, will end up paying
for some part of their fertility treatment compared to patients with less foresight
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Conclusion 143
who will not end up paying for treatment (Mertes &
Pennings,
2012). Accord-
ing to Mertes and
Pennings
(2012), if freezing for non-medical reasons receives
partial coverage, then the health care system only gets involved when a medical
problem immediately presents itself. At this point, the patient is indistinguishable
from other patients requiring fertility treatment. While this model may appear
logical and morally unproblematic, it is arguably not fair toward the individu-
als who opt for freezing their eggs, as they end up paying for some parts
of
their
fertility treatment that other patients in fertility treatment do not have to pay for,
merely because they had the foresight to freeze their eggs (Mertes &
Pennings,
2012). What might instead be offered as a full coverage model increases equality
and fair access to cryopreservation technologies, but clearly, in the context ;of a
welfare state, lays claim to valuable public resources.
The distinction between medical and non-medical freezing persists as a
dominant imaginary in all of the Scandinavian welfare states, and the material
additionally reiterates and draws upon an imaginary of Scandinavian exceptional-
ism. Because of the ways that ideas of a gender-equal and technologicallyp'rogres-
sive Scandinavia persist in the material, we also wish to embed these imaginaries
critically within feminist theorizing of "exceptionalism" (e.g. Nebeling, Petersen,
Krolokke, & Myong, 2017; Puar, 2007). Briefly, whereas Browning (2007) shows
how the concept of "exceptionalism" has become, integral to the construction of
a Nordic brand, feminist scholars such as Puar (2007) document how nations can
be "exceptionally" heteronormative and xenophobic, even as they claim to be
"exceptionally" tolerant. According to Puår (2007), claims to exceptionalism are
frequently loaded with normative understandings related, for example, to gender,
sexuality, and race. In Chapter 5, for example, we discussed how fertility preser-
vation in relation to gender affirmation treatment becomes culturally intelligible
only when transgender reproduction is (re)organized along normative lines of
specific relations of binary gender categories. Accordingly, exceptionalism can
be seen as a discursive framework as well as a smokescreen for the re-enactment
of normative values associated with who, how and when individuals can repro-
duce (Loftsdottir & Jensen, 2012; Nebeling, Petersen et al., 2017). A similar
understanding or critique
of
Nordic exceptionalism is present in Loftsdottir and
Jensen's (2012) analysis of postcolonialism and whiteness in the Nordic countries.
To them, exceptionalism illustrates the ways that the Nordic countries are made
to appear exceptional (epitomized as peace-loving and gender-equal nations, for
example) yet, through this filter of exceptionalism, also blind as well as resist-
ant to self-examination of the ways that, for example, legal frameworks stipulate
normative understandings of, in this case, reproduction.
While the Scandinavian cryopolitics have been guided by the above distinc-
tions, embedded in an imaginary of Scandinavian exceptionalism, reproduc-
tive technologies have consistently been conceptualized and organized through
politico-legal processes that privilege and uphold the imaginary of family forma-
tion as a social good. This is notably the case in Parliamentary debates yet also
co-opted amongst other cryogenic agents such as prospective parents who simply
wish to be able to start their "own family." Briefly, and as also documented in
a more historical account of the welfare state, the welfare state first saw family
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The Cryopolitics of Reproduction on Ice
building as nation building when conceptualized as a social-democratic project.
The introduction of free education, flee healthcare, and a rights-based social wel-
fare system was costly and created an interest in the "quality" of the nation's
population (Koch, 2006). The 1930s saw the introduction of coercive eugenic leg-
islative measures introduced with support from the full political spectrum but
also the first reproductive freedoms. While abortion was generally viewed as mor-
ally repugnant, abortion, in the case of fetal disease or malformation, became
legalized — even discursively conceptualized as morally sound and a civic duty.
Making healthy, able and self-reliant families then became the normative basis for
the welfare state. For example, in the 1970s, even though autonomy and eman-
cipation was at the forefront of public debate, the government's main reason for
legalizing on-demand first trimester abortions, given in the Bill's supporting com-
ments, was to safeguard women. The government recognized that abortions took
place, but in clandestine and unsafe conditions, thus putting women at risk and
families at risk of losing their mother. The first trimester limit is even legiti-
mized with data material from the 1960s which had shown that the medical risk
for the woman undergoing the surgical abortion procedure increased after week
12 (Herrmann, 2005).
During this time period, the legalization of abortion then became an act of a
moral state — a caretaker of families. The focus on fåmily formation became, early
on, key to the regulatory model on reproductive practices;
As
assisted reproductive
technologies entered the clinics in the late 1980s/early-1990s, the use of donated
sperm by clinicians aligned itself along another family formation logic. During
those early years, sperm donation was anonymous and untraceable; a 1992 work-
ing group set up by the Danish ;Ministry of Health reiterated the fundamental
arguments behind the practice of anonymity in their report (1992), that considered
it timely to discuss if anonymity was still an appropriate principle to uphold in
Denmark since the adoption of a new law in neighboring Sweden in 1985 giving
the child a right to any information about the donor recorded in the medical files.
The reasoning behind anonymity in donation was tied to the purpose of providing
insemination as a fertility treatment. It was, however, also to reiterate an under-
standing that a child's upbringing, and place in the family, ought to mirror what,
at that time was considered, as normal and natural a way as possible (Herrmann,
2013). Making families as an argument was cemented as anonymity was enshrined
in the,first Danish, Act on Artificial Reproduction in 1997.
Against this historical backdrop, making families has similarly been employed
as a key sociotechnical imaginary as far as cryopreservation is concerned. The
making 'of the nuclear family was key to arguments aimed at lengthening the.
Danish Act's cryopreservation limit for eggs and embryos in 2006 to 5 years. This
lengthening was aimed to allow couples enough time to come back and use stored
eggs and embryos effectively in the creation of the nuclear family (Herrmann &
Kroløkke,
2018). Similarly, the making of "own" families is, as we have shown,
at the heart of interviews with Danish women and men who have deposited their
reproductive cells or tissue. Meanwhile, although family formation has also been
at the center of Norwegian practices and regulations, the concerns of technolo-
gies to be tamed have led to more rigid regulatory responses. We saw this, for
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Conclusion 145
example, in the accounts detailing women traveling to Sweden for elective egg
freezing (Chapter 3) as well as in the material with Norwegian men going to
Denmark for sperm deposits (Chapter 2). It is noteworthy, however, to reckon
that the Norwegian welfare state came into being two decades after neighboring
Sweden and Denmark. As a result, in the case of Norway, collective and indi-
vidual interests entangle very differently. Whereas the social welfare state has
provided Scandinavian citizens with a foundation for individual autonomous
reproductive desires and wishes to unfold, the state is also moralistic or moraliz-
ing, positioning assisted reproductive technologies, in this case cryo-technologies,
to be tamed. Meanwhile, concerns related to gender equality and a deeper trust
afforded to the medical scientific community characterize, as we have shown, the
Swedish case. This is notably the case with freezing for non-medical reasons as
well as in the case of fertility preservation for transmen, where Sweden has taken
a more liberal approach by viewing cryo-technologies as enabling' women as well
as transmen the ability to preserve their reproductive cells (Chapters 3 and 5).
Theorizing the in-betweenness produced by cryopreservation we have, through-
out the book, shown how cryo de- and re-stabilizes normative understandings
of reproductive temporality as well as, at times, invigorates in particular Danish
debates associated with Dr Frankenstein or the monstrous potentialities of new
technologies. This was readily the case in Chapter 2, when ovarian tissue preserva-
tion becomes seen as a rescue technology enabling young women to fulfill their
(rightful) desire for maternity while it, iii the case of posthumous reproduction,
produced concerns related to Dr Frankenstein's technologies. Meanwhile, our
qualitative studies reveal how individuals themselves negotiate cryo-technologies
to fit within quite normative understandings
of
reproductive citizenship includ-
ing the reproduction of genetically "own",,children. In Chapter 4, for example,
women negotiated their cryopreserved :embryos to fit within quite normative
family kinship hierarchies conceptualized as siblings rather than a collection of
cryopreserved reproductive cells. By imagining the technologies within a heter-
onormative symbolic order of kinship, family, and love, the technologies (and
the concrete embryos) are domesticated and the dystopias of Dr. Frankenstein
are bypassed. Clearly, cryopreservation produces, as we have shown throughout
the book, suspense and moral drama. In transgressing boundaries between life
and death, cryo-technologies engage in liminal politics. They are tamed, albeit
differently, throughout the Scandinavian region. Whereas a domestic as well as
international market in sperm, in Denmark, for example, naturalizes the ways
that cryopreserved sperm moves transnationally, in the case of cryopreserving
eggs for non-medical freezing, imaginaries of reproductive autonomy co-exist
with cultural and political concerns related to the rightful timing of kinship as
well as fertility preservation in relation to gender affirmation treatment.
The notion of cryopolitics has, throughout this book, assisted us in theorizing
the political and regulatory attention in which reproduction, in the Scandinavian
countries, finds itself. Because cryo-technological intervention is highly contex-
tual and thus, intervenes differently, the concepts of liminality and temporality
help to reveal the ways that the imaginaries of cryo-technologies are constantly
negotiated and re-negotiated. While this is not surprising, of-course, in centering
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The Cryopolitics of Reproduction on Ice
Scandinavian repro-cryopolitics, we have prioritized particular cultural contexts.
Notably, as we also revealed in our introductory chapter, the Scandinavian wel-
fare states are redistributive and provide a wide range of benefits and services as
citizens' entitlements with the aim of creating a more egalitarian society (Leira,
2002, p. 32). This includes, but is not limited to, paid parental leave, affordable
childcare centers, child support to single parents or lower-income families as well
as free education, healthcare and financial provision for students, pensioners and
the unemployed. The welfare state is thus based on a fundamental contract of
mutual financial support between the different generations organized through a
system of redistributive taxation; grand-parents have paid for education, child-
care and healthcare for their children who in turn support them in retirement
through the world's highest taxes. Cryopreservation potentially disrupts this gen-
erational temporality. Such disruptions are understood as monstrous. As noted
by Cooper (2008), in the welfare state, women must dutifully manage their repro-
ductive abilities in order to reproduce not only the family but; in fact, the nation.
This logic is similarly apparent in how generational temporality and reproductive
order entangle in the welfare state. Domesticating the technologies, thus, includes
reframing and re-ordering repro-cryopolitics within the generational contract,
the family and the structural gendered order of heteronormativity.
2. Final Thoughts on Methodology
To acknowledge the differences amongst the Scandinavian welfare states as well
as the complexity of our empirical material, we briefly expand upon our
comparative method (Jasanoff & Metzler, 2018). As noted by Jasanoff and
Metzler (2018, p. 7) in what they develop as "comparative problematization,"
engaging a comparative method furthers analyses of the ways that technologies
and technological practices emerge as well as become contested:
This approach presumes that nation-specific imaginaries of
ordered state-society relations (alternative constitutionalisms)
come most sharply into view when the matter in question is
not simply how to apply extant rules to a novel constellation of
facts but to determine whether rules are needed at all and, if so,
which ones apply in the particular context. (Jasanoff & Metzler,
2018, p. 7),
Similarly to Jasanoff and Metzler's (2018) goal of comparing different rules and
practices related to reproductive matter, we have prioritized the ways that cryo-
technologies produce different legal, commercial, and ethical responses within
the Scandinavian countries. Yet, unlike their approach, we have, throughout this
book, gone beyond state-society relations and prioritized ethnographic and large
interview accounts that detail cryogenic user accounts which help reveal the jux-
taposition between more official or macro-level concerns like those found in the
legal regulations and, at times, articulated by different ethical councils related
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Conchrsion 147
to cryo-technologies, compared to the ways that cryogenic agents make sense of
cryo-technologies as promissory technologies of future genetic kinship.
Accordingly, we have methodologically followed how different imaginaries
concerning family formation emerge and effectively, at times, reconfigure, circu-
late and shape the everyday practices and legal regulation of fertility preservation.
The comparative approach has, in this regard, been useful. It enables analysis
of how imaginaries emerge and change as technologies and practices develop as
well as how they inform what becomes seen as desirable or even prohibited. The
shared focus on imaginaries has provided us with the ability to engage in ana-
lytical incisions, centering how collective imaginaries become entangled in norms,
cryo-technologies, regulations and ethical debates.
Clearly, sociotechnical imaginaries circulate across different empirical arenas
from the development of regulations, ethical and political debates to the practices
involved in the medical freezing of gametes and tissue. In her own work, Jasa-
noff centers empirical material such as legislation and political debates, which
would typically be perceived to be macro-level. Throughout this book, we have
sought to illustrate what can be gained by pushing the conceptual use of the term
sociotechnical imaginaries
to also include analysis of imaginaries at what might
be referred to as the micro-level. While cryo-technologies are indeed regulated at
the macro-level of the state and markets, they also, in very physical and concrete
ways, entangle with bodies that freeze as well as those who have bodily material
stored.
In our choice to center different forms of cryogenic agency, a focus on this
micro-level is necessary for other reasons as well: Not only does it help reveal
how three similar welfare states end up developing very different policies and
practices over time, but it also tells us something about how the users of cryo-
technologies experience and think about these techniques. Furthermore, this
approach speaks to our. initial ,interdisciplinary methodology. We believe that
competencies in law, ethics, sociology, cultural studies, feminist studies, and STS
are all necessary in order to get. a fuller understanding of what is at stake as cryo-
technologies of human 'gametes and tissue are developed and implemented in,
for our purposes, the Scandinavian welfare states. This is also why we have meth-
odologically, included and ourselves produced very different empirical material
such as interviews with women and men that have cryopreserved and stored eggs,
sperm, embryos, 'and ovarian tissue, legal briefs, media debates, reports from ethi-
cal councils, commercial material, webpages and more. In this manner, our inter-
disciplinary contribution goes beyond the specific analytical incisions of disease,
delay, death, and 'disturb. In elaborating on Jasanoff's notion of sociotechnical
imaginaries as unfolding at both the macro- and the micro-level, we broaden the
scope of this methodology and reveal the importance of micro-level perspectives
on cryo-technologies.
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Appendix: Empirical Work
In this appendix, we describe in more detail the empirical studies and sources upon
which the analyses in this book are based. While the empirical data transcend sev-
eral disciplines and research fields, we commonly rely on what can be conceptual-
ized as more interpretative approaches. This means looking into how meaning
is produced and negotiated in, for example, legal documents, white papas from
national parliaments as well as advisory ethical councils and news media. Addition-
ally, the book features new qualitative studies centering the accounts the people
who cryopreserve their reproductive materials as well as ethnographic observa-
tions in different clinical settings in Denmark. The following sections specify the
approach, within the different strands of empirical research,, while a more,overall
discussion of the value of interdisciplinary analysis can be found in the introduction
and the conclusion of the book.
1. Empirical Work and the Legal Dogmatic Method
In the case of our legal analyses, we employ a legal dogmatic method to identify
the relevant legal sources that regulate the freezing-and use of reproductive cells
(identification of the legal Acts and regulation which
apply
to the facts before us).
In the case of Denmark Bills, Acts, preparatory comments, Ministerial Orders,
and guidelines have been identified by use of the official databases for legal
resources www.retsinformation.dk and www.folketingetAk. Public consultation
documents; that is, early versions of Bills and public consultation responses can
be accessed via https://hoeringsportalen.dk/. White papers have been accessed
via https://www.foxylex.dk/betaenkninger/ or in their printed book form. Bills,
Parliamentary readings, and adopted Acts dating from before digitalization have
been accessed via the printed publication
Folketingets Forhandlinger.
We have
been granted access to unpublished parliamentary documents through a visit to
the archives of the Library of the Danish Parliament. Judgments are not pub-
lished in an official database; all Supreme Court judgments and a selection of
High Court judgments are published in the weekly law journal
Ugeskrift
for
Retsiwsez.
Judgments from local city courts are not published. We have been
granted access to a number of relevant unpublished judgments; possible bias in
this respect is that we have relied on media coverage and professional networks to
make us aware of relevant cases before the Courts. Likewise, decisions and public
administrative files that are not publicly available have only been accessed in so
far as we have been aware of their existence and granted access to them under
freedom of information decisions.
Norwegian legal sources have been identified through the databases https://
www.rettsdata.no/ and https://Iovdata.no/pro with the latter being the publication
channel for all Norwegian Supreme Court and High Court judgments but only
some local city courts judgments.
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150
The Ciyopolitics of Reproduction on Ice
Swedish parliamentary documents, Bills, and Acts have been accessed via the
official databases https://www.riksdagen.se/sv/Dokument-Lagar/ and https://
lagrummet.se/. Not all judgments are published, but those that are can be accessed
via https://pro.karnovgroup.se/.
One of the most widespread methods in comparative law methodology is func-
tionalism which focuses on the ways in which different legal systems resolve the
same legal problem (Zweigert & K6tz, 1998). However, there is an inherent poten-
tial for sample bias when conducting comparative legal analyses or identifying
the law and administrative practices of a foreign legal system. In the words of
Geertz (1983, p. 216)
a comparative approach to law becomes an attempt to formu-
late the presuppositions, preoccupations, and the frames of
action, characteristic of one sort of legal sensibility in terms of
those characteristics of another. Comparative law should ideally
not only be based on the law in books but also on the law in
i
action.
Despite, being a relatively homogenous region with legal systems that belong
to the same legal family, there is none the less the potential for sample bias in that
a legal scholar from a different jurisdiction will only reach the "law in the books"
level and not the "law in action" level. Herrmann has been responsible for the
legal contributions assisted by law students Stephanie Nazalee Lynn-Atife and
Laura Danielsen.
2. Empirical Work
in
Applied Ethics
When we identify, systen~åtize and reconstruct the ethical attitudes and argu-
ments, that can be found in many of the imaginaries concerning cryopreservation,
we collect material from
a
wide variety of sources:
First, we identify and;
for
example, critically discuss attitudes and ethi-
cal arguments that are based on the reports of the national ethical councils in
Denmark, Sweden, and Norway, that has to do with assisted reproduction and
cryopreservation. Our focus for these councils is narrowed down to the period
1995 until the time of writing, primarily because little easily accessible and
internet based material exists before 1995. Assess to the Danish reports that
have been used in this book is from the following website: http://www.etiskraad.
dk/. Although some of the reports from the Danish Council on Ethics is
translated into English (http://www.etiskraad.dk/english), unfortunately
none of the reports that deals with the ethical attitudes and arguments that
we present and discuss in this book are translated. From Norway we have
used material from The Norvegian Biotechnology Advisory Board (http://
www.bioteknologiradet.no/temaer/assistert-befruktningl), again little material has
been translated into English and those reports that have been translated, are of
no direct interest for our work on this book (http://www.bioteknologiradet.no/
temaer/assistert-befruktning/. Material from Sweden is based on reports from
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Appendix 151
the Swedish National Council on Medical ethics http://www.smer.sen, again lit-
tle material has been translated into English and those reports which have been
translated are of no direct interest to our book (http://www.bioteknologiradet.no/
temaer/assistert-befruktning/). Second, some of our discussion on different imag-
inaries are based on our own empirical studies concerning, for example, attitudes
on maternal age or social freezing. Third, we have taken into account research
literature within applied ethics and bioethics. We have here used the database Phi-
losopher's Index and Google Scholar — our keywords/phrases have, for example,
been "ethics and money/markets," "ethics and social freezing," and "ethics and
older mothers." Finally, we have made use of attitudes and arguments in the pub-
lic debate. The material from the public debate, is in no way representative,
but
we
have often used it as cases in order to make an illustration of ways in which one
can imagine cryopreservation.
Moreover, in critically analyzing the moral values and moral principles
embedded in the sociotechnical imaginaries on cryopreservation, in the anal-
ysis of ethical documents, Petersen and Hansen have relied on John Rawls'
methodology called "reflective equilibrium" (Daniels, 2011; Petersen, 2016;
Rawls, 1999). This methodology says we have a reason to accept moral intui-
tions and moral principles if they enter into a coherent system with each other
and relevant background theories — theories which in the context of this book
include research from, for example, applied ethics, cultural studies, medical
science, law, sociology, and economics.-In taking this approach, Petersen and
Hansen have worked to create coherence or equilibrium between
(i)
general
normative principles, (ii) considered moral intuitions, and (iii) the relevant
background theories
3. The Qualitative Studies
The book draws on empirical data from three comprehensive qualitative studies
on respectively sperm depositing (Chapters 2 and 4), embryo storage (Chapter 4),
and the cryopreservation of ovarian tissue (Chapter 2).
3.1.
Sperm Deposits and Banking
The sperm deposit study was conducted by Adrian between November 2018
and February 2019. Through a newsletter sent to 770 sperm deponents by Cryos
International, Adrian conducted interviews with 30 deponents. The focus of the
interviews was an inquiry to why men deposit sperm, the deponents' reflections of
having sperm stored, and the practices of establishing the deposits. The interview
took between 20 minutes and 120 minutes. Most of them were conducted through
phone or Skype, while six interviews took place either at Adrian's office or the
deponent's workplace. Data collection and storage were approved by the Danish
Data Protection Service through Aalborg University. All the interviewees have
been anonymized through the application of new names. Moreover, Adrian has
conducted observation of the preservation of testicular tissue at the Laboratory
of Reproductive Biology in Copenhagen.
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152
The Cryopolitics of Reproduction on lee
The sperm deposit study followed two ethnographic studies that partly took
place at Cryos International. Both of these studies have implicitly been used not
the least in chapter 1. They were carried out by Adrian between 2002-2003 and
2011-2013. While the first study was on Danish and Swedish fertility clinics and
sperm banks, the latter focused on sperm banks and fertility traveling to Den-
mark. Both studies were multi-sited ethnographic studies (Adrian, 2006, 2010,
2016, 2019; Adrian &
Kroløkke,
2018).
3.2. Embryo Storage
The study about women's storage of cryopreserved embryos was conducted by
Nebeling Petersen. Eleven women in the age group from 28 to 42 were interviewed
during the summer of 2018 in urban areas in Denmark. All interviewees had
cryopreserved embryos stored as surplus embryos from fertility treatments that,
at the time of the interview, had ended. All but one interviewee had one or more
children. The interviewees were recruited through a call on social network plat-
forms (Facebook and Twitter), which was posted on fertility clinics' Facebook
pages and within Facebook groups for and by people infertility treatments. The
interviews were all conducted in the homes of the interviewees and lasted between
25 and 55 minutes. All interviews were conducted
as
semi-structured interviews,
followed the same interview guide and have been anonymized through the appli-
cation of new names.
3.3.
Ovarian Tissue
Freezing
The study on ovarian tissue freezing involves a multi-sited ethnographic study
conducted by Bach and
Kroløkke
combining observations in clinics, laboratories
and at scientific events, document analysis and qualitative interviews. Both Bach
and
Kroløkke
have done ethnographic fieldwork at the Laboratory of Repro-
ductive Biology in Copenhagen, including interviews with the research staff, and
participated at international scientific conferences on fertility preservation in
respectively Switzerland and Austria.
This empirical study further includes document analysis of patient informa-
tion provided.
by
the Danish hospitals online as well as in paper handouts. In
Chapter 2, we
also
draw on an archive of biomedical scientific articles on ovar-
ian tissue freezing. The archive comprises 89 medical on
autotransplantation
of
cryopreserved human ovarian tissue, including 15 articles with Danish scientists
on the list of contributors. This collection departs in a reference list provided in
November 2017 by medical student
Sofie
Elise Gjellert who in relation to research
done at the Laboratory for Reproductive Biology in Copenhagen conducted a
search, in PubMed for all article between 2000 and 2017 on
autotransplanta-
tion
of cryopreserved human ovarian tissue. To these articles have been added
a number of more recent medical articles concerning the use of frozen ovarian
tissue specifically as menopause treatment as well as concerning other aspects rel-
evant to the discussions in this book, such as more general discussions of fertility
preservation strategies.
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Appendix 153
The patient interviews centered in this book were conducted by Bach in
2017-2018 in Denmark. All of the interviewees had ovarian tissue cryopreserved
in relation to being treated for serious disease; the majority had cancer. Thirty one
of the interviewees had had tissue transplanted, and ten had only tissue preserved.
The interviewees were aged between 22 and 52 at the time of the interview and
had been between 15 and 41 years old when they had ovarian tissue preserved.
The interviewees were recruited through Danish cancer patient organizations
(N =11)
and through the national registry at The Laboratory of Reproductive
Biology at the General Hospital in Copenhagen where all tissue is stored in Den-
mark. Letters were sent out to all transplanted patients in the register
(N `_{
92)
after permission had been obtained from the Danish Patient Security Author-
ity (interviews = 30). The semi-structured interviews lasted between 90_ minutes
and three hours. Written informed consent was obtained from all participants.-
Data collection and storage were approved by the Danish Data Protection Service
through the University of Southern Denmark. Ethics Committee approval
is
not
required in Denmark for voluntary qualitative studies. All of the interviewees have
been given new names and due to the limited number of ,patients in Denmark, bio-
graphical specificies have been blurred in order to protect their anonymity.
4. The Danish Survey on Fertility Preservation
The survey of Danish students was conducted in 2019 at three Danish higher
education institutions located in two of the larger Danish cities (Copenhagen and
Odense) by
Kroløkke
and with the research assistance offered by Caroline Wraa
Rasmussen as well as in collaboration with Israeli collaborators Yael Hashiloni-
Dolev and Amit Kaplan. The survey resulted in a total of 508 student responses
consisting of 125 medical students, 20 economics students, 35 law students, 65
social science students, 45 computer science students, 9 business students, 99 engi-
neering students, 'and 102 humanities students. Over half of the students (55.71
/6)
were female and the majority of the students were between 21 and 27 years of age.
Students were given the survey in class and asked about their attitudes related to
fertility, preservation for medical as well as non-medical reasons. While the survey
predominantly focused
on
women's ability to freeze their reproductive cells, it also
asked more general questions related to fertility preservation in the wider context,
including the welfare state's involvement, if any, and provided the students with
a qualitative component where they were able to write their opinions. Notably,
student responses to the following two questions have been included in this book:
(t) Think of a 30-years old woman with no children. The state offers her to
fund egg freezing as a way to preserve fertility. What do you think of the offer?
(2) Think of a 30-years old woman with no children, working full-time in a large
corporate firm. Her employer offers her to fund egg freezing as a way to pre-
serve fertility. What do you think of the offer? Thus, while the survey granted
us an overview of students' attitudes toward cryopreservation, included in this
book, is the more qualitative responses to these two questions. All responses were
anonymized yet age and study background were included to help contextualize
the responses.
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154
The Cryopolitics of Reproduction on Ice
5. Other Empirical Materials
Throughout the book, we include a diverse range of news media sources, medi-
cal articles and marketing materials selected to provide illustrative examples and
provide our arguments with empirical evidence. In this section, we briefly reflect
on these materials and their limitations.
Chapters 2 and 3 rely additionally on marketing material from a diverse'range
of fertility clinics in the Scandinavian countries as well as the international com-
pany Legacy which markets sperm deposits for an international market, includ-
ing to Scandinavian men who wish to establish a deposit in a private context. The
marketing material has been accessed through the websites of the clinics available
to the public. Yet, these analyses do not rely on an exhaustive study of
all
avail-
able clinical sites.
In the section of Chapter 5 on fertility preservation in relation to transgender
treatment, we draw on a wide selection of materials concerning fertility preser-
vation in transgender individuals in the Scandinavian context as
well as
in the
international debates, including national white papers and clinical guidelines as
already accounted for in the above section on legal dogmatic method. The section
draws on medical articles on the topic and news media accounts. Yet, as transgen-
der fertility preservation primarily serves as an example among others to illustrate
how cryotechnologies come to disturb social categorizations and medico-legal
demarcations, a systematic review of news media accounts or biomedical articles
has not been conducted and thus, the data gathering process cannot be regarded
as an exhausted analysis. Overall, the topic of fertility preservation in transgender
individuals calls for more thorough social scientific inquiry.
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Index
Note:
Page numbers followed by
"n"
with numbers indicate footnotes.
Act on Sex Change (1972), 130
Age in fertility preservation, 51
Allied Market Research group, 19
Altruism, 32, 34
Altruistic surrogacy, 132
Artificial conception issue, 22
Artificial fertilization, 23
Artificial insemination, 37
ARTS, 31, 37, 39, 43, 55, 77, 97-98,
114,123-124
Best interests of (older) women,
90-93
"Best interests of child", 36-37, 43-14,
88-90
"Biological clock", 82
Biomedicalization, 52
Biotechnology Advisory Board, 133
Blossom programs, 102
Business-to-Business-model, 28-30
Business-to-Consumer-mo del,
28-30
Cancer survivors, 54, 58, 59, 62
Carl von Linn6 Clinic,
74171,
770,
84
Central Sperm Bank, 26-27
Centre for Gender Identity, 117
Chrononormativity, 78
Commercialization
domesticated eggs, 44
travelling sperm, 37-39
Controlling eggs, 77
Council on Ethics, 42
Cross-dressing, 115
Cryo-insurance, 66
of reproductive futurity, 62-66
Cryopolitics of reproduction, 1-3, 98
freezing and re-animating, 7-13
reproductive imaginaries and
methodological
entanglements, 13-15
Scandinavian legal cryo
landscapes, 3, 4-5
Scandinavian welfare states, 3, 6-7
Cryopolitics of Reproduction, The,
8-9
and cultural temporalities, 11
and interdisciplinary approach, 10
responsibility,
l r
Cryopreservation, 9, 11-12, 15, 44, 47,
75,80
of eggs, 25
entangles with market and kinship
needs, 79
practices on medical indication, 49
of sperm, 25-26
of women's oocytes, 2
of women's reproductive capacities,
41
Cryopreserved sperm and embryos,
99
Cryoprotectants, 31
Cryos International, 20-21, 26-27, 29,
31, 44, 104
Danish Act on Artificial Fertilization,
27, 31, 37
Danish Comprehensive Act (1997), 96
Danish Council on Ethics, 38, 122
Danish sperm bank, 44
Death and destruction, 17, 95-96
imaginaries of, 101-111
legal framework, 96-98
theorizing, 98-101
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176 Index
Delay, 73-74
as socio-cultural coercion and
market exploitation, 85-88
theorizing, 78-80
Denmark, 1, 3
assisted reproduction in, 25
fertility industry, 19
gender affirmation surgeries, 116
legal cryo landscapes, 4
reproduction in, 6
Diagnostic and Statistical Manual
of Mental Disorders
(DSM-III), 116
Disturbance, 17-18, 113-114
gendered reproductive categories,
127-138
generational kinship order, 124-127
imaginaries of, 121
legal framework, 114-117
of reproductive time-old mothers,
122-124
theorizing, 117-121
Dolly Mixtures,
13
Domesticated eggs, imaginaries of,
39-40
commercialization, 44
kinship and best interests of child,
43-44
nature and safety, 40-43
Eggs, 138
cells, 133
freezing, 83-85
Elective oocyte preservation, 74
Embryos, 25, 40, 48, 63, 81, 96, 101
Endometriosis, 136
European Convention on Human
Rights, 15
European Economic Area (EEA), 15
European Sperm Bank, 26, 29
Exceptionalism, 130
"False hope", 59-60
Feminist affect theory, 109, 117-118
Feminist thinking, 118
Fertility market, 19
Fertility preservation (FP), 50, 55, 113,
128-129
age in, 51
conceptualisation, 62
on medical indication, 53
practices, 53-54
"Fertilization outside the Body", 40
Freezing on medical indication
(see
Medical freezing)
Gametes, 33-34,95, 138
Gender
affirmation surgeries, 116
cells, 137
dysphoria, 1151 `
gendered reproductive categories,
disturbing, 127-138
incongruence, 115
Genealogical bewilderment, 125-127
Generational kinship order,
disturbing, 124-127
Global oocyte'market, 2
Gynaecological examination, 138
`Harvard Innovation Lab" in
Cambridge, 60
Heteronormativity, 35, 67, 96, 112
Heteronormativity through market,
27-28
Hidden rhythms, 11, 78
HIV, 26
Homosexuality, 115
ICSI treatments, 28
"Illegitimate" children, 23
Imaginaries
of death and destruction,
101-111
of disturbance, 121-138
of domesticated eggs, 39-44
of families, 104-111
on freezing for non-medical reasons,
81-93
on medical freezing, 55-69
of progress and possibility, 55-57
of travelling sperm, 34-39
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Index 177
Imageries of Dr Frankenstein's
Monstrous Technologies,
102-103
Infertility, 19, 52, 53, 59, 61, 76
future, 50, 62, 70, 71, 79, 80, 88, 93
risks of, 9, 62
Informed choices, 91
Insemination, 22, 134
Interdisciplinary methodology, 10, 14-15
International Glossary of Infertility
and Fertility Care, 53
IVF, 26, 40, 42, 134
cycles, 22
Kinship, 36-37, 43-44
Kinship temporalities
and best interests of (older) women,
90-93
best interests of child, 88-90
Klinefelter syndrome,
59n2
Latency, 99, 107-111
Legacy, 60-61
Lesbian, gay, bisexual, transgender
rights (LGBT rights), 129
LGBTQ rights, 129
Liminality, 9-10, 100, 107-111
Market exploitation, delay as, 8588
Market in human reproduction, 19-20
Market in ice, 19-21
imaginaries of domesticated eggs,
39-44
imaginaries of travelling sperm, 34-39
legal framework, 21-31
theorizing, 31-34
Mater semper certa est
principle, 137
Medical freezing
(see also
Non-medical
reasons, freezing for), 7-13,
16, 47, 49, 128
cryo-insurance and imaginary of
reproductive futurity, 62-66
development of programmes, 47
imaginaries of "normal"
womanhood and "potent"
masculinity, 66-69
imaginaries of progress and
possibility, 55-57
imaginaries on, 55
legal framework, 49-52
on medical indication, 16
and new regime of risk prediction
and management, 5742
for non-medical reasons, 16-17
theorizing disease, 52-55
Menstruation, 138
Mermaid Clinic, 26-27
Methodological entanglements, 13-15
Monetary
market, 20
Moral Danish state, 42
National Board of Medicine,
23
National Health Board, 96
Non-medical reasons, freezing for
(see also
Medical freezing),
73, J75-76
imaginaries ;of reproductive
autonomy, 81-88
imaginaries of rightly timed kinship,
88-93
imaginaries on, 81
legal framework, 76-78
theorizing delay, 78-80
Nordic Meeting for Lawyers, 22
"Normal" womanhood, imaginaries
of, 66-69
Norway, 3
legal cryo landscapes, 4-5
reproduction in, 6
Norwegian Biotechnology Advisory
Board, 133-134
Obligatory blood testing, 63
Ovarian tissue, 133
freezing, 50
Ovary preservation, 63
Ovary transposition, 48
Pelvic examination, 138
"Planned" cryopreservation, 74
"Potent" masculinity, imaginaries of,
66-69
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178 Index
Private cryopreserved sperm
banking development in
Scandinavia, 26-27
Quality children, 61
Queer theory, 11, 117-119
Queerness, 100
Re-animating, 7-13
Reasonable welfare principle, 126
Reproductive autonomy, 2, 65
imaginaries of, 81-88
Reproductive citizenship in welfare
state, 128-135
Reproductive futurity, 64
imaginary of, 62-66
Reproductive imaginaries, 13-15
Reproductive time, disturbance of,
122-124
Rightly timed kinship, imaginaries of,
88-93
Scandinavia, 1
cryotechnologies in, 82
private cryopreserved sperm ;banking
development in, 26-27
Scandinavian legal cryo
landscapes, 3, 4-5
Scandinavian welfare states, 3, 6-7,
15,21-22,116
Scandinavia-ism, 3
Science and Technology Studies (STS),
10
Self-donation, 74
Serological Clinic, 116
Snowflake Embryo Adoption, 102
Social cohesion, 34
Social freezing, 53, 74
Socio-cultural coercion, delay as, 85-88
Sociotechnical imaginaries, 13, 118
Sperm
cryopreservation, 26
donation, 28
drought, 27
quality, 69
Statens
Offenliga Utredninger (SOU),
23n4
surrogacy, 132
Sweden, 3
legal cryo landscapes, 5
market in freezing for non-medical
purposes, 77
reproduction in, 6
Swedish National Council of Medical
Ethics 2013, 89
Swedish Parental Act, 23
"Thick time", 79
Time of reproduction, 11
Tissue preservation, 51
Transgender,127n6
individuals, 121
phenomena, 113
reproduction, 138
Transgenderism, 117
Transsexualism, 115, 117, 133-135
Travelling sperm, imaginaries of, 34-35
commercialization, 37-39
kinship and best interests of child,
36-37
nature and safety, 35-36
Troubling reproductive categorization,
135-136
Turner's syndrome, 125
Twins in separate pregnancies, 43, 97,
114
Unnaturalness, 43
objection, 35
Unwanted destruction, 101
Viking strategy, 21
Vitrification, 30
Waithood, 74
Wisdom of repugnance, 120
World Health Organisation (WHO), 52
World Professional Association
for Transgender Health
(WPATH), 127-128
Standards of Care, 132
World War 2 (WW2), 3
Yuck factor, the, 120
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— Abstracts —
Abstract
RhetoricaScandinavica,
ISBN
1397-0534
No 79, 2019, pp 44-65
Publisher: Retorikforlaget AB
Authors
Charlotte Kroløkke, University of Southern
Denmark, and Janne Rothmar Herrmann, Copenhagen
University of Copenhagen.
Title
"Regulating Kinship. Feminist Legal Rhetoric as an
Analytical Framework and Its Potential to Identify the
Law's Performative Effects" ["Slægtskabsreguleringer. Femi-
nistisk retsretorik som analyseramme og dens potentiale for
at identificere lovens performative effekter"].
Abstract
Involuntary childlessness is a well-known phenome-
non, and in Denmark, every twelfth child is born through the
use of assisted reproduction. Denmark is currently positioned as
one of the key global actors both as far as the use of in-vitro
fertilization (IVF) is concerned as well as within the global
market in sperm and reproductive technologies. In this article,
the authors develop a feminist legal rhetorical framework to
discuss how the Danish law and ethical guidelines on adoption
and assisted reproduction rhetorically produce different master
plots on "natural," "artificial," and "monstrous" forms of kinship.
The authors conclude with a discussion of the potential that a
feminist legal rhetorical framework holds, including its ability to
analyze how rhetorical figures and metaphors legitimize certain
types of kinship as well as the ability to raise new and provo-
cative questions related to gender equality within the law.
Keywords
feminist legal rhetoric, assisted reproductive
technologies, reproductive law, critical adoption studies,
feminist rhetoric.
— RhetoricaScandinavica 79 • 2019 —
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44
Charlotte Krolakke er professor nuo på Institut for Kulturvi-
denskaberpå Syddansk Universitet.
E-mail.• [email protected]
Janne Rothmar Herrmann er professor mso på Det Juridiske
Fakultet, Københavns Universitet.
[email protected]
Charlotte Kroløkke og Janne Rothmar Herrmann:
Slægtskabsregu leringer
Feministisk retsretorik som analyseramme og
dens potentiale for at identificere lovens
performative effekter
Ufrivillig barnløshed er et efterhånden velkendt fænomen og i Danmark
bliver hvert tolvte barn i dag født ved hjælp af assisteret reproduktion.
Danmark indtager i dag en nøgleposition både, hvad angår antallet af
børn, der fødes efter et besøg på en fertilitetsklinik, og som aktør på det
globale marked i sæd og reproduktive teknologier. I artiklen udvikler for-
fatterne en feministisk retsretorisk analyseramme og belyser, hvordan det
danske lovmateriale om adoption og assisteret reproduktion samt Det
Etiske Råds redegørelser konstruerer meget forskellige rammefortællinger
om "naturlige", "kunstige" og "monstrøse" måder at få børn på. Afslut-
ningsvis diskuterer forfatterne den feministiske retsretoriske analyseram-
mes potentiale herunder dens evne til at kunne fremanalysere retoriske
figurer og metaforer, der (il)legitimerer bestemte typer af slægtskaber,
samt dens mulighed for at forholde sig til kønsligestilling i loven.
ed overskrifter som "Kunstig befrugtning bliver betalt af staten, mens
adoption koster forældrene 200.000"' og appeller til følelserne som
"Hjælp et barn til et bedre liv i Danmark"' er måder at få børn på blevet
et omdiskuteret emne. Hvor adoption længe har været reguleret af staten, er regu-
1
2
Larsen, Pelle. Medlem af Etisk Råd: Adoptivforældre bliver forskelsbehandlet. 20.03.2014.
Hentet fra: https://jyllands-posten.dk/indlandlarticle6575526.ece
Kommentar fra Thomas Ploug tidligere medlem af etisk råd gengivet i artiklen: Medlem af
Etisk Råd: Adoptivforældre bliver forskelsbehandlet. 20.03.2014. Hentet fra: hupsd/jyl-
lands-posten.dk/indland/article6575526.ece
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— Kroløkke & Rothmar Herrmann: Slægtskabsreguleringer —
45
leringen af assisteret reproduktion af noget nyere dato. Begge måder at danne fami-
lie på har dog i lige stor målestok påkaldt sig lovgivningsmæssig interesse. I artiklen
udvikler vi en feministisk retsretorisk analyseramme til belysning af denne lovgiv-
ning og stiller spørgsmålene: Hvilke fortællinger om biologi og slægtskab italesættes
i det danske lovgivningsmateriale og i Det Etiske Råds redegørelser om assisteret
reproduktion og adoption samt hvilke retoriske forestillinger om det "naturlige,"
det "kunstige" og det "monstrøse" producerer de?
Formålet med artiklen er dobbelt: Vi ønsker at udvikle en tværfaglig retorisk og
juridisk analyseramme — en udvidelse af det retsretoriske felt — samtidig med, at vi
illustrerer analyserammens potentiale ved at anvende den på udvalgt lovmateriale.
Helt grundlæggende anskuer vi lovmaterialet og redegørelserne fra Det Etiske Råd
som retoriske rammefortællinger.' Bjerggaard Nielsen definerer den retoriske ram-
mefortælling på baggrund af Walter Fishers teori om det narrative paradigme.'
Rammefortællingen er, siger han, "d€t masterplot, der i en given tekst indtager en
styrende rolle"' Hvor Bjerggaard Nielsen kort eksemplificerer tilgangen i en analyse
af Rachel Carsons debatbog
Silent Spring
fra 1962, overfører vi begrebet på udvalgt
lovmateriale og redegørelser. Vi beskæftiger os derfor både med loven og dens for-
forståelser såvel som med de retoriske figurer og strategier, der er med til at produ-
cere lovens mening og "ånd". Jura og retorik er, argumenterer James Boyd White,
tæt forbundet. Som White argumenterer vi for, at love og nationale forfatninger kan
ses som et sæt retoriske tekster, der etablerer "a set of speakers, roles, topics or
occasions for speech'." Juraen og retorikken er på den måde kulturbærende såvel
som kulturskabende.
Vi indleder artiklen med en udvikling af feministisk retsretorik og viser dernæst
dens anvendelse på dansk adoptionslovgivning og assisteret reproduktionslovgiv-
ning fra de kongelige adoptionsbevillinger i 1815 til i dag. Vi anskuer lovgivningen
som biopolitisk forstået som statens måde at regulere bestemte typer af relationer
og slægtskaber på. For at få indsigt i de forforståelser, som lovgivningsarbejdet byg-
ger på, bruger vi de kilder, som jurister under anvendelse af den juridiske metode
bruger for at fastslå hvad gældende ret er på området (love, lovforslag med tilhøren-
de bemærkninger og betænkninger), men vi har også valgt at inddrage tre rede-
gørelser fra Det Etiske Råd. Det Etiske Råd er interessant, fordi det blev grundlagt
med det specifikke formål at rådgive Folketinget samt bidrage til debat om nye bio-
og genteknologier.' I artiklen sætter vi fokus på tre redegørelser (fra henholdsvis
3
4
5
6
7
Bjerggaard Nielsen, Esben. "Den retoriske rammefortælling. Det styrende masterplot i
funktionelt orienteret narrativ kritik,"
Rhetorica Scandinavica
74
(2017), 72-91.
Bjerggaard Nielsen, "Den retoriske rammefortælling," 72-91.
Bjerggaard Nielsen, "Den retoriske rammefortælling," 73.
White, James Boyd, "Law as Rhetoric, Rhetoric as Law: The Art of Cultural and Commu-
nal Life,"
Vie University
of
Chicago Law Review
52
(1985), 684-702.
Det Etiske Råd blev grundlagt i 1987. Rådets arbejde er blandt andet tydeliggjort på hjem-
mesiden http://~v.etiskraad.dkl
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46
— Kroløkke & Rothmar Herrmann: Slægtskabsreguleringer —
1995,8 20019 og 200410), fordi de knytter sig til efterfølgende lovændringer og der-
med udgør de første overvejelser om emner, som Folketinget efterfølgende har taget
stilling til. Rådets redegørelser giver sjældent enstemmige anbefalinger til Folketin-
get, men allerede i rammesætning og sprogbrug udstikkes nogle bestemte forståel-
ser og betegnelser, der får betydning for forståelsen af de underliggende forhold."
Samlet ønsker vi at illustrere, hvordan dansk lovgivning og de etiske debatter om
adoption og assisteret reproduktion producerer bestemte forståelser af "naturlige"
(gode), "kunstige" (problematiske) og "monstrøse" (dårlige) former for slægtskab.
Udviklingen af en feministisk retsretorisk analyseramme
Artiklen henter sit teoretiske og analytiske ståsted fra feministisk videnskab og i
mødet mellem feministisk retsteori og retorik." Feministisk retsvidenskab muliggør
et kritisk syn på retten, der tager udgangspunkt i køn" og kan derfor placeres i den
bredere kritiske retsvidenskab, hvor de værdier, som retten baserer sig på og udtryk-
ker, synliggøres og analyseres." Feministisk retsvidenskab stiller i forlængelse heraf
spørgsmålstegn ved de mest grundlæggende udgangspunkter for forståelsen af rets-
systemet og fremanalyserer, hvordan retten legitimeres, og hvilken funktion og rela-
tion retten har til mennesker.15 Tilsvarende argumenterede den tidlige feministisk
retoriske forskning for at indlemme kvinders kommunikationsformer og —måder i
8
9
1995
-redegørelsen var i høj
grad
grundlaget
for den
første lov om kunstig befrugtning fra
1997.
Nogle af
2001
-redegørelsens overvejelser blev medtaget i dette efterfølgende lovforslag
http://webarkiv.ft.dk/samling/20031
/lovforslag
som—fremsat/1187.htm
10 2004
-redegørelsen ledte
op
til lempelsen af
ægdonationsreglerne http://ivww.ft.dk/sam-
ling/20051/lovforslag/1151/index.htm
11 At
det retlige sprog har betydning
for
forståelsen af
de
underliggende forhold påvises også
af
Petersen, Frank
Høgholm, "Det retlige sprog som
virkelighedsskabende —
graviditets-
vært kontra surrogatmoder",
Tidsskrift
for
Familie- og Arveret
(2018) 1,2-10.
12 Condit, Celeste Michelle,
Decoding Abortion
Rhetoric,
Communicating Change
(Urbana and
Chicago: University of Illinois Press, 1990); Condit, Celeste Michelle,
The Meanings
of tite
Gene. Public Debates about Human Heredity
(Madison: University of Wisconsin Press,
1999a); Condit, Celeste Michelle, "Crafting Virtue: The Rhetorical Construction of Public
Morality,"
i
Contemporary Rhetorical Theory: A Reader,
red. by Lucaites, Condit, Caudill
(New York: The Guilford Press, 1999b), 240f. Mary M. Lay, Laura J. Gurak, Clare Gravon,
and Cynthia Myntti, "Introduction: The Rhetoric of Reproductive Technologies"
i
Body
Talk. Rhetoric, Technology, Reproduction
red. Lay, Gurak, Gravon
og
Myntti (Madison:
University of Wisconsin Press, 2000), 308£; Eva-Maria Svensson,
Genusforskning inotn juri-
diken. (
Stockholm: H6gskolaverket, 2001). https://wivw.kultur.gu.se/digitalAssets/835/
835965_genusjuridik.pdf (downladet 2018.02.14); Briggs, Laura,
How all Politics Became
Reproductive Politics. From Welfare Reform
to
Foreclosure to Trump
(University of California
Press, 2017).
13 Svensson, Eva-Maria,
Getntsforskning inottt
juridikett. (
Stockholm: H6gskolaverket, 2001)
https://www.kultur.gu.se/digitalAssets/835/835965—genusjuridik.pdf (downloaded
02.17.2018).
14 Ketscher,
Kirsten,
"Mod en argumentativ
ret,"
Jussens
Vetoler
5-6 (2000), 272-87.
15 Svensson,
Genusforskning inotn juridiken,
12
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— Kroløkke & Rothmar Herrmann: Slaegtskabsreguleringer—
47
den retoriske tradition.16 På den måde ser feministisk retsteori og feministisk retorik
et potentiale i at udfordre såvel som ændre de værdier eller magtstrukturer som
både retten og retorikken hviler på. I dette afsnit skitserer vi først kort den eksiste-
rende kønsforskning, der kobler køn og slægtskab i en dansk kontekst, for dernæst
at udvikle en feministisk retsretorisk analyseramme.
Kønsforskere har allerede vist, hvordan de danske politiske debatter om repro-
duktive teknologier re-installerer heteronormative fortællinger om det gode, natur-
lige forældreskab." For eksempel tydeliggør Mette Bryld og Nina Lykke, at repro-
duktive teknologier udfordrer fortællingen om den "naturlige" familie. Tilsvarende
viser Michael Nebeling Petersen i en diskursanalyse af Folketingets forhandlinger
om assisteret reproduktion i 2006, hvordan lesbiske og enlige kvinders adgang til
assisteret reproduktion bliver sat i scene gennem en ansvarligheds-, en rettigheds-
og en liberalistisk diskurs. I en analyse af den skandinaviske velfærdsstat illustrerer
Christel Stormhøj, hvordan hetero-forældreskaber bliver legitimeret og siger: "The
heterosexual
norm
becomes increasingly precarious, when challenged
by trans-
formative forces in- and
outside
the
scientific field
in the
late modern
period""Vi
bygger ovenpå den eksisterende kønsforskning samtidig med, at vi udvider det
empiriske felt til at rumme lovgivninger, debatter og materiale fra Det Etiske Råd
om både adoption og assisteret reproduktion.
Kritiske slægtsskabsstudier fungerer endvidere i artiklen som et teoretisk
bagvedliggende tæppe. I antologien
Critical Kinship
Studies
anskuer forfatterne
adoption og assisteret reproduktion som et sæt reproduktive teknologier, der med
det samlede formål at skabe forældre, ofte (re)producerer kulturelle værdier,
slægtskabsøkonomier og globale uligheder." Den nordamerikanske kritiske adop-
tionsforsker Laura
Briggs
understøtter det perspektiv. Ifølge
Briggs
er den velkendte
adoptionsrammefortælling "Hjælp et forældreløst barn" fremtrædende i vestlige
forståelser af transnational adoption." Ikke alene er rammefortællingen ofte deci-
deret forkert, argumenterer
Briggs,
men den reproducerer en hierarkiseret virkelig-
hed, hvor førsteverdenen (de hvide kommende forældre) heltemodigt redder de, i
16 Kroløkke, Charlotte og Karen
Foss,
"'Sørg hellere for en solid tremmeseng. Feministiske
udfordringer til retorikken,
Rhetorica Scandinavica
42
(2007), 4-19; Karlyn Kohrs
Camp-
bell,
"The
Rhetoric of Women's Liberation:
An
Oxymoron"
i
Contemporary Rhetorical
Theory. A Render
edited
by Lucaites,
Condit,
Gaudill. (New York & London: The
Guildford
Press,1999).
17
Condit,
DecodingAbortiort Rhetoric,
Lay
et al.,
Body
Talk,
Bryld, Mette & Nina Lykke,
"Cyborgbabyer og den politiske debat om `det naturlige' i G. Balling (eds.).
Homo sapiens
2.0
(pp.
195-215). København:
Gads
forlag, Petersen, Michael Nebeling, "Fra barnets tarv
til ligestilling. En queerteoretisk undersøgelse af Folketingets forhandlinger om kunstig
befrugtning",
Kvinder, køn
&
forskning
2, 2009, 30-42, Petersen, Michael Nebeling,
Somewhere, over the rainbow. Biopolitiske konfigurationer
af den homoseksuelle figur.
Ph.d.
afhandling, 2012, Stormhøj, Christel,
"Queering
the
family. Critical reflections on state-
regulated
heteronormativity in the
Scandinavian countries':
Lamda
Nordics,
1
-2, 38-56.
18 Stormbøj,
"Queering
the
family",
39.
19 Kroløkke et al.,
Critical Kinship Studies.
20
Briggs,
Somebody's Children.
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48
— Krolokke & Rothmar Herrmann: Slægtskabsreguleringer —
fortællingen, "stakkels" (og ofte brune) tredjeverdens børn. Lene Myong og Michael
Nebeling Petersen deler den kritik, når de dekonstruerer transnational adoption
som "indlysende" til barnets bedste." Også den kritiske reproduktionsforskning har
haft fokus på, hvordan slægtskab er til forhandling og bliver naturliggjort. Kroløkke
og Hvidtfeldt Madsen bruger respektabilitet som retorisk begreb til at indfange
mødet mellem intenderede forældre, økonomi, marked, teknologi, rugemødre og
børn," mens Markens skitserer konkurrerende retoriske rammefortællinger for-
bundet med rugemoderskab i USA.23 Samlet set indskriver kritiske slægtskabs-
studier derfor den feministiske retsretoriske analyse i en bredere social orden.
I denne kontekst argumenterer vi for, at feministisk retorik kan fungere som en
kritisk analytisk linse. Vi placerer således reproduktion indenfor retorikkens faglige
rammer.' Den feministiske retoriker Celeste Condit understreger netop værdien af
at analysere reproduktionsspørgsmål retorisk, når hun i analyser af abortretorik i
USA viser, hvordan retoriske figurer og metaforer producerer forskellige (og ofte
kontrasterende) forståelser af fostret (som celler og som liv) såvel som divergerende
tilgange til kvindens krop og hendes reproduktive rettigheder (eller manglen på
samme).` Med et tilsvarende sæt af retoriske værktøjer fremanalyserer Kroløkke og
Hvidtfeldt Madsen fem forskellige retoriske figurer om den hvide, vestlige fertili-
tetsrejsende og surrogatmoderskab: Den fertilitetsrejsende som patient, helt, turist,
forbruger eller skurk " Kroløkke og Hvidtfeldt Madsen viser, hvordan hver enkelt
figur trækker på bestemte retoriske strategier og konstituerer forskellige problem-
og løsningsstrategier.27 I en norsk kontekst, eksemplificerer Merethe Flatseth des-
uden metaforanalysens evne til at kunne udfolde, hvordan abort i norske stortings-
debatter bliver konstitueret som et etisk problem såvel som en etisk praksis." Vi
lægger os i forlængelse af denne feministiske retoriske forskning og argumenterer
for, at retorikken med dens fokus på relationen mellem form og indhold samt fokus
på stil er et produktivt analyseredskab til at forstå, hvordan fænomener som biologi,
slægtskab samt det naturlige, det kunstige og det monstrøse bliver til og får retlig
legitimitet. Disse forforståelser kan være medkonstituerende for det vi her vælger at
kalde 'lovens ånd' (dens mening og hensigt), ligesom man ved at kaste lys på meta-
forer og talefigurer, kan synliggøre de værdier, som retten baserer sig på, eller vise,
at de rammefortællinger, der strukturerer lovgivningen, netop ikke altid er i over-
21 Myong, Lene og Michael Nebeling Pedersen, "(U)levelige slægtskaber. En analyse af filmen
Rosa Morena';
K&KKultur &Klasse
113 (1) (2012),119-132.
22 Kroløkke, Charlotte og Karen Hvidtfeldt Madsen, "Også respektabel? Retoriske kon-
struktioner af fleksible (u)frugtbare kroppe",
Rhetorica Scandinavica
56 (2010), 31-48.
23 Markens, Susan,
Surrogate Motherhood and the Politics of Reproduction.
University of Cali-
fornia Press, Berkeley. 2007.
24 Briggs,
Hoty all Politics Became Reproductive Politics.
25 Condit,
Decoding Abortion Rhetoric.
26 Kroløkke og Hvidtfeldt Madsen, "Også respektabel?", 31-48.
27 Kroløkke & Hvidtfeldt Madsen, "Også respektabel", 31-48.
28 Flatseth, Merethe,
Førende forestillinger i Fosterpolitikken. En metafor- og diskursanalyse av
abort og fosterdiagnostikk,
(Bergen: Universitetet i Bergen, 2009).
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49
ensstemmelse med retssystemets mest grundlæggende normer om frihed og lighed.
Når vi vælger at udvikle en feministisk retsretorisk analyseramme, er det fordi,
vi mener, at den både bidrager teoriudviklende og rammesætter lovgivningsmateri-
alet analytisk. Retsretorik er ikke en ny analytisk praksis men snarere en samle-
betegnelse for et diffust felt,29 der overvejende tager sigte på den praktiske rets-
anvendelse, dvs. som juridisk argumentationslære ved domsforhandling af juridiske
sager. Retskilderne er i dette perspektiv, som den retoriske topik, steder, man kan
argumentere ud fra med den forskel at retskilderne er en formel form for topik,
hvorfra man
skal
hente belægget for sin argumentation.30 Maria Louise Staffe peger
således på, at
doxai i
retlig argumentation findes i to hovedformer, som formelle
topoi (retsreglerne, der er nedfældede, kodificerede værdidomme i det samfund,
hvor de er vedtaget) og som uformelle topoi (vage værdidomme og antagelser, som
også findes i samfundet, og som ligesom de kodificerede retsregler er med til at
præge argumentation og afgørelser). " Jack M. Balkin bruger eksempelvis topikken
som metodisk greb, der gør juristen klogere på selve det pågældende retsområde,
fordi man ved at katalogisere retsområdets argumenttyper får udledt dets grund-
læggende retlige figurer." Tilsvarende Balkin, bruger vi retorisk figur ikke i en tra-
ditionel og konventionel stilistisk forstand, der henviser til form uanset indhold. I
stedet bliver begrebet anvendt som en trope eller et narrativt undertema. Til forskel
fra en traditionel retsretorisk analyse, der kan vise, hvilke retoriske virkemidler, der
kan være medafgørende for udfaldet af en domsforhandling," eller en katalogise-
ring af et retsområdes argumenter som metodisk greb til at forstå selve retsområdet,
så kan denne tilgang 1) synliggøre de forforståelser, som retskildematerialet baserer
sig på og belyse, hvordan lovgivningen legitimerer sig, 2) vise de retoriske strategiers
kommunikative og performative effekter" — altså hvordan regulering af måder at få
børn på retorisk skaber bestemte slægtsskabsfortællinger samt normative rammer
om (il)legitime slægtskaber — samt 3) forholde sig til ligebehandling i loven.
Med udgangspunkt i den retoriske rammefortælling som begreb,35 vil en femi-
nistisk retsretorisk analyse ikke alene kunne skitsere lovgivningens mest frem-
trædende masterplots, men også påvise, hvordan den overordnede fortælling struk-
turerer kønnede, seksualiserede, nationale og racialiserede fortællinger. Vi vender os
derfor nu mod lovmaterialet og redegørelserne fra Det Etiske Råd. Vi forholder os
29 Gabrielsen, Jonas, "Rationaler og potentialer i moderne retsretorik. En kortlægning af fel-
tet',
Rhetorica Scandinavica (75)
(2017), 55
30 Staffe, Maria
L., Retsretorik
(København: Karnow Group 2008), 49.
31 Staffe,
Retsretorik.
32 Balkin, J.M., "A Night in the Topics: The Reason of Legal Rhetoric and the Rhetoric of
Legal Reason,
i Law's Stories. Narrative and Rhetoric
it?
the Law,
red. Peter Brooks og Poul
Gewirtz (New Haven: Yale University Press, 1996), 211 og Gabrielsen, "Rationaler og
potentialer i moderne retsretorik , 61
33 Staffe,
Retsretorik.
34 Berg, Kristine Marie & Sine Nørholm Just, "Når kultur sættes til debat—argumenter for et
diskursivt kulturperspektiv i retorisk kritik',
Rhetorica Scandinavica
69, 2015, 42.
35 Bjerggaard Nielsen, "Den retoriske rammefortælling , 72-91.
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delvist kronologisk til materialet og diskuterer først iscenesættelsen af »kunstige» og
"ægte" biologiske slægtskaber i den første regulering af adoption for dernæst at vise,
hvordan nyere redegørelser fra Det Etiske Råd rammesætter den reproduktive tek-
nologi som potentiel "monstrøs , mens adoption undslipper sig den teknologiske
rammefortælling og i stedet bliver etableret som "humanitære slægtskaber". I det
sidste analyseafsnit vender vi os mod vederlag og værdighed og diskuterer her, hvor-
dan monstrøsitet nu ikke i samme grad knytter sig til reproduktive teknologier, men
i høj grad klistrer til økonomiske transaktioner.
Kunstige slægtsforhold og ægte (biologisk og genetisk) slægtskab
Hvor reproduktive teknologier er af forholdsvis nyere dato, har adoption en noget
længere historie. Vi præsenterer derfor kort lidt baggrundsmateriale inden, at vi
fremanalyserer den tidlige italesættelse af (fremmed)adoption. Før kongelig resolu-
tion af 13. december 1815 skete adoptioner gennem kongelige bevillinger på bag-
grund af kongelovens artikel 3, der gav kongen uindskrænket lovgivningsmagt.
Adoption var imidlertid blevet så udbredt, at man mente, der måtte en administra-
tiv omlægning til. Med resolutionen af 1815 kunne kancelliet nu udfærdige bevil-
linger på egen hånd — forudsat, at adoptanten ikke havde livsarvinger i forvejen.
Adoptionsbevillingen kunne således kun
være
en administrativ "ekspeditionssag",
hvis adoptanten ikke havde en "ægte" (defineret som biologisk) slægtning i ned-
stigende linje (barn, barnebarn, oldebarn). Ønskede man at adoptere, selvom man
havde livsarvinger, var det altså en noget alvorligere sag, som krævede Kongens
bevilling. Adoptionens almindelige retsvirkning var, at barnet fik stilling som adop-
tantens ægtebarn, medmindre der var taget særlige forbehold i bevillingen i forhold
til arveret eller familienavn. Selv om bevillingspraksis i tidens løb udviklede sig på
en sådan måde, at bevillingerne blev udfærdiget efter ganske bestemte retnings-
linjer, fandt lovgiver det utilfredsstillende, at et så vigtigt område af familieretten
ikke var kodificeret og dermed tilgængeligt for offentligheden. Dette hang sammen
med, at antallet af bevillinger var steget fra 5-10 bevillinger årligt i midten af 1800-
tallet til 3-400 bevillinger årligt omkring 1900 36
I 1913 afgav familieretskommissionen på grundlag af nordisk samarbejde sin
betænkning om adoption. Betænkningen bestod i et lovudkast," som den første
adoptionslov (lov nr. 87 af 26. marts 1923 om adoption)38 udtrykkeligt baserede sig
på" Lovens udgangspunkt (§ 15) var, at barnet fik status som adoptantens »ægte-
barn", dog således, at der ikke skete nogen forandring i forholdet mellem adoptiv-
36 Frost, Lis,
Fremmedadoption. Retshistorisk belyst
(København: Jurist og Økonomforbundets
Forlag, 2005), s. 3.
37 Udkast til Lov om Adoption med tilhørende Bemærkninger udarbejdet af den ved Kgl.
Resolution af 25. juli 1910 og 19. juni 1012 nedsatte Kommission. København, J. H.
Schultz a/s, 1913.
38 Optrykt
i Lovtidende
1923 afdeling Al, s. 409-412.
39 Forslag til lov om adoption fremsat i Landstinget den 4. oktober 1922, Rigsdagstidende,
tillæg A, samling 1922-23 I, spalte 2641-2652.
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51
barnet og dets "naturlige" (forstået på det tidspunkt som genetiske og biologiske)
slægt, og at adoptionen ikke bevirkede nogen retlig familieforbindelse mellem den
ene part og den andens ægtefælle eller slægtninge og heller ikke mellem adoptiv-
børn indbyrdes.
Det fastslås i disse bestemmelser, at adoptionens hovedvirkning er at etablere et
"ægtebarnsforhold" mellem barnet og adoptanten. Det fastslås udtrykkeligt, at
bevillingens virkninger normalt er begrænset til forholdet mellem netop disse per-
soner; den influerer hverken på forholdet mellem barnet og dets "naturlige" slægt
eller på barnets stilling til adoptantens slægt. Selvom § 8 fastsætter, at adoptionen
skal være til gavn for den adopterede, så er det tydeligt, at et ligeså vigtigt fokus er
adoptanten og adoptantens slægt (slægtsnavn og formuegoder), idet % 10,13 og 14
gav mulighed for, at barnet ikke ligestilles i disse henseender. På det tidspunkt, hvor
Familieretskommissionen afgav sin betænkning og frem til 1923-lovens ikraft-
trædelse blev der konkret i 75% af bevillinger netop taget forbehold på det arve-
retlige område.70 Synspunktet, at formuer burde blive i det, der fremstår som den
"naturlige" slægt understreges af, at loven opretholdte arveretten mellem barnet og
de biologiske forældre. Bemærkningerne til lovforslaget angiver, at loven på dette
punkt var mere vidtgående end betænkningens forslag:
Idet man frygter for, at en Ordning, der hindrer Adoptanten i at begrænse
Adoptivbarnets Arveret, let kan medføre, at Adoptioner, som i øvrigt maatte
anses at være til det paagældende Barns Tarv, ikke kommer i stand
41
Selv forsørgelsespligten i §12 har ikke udelukkende fokus på barnets ret til penge-
og omsorgsforsørgelse fra den nye forælder, men derimod også på adoptanten, der
som hovedregel intet krav har på at få godtgjort sine udgifter af "barnets virkelige
forældre».` Det anføres således, at den forsørgelsespligt, der ifølge den dagældende
Fattiglov var pålagt adoptanten var ubetinget både over for barnet "og dets For-
ældre': Denne ubetingede pligt fritog dog ikke de "virkelige forældre" for forsørgel-
sespligt, idet faren til et uægte barn fortsat var bidragspligtig også efter barnet var
bortadopteret. Formuleringen "de virkelige forældre" følger desuden direkte af ord-
lyden af den endeligt vedtagne lov."
Adoption rammesættes således retsretorisk som etablering af et "mindre virke-
ligt" slægtsskabsforhold som følge af den tids vægtlægning af biologisk slægtskab og
arvefølge som sikring af, at slægtens formuegoder forblev i slægten. Arvelovs-
kommissionen videreførte i 1941 synspunktet om, at barnet ikke skulle være
tvangsarving. Der var imidlertid ikke udelt enighed blandt jurister om adoption og
dens retsvirkninger. I starten af 1940'erne diskuteredes emnet løbende i retsviden-
40
Se den historiske udredning i Betænkning
111/1954, s. 8
41
Bemærkninger ad
§ 13.
42
Udkast til
Lov
om Adoption med tilhørende Bemærkninger udarbejdet af den ved Kgl.
Resolution af
25.
juli
1910
og
19.
juni
1012
nedsatte Kommission. København, 1.
H.
Schultz a/s,
1913,
bemærkninger
til § 12, p. 5.
43 Lovtidende 1923,
afdeling A
1, s.
409-412,
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skabelige artikler, og dommer Niels Harbou argumenterede med udgangspunkt i de
norske regler for mere vidtgående danske regler, således at der kunne ske adoption
med "fuldt familieskifte': Harbou anfører bl.a., at der ikke kan være tvivl om, at et
adoptivbarn er og bør være socialt knyttet til adoptivforældrene og deres slægt og
ikke til sin egen slægt: "På denne baggrund bør den sociale forbindelse og ikke det
biologiske slægtskab lægges til grund". " Et fuldt familieskifte, hvor adoptivbarnet
ligestilles med biologiske børn i juridisk henseende i forhold til arv og slægtsnavn,
medfører i denne udlægning, at både den retlige og sociale tilknytning til barnets
egen slægt må afbrydes. Dommer Jørgen Trolle udtrykker derimod bekymring for
en sådan ordning, da han finder det »besynderligt», hvis adoptanten skal kunne til-
lægge barnet fuld legal arveret efter adoptantslægten, "uden at dennes medlemmer
.
bliver spurgt eller endog behøver at få noget at vide herom"
I
Blodets bånd forbliver
her retorisk konstituerende for familietilhørsforholdet.
Det blev netop spørgsmålet om det "kunstige" og "det ægte", der ledte frem til
den næste lovændring. Lovgivningsarbejdet blev skudt i gang med betænkning
111/1954 om ændring af reglerne om adoption, der i redegørelsen for de på det
tidspunkt gældende regler om adoption rammesætter dem som "etablering af et
kunstigt slægtsforhold mellem barnet og adoptanten"' Betænkningen dannede
grundlag for, at man i 1956 ændrede adoptionsloven væsentligt med indførelsen af
såkaldte "stærke" adoptioner, hvor adoptivbørn ligestilles med egen-fødte børn på
alle måder og forbindelsen til de biologiske forældre afbrydes fuldstændigt. Det tid-
ligste materiale om adoption viser en udvikling, hvor adoption bliver mindre og
mindre 'kunstig` i takt med at "ægte" slægtskab i stigende grad afkobles fra ideer om
slægten som etableret gennem genetik og biologi. Hvor adoption bliver mindre og
mindre "kunstig", så bliver de
nye
reproduktive teknologier monstrøse, bl.a. for at
skabe nye forstyrrelser af genetik og biologi som ikke en men to kategorier.
Monstrøse teknologier og humanitære slægtskaber
Hvor slægtskabet mellem adoptanten og den adopterede i den tidlige adoptionslov
blev rammesat som "kunstig" og "mindre virkelig'; producerer Det Etiske Råd i
perioden fra 1995 til 2004 en anden hierarkiseret forståelse af slægtskab og måder
at få børn på. I redegørelserne bliver ordet "kunstig" nu anvendt om udvalgte for-
mer for assisteret reproduktion samtidig med, at de reproduktive teknologier reto-
risk bliver fremstillet som potentielt monstrøse. I dette afsnit analyserer vi først Det
Etiske Råds iscenesættelse af assisteret reproduktion inden, at vi vender os mod,
hvad den fremvoksende fortælling om adoption som et humanitært velfærds-
statsarbejde gør ved forståelsen af måder at få børn på.
I Etisk Råds redegørelser fungerer det heteroseksuelle samleje som en uomtviste-
lig retorisk figur for
den gode
reproduktion. På den måde bliver assisteret reproduk-
44 Ugeskrift for Retsvæsen 1944
B s.
181-186.
45 Ugeskrift for Retsvæsen 1944
B s.
189-94.
46
Betænkning
111/1954, s. 7.
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53
tion
gjort
kunstig i lyset af, hvad der fremstår som den "naturlige" forplantning. I
redegørelsen fra 2001 forholder Rådet sig eksempelvis til, hvorvidt teknologierne
kan efterligne den "naturlige" forplantning, når de skriver:
Reproduktionsteknologierne bør ikke tages i anvendelse, hvis de sigter på at
fremkalde graviditet i situationer, som ikke er ubetvivleligt analoge til
situationer, som forekommer eller kunne forekomme, uden at der anvendes
kunstig befrugtning."
Sæddonation fremstår i Rådets redegørelse som et eksempel på en sådan analog
teknologi, retorisk fremskrevet som uproblematisk. Rådet skriver: "Behandlingen er
lavteknologisk og repræsenterer kun en mindre afvigelse i forhold til forplantning
ved samleje"." I 2004 redegørelsen fastholder Rådet tilsvarende ønsket om, at de
reproduktive teknologier skal ligne "den naturlige proces mest muligt»,` men ud-
vider dog nu mulighederne til også at kunne imødekomme enlige og lesbiske
kvinder, der ønsker at få hjælp til at få børn. Som Rådet anfører det: "Mange børn
er gennem historien kommet til verden på helt naturlig vis efter et eneste møde og
samleje mellem en kvinde og en mand"
I
I fortællingerne, hvor samlejet mellem kvinden og manden figurerer, fungerer
det heteroseksuelle samleje, og hvad Petersen kalder "heteroseksuel levevis," fortsat
som en primær rammefortælling." De reproduktive teknologier skal helst simulere
den "naturlige" forplantning. Særligt problematisk for Rådet er derfor den repro-
duktion, der foregår udenfor (kvinde)kroppen. Den sættes i Rådets behandling i en
farlig forbindelse med "teknologisering" og en uønsket "menneskeopfattelse":
Udbuddet af de forskellige teknikker til kunstig befrugtning indebærer en
generel teknologisering af forplantningen og indebærer en væsentlig risiko
for en stærkt uønsket påvirkning af selve vores menneskeopfattelse. Man taler
om sæd og æg, fosteranlæg og fostre, som om det var ting, og man behandler
dem som ting: De smides væk, forskes på, foræres væk, og man diskuterer,
hvem der har ejendomsret og råderet over dem. På den måde udgør anven-
47
Det Etiske Råd, Etiske
problemer vedrørende kunstig befrugtning,
I.
Del. (København, Det
Etiske Råd
2001),
http://www.etiskraad.dkl—/media/Etisk-Raad/Etiske-Temaer/Assisteret-
reproduktion/Publikationer/
2001-
Kunstig-befrugtning-del-I.pdf (downloadet
2018.02.13), 29.
48
Det Etiske Råd,
Kunstig Befrugtning—En redegørelse (
København: Det Etiske Råd,
1995),
http://www.etiskraad.dk/—/media/Etisk-Raad/Etiske-Temaer/Assisteret-reproduktionIPub-
likationer
/1995-
kunstig-befrugtning.pdf (downloadet
02.14.2018), 56.
49
Det Etiske Råd,
Kunstig befragtning— Etisk set
(København: Det Etiske Råd,
2004),
http://www.etiskraad.dk/—/media/Etisk-Raad/Etiske-Temaer/Assisteret-reproduktionIPub-
likationer
/2004-01-04-
kunstig-befrugtning-etisk-set.pdf (downloadet
02.14.2018), 13.
Rådet viderefører i øvrigt her det heteroseksuelle samleje som rammesætningen fra sin
allerførste redegørelse på området Beskyttelse af menneskelige kønsceller, befrugtede æg,
fosteranlæg og fostre.
50
Det Etiske Råd,
Kunstig befrugtning— Etisk set,
13.
51
Nebeling Petersen,
Fra
barnets
tarv til ligestilling,
31
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delsen og udbredelsen af kunstig befrugtning en tingsliggørelse af de mel-
lemmenneskelige forhold og selve forplantningsprocessen."
Et flertal af Rådet er således i 1995 imod "kunstig" befrugtning, der foregår "uden-
for" (kvinde)kroppen. Ikke alene skitserer Rådet problematikker forbundet med en
"opsplitning" af moderskabet (rugemoderskab og ægdonation fungerer som kon-
krete eksempler), men teknologien producerer også, jævnfør Rådet, en "tingslig-
gørelse" af det reproduktive. I redegørelsen fra 1995, beskriver Rådet eksempelvis
teknologiernes evne til at kunne "fryse ned" og "tø op" og de uhensigtsmæssige
muligheder forbundet med nu at kunne "overplanlægge" eller "skabe" sit eget barn.
Ved hjælp af ord som "adoptiv-æg", "teknificeret og fremmedgørende" og "ube-
hagelige muligheder" skaber Rådet i 1995 en monstrøs teknologiscene, som de nye
teknologier indfinder sig på:
En del af flertallet lægger desuden til grund for et forbud, at reagensglas-
befrugtning med donoræg og donorsæd — "adoptiv-æg" — repræsenterer en
for teknificeret og fremmedgørende form for forplantning. Dertil kommer, at
muligheden for at kombinere æg og sæd fra forskellige banker og skabe børn
på den måde åbner ubehagelige muligheder for, at forældre kan vælge, hvilket
æg og hvilken sæd, de vil sætte sammen til et barn 53
Redegørelserne forholder sig endvidere kritisk såvel som bekymret i forhold til det
sociale "pres" som forskellige reproduktive aktører bliver udsat for. På den måde
bevæger de retoriske strategier sig fra det individuelle ønske om et barn til en re-
installering af velfærdsstaten som nationens moralske vogter
("vores
menneske-
opfattelse»).` Barnløse er beskrevet som par, der oplever pres fra familie og venner
("parret kan føle pres fra omverdenen»)." Rugemødre (hvis det ellers var tilladt)
ville opleve pres fra de intenderede forældre og potentielt blive udsat for større
emotionelle udfordringer." Sådan skriver Rådet:
Overdragelsen af barnet giver som regel rugemoderen store psykologiske
problemer, og hun er også i mange tilfælde udsat for et pres fra den eller de
kommende sociale forældre under selve graviditetsforløbet."
I redegørelserne producerer Det Etiske Råd en fortælling, hvor nu ikke alene
genetisk men biologisk slægtskab (særligt hvis det kan imitere det heteroseksuelle
samleje) er ønskværdigt. I skarp modsætning hertil, iscenesættes de reproduktive
teknologier retorisk som potentielt monstrøse i deres evne til at kunne skabe slægt-
52 Det Etiske Råd,
Kunstig Befrugtning— En redegørelse,
49.
53 Det Etiske Råd,
Kunstig Befrugtning—En redegørelse,
59.
54 Det Etiske Råd,
Kunstig Befrugtning— En redegørelse, 49.
I
"Crafting Virtue"
præsenterer
Condit
en feministisk retorisk læsning af de måder, hvorpå individuelle behov og ønsker,
gennem en række retoriske strategier, bliver transformeret til et offentligt samt et objekti-
veret moralsk kodeks.
55 Det Etiske Råd,
Kunstig Befrugtning—En redegørelse,
12.
56 I redegørelserne anvender Rådet konsekvent ordene "rugemoderskab" og "rugemødre':
57 Det Etiske Råd,
Etiske problemer vedrørende kunstig befrugtning,
32.
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55
skab, når genetikken og sågar biologien går ud. Det er slægtskaber, der er til fare for
barnets ve og vel såvel som dets tarv samtidig med, at det, som anført af Det Etiske
Råd, overskrider de (gode) danske "kollektive" værdier. I Folketingets behandling af
den første lov om kunstig befrugtning genfortælles det naturlige for eksempel også
i den socialdemokratiske ordførers åbningsbemærkning:
Det overordnede princip er, at det foster, der skabes, ikke må adskille sig fra
det, der principielt kunne være frembragt ved sædvanlig befrugtning. Det vil
sige ingen manipulationer, ingen fremstilling af kopier af et og samme
individ, ingen deling af
æg
anbragt i forskellige kvinder, hvorved der kunne
fødes tvillinger med forskellige mødre, ingen udvikling af æg, uden for
kvindens livmoder, ingen rugemødre..,
se
De reproduktive teknologier skal i den rammefortælling kunne imitere den "natur-
lige" forplantning ("det, der principielt kunne være frembragt ved sædvanlig
befrugtning"). Samtidig bliver 'det monstrøse italesat som nye teknologier såsom
kloning ("kopier af et og samme individ") og rugemoderskab.
I skarp modsætning til de monstrøse teknologier, bliver adoption, i Etisk Råds
tre redegørelser, til en økologisk og altruistisk måde at skabe slægtskab på. Rede-
gørelserne kobler rammefortællingen om en overbefolket verden sammen med en
anden rammefortælling — nemlig den, der handler om et forældreløst barn. På den
måde undslipper adoption helt de teknologiske og værdighedstruende rammer. I
stedet bliver adoption konstitueret som en form for humanitær næstekærlighed.
Adoption bliver en værdig slægtskabsteknologi samtidig med, at de danske adoptiv-
forældre bliver retorisk fremstillet som modige individer, der tør tage et "handi-
cappet eller et udenlandsk udseende barn til sig"." I den fortælling indgår også en
forståelse af den danske velfærdsstat som en særlig god ramme at vokse op i. Rådet
opmuntrer således til øget adoption, når de skriver:
Det ville være mere ønskeligt om samfundet tilskyndede de barnløse til at
adoptere børn, der er født, eller tage dem i pleje. I stedet for ved hjælp af
avanceret teknologi at skabe nye børn, kunne man give nogle af de allerede
fødte børn ordentlige muligheder.60
Fortællingen vinder genklang ved Folketingets behandling af den første lov om
kunstig befrugtning, hvor den socialdemokratiske ordfører minder om, "at vi
lægger megen vægt på, at der gives en grundig oplysning om adoptionsmuligheder-
ne før påbegyndelsen af behandling mod barnløshed"61 ligesom ordføreren for SF
58
Første behandling af lovforslag nr.
L5
(Forslag til lov om kunstig befrugtning i forbindelse
med lægelig behandling, diagnostik og forskning mv.), Folketingets Forhandlinger
8.
okto-
ber
1996, s. 245.
59
Det Etiske Råd,
Kunstig Befrugtning— En redegørelse,
12.
60
Det Etiske Råd,
Kunstig Befrugtning— En redegørelse,
50.
61
Første behandling af lovforslag nr.
L5
(Forslag til lov om kunstig befrugtning i forbindelse
med lægelig behandling, diagnostik og forskning mv.), Folketingets Forhandlinger
8.
okto-
ber
1996, s. 245.
Der var tale om en genfremsættelse, idet man ved første fremsættelse af
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56
— Krolokke & Rothmar Herrmann: Slægtskabsreguleringer—
mener, at "vi skal presse på...., så den naturlige løsning på problemet barnløse
forældre og forældreløse børn bliver, at man lader dem finde hinanden i et lidt
større omfang end man gør i dag". " Det blev og er fortsat derfor et krav i lov om
assisteret reproduktion, at der inden behandling skal gives information også om
adoption, j£ § 23, stk. 2
63
Et krav, der i SF ordførerens udtalelse sågar bliver natur-
liggjort ("den naturlige løsning på problemet").
De reproduktive teknologiers monstrøsitet understøttes endvidere, når de ram-
mesættes som direkte i konkurrence med rammefortællingen om de "forældreløse
børn." Reproduktive teknologier bringer således "et barn
til at
eksistere
og dermed
nedbringer antallet af potentielle adoptanter, således at
adoptivbørnenes
frem-
tidsmuligheder generelt set forringes»," Den potentielle uværdighed som reproduk-
tionsteknologien rummer overføres her retorisk til rammefortællingen om den glo-
bale uværdighed forbundet med de forældreløse børns vilkår. I redegørelsen fra
2001 konstituerer Det Etiske Råd det adopterede barns vilkår som så dårlige, at de
opmuntrer til en nytænkning af kravene til det (danske) modtagerpar:
Hvis barnets livsbetingelser inden adoptionen er tilstrækkeligt dårlige, har
dette således en afgørende betydning for, hvilke krav det er fornuftigt at stille
adoptanten. For eksempel kan det udmærket være i et udenlandsk barns
interesse at blive placeret hos forholdsvis dårligt fungerende forældre, hvis
denne placering er den bedste blandt de realistiske alternativer til den
øjeblikkelige situation."
Selvom fattigdom og geopolitik, som
Briggs
anfører det, er væsentlige medvirken-
de aspekter i transnationale adoptionssager, reproducerer Rådet her en ramme-
fortælling, hvor den (gode) hvide danske barnløse redder de forældreløse børn fra
den tredje verden. Som anført af Rådet: "Endelig er det i realiteten således i dag, at
det er umuligt at adoptere et dansk spædbarn, fordi der årligt kun bortadopteres
ca.
20-30 sådanne børn'' 67
De etiske redegørelser producerer således bestemte forståelser af gode og poten-
tielt dårlige (kommercielle) slægtskaber. I fortællingerne indgår forståelsen af tek-
nologi og forplantning, der finder sted uden for kroppen som potentiel altid mon-
lovforslaget kun havde haft 4 måneder til at behandle lovforslaget. Det fandt man var for
lidt, og det bortfaldt derfor ved Folketingsårets udgang.
62 Ibid s. 248.
63 Inden lovens vedtagelse var denne pligt for lægerne til at informere om muligheden for
adoption medtaget i Sundhedsstyrelsens vejledning af 22. december 1993 om lægers
anvendelse af kunstig befrugtning og andre former for reproduktionsfremmende behand-
ling. Vejledningen var en del af den allertidligste regulering, foranlediget af regeringens
pressemeddelelse om dens intention om at opstille klare retningslinjer på området
http://webarkiv.ft.dk/?/samling/ 19931/udvbilag/suu/almdel_bilag63.htm1.
64 Det Etiske Råd,
Etiske problemer vedrørende kumstig befrugtning,
65.
65 Det Etiske Råd,
Etiske problemer vedrørende kunstig befrugtning,
64.
66
Briggs,
Somebody's Children.
67
Det Etiske Råd,
Kunstig befrugtning. En redegørelse,
12.
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57
strøs, mens særligt den transnationale adoption indskrives i en altruistisk ramme-
fortælling. Samme rammefortælling ses ved Folketingets behandling af den første
lov om kunstig befrugtning: S-ordfører Tove Lindbo Larsen udtaler som første taler
ved første behandlingen i Folketinget, at information om kunstig befrugtning skal
fortælle "klart om mulighederne for at adoptere et barn. Der er mange børn i ver-
den, der har hårdt brug for et trygt hjem at vokse op i"." For K-ordfører Henriette
Kjær er den teknologiske indblanding i forplantningen monstrøs, "det er tanken om
det kunstige, der skræmmer mig"," mens R ordfører Vibeke Peschardt knytter det
kommercielle rugemoderskab til Huxleys fremtidsvision fra 1932, "der har været
meget nærværende i debatten.... Den fagre, nye verden er her allerede, og lov-
forslaget drejer sig derfor om, at regulere de værste vildskud fra teknikkens overdrev
væk"." De reproduktive teknologier bliver performativt konstitueret som mon-
strøse — en monstrøsitet som i dag tilsvarende knytter sig til økonomiske trans-
aktioner og det globale forplantningsmarked. Efter teknologiernes indtog skifter
adoption samtidig status — hvor adoption før blev rammesat som et kunstigt slægt-
skabsforhold, der blev monstrøst for sin potentielle indlemmelse af ikke-biologiske
arvinger i den biologiske slægts navn og formuegoder, blev adoption — også i takt
med adoptioner ikke længere var lokale men transnationale — sidenhen set som
truet af teknologien, der kunne skabe 'ægte' biologiske børn, men som var
monstrøs for sit potentiale til at efterlade en masse 'stakkels' børn uden adoptanter
i Danmark. Afsnittet har vist, hvordan det monstrøse flytter undervejs. I det næste
afsnit sætter vi fokus på, hvordan kommercielle transaktioner nu indtager den mere
monstrøse position.
Penge lugter! Monstrøse slægtskaber
Mens de tidlige redegørelser og lovgivning om "kunstig befrugtning" benytter sig af
talefigurer som "vildskud" og andre skræmmebilleder, og adoption bliver altruistisk
og økologisk, så bliver kommercielle transaktioner centrale i det nyere materiale, og
der udstikkes to spor for, hvordan penge må eller ikke må være i spil i slægtsskabs-
etableringen. Det gør sig særligt gældende i nyere adoptionssager såvel som i rede-
gørelser og lovmaterialet forbundet med rugemoderskab.
Den 29. november 2017 afsagde Retten i Sønderborg dom" i en sag om et barn-
68 Første behandling af lovforslaget L200: Forslag til lov om kunstig befrugtning i forbindelse
med lægelig behandling, diagnostik og forskning m.v., 23. februar 1996, Folketingets For-
handlinger spalte 4055.
69 Første behandling af lovforslaget L200: Forslag til lov om kunstig befrugtning i forbindelse
med lægelig behandling, diagnostik og forskning m.v., 23. februar 1996, Folketingets For-
handlinger spalte 4060.
70
Første behandling af lovforslaget L200: Forslag til lov om kunstig befrugtning i forbindelse
med lægelig behandling, diagnostik og forskning m.v., 23. februar 1996, Folketingets For-
handlinger spalte 4066.
71
Dom i sag nr. K01471012017 http://www.domstol.dk/soenderborg/Nyheder/Doms-
resum%C3%A9er/Documents/D 16.pdf
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58
— Krolokke & Rothmar Herrmann: Slægtskabsreguleringer —
løst dansk par, der havde købt et nyfødt barn i Polen. Parret blev dømt for at afgive
falske oplysninger, men selve transaktionen faldt uden for adoptionslovens forbud,
der alene gik på aftaler om etablering af surrogatmoderskab og følgende over-
dragelse af barnet indgået inden fødslen. I følge børne- og socialminister Mai
Mercado
signalerede sagen, at det er "dybt forkasteligt at gøre børn til en handels-
vare"," og tilsvarende istemte Venstres socialordfører Carl Holst:
Vi har et adoptionssystem, hvor der gælder nogle regler. Vi skal ikke have et
parallelsystem, hvor man på egen hånd kan rejse rundt i verden og finde folk,
der giver samtykke til, at man sælger sit barn."
Det politiske budskab er altså, at der er et officielt adoptionssystem, hvor barnløse
forbindes med forældreløse børn på altruistisk grundlag, som står i skarp kontrast
til situationen, hvor parret selv opsøger en nybagt mor og betaler hende i forbindel-
se med overdragelsen af barnet. Men faktisk havde der i 2012 og 2013 været kritisk
fokus på international fremmedadoption fra Etiopien gennem den såkaldte
Amy
-
sag og dokumentaren Adoptionens pris." Det viste sig, at forældre var blevet fra-
narret to af deres børn med løgne og falske løfter. Dette satte fokus på det som nogle
kaldte 'handelselementet' ved international adoption.75 I den første adoptionslov
var holdningen til vederlag i forbindelse med adoption imidlertid mere tvetydig.
Kommissionens lovbemærkninger, der stod uimodsagte ved fremsættelsen af 1923-
loven, anerkender således (jf. § 9), at vederlæggelse udgør en særlig vanskelighed,
fordi et vederlag på den ene side kan sikre adoptanter fra små kår, at et oprigtigt følt
ønske om adoption kan realiseres med en naturlig erstatning for de udgifter, der er
forbundet med opfostring af barnet, og at en far til et uægte barn ofte nemmere vil
kunne udrede et vederlag en gang for alle end at påtage sig barnets opdragelse. På
den anden side rummer vederlag stor fare for spekulation fra adoptanter og
mellemmænd. Afgørende blev derfor vederlagets størrelse og om det var til betryg-
gelse af barnets livsvilkår. Det fremhæves i den forbindelse, at bevillingsmyndig-
heden må påse, at adoptionen virkelig er til barnets tarv, og at "barnet f.eks. ikke er
købt for at opdrages til gøgler, som offer for hvid slavehandel eller lignede".'
Mens adoption af danske børn, stedbarnsadoption og familieadoption i dag stort
set er gratis, er international "fremmedadoption" forbundet med høje udgifter. Det
danske adoptionssystem baserer sig tillige i dag på private adoptionsformidlere, og
selvom der udbetales et kommunalt adoptionstilskud efter adoptionen, så rækker
det langt fra. Der er således stadig en tvetydighed at spore, hvor man på den ene side
72 Politiken 2.
december 2017 https://politiken.dk/indland/art6233864/Ministre-vil-granske-
regler-efter-sag-om-barne~3%B8b
73 Politiken 2.
december 2017 https://politiken.dklindland/art6233864/Ministre-vil-granske-
regler-efter-sag-om-barnek%C3%B8b
74
Mercy Mercy
— Adoptionens pris, 26. november 2012 (Katrine
W.
Kjær).
75 https://www.information.dk/debat/2017/12/sikret-boernehandel-blot-fordi-adopterer-via-
etablerede-system
76 Udkast til lov om adoption med tilhørende bemærkninger udarbejdet af den ved Kgl.
resolutioner af 25. juli 1910 og 19. juni 1912 nedsatte kommission.
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59
overlader adoption til private adoptionsformidlere, der tjener penge på sin virk-
somhed, samtidig med at loven i vidt omfang forsøger at skabe tryghed om det
kommercielle aspekt: Gebyret til de adoptionsformidlende organisationer dækker
udgifter som tilskud til børneinstitutionen, udgifter til barnets pleje frem til adop-
tionen, medicin, vaccinationer, juridisk bistand til adoptionen, oversættelser mv,
idet organisationen ikke må opnå utilbørlig økonomisk vinding i forbindelse med
adoptionshjælpen og ikke må modtage betaling, der står i misforhold til det udførte
arbejde." Tilsvarende må organisationerne kun virke som adoptionsformidlere
med Socialministerens tilladelse, og den adoptionshjælp, de yder, skal være bestemt
af hensynet til barnets bedste og være etisk og fagligt forsvarlig.78 Et egentligt forbud
mod at købe et barn udenom det lovregulerede adoptionssystem findes ikke, hvilket
af flere politikere blev opfattet som et hul i loven," da et par i 2017 alene blev dømt
for at afgive falske oplysninger i forbindelse med, at de havde fået overdraget et barn
i Polen fra en nybagt mor mod betaling.80
Vederlag og værdighed er problematiske størrelser også i Det Etiske Råds rede-
gørelser. Her bliver den "menneskelige værdighed"81 sat på spidsen — dog ikke i
Rådets behandling af transnational adoption men i dets diskussion af rugemoder-
skab og ægdonation. Rugemoderskab beskrives eksempelvis som "bestilt adop-
tion"BZ og "salg af børn".` I de tre redegørelser bliver alle former for mellemmands-
virksomhed samt brug af "kunstig befrugtning" til det formål gjort ulovlig og straf-
bar: "Formidlingen af rugemoderskab er forbudt både for formidleren og parterne
selv".' I Rådets redegørelser bliver rugemoderskab en potentiel monstrøs form for
slægtskabsteknologi. Rugemoderskab skaber "unaturlige forhold":" En kvinde
føder et barn, der er intenderet en anden, samtidig med, at forholdet mellem "man-
den og kvinden" — i skarp modsætning til "den naturlige befrugtning" — alene er,
skriver Rådet, af "ydre og instrumental karakter"." Det samme gør sig potentielt
også gældende i ægdonation og i det, som Rådet kalder "opsplitningen af moder-
skabet"." Jævnfør lov om assisteret reproduktion er det ikke tilladt at "sælge, for-
midle salg eller på anden måde medvirke til salg af ubefrugtede eller befrugtede
77 j£ adoptionslovens § 30a, stk. 2
78 j£ adoptionslovens § 30, stk. 2.
79 "Par købte polsk dreng for 5.600 kr. Ministre vil granske regler efter sag om barnekøb",
Politiken
2.12.2017 https://politiken.dk/indland/art6233864/Ministre-vil-granske-regler-
efter-sag-om-barnek%C3%B8b (tilgået 14. juni 2018).
80 Retten i Sønderborgs dom af 29. november 2017 http://ivww.domstol.dk/soenderborgl
Nyheder/Domsresum%C3%A9er/Documents/D16.pdf (tilgået 14. juni 2018).
81 Det Etiske Råd,
Kunstig befrugtning— Etisk set, 10.
82 Det Etiske Råd,
Kunstig Befrugtning—En redegørelse,
30.
83 Det Etiske Råd,
Etiske problemer vedrørende kunstig befragtning,
31.
84 Det Etiske Råd,
Kunstig Befruugtning—En redegørelse,
30 (jf. også adoptionslovens § 33)
85 Det Etiske Råd,
Etiske problemer vedrørende kunstig befrugtning,
30.
86 Det Etiske Råd,
Etiske problemer vedrørende kunstig befrugtning,
55.
87 Det Etiske Råd,
Kunstig Befrugtning — En redegørelse, 57
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60
— Kroløkke & Rothmar
Herrmann:
Slægtskabsreguleringer —
menneskelige
æg
"'" I begge tilfælde fungerer vederlag som en forurenende størrel-
se:
Reproduktion bør ikke underkastes den pengemæssige logik, hvor det solgte
betragtes som en genstand, der er afhændelig til højestbydende. Den enkelte
rugemoder bør derfor ikke have mulighed for at "udleje" sin livmoder og
sælge sine
æg.90
I lovbemærkningerne til de første lovbestemmelser vedrørende surrogats-arrange-
menter hedder det ligeledes:91
Ved aftaler om vederlag eller betaling for tabt arbejdsfortjeneste må myndig-
hederne ikke medvirke til, at barnet far lovligt ophold hos det par eller den,
der har `bestilt' barnet, feks. gennem plejetilladelse, ligesom ansøgning om
overførelse af forældremyndigheden eller adoption skal afslås. Ønsker
moderen ikke at have barnet, kan hun give tilladelse til, at barnet anbringes i
familiepleje eller adopteres af et par, der er godkendt til adoption.
I betænkning 1350/1997 om børns retsstilling understreges det, at selve det at virke
som surrogatmor ikke er forbudt, heller ikke hvis der ydes vederlag for det. Men
udbredelsen af surrogatmoderskab er i øvrigt søgt begrænset på forskellige måder,
bl.a. ved i de administrative regler at præcisere, at statsamtet ikke må godkende
aftaler om overførelse af forældremyndighed eller meddele bevilling til adoption,
såfremt der skal ydes vederlag eller betaling for tabt arbejdsfortjeneste til inde-
haveren af forældremyndigheden eller den bortadopterende. Det er altså ikke for-
budt at modtage vederlag, men hindring af den sociale moders mulighed for at få
del i forældremyndigheden - og at stedbarnsadoptere barnet - er tænkt som et
værn mod forekomsten af surrogati-arrangementer med betaling.92
Til trods for den opmærksomhed, som dokumentaren Adoptionens Pris filt, så
88
Lovens
§ 12,
se også nærmere Søbirk Petersen, Thomas & Janne Rothmar
Herrmann
'Altruistisk surrogatmoderskab og straf', Bibliotek for Læger
211, 2019, 44.
Tilsvarende i
bemærkningerne til
1997-loven
om kunstig befrugtning (dengang fremgik forbuddet mod
salg af æg af
§ 11)
som understreger, at mens forbudsbestemmelserne primært er rettet
mod den læge og eventuelt andet medhjælpende personale, der udfører kunstig befrugt-
ning i strid med lovens bestemmelser, så er det ikke fundet rimeligt at straffe de personer,
der er donorer eller modtager behandling, da de ikke selv udfører de pågældende behand-
linger m.v. og heller ikke kan forventes at kende de retlige rammer for behandlingsmulig-
hederne nærmere. Det understreges dog, at dette ikke gælder bestemmelsen i lovens
§
11
om salg og formidling af menneskelige
æg,
idet det for eksempel her findes rimeligt, at den
kvinde, der måtte sælge sine æg til donation, kan straffes.
89
Denne forskel på
æg
og sæd skyldes, at ubefrugtede æg i højere grad opfattes som fremti-
dige børn i modsætning til sæd, se mere indgående
Herrmann,
Janne Rothmar & Charlot-
te Kroløkke, "
Eggs on Ice.
Imaginaries
of Eggs
and Cryopreservation in
Denmark
, NORA
-Nordic
Jottrnal
of
Fetninist and
Gender
Research 26, 2018, 19-35.
90
Det Etiske Råd,
Etiske problemer vedrørende kunstig befrugtning 33.
91
Folketingstidende
1985-86
tillæg
A
spalte
4165-4166.
92
Pedersen, Frank Høgholm, "Forældremyndighed i forbindelse med økonomisk kompense-
ret surrogatmoderskab,"
Tidsskriftfor Familie og Arveret 2 (2017), 76-86.
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— Krolokke & Rothmar Herrmann: Slægtskabsreguleringer —
61
er det bemærkelsesværdigt, at opmærksomheden på handel og adoption er klokke-
klart rettet mod korruption i det pågældende land samt dets evne til at kunne hånd-
tere adoption. I en helhedsanalyse understreger Ministeriet for Børn, Ligestilling,
Integration og Sociale Forhold i 2014 således til et "grundigt kendskab til afgiver-
landene" herunder kendskab til "risikoen for korruption':" På den måde undslipper
transnational adoption sig en mere generel rammefortælling, hvor det kommer-
cielle og det uværdige kobles sammen. I modsætning til afsenderlandet fremstår
modtagerlandet fortsat som forplantningens moralske vogter samtidig med, at
transnational adoption bliver genfortalt inden for rammen om det gode forældre-
skab. På den måde undslipper transnational adoption den monstrøse ramme og
bliver i stedet geninstalleret i en altruistisk rammefortælling.
Penge skaber monstrøsitet, når måder at få børn på involverer kommercielle
transaktioner. Men det monstrøse bliver konfigureret på forskellig vis; på adop-
tionsområdet er 'markedet' indrettet sådan, at visse ikke-monstrøse pengetrans-
aktioner godt kan finde sted, ligesom visse pengetransaktioner på det reproduktive
område accepteres (fx salg af sæd), mens andre ikke gør (salg af æg).
En opsummering: Feministisk retsretorik som analyseramme
Vi har i artiklen udviklet en feministisk retsretorisk analyseramme og anvendt den
på udvalgt lovmateriale og redegørelser fra Det danske Etiske Råd. Måder at få børn
på indgår i meget forskellige rammefortællinger. Hvor blodets bånd i den tidlige lov
og betænkning om adoption retorisk etablerede adoption som mindre virkelige
slægtskaber, så bliver adoption i dag, i nyere lov og i det Etiske Råds redegørelser,
retorisk naturliggjort som en god måde at få børn på. Til sammenligning bliver de
reproduktive teknologier positioneret som altid potentielt monstrøse. Det gør sig
særligt gældende, når forplantning sker udenfor kvindekroppen, og når det økono-
miske vederlag retorisk konstitueres som en forurenende størrelse. Til trods for, at
monstrøsitet, i de forskellige perioder, klistrer sig til forskellige aktører og tekno-
logier, så fremstår velfærdsstaten retorisk i hele perioden som nationens og for-
plantningens moralske vogter.
Den retsretoriske analyseramme har vist sig behjælpelig med at synliggøre ret-
tens forforståelser og understreger de retoriske strategiers performative effekter i de
måder, hvorpå bestemte slægtskaber bliver gjort til (il)legitime. Som anført i den
skematiske oversigt (Figur 1, næste side) er de forskellige rammefortællinger pro-
duceret af et sæt meget forskellige retoriske figurer og metaforer.
93 Ministeriet for Børn,
Ligestilling, Integration og Social Forhold. Helhedsanalyse af det danske
adoptionssystem
(2014), 69.
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62
— Krolokke & Rothmar Herrmann: Slægtskabsreguleringer —
Slægtskabsteknologier
Forplantningens
rammefortælling
Retoriske figurer og
metaforer
Forældreløse (stak
kels) børn,
næs
-
tekærlighed, "ægte-
barn', den gode hvi-
de vesterlænding
Sæd som altid done-
ret materiale, mulig-
hed for at imitere det
"naturlige" og gode
heteroseksuelle sam-
leje
Moderskabets
opsplitning, kom-
mercialisering,
"adoptiv
-æg
",
forplantning udenfor
kvindekroppen, tek-
nificering og tings-
liggørelse
Adoption
Den kunstige men
også altruistiske
Sæddonation
Den (næsten) natur-
lige
Ægdonation
Den teknologisk
kunstige
Rugemoderskab
Den monstrøse
Penge lugter, pres fra
omverdenen, handel,
købebørn og salg af
børn, moderskabets
splittelse, udnyttelse
af resursesvage kvin-
der.
Figur 1: Rammefortælling i forskellige slægtskabskonstruktioner samt de retoriske
figurer og strategier
I fremstillingen bliver adoption og sæddonation til "gode" økologiske slægtskabs-
teknologier. I de to rammefortællinger bliver potentielt forurenende størrelser som
"vederlag" og "teknologi" transformeret og gjort naturlige og acceptable. Barnet
bliver altså i nyere fortællinger om adoption performativt konstitueret som et alle-
rede (naturligt) ventende og forældreløst barn. I rammefortællingen omkring sæd-
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— Kroløkke & Rothmar Herrmann: Slægtskabsreguleringer —
63
donation bliver sæd ligeledes omskrevet til et "naturligt" doneret materiale. I skarp
modsætning fremstår ægdonation, rugemoderskab og særligt den økonomiske
transaktion, der kan forekomme her, i en "teknificeret", "kunstig" og "monstrøs"
rammefortælling. Hvor ægdonation bliver retorisk fremstillet som en potentielt
monstrøs tingsliggørelse af forplantningen, så bliver rugemoderskab altid forankret
i en monstrøs rammefortælling. Kendetegnende for ægdonation såvel som ruge-
moderskab er moderskabets splittelse, teknologiens intervention og det kommer-
cielles forurening af den (gode) økologiske forplantning.
Denne analyse understøtter desuden eksisterende kønsforskning og viser, hvor-
dan den heteronormative rammefortælling fungerer som bagtæppe for de øvrige
fortællinger, samtidig med, at det monstrøse flytter sig fra de uægte adoptanter til
de teknologier udviklinger og nu også klistrer sig til de kommercielle transaktioner.
Det empiriske materiale tydeliggør, hvordan forskellige måder at få børn på trækker
på meget forskellige retoriske figurer og rammefortællinger. Hvor evnen til at
kunne reproducere udenfor kvindekroppen mistænkeliggøres som »kunstig», så
knytter den monstrøse rammefortælling sig i dag i langt højere grad til de finan-
sielle transaktioner herunder frygten for tingsliggørelse af kvindekroppen og for, at
barnet bliver en (bestilt) handelsvare.
En feministisk retsretorisk analyseramme bevæger sig fra en analyse af rets-
anvendelsens argumenter og argumentationslære til selve retskildematerialet. Vi har
vist, hvordan en sådan analyseramme kunne interessere sig for statens regulering af
måder at få børn på, men den har selvfølgelig et langt bredere sigte, og kan bruges
som analytisk linse på alle retsområder, hvor rettens kønsneutralitet, kønsbalance
og ligestilling/ligebehandling ønskes efterprøvet eller hvor det er relevant at løfte
sløret for rettens væsen, strukturer eller hvilke magtforhold, der gemmer sig under
en retlig legitimation. Her kan feministisk retsretorik bruges til at fremanalysere,
hvordan retoriske figurer og metaforer skaber de rammefortællinger, der legitime-
rer lovgivningen. Kun ved at få forforståelserne frem i lyset, kan man vurdere om
reguleringens indhold kan stå sin prøve om lighed og ligebehandling.
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Eggs on Ice: Imaginaries of Eggs and
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Eggs on Ice: Imaginaries of Eggs and Cryopreservation in
Denmark
Janne
Rothmar Herrmann and Charlotte Krolokkeb
aFaculty of Law, University of Copenhagen, Copenhagen, Denmark; bDepartment for the Study of Culture,
University of Southern Denmark, Odense M, Denmark
ABSTRACT
While Denmark is widely known as a global exporter of cryopreserved
sperm, Danish women's eggs face a very different fate. This
paper combines legal and rhetorical analyses with the concept
of sociotechnical imaginaries. In establishing the genealogy of
the sociotechnical imaginaries that shaped Danish regulation of
the cryopreservation of eggs, we analyse the relevant Acts, Bills,
preparatory work, and readings in Parliament, along with the
concurrent public and ethical debates that over time relaxed the
legal limit for the cryopreservation of eggs to the current five years
and today continue to ignite discussions on elective egg freezing.
We rely on welfare-state perspectives to discuss why reproduction, in
the Danish context, is seen as a legitimate and appropriate sphere to
regulate, and we turn to feminist theorizing to discuss the gendered
implications captured in the sociotechnical imaginaries of the
"Moral State", "technologies to be tamed, "the nuclear family, and
"technology as equality and hope": We end by discussing how an
interdisciplinary approach enriches our understanding of the legal,
cultural, and political entanglements related to putting eggs on ice.
ARTICLE HISTORY
Received 14 July 2017
Accepted 3 January 2018
KEYWORDS
Cryopreservation;
sociotechnical imaginaries;
egg freezing; reproduction;
Danish law
Introduction
The accidental discovery by Polge, Smith, and Parkes published in
Nature
in 1949 that glyc-
erol enabled fowl spermatozoa to survive freezing to —70°C initiated a phase of dramatic
development in the techniques we now know as cryopreservation. Meanwhile, vitrification
is a more recent technique that enables egg cells to be cooled to cryogenic temperatures in
the absence of ice. Although success rates in establishing pregnancies are still higher for
frozen sperm than frozen egg cells, in 2012, the American Society for Reproductive Medicine
announced that egg freezing was no longer considered experimental. In this article, we trace
the Danish legal regulations alongside ethical and public debates on women's egg cells in
order to respond to the research question: What sociotechnical imaginaries are embedded
within the Danish cultural, legal, and political discourses on (frozen) egg cells?
CONTACT
Janne Rothmar Herrmann ® [email protected]
ø 2018 The Nordic Association for Women's Studies and Gender Research
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20
O
J. ROTHMAR HERRMANN AND C. KROLØKKE
Whereas we draw on welfare-state perspectives to capture the complex entanglements
between the state, the law, and reproductive technological developments, we use the con-
cept of sociotechnical imaginaries to analytically grasp how cryopreservation becomes
imagined in Danish regulatory processes as well as in public debates (Jasanoff, 2015,
pp. 1-33). Sociotechnical imaginaries can be defined, according to Jasanoff, as "collectively
held, institutionally stabilized, and publicly performed visions of desirable futures, animated
by shared understandings of forms of social life and social order attainable through, and
supportive of, advances in science and technology" (Jasanoff, 2015, p. 4). Following this
definition, we turn our attention to the imaginative work undertaken during different time
periods within Danish law, and we theorize the ways in which legal regulation, along with
ethical and public debates, coproduce different values and perform different visions and
gendered imaginaries. As noted by Jasanoff and Kim (2009), imaginaries are almost always
related to what is good and what best serves "national interests" (p. 121). In the case of
Denmark, such national interests might be the political economy of assisted reproductive
technologies (ARTS) as Herrmann (2013, p. 508) notes, where the economic interests at
stake were the explicit political reason for upholding anonymous sperm donation, or they
might relate to the economy of the Danish welfare state, where reproduction is positioned
as requiring control. We thereby hope to establish not only a general overview of the ways
in which Danish imaginaries of egg cells and cryopreservation come together with national
interests, but also the specific ways in which public debates infiltrate and become entangled
with the law to coproduce gendered sociotechnical imaginaries related to eggs on ice.
The biopolitics of the Danish welfare state:
Do it for Denmark!
Can sex save Denmark? With this compelling question, the Danish travel agency Spies
launched its 2014
Do it for Denmark
campaign.' In the video, the viewer is confronted with
drastically falling birth-rates, the struggle to support an ageing population, and biomedical
evidence that Danes have more sex while on vacation. In
Do it for Denmark,
reproduction
becomes a welfare-state duty as well as a business opportunity repackaged into a competitive,
attractive, and active holiday. In this section, we use welfare-state and feminist theory to
situate Danish biopolitics on reproduction, and we then discuss why Denmark constitutes
a compelling case to study.
The relationship between the state, market, and family is a major focal point in wel-
fare-state theory. The Danish welfare state is redistributive and provides a wide range of
benefits and services as citizens' entitlements with the aim of creating a more egalitarian
society (Leira, 2002, p. 32). This includes, but is not limited to, paid parental leave, affordable
childcare centres, and child support to single parents or lower-income families. Feminist
scholars have specifically addressed the gendered nature of care, such as the fact that women
continue as the primary caretakers in the welfare state (Orloff, 1996), while simultaneously
pinpointing how reproduction becomes not exclusively a concern for the individual but,
rather, pivotal to the state. As noted by Cooper (2008, p. 38), in the welfare state, women
must dutifully manage their reproductive abilities in order to reproduce not only the fam-
ily but, in fact, the nation. This logic is similarly apparent in the introduction to the first
comprehensive Danish Abortion Act in 1938 when the general moral and legal taboo on
abortion was relaxed for the first time, and the relationship between reproductive policies
and the welfare state was cemented:
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NORA-NORDIC JOURNAL OF FEMINIST AND GENDER RESEARCH
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21
The rights of society to intervene in individual reproductive life were already broadly accepted
in medical and political circles that believed that the state was responsible for public health
... Reproduction, as it impinged on society, was primarily a social and only secondarily an
individual matter. (Koch,
2006, p. 308)
Reproduction and fertility have continued to be focal points in welfare-state theory (Esping-
Andersen,
2007;
Yuval-Davis,
1997).
Scholars have indeed demonstrated how economic
and labour issues provide the context in which women and their partners negotiate ques-
tions about reproducing through ARTs (Nahman,
2016),
and we suggest that these issues
also provide the context in the making of the law. Although the categorization of citizens
as (male) breadwinners and (female) dependants by the National Agency for Statistics
had been dropped in the early
1970s
(Statistics Denmark,
2015),
our analysis shows that
traditional perceptions of male breadwinners and female providers of care within families
continued to dominate the Danish case during the following decades. Yet, the value of car-
rying the welfare state's reproductive burden as a necessity in upholding the welfare state
is absent from this rhetoric, exemplified in the problematization of the fact that Danish
women remain dependent on the financial support of the welfare state, as a newborn girl
will receive welfare benefits and services worth
1.6
million DKK more than she contributes
in taxes during her lifetime (Smith,
2012),
with the value of her contribution to uphold the
welfare state through reproduction largely missing.
However, the collectively oriented Danish welfare state is under pressure from neoliberal
ideology. Although neoliberalism can be seen as predominantly an economic theory empha-
sizing minimal state actions and the free market, it can also include a perspective on moral
virtue; the virtuous person is one who is able to access the relevant markets and function as
a competent actor in these markets. Individuals are also seen as being solely responsible for
the consequences of the choices and decisions they freely make (Thorsen,
2010, p. 204).
In
terms of the Danish economy, labour market, and welfare state, the neoliberal political era
has seen major labour-market reforms, more than halving the duration of unemployment
benefits (Larsen & Andersen,
2009, p. 244),
tying in to some degree with neoliberal ideology
in which welfare states with high taxes and generous social transfer payments are seen to
corrupt unemployed people (Dean & Taylor-Gooby,
1992),
yet at the same time being pre-
sented as a recalibration of the welfare state to enable it to survive both external and internal
challenges. The neoliberal ideology accordingly puts a premium on individualized rights.
In terms of reproduction, the neoliberal consequently emphasizes reproductive autonomy
(Kroløkke & Pant,
2012).
That women are seen as individual and free agents is perhaps not
surprising, given the fact that women (like men) are agents of economic growth coinciding
with the female participation rate in the Danish workforce rising since the
1980s
(Statistics
Denmark
2014).
Yet, while Danish women today, similarly to men, are breadwinners, the
responsibility associated with pregnancy and parenting continues to be placed more solidly
on women's shoulders (Kremer,
2007).
This gendering of reproduction is similarly extended
to fertility-awareness campaigns such as the recent Copenhagen campaign entitled
Have you
counted your eggs today?
in which young Danish women (through a depiction of six chicken
eggs) are targeted and made aware of the relationship between age and fertility. The ways
in which the Danish welfare state today coexists with neoliberal ideology has effectively
positioned women as responsible for their fertility, including the need to make behavioural
and lifestyle choices that maximize their chances of pregnancy (Kroløkke & Pant,
2012).
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J. ROTHMAR HERRMANN AND C. KROLØKKE
Consequently, in many ways, Denmark constitutes a compelling case to study. Not only
is the country a global leader in the export of sperm (KrolØkke, 2009) and laboratory
equipment, it is also a well-known fertility destination for European single women as well as
lesbian and heterosexual couples desiring anonymous sperm donation (Adrian &
Kroløkke,
in review). In the case of the cryopreservation of eggs, however, Denmark is more restrictive
than neighbouring Sweden, and, consequently, Swedish fertility clinics encourage Danish
women to go to Sweden by offering them the benefits of long-term storage.2 Combined
with the fact that one out of twelve Danes is currently conceived through the use of in vitro
fertilization (IVF) (Mohr & Koch, 2016), this apparent contradiction between the quest
to reproduce and the restrictions on the cryopreservation of eggs calls for examination.
Accordingly, we use a genealogical analysis of the Danish law, engaging with Parliamentary
debates as well as commentaries from the National Council of Ethics on cryopreservation
more generally and elective egg freezing specifically.
Methodology and data collection
This article is effectively structured around the four periods of Danish regulatory response
to assisted reproductive technologies (ARTs) and cryopreservation technologies ranging
from 1984 until 2017. Empirically, we focus on Danish regulation of the cryopreservation
of eggs, tracing the Danish Bills through the legislative process with their three readings
in Parliament and the ensuing debates in both Parliament and the Parliamentary Health
Committee, and the concurrent public and ethical debates that over time relaxed the legal
limit for the cryopreservation of eggs from the initial proposed one-year limit to the current
five years. To do this, we searched the Parliamentary files electronically (www.folketinget.dk
and www retsinformationAk) and manually
(Folketingstidende)
for Bills, debates, Health
Committee deliberations, public consultation files, and Acts related to the cryopreservation
of fertilized and unfertilized eggs. We were furthermore allowed access by the Parliamentary
Library to files not publicly available.
In this article, we combine two different disciplinary methods: a dogmatic legal analysis
which establishes what the law is, and a rhetorical analysis that assists in identifying the
sociotechnical imaginaries embedded within the empirical material. Because egg freezing is
a recent technological development that ignites widespread discussion, we empirically turn
to the ways in which the cryopreservation of eggs has been debated in mediated accounts
dating from 2007 until the present day. To do this, we carried out a computer-generated
info-media search using the words "freezing", "eggs", and "social freezing", generating a total
of 2,866 Danish articles written in the 10-year span of 2007-2017. A qualitative screening
of all these articles using relevance as an indicator (leaving out unrelated articles such as
recipes) helped narrow the empirical material to a total of 89 Danish newspaper and media
accounts. In the subsequent analysis, we identified imaginaries through an emphasis on the
interpretation of symbols and the use of rhetorical tropes such as metaphors and metonymy.
Because language is central to the formulation of Bills, in the readings as well as the various
public debates, we use a rhetorical toolbox in the formulation of different sociotechnical
imaginaries. Consequently, while the law constitutes a site in which sociotechnical imagi-
naries unfold in practice (Jasanoff, 2015), attention to the images that different rhetorical
tropes generate has been at the core of our analytical approach.
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The choice to combine Danish regulations, readings, and debates in Parliament with
public and ethical debates was made in order to prioritize the complex relationship between
reproductive technological developments and the regulatory and public-opinion environ-
ments within which they unfold. A basic assumption is that legal regulation does not exist
in a vacuum but, rather, regulatory decisions as well as ethical and public debates become
entangled in ways that call for interesting theorizing. Generating a strong sense of the
sociotechnical imaginaries is helped by the juxtaposition of different empirical material.
We examine and privilege times of flux and changes over time, therefore necessitating a
chronological approach, evident in this article in the choice to foreground different time
periods (Fischer, 1995). Documents and other verbal texts related to science, technology,
and power, such as legislative hearings, policy reports, judicial opinions, legal briefs, political
speeches, and media reports, provide some of the most accessible and ubiquitous resources
for analysing sociotechnical imaginaries. Consequently, we seek to discuss how different
sociotechnical imaginaries are constructed by comparing different arenas of power, from
the legal to the public and political. This involves analysing recurrent themes or tropes
and positioning them in reference to the welfare state, articulated in this material in four
sociotechnical imaginaries: the imaginary of the Moral State, technologies to be tamed, the
nuclear family, and technology as equality and hope.
The sociotechnical imaginary of the Moral State
Up until 1984, in Denmark, assisted reproduction was not subjected to regulation. Instead,
the sociotechnical imaginary of the competent and independent scientist had dominated the
Danish case. Medical issues had been seen as best left to the medical profession to decide
on a professional and scientific basis, and for that reason most medical issues were not
addressed by legislation. In October 1984, however, a working group under the Ministry
for Interior and Health published its report "The Price of Progress" which recommended
the establishment of a Council of Ethics. In 1987, the Council of Ethics was established by
Parliament, and in 1989 it published a report on the protection of human gametes, embryos,
pre-embryos, and foetuses. It observed that viability was hard to preserve and recommended
a time limit for cryopreservation. A majority of the Council found "that cryopreservation
of eggs should be allowed subject to the same conditions applicable to sperm, i.e. that cryo-
preservation should be allowed for a limited time and [they] had to be destroyed at the time
of the banker's death" (p. 81). However, when the Council considered the cryopreservation
of sperm, it did not consider that it should be subject to any limitations except on medical
or administrative grounds as long as the sperm was destroyed when the banker died (1989,
pp. 60-61). This requirement exclusively addressed the time lag between the deposit and the
fertilization, ensuring that fertilization did not take place after death. Jointly, the Council
of Ethics, along with increasingly sophisticated technological developments, led to a shift
in the sociotechnical imaginary, from the imaginary of the competent scientist to the soci-
otechnical imaginary of the Moral State.
The sociotechnical imaginary of the Moral State became highly gendered. Whereas male
gametes had no storage limit, women's eggs were restricted in the number of years they could
be preserved in a frozen state (with a further restriction regarding their transnational mobil-
ity added in 1994). The Council of Ethics' report formed part of the background material
for the 1991 Act on Biomedical Research Ethics Committees, which lifted the research ban
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J. ROTHMAR HERRMANN AND C. KROLØKKE
on fertilized eggs in order to ensure adequate quality in the provision of fertility treatments.
IVF was now becoming a recognized clinical treatment, which meant that research—as was
the case for all other treatments offered—was deemed integral to ensuring good quality. In
Article 14, the Act authorized the Health Minister to issue a ministerial order regulating
the donation and cryopreservation of human eggs. This primarily concerned requirements
when establishing egg banks and cryopreservation. But the authorization was in reality
not solely for the regulation of technical questions. A normative issue was intended to fall
within the authorization, reflected in the fact that the government explicitly stated that it
presupposed a maximum cryopreservation period of 12 months for eggs and embryos, but
no reasons for this limit were given in the comments included in the Bill (L59/1991). In
this manner, eggs and embryos were regulated in ways that sperm was not. For the Council
of Ethics, the winning argument for regulating storage seemed to be the preservation of
viability, while the government did not give any reasoning for fixing the limit at 12 months
in the preparatory work.
The Moral State sought to regulate the normative issue of the status of the egg as well as
that of the embryo. Authorization was assigned to the Minister in order to regulate techni-
cal issues in a law predominantly concerned with codifying the framework for biomedical
research ethics that had previously been based on a non-binding professional framework.
The Moral State was clearly not completely comfortable with regulating medical practices,
which was in line with the general legal trend at the time—medical issues were on the
whole best left to doctors to decide on a professional basis. Between readings in Parliament
as the Bill passed on to further deliberations in the relevant parliamentary committee, the
Health Minister had stated, in a reply to the Committee's question 96, that "cryopreser-
vation of eggs is allowed when intended for later implantation in the same woman or for
donation. Unfertilized human eggs cannot be cryopreserved for more than 12 months"
(White Paper No. 59, 1992). Since the Acfs authorization had to be interpreted in light of
the scope articulated in the preparatory work, cryopreservation was regulated accordingly
in administrative practice. In spite of the fact that the Ministry had received more than 100
applications from couples asking for extensions to the 12-month period due to physical and
mental problems related to having to undergo a renewed cycle of egg retrieval, it had been
impossible to grant extensions due to the lack of a legal basis to do so.
In 1993, the sociotechnical imaginary of the Moral State was reiterated once again in the
government's attempts to regulate assisted reproductive technologies 3 The headline of the
government's paper outlining its intent to regulate ARTS seemingly offers reassurance while
reinstating ARTs as "unnatural': Offering "clear guidelines for artificial fertilization", it states
that the Minister has asked the National Board of Health to issue guidelines based on the
government's "comprehensive initiative to regulate: This initiative included limiting the
maximum number of embryos to be implanted after IVF, a requirement to use cryopreserved
(rather than fresh) sperm for donation for safety reasons, to implement a national reporting
system allowing the Board of Health to
"control retrieved eggs"
and supervise the quality of
treatment, and to set in place guidelines which mirrored what was described as women's
natural ability to bear children. Bearing in mind that the said ability could end unnaturally
early in some women, publicly funded IVF was nevertheless only to be offered to women up
to 40 years of age. But, due to what was framed as the maintenance and upbringing of the
child, in Denmark, 45 years was to be the upper limit for women to legally receive ART within
the private sector, while no age limit existed for men. In a response to the parliamentary
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Committee for Health, the Minister added that the increased risk during pregnancy and at
birth for older women was also to be considered in setting the upper limit at 45 years
4
These
guidelines clearly invoked gendered imaginaries and normative understandings related to
the appropriate age for motherhood as well as the desire to control women's eggs, even in
the frozen state. Subsequent legal interpretations would also rely on the intention to control
as the basis for denying eggs transnational mobility (Ombudman opinion, 1993).
In setting an upper age limit, the Danish law mirrored traditional and welfare-state views
of women's role in the family (Pateman, 1989), which emphasize the importance of the
female (and not the male) presence in the upbringing and care of the child. In this manner,
the sociotechnical imaginary of the Moral or moralistic State replaced the earlier imaginary
of the responsible scientist. To address the rapid developments within ARTs, the Moral State
set out to stipulate guidelines that aligned themselves with gendered constructions of nature,
including the limited, or non-existent, mobility or preservation of women's eggs. While it had
previously been seen as natural that medical issues were best left to the medical profession
to decide upon, the Moral State introduced a new set of legislative guidelines imbued with
gendered implications that set the stage for taming scientific developments. The potentiality
of ARTs to be monstrous was becoming a more powerful imaginary than that of the moral
doctor. As noted by feminist scholars, in patriarchal cultures, technological developments
are frequently discussed as having monstrous outcomes (Shildrick,1996). While sperm had
unrestricted international mobility, eggs were subject to a travel ban in order to control them.
Both the Danish law and the Parliamentary debates reproduced particular understandings
of the Danish nation. This ideal and imaginary state included the Viking nation, which was
made territorially great by spreading its (male) seeds by travelling—a narrative which was
heavily invoked in later international media news stories under such compelling headlines
as "The father's a Viking"
(The Guardian,
4 February 2011), "Invasion of the Viking babies"
(The Telegraph,
23 June 2014), "Spreading Scandinavian genes, without Viking boats"
(New
York Times,
30 September 2004).
Technologies to be tamed
It was clear from the 1994 debate that Parliament was anxious for the Government to
propose comprehensive regulation of ARTs because of the ethical concerns they raised. In
February 1996, a Bill (1995/1 LSF 200) was introduced to regulate artificial fertilization,
thus providing a legal basis for the prohibitions, which had previously been issued adminis-
tratively (guidelines 15,120/1993, circular 108/1994, and guidelines 109/1994). This meant
that the regulation of ARTs moved away from being an administrative regulation of the
physicians' professional activity to becoming a normative comprehensive Act with sanctions
inscribed in criminal law,
The Bill's overall approach was to regulate in the language of prohibition, in relation
to both research activities and clinical applications, combined with an approval system.
It included a provision on cryopreservation in Article 14, which codified the limitation
on the cryopreservation of eggs and embryos to 12 months but with the possibility of the
National Health Board granting permission to extend this period "in special cases, where
the woman's health or other critical grounds" spoke in favour of an extension. Once again,
no upper storage limit existed for the cryopreservation of sperm. Moreover, in an explicit
quest to tame ARTs, the adopted Act continued to include what was discursively positioned
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as an "objective" age limit of 45 years for women to replace the Bill's suggested subjective
limit of 40-45 years based on an individual assessment of the womans reproductive capac-
ity and whether or not it has ceased because of age or the onset of menopause. While this
assessment was initially intended to apply to both men and women, in reality it became
gendered, as the adopted requirement related to women only. During the Parliamentary
Health Committee's deliberations, different constellations of party minorities, majorities,
and individual members proposed a large number of amendments. One amendment pro-
posed to continue the 45-year age limit for women only. The proposition stated that this
would legally fix the age limit, which the government had proposed in 1993 as part of a
press release and which had subsequently been part of the Health Board's guidelines of 22
December 1993.
While the monstrosity of the old mother is present throughout this material, other mon-
strosities were invoked as well. Notably, in these Parliamentary debates, the monstrosity of
disrupting what appeared to be a normative kinship order ("twins in separate pregnancies")
became pivotal. According to a spokesperson for the Social Democratic Party, separating
"twins" became morally suspect: "At present no eggs are frozen, but technology may catch
up. I find 12 months to be right. To me, there is something unethical about having embryos
Similarly, the Conservative
in storage, maybe even to have twins in separate pregnancies."I
Party's spokesperson expressed concern when comparing frozen reproductive cells with
what she speculated to be the similarly poor viability of frozen food: "It is the thought of
the artificial that scares me ... after two or three years in the freezer ... are the eggs in good
condition? The food we freeze has a shorter shelf life" (1996/1 LSF 5 debate). Meanwhile,
the spokesperson for the Socialist Party reiterated the need to tame ARTs by simply refer-
ring to the technological developments as "monstrous research" (1996/1 LSF 5 debate). The
Bill, however, did not succeed in being read three times during the parliamentary working
year because the Parliamentary Health Committee felt that there was insufficient time to
debate and negotiate it, and consequently it was automatically struck. The Government
put forward the Bill with slight revisions the following Parliamentary year (1996/1 LSF 5).
During this time period, the Parliamentary debates reiterated a concern about the "unnat-
ural", which featured heavily in the image of the freezer, the ageing mother, and the best
interests of the child. For example, in one proposition, a leading Danish politician stated in
reference to the cryopreservation of embryos that it was offensive to have "the family in the
freezer", calling for a maximum two-year cryopreservation period. Meanwhile, the general
extension of the one-year legal limit was believed to address concerns related to the woman
and her family, cases of illness, and the physical and mental trauma of having to undergo
renewed hormone stimulation and egg retrieval. The extension was meant to ensure the
successful achievement of one pregnancy in accommodating further treatment cycles if the
first attempts were unsuccessful. It was noted that longer cryopreservation limits abroad
indicated that there were no safety issues in extending the limit. However, the limit was
not extended beyond the two years out of consideration for the ethical concerns that had
been voiced, including by the Council of Ethics, which in its 1995 annual report stated that
scientific studies indicated that the cryopreservation of eggs would likely damage the chro-
mosomal material. Between readings, the Parliamentary Health Committee considered the
Bill and members posed various suggestions for amendments. Their deliberations, the mate-
rial they received during the public consultation process, and the suggested amendments
reflect a number of key concerns and questions: Would the technology lead to unnecessary
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treatments, potentially burdening the welfare state? And what were the consequences of
individualizing eggs and embryos in this way in relation to womens rights on the one hand
and disposition rights over the material on the other?
The imaginary of medicine as a scientific endeavour in the service of the moral good
was changing during this time period. The adoption of the Act on Artificial Reproduction
was followed by the adoption of the Patients' Rights Act 1998, reflecting a general legisla-
tive move away from self-regulation towards taming reproductive technologies, including
the technologies of cryopreservation. In this sociotechnical imaginary, eggs became seen
as vulnerable entities in need of protection, while no such concerns were expressed about
sperm. Medicine in the realm of new technology had to be tamed because of what became
framed as the risks to the patients and the overall ethical concerns related to present and
future reproductive options, including the gendering of reproductive cells. Meanwhile,
cryopreserved sperm did not invoke the same kind of response or concern. In this manner,
eggs became bearers of kinship in need of state protection, and technological developments,
including the ability to cryopreserve eggs and embryos, became technologies to be tamed.
Consequently, the entanglements between Parliamentary debates and Danish law produced
an image of the welfare state as rightfully controlling womens ability to put eggs on ice.
The nuclear family
In
2006,
a Bill
(2005/1
LF
151)
to modernize the Act on Artificial Fertilization included
new provisions for the assessment of parental skills, widened access to egg donation, and
extended the maximum period of cryopreservation of eggs to five years. The accompanying
remarks state that both the Ministry and the National Board of Health had continued to
receive requests for dispensation so that couples could try for a second child with their cry-
opreserved fertilized eggs. It is noteworthy that, during this time period, the debates made
reference to cryopreserved eggs and fertilized eggs interchangeably. Whereas
one
pregnancy
had been the goal of the previous legislation, the issue was now that of securing families more
time to establish
a second pregnancy 6
Relying upon scientific evidence that cryopreservation
posed no risks, the government extended the time limit to five years, successfully enabling
the possibility for two children to be born within a normative kinship order. It was stressed,
however, that cryopreserved eggs were subject to other legal limitations besides the length
of the cryopreservation period, such as the requirement that they be destroyed in cases of
death or divorce, the rules on donation to other women, and the requirement for consent
in the case of donation to research. It was in order to ensure the enforcement of these rules
and requirements that an upper limit for cryopreservation was left in place. Meanwhile, no
upper storage limit was imposed on the cryopreservation of sperm.
Clearly, the technological ability to successfully cryopreserve women's eggs was still in
its infancy during this time period. In the popular debates, cryopreservation was frequently
problematized and seen as a potentially monstrous technology. This was especially true in
cases when same-age embryos (created during the same IVF treatment) were used during
separate IVF treatments and pregnancies. As noted in one Danish account, but in refer-
ence to a case in the United States, where a 42-year-old woman used a 20-year-old embryo
to create a healthy child: "How about having a child that comes from an egg older than
yourself?" (Jyllandsposten, 2010). Similarly, the headline "Created at the same time: Twins
born five years apart" underpinned what became seen as the "unnaturalness" associated
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with the disruption of sibling (kinship) time. As echoed in the article in which the older
child's resemblance to the newborn is presented as uncanny:
He was an easygoing and happy boy, and while he was growing big and strong turning into
the five-year-old bundle of energy he is today, little Floren was on ice. The egg, which ended
up as the loveliest of girls, was stored at minus
196
degrees. (Sogaard,
2012)
In the public imaginary, then,
eggs
and embryos—even when put on ice—age and turn into
a "twenty-year-old egg" (Mama.dk, 20 10) or a "twenty-year-old sister" (Mama.dk, 2010).
While the monstrosities associated with disrupting the normative kinship order (embryos
created at the same time should be born at the same time) continue to be visible, the soci-
otechnical imaginary of ice is not exclusively negative during this time period. Rather, in
the popular debates, ice becomes aligned with the notion of strong and healthy babies. As
noted in one account, cryopreservation is constructed as good news for the parents, because
frozen embryos result in the birth of larger babies, simultaneously diminishing the risk of
prematurity (Foghsgaard, 2009). So, while ice disrupts kinship temporalities, it is seemingly
and positively also seen to contribute to the baby's health. This ambivalence between ice
as unnatural and monstrous (separating twins and siblings), on the one hand, and healthy
(making for sturdier children), on the other, coincides with attempts to regulate ice within
certain normative frameworks. Additionally, the imaginary draws upon nationalized and
preconceived notions of frost as healthy, such as babies who, in the Scandinavian countries,
conventionally nap outside in cold weather, for example. Jointly, the modernization of the
Bill and increased awareness concerning the possibilities of cryopreservation came together,
during this time period, to create a new set of sociotechnical imaginaries. The sociotechnical
imaginary of the modern nuclear family included the desire for two children along with the
notion that frost did not hinder but in fact supported the making of strong Danish babies.
Technology as equality and hope
It was not until 2015 that the Danish Council of Ethics made a statement on the storage and
use of unfertilized eggs. Notably, the Council found that it had not sufficiently discussed
how the storage and use of unfertilized eggs ought to be regulated in light of the new pres-
ervation possibilities, stressing that it had been assumed without explicit reasoning or dis-
cussion that the regulation of unfertilized eggs would follow that of fertilized eggs. Central
to the debates, once again, was the best interests of the child, including the development of
a practice ensuring that cryopreservation would be used to increase the opportunities for
creating well-functioning children as conceptualized within the parameters of welfare-state
perspectives as the creation of future responsible (healthy and tax-paying) citizens.
Whereas the Council expresses concern related to the cryopreservation of eggs, it explic-
itly seeks to manage cryopreservation through a reinstatement of the womans age. A contin-
uation of the age limit would, according to the Council, serve as a general encouragement
for women to reproduce earlier. Interestingly, the Council notes that, if the upbringing of
the child and the child's best interests are key concerns, as they indeed were in the adoption
of the 1997 Act, then an age limit should apply to men too. Yet, due to the fact that men's
reproductive abilities are seen as not ceasing "naturally', the Council in its deliberations
cements the concern to exclusively centre on the image of the older mother. Accordingly,
the Council calls for legal frameworks that discourage women from "deliberately choosing
to postpone pregnancy" (The Danish Council of Ethics, 2015, p. 8), encouraging women
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instead to have children prior to their 35th birthday. In terms of "social freezing" the Council
conceptualizes the technology as not altogether a "free choice" but in fact caused by the
absence of suitable male partners, thus reinstating social egg freezing within a heteronor-
mative framework (Waldby, 2016). An extremely divided Council remains critical, however,
of women's ability to deliberately postpone reproduction to their later years, discussing
arguments for and against regulating sperm and eggs in the same way. The Council advises
that sperm and eggs
are
different—amongst other things, sperm, according to the Council,
is easier to access and exists in larger numbers—encouraging in fact the development of
differential and gendered legislation.
In contrast to a sceptical Council, in the popular debates, social egg freezing is celebrated
as a new reproductive revolution enabling women to put their fertility on hold at will. As
noted in one account:
Through cryopreservation, women can expand their biological time and plan their way out of
the crisis, which is why an egg on ice seems like an obvious solution, especially if you want to
enjoy your success in the job, find the man that you dreamt about in your teenage bedroom
and, for once, do not see the necessity of having children in your early spring because you
expect to turn
100
years old. (Wallach,
2015)
Similarly, Danish newspapers rely on the experiences of North American fertility clinicians
such as David Keefe, head of New York University Fertility Center, who positions egg
freezing as a natural extension of women's ability to make their own reproductive choices:
"We have been successful at liberating women from pregnancies, but we have never been
successful at letting women have children when they want them' (Vestergaard, 2014). Social
egg freezing, in these debates, extends the reproductive choices afforded by the birth-control
pill, making cryo-pregnancies appear normal—even attractive—as they enable women to
synchronize their "biological clock" with the rest of their lives or, as noted in one account:
"Wise women freeze" (Tholl, 2016). In this manner, popular debates on social egg freezing
put a premium on neoliberal modes of reproductive rights and autonomy.
Meanwhile, Danish women's ability to bring their reproduction into sync with the rest of
their lives (and not the other way around) continues to be limited by the five-year cryopres-
ervation time period. This limitation has been criticized, however. For example, the Danish
bioethicist Thomas Søbirk Petersen notes that egg freezing is seen as having a potentially
positive impact on women's careers, when he says:
If we allowed egg freezing to all women, we might have more ambitious women in the top
posts of society. Those women would have an easier time changing structures within their
present workplaces so, in the end, it would be easier for other women to have their children
earlier. (Wallach,
2015)
The gender-equality argument is similarly employed by the head of The Laboratory of
Reproductive Biology at Copenhagen University Hospital, Claus Yding Andersen, when,
in reference to men's cryopreservation options, he is quoted as asking critically: "Why can
men have their sperm frozen indefinitely, while women can freeze for a maximum of five
years?" (Ejsing, 2014). In this sociotechnical imaginary, freezing or postponing reproduction
is aligned with the promise of a more gender-equal society. Ice becomes a technology that
frees women, assisting them in synchronizing their reproductive bodies with their careers
and romantic time, yet also firmly situating women's reproduction within a biomedical
mode (Thompson, 2005). In these accounts, neither frozen eggs nor women's uteruses age:
"A woman has the best chance of becoming pregnant while she is young. Here the eggs are
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best and plentiful. The uterus on the other hand does not age", one reporter notes.' Having
eggs on ice, then, is imagined as granting women the freedom to choose, an individualized
and neoliberal reproductive solution to what might otherwise be construed as a collective
problem riddled with structural and gendered barriers.
In spite of these more celebratory accounts, social egg freezing continues to be ques-
tioned in light of women's ageing bodies as well as the limitations that the Danish five-year
cryopreservation period poses. Here, egg freezing is narrated within a heteronormative
framework and positioned as constituting both false and limited promises. As argued by
the former head of the Danish Council of Ethics, Jacob Birkler:
It is not about preventing women from having the same rights as men, but amongst other things
about fooling them and giving them the impression that they can use freezing to extend their
reproductive time and wait for children until their career is in place and the man has been
found. (Danish Ethical Council,
2015)
Similarly, clinician Karin Erb sees egg freezing as creating a false sense of security, leading
women to potentially waste their fertile time: "I am worried that women think they are
assured children until they are 45, if they freeze 10 eggs" (Dahlgaard, 2013). Mai Mercado
from the Conservative Party echoes this when she speculates that freezing may increase
the age difference between parents and their children. While Mercado (2014) positions her
concern as having to do with "parents", it is effectively gendered towards "mothers", as no
age limit currently exists for men:
Now you will
pretty soon be able to freeze your eggs when you are in your early
20s
and then
wait until your
40s
to use the completely young eggs.
I
think you are interfering with nature
too much. To me, it is also important that the age difference between
parents
and children is
not too great. (Mercado,
2014)
In this imaginary, the notion of mothering at a grandmother's age disrupts the normative
temporality of reproduction. Thomas Søbirk Petersen addresses this when he is quoted as
saying: "I think a lot of people basically find it disgusting and gross when mothers are in
their 50s and 60s" (Vestergaard, 2014).
Consequently, the more celebratory imaginary of ice is replaced, in these debates, with
an alarmist imaginary citing freezing as a potential scam that, when combined with the
monstrosities associated with the ageing (in)fertile female body, turns the cryopreserva-
tion of eggs into a negative right. In the cold new world of cryopreservation, ice is made
to appear a viable option enabling reproductive autonomy and fertility at a later age, yet
also problematized as invoking commercial exploitation in the form of false promises and
misplaced hope. Feminist scholars echo this latter perspective when they critically position
ARTs as a technology of hope, noting that the requirement to be hopeful is an earmark of
neoliberal ideology (Franklin & Lury, 2006). In both understandings, social egg freezing
is positioned within an individualized imaginary in which women (but not men) navigate
the responsibility associated with reproductive technologies and family planning.
Concluding remarks
In this article, we have discussed the Danish sociotechnical imaginaries of cryopreservation
as being embedded within Danish legal regulatory practices as well as within the Council
of Ethics, and Parliamentary and public debates. We have seen how competing imaginar-
ies unfold in the Danish case between the early sociotechnical imaginaries of the Moral
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31
State and the taming of freezing technologies, and the more contemporary imaginaries of
the modern nuclear family, along with monstrous disruptions of reproductive temporality
and autonomy. To some extent, the imaginary of cryopreservation in which the family (or
fertility) is put in the freezer has been present during all of these time periods. Here, the
workings of the law have been to regulate reproductive lives to fit within the nationalized
ideal of the Moral State and the moral professional, now extended to the modern nuclear
family along with what gets framed as the fit, autonomous, and younger (under 35) mother.
Danish law has repeatedly sought to control women's eggs, both in terms of their inability
to move transnationally and their ability to stay on ice. Here, the image of older mothers
deliberately defying age-defined reproduction, positioning grey maternity as a form of
bodily rejuvenation (Lahad & Hvidtfeldt Madsen, 2016), appears especially problematic.
Meanwhile, women continue in these sociotechnical imaginaries to shoulder the respon-
sibility for bearing children as well as becoming the bearers of the Danish welfare state.
As evidenced in the material, however, the moralistic yet controlling welfare state is
under siege. Confronted with the imaginary of individualized reproductive autonomy and
neoliberal reproductive citizenship, normative imaginaries associated with reproductive
time and age are potentially disrupted. Yet, the discourse simultaneously reiterates a natu-
ralized desire for heterosexual coupledom prior to pregnancy as well as women who become
positioned as responsible reproductive decision-makers. In the public debates, however,
cryopreservation is both celebrated as a gender equalizer and also critically questioned as
an insurance policy—a speculative banking of one's fertility of sorts, as well as an indicator
of health, because ice is seen to make sturdier babies.
Our findings cement the importance of interdisciplinary feminist scholarship. In the
Danish case, reproduction has been a central tenet of the welfare state. In seeking to con-
trol women's eggs and the age at which women—at little cost to the welfare state—can
reproduce, the Danish welfare state has applied a gendered rationale in which meiA repro-
ductive cells "naturally" transgress the borders of geographical place, life, death, and the
market. Meanwhile women's eggs continue to be regulated as the property of not only the
individual woman but also the state. Danish women are expected to manage the burden
of the welfare state through reproducing responsibly, reiterated in our empirical material
as limiting cryopreservation and managing pregnancy within a normative age framework.
The monstrous constructions of the older mother and the disruption of sibling temporality
are managed in order to fit particular understandings of the good mother/citizen and the
healthy/responsible child. In combination, we have shown that interdisciplinary feminist
scholarship contributes with important knowledge about the ways in which the Danish law
becomes entangled with technological developments as well as Parliamentary, public, and
Council of Ethics debates.
Notes
1. The video Do
itforDenmark
can be found at: https://www.youtube.com/watch?v--vr03TQc9Qw
Retrieved October
2017.
.
2. Cura Oresund markets its services specifically to Danish women on its website: http://www
ivfkliniken.se/curaoresund/behandling
_2012
/nedfrysning-of-aeg/ Retrieved October,
2017.
3. http://webarkiv.ft.dk/?/samling/19931/udvbilag/suu/almdel_bilag63.htm. Document is not
electronically available, but made available to the authors courtesy of the Parliamentary
Library.
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32
O
J. ROTHMAR HERRMANN AND C. KROLØKKE
4. http://webarkiv.ft.dk/?/samling/19931/udvbilag/suu/almdel_bilagl37.htm. Document is
not electronically available, but made available to the authors courtesy of the Parliamentary
Library.
5. Debate on Bill No. 200 of 23 February 1995 printed in
Folketingets Forhandlinger
p.
4055
http://webarkiv.ft.dk/?/samling/ 19951 /lovforslag_oversigtsformat/1200.htm
6. See also the Health Minister's speech during the first parliamentary debate http://www.ft.dk/
samling/20051 /lovforslag/1151 /b eh 1-48/81 /forhandling.htm?startitem=#n av
7. Kvinder fryser sig til sen graviditet. Derfor frosser yngre kvinder
æg
ned, mens de venter på
drømmeprinsen [Women freeze to have a late pregnancy. These are the reasons why younger
women freeze while they await the prince of their dreams]. 24
timer,
28 June 2010.
Disclosure statement
No potential conflict of interest was reported by the authors.
Funding
This work was supported by the Danish Research Council under the Grant "Ice Age: Reproductive
Lives, Times and Ethics in Fertility Preservation , grant # 7013-00042B.
Notes on contributors
Janne
Rothmar Herrmann is
an associate professor at the Faculty of Law, University of Copenhagen.
She has written monographs dealing with legal and ethical issues at the beginning and end of life.
Recent publications include a chapter, "The Human Embryo and Foetus", in the
European Compendium
on Health Law
(Maklu, 2017) and a volume on Danish medical law in the International Encyclopedia
of Law series (2016). Research interests include: reproductive rights, law and technology, medical
law, bioethics, and privacy. She has worked in interdisciplinary ways through the research projects
BioCampus and Global Genes, Local Concerns, and is currently a partner in the research project
Ice Age.
Charlotte
Kroløkke
is
professor in the Department for the Study of Culture, University of Southern
Denmark. Her scholarship has been published in international journals such as
European Journal
of
Women's Studies
and
Women's Studies in Communication.
She is head of the research projects
Reproductive Medicine and Mobility (REMM) and Ice Age: Reproductive Lives, Times and Ethics
in Fertility Preservation (Ice Age). Research interests include: cultural and feminist perspectives
on preservation technologies, reproductive medicine and mobility, cultural and gender analyses of
reproductive waste and value, and intersections of cultural studies, law, and medicine.
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Dansk lov forhindrer kvinder i at eje deres krop
https://hvww.berlingske.dk/opinion/dansk-lov-forhindrer-kvinder-i-at-eje-...
OPINION
Dansk lov forhindrer kvinder l at eje deres krop
Kvinders nedfrosne æg bliver destrueret efter fem år, men der er ingen tidsgrænse for nedfrysning af mænds sæd.
»Er det virkelig etisk forsvarligt, at kvinder ifølge dansk lov ikke kan nedfryse deres æg lige så længe de ønsker, mens dette er muligt for mænd?« skriver Thomas Søbirk
Petersen. Billeder fra Dansk Fertilitetsklinik.
Foto: Asger
Ladefoged
Torsdag d. 26. december 2019, kl.15.45
Del denne artikel .-
Thomas Søbirk Petersen, professor i Etik ved Roskilde Universitet
Hvem synes du, der skal bestemme over din krop - du selv eller staten?
Jeg tror, at de fleste vil mene, at det skal vi selv. En fundamental etisk rettighed er, at vi ejer os selv, og at vi kan gøre med vores
krop, hvad vi vil, bare vi ikke skader andre.
Vi bør bekæmpe, at andre tager ejerskab over vores krop. Et eksempel på, at selvbestemmelsesretten bliver krænket, finder vi i
dansk lov om assisteret reproduktion.
Ifølge loven kan mænd nedfryse deres sæd lige så længe, de ønsker - også efter deres død (§23, stk. 5) - mens det er strafbart at
nedfryse kvinders æg i mere end fem år (§15)• Straffen er ifølge lovens §29 op til fire måneders fængsel. En straf for at hjælpe
kvinder med at bevare nogle af kvindens egne celler.
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Dansk lov forhindrer kvinder i at eje deres krop
https:Hvm,w.berl ingske.dk/opinion/dansk-lov-forhindrer-kvinder-i-at-eje-...
Thomas Søbirk Petersen
Er det virkelig etisk forsvarligt, at kvinder ifølge dansk lov ikke kan nedfryse deres æg lige så længe, de ønsker, mens dette er
muligt for mænd? En forskel der gør, at mænd kan eje deres sæd på ubestemt tid, mens det ikke er muligt for kvinder. En forskel
der gør, at mænd har bedre chance for at få børn end kvinder.
Kvinder bør stilles lige med mændene. Både fordi der er gode grunde for en ligestilling mellem kønnene, hvad angår ejerskab af
egen krop, og fordi der ingen gode grunde er for denne forskelsbehandling. Desuden kan en lovændring øge chancen for, at børn
bliver født med færre alvorlige genetiske sygdomme. Hvis en kvinde nedfryser sine æg som f.eks. 25-årig og igen anvender dem
som 40-årig, er risikoen for, at barnet har genetiske sygdomme mindre, da en 25-årig kvindes æg i gennemsnit er mindre
disponeret for genetiske sygdomme end hendes
æg,
når hun er 40 år.
»Den overvejende grund til, at kvinder får børni en senere alder, er, at mange mænd er ramt af et Peter Pan-
syndrom, der gør, at de først ønsker at få børn 14Oerne og 50erne.«
Man kan mene, at det er farligere for kvinder at være gravid og føde børn i en senere alder, og at en ændring af loven vil betyde,
at flere kvinder får børn i en senere alder, end det er tilfældet i dag. Det er rigtigt, at der er en øget risiko for moderen, hvis man
bringer et barn til verden som 40-årig end som 25-årig. Men hvis man som kvinder bliver informeret om disse meget lave risici,
er det vel kvinden selv, der skal bestemme, om hun ønsker at få børn? Vi tillader jo, i al almindelighed, kvinder over 40 år at få
børn.
Man kan også mene, at staten ikke bør støtte, at kvinder kan få børn i en senere alder, og at kvinders ejerskab over deres
kønsceller vil øge sandsynligheden for dette. Jeg er helt på det rene med, at det er sund fornuft at prøve at få børn, mens man
som kvinde er i toerne. For det vil øge chancen for at få de børn, man ønsker at bringe til verden. Men der er mange andre
grunde til, at kvinder får børn i en senere alder, end at kvinder udskyder at få børn, fordi det er teknologisk muligt. Det kan være
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Dansk lov forhindrer kvinder i at eje deres krop
https://www.berlingske.dk/opinion/dansk-lov-forhindrer-kvinder-i-at-eje
-...
fordi, man har mistet et eller flere børn, eller at man har mistet den kæreste eller ægtefælle, som man gennem mange år troede,
man skulle have børn med.
Forskningen viser, at den overvejende grund til, at kvinder får børn i en senere alder, er, at mange mænd er ramt af et Peter
Pan
-
syndrom, der gør, at de først ønsker at få børn i 40erne og 5oerne. Da er det ofte for sent for deres jævnaldrende kvinder. Kvinder
ønsker at få børn i en tidligere alder, men det er altså ofte mændene, der forhindrer dette.
»At man vil straffe individer, der vil hjælpe kvinder med at bevare deres nedfrosne æg, er svært at forstå i et
foregangsland som Danmark.«
Man kan også mene, at det er synd for børnene, når kvinder får børn i en senere alder, fordi børnene har deres mødre i kortere tid
end yngre mødre.
Men så længe, der er tale om børn, der har liv, som er værd at leve, er det svært at se, hvorfor det skulle være synd for dem at
blive til, eftersom alternativet ville være aldrig at være blevet født. Og - som nævnt før - i nogle tilfælde vil frysning af æg faktisk
formindske risikoen for, at børn bliver født med genetiske sygdomme, eftersom denne risiko er mindre, når man bruger unge æg.
At kvinder ifølge dansk lov bliver lagt på is, når det handler om at få børn og selvejerskab, er problematisk. At man vil straffe
individer, der vil hjælpe kvinder med at bevare deres nedfrosne æg, er svært at forstå i et foregangsland som Danmark, hvor vi
sætter ejerskab over egen krop højt, og hvor vi mener, at kvinder og mænd skal have lige adgang til at få de børn, vi ønsker at
bringe til verden. Giv kvinderne en oplagt julegave: lad dem bestemme over deres egen krop, og slet den formynderiske fem års
grænse...
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Kvinde, hvor mange æg har du i banken?
https://videnskab.dk/krop-sundhed/kvinde-hvor-mange-aeg-har-du-i-banken
Kvinde, hvor mange æg har du i
banken?
KOMMENTAR. Britiske, amerikanske og svenske kvinder kan nemt fa
deres æg frosset ned. Er du kvinde i Danmark, er det til gengæld knap så
let. Hvorfor halter Danmark stadig efter?
Når nedfrysning bliver set som »uværdigt« , er det fordi kvinders arveanlæg ikke 'bare' er
kønsceller, men i højere grad gjort til fremtidige børn. (Foto: Shutterstock)
Charlotte Kroløkke - Professor MSO, Institut for
Kulturvidenskaber, Syddansk Universitet &
Janne Rothmar Herrmann - Lektor, Det juridiske Fakultet,
Københavns Universitet
08 marts 2018
FORSKERZONEN
(KOMMENTAR) (PARFORHOLD)
Evnen til at kunne reproducere os selv'kunstigt' udvikler sig hastigt i disse år. Vi bliver bedre til at
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Kvinde, hvor mange æg har du i banken?
https://videnskab.dk/krop-sundhed/kvinde-hvor-mange-aeg-har-du-i-banken
opbevare menneskelige æg, sæd, ovarievæv og embryoner. Det skaber helt nye og komplekse
dilemmaer for lovgivere, kliniske praktikere og de involverede kvinder og mænd.
Skal en kvinde eksempelvis have mulighed for at forlænge sin reproduktive alder ved at nedfryse
sine æg, og hvor lang tid bør en kvindes æg egentlig kunne ligge på køl?
Danmark er kendt for at have verdens største sædbank, men mens retsreglerne understøtter salg
og opbevaring af sæd, ser det anderledes ud for kvinders æg. Lovgivningen begrænser i dag
opbevaringstiden af æg og embryoner til fem år, og man må kun bruge dem indtil kvinden fylder 46
å r.
Derimod er der intet til hinder for, at en 65-årig mand donerer sæd eller bruger sin allerede
opbevarede sæd til at få børn med - har han sagt god for det, kan sæden endda bruges, efter han er
død.
Hvilke værdier gælder på hvilket
tidspunkt?
Men hvad er det egentlig for værdier, hensyn og
forestillinger, der ligger til grund for, at lovgivningen er
indrettet, som den er? Og er de hensyn fortsat gangbare
som argument for at opretholde gældende lovgivning?
Fakta
Ægudtagning
Det satte vi os for at undersøge ved at analysere mediedebatter, etiske debatter, folketingsdebatter,
lovforslag og love - helt tilbage fra den første regulering af assisteret reproduktion i 1997 frem til
den nugældende lovgivning og aktuelle debatter om det, man i dag kalder'social freezing' - altså det
fænomen, hvor kvinder får frosset æg ned, fordi deres livssituation ikke er til et barn nu og her.
Vores resultater er netop udkommet i artiklen 'Eggs on Ice: Imaginaries of Eggs and
Cryopreservation in Denmark' i Nordic journal of Feminist and Gender Research (NORA).
Æg og reproduktion skulle kontrolleres
18, oktober 1983 blev Troels Renard Østbjerg født som Danmarks første reagensglasbarn. Hans
fødsel og de reproduktive teknologiers ankomst skabte et nybrud: Hvor man før havde opfattet
lægen som en moralsk ansvarlig figur i det godes tjeneste, opfattede man nu de nye teknologer som
potentiel 'monsterforskning', der skulle tæmmes.
Det kunne man ikke overlade til forskerne og lægerne selv. I stedet måtte lovgiverne på banen. De
var ikke helt trygge ved at bevæge sig ind på lægernes domæne - og den første, spæde regulering
havde derfor hovedsageligt karakter af faglige vejledninger. Den første samlede lovgivning, der
trådte i kraft i 1997, rammesatte de reproduktive teknologier som kunstige (lov om kunstig
befrugtning) og regulerede hovedsageligt i forbudssprog.
Et centralt element i loven var ønsket om at kontrollere æg - også de ubefrugtede. For eksempel har
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Kvinde, hvor mange æg har du i banken?
https://videnskab.dk/krop-sundhed/kvinde-hvor-mange-aeg-har-du-i-banken
handel med æg længe været fordømt som uønskeligt, mens vi har kunne bryste os af at være
førende på det globale marked i sæd.
Ønsket om at kontrollere forplantningen kan da også spores helt tilbage til den tid, hvor
velfærdsstaten var under opbygning.
Vi får eksempelvis den første abortlov i 1939 - der trods en grundlæggende opfattelse af abort som
naturstridigt og samfundsfarligt - nu gav mulighed for at abortere syge eller misdannede fostre, så
byrden på de offentlige kasser, der skulle sørge for pleje og underhold, ikke blev for stor.
Da Det Etiske Råd bliver oprettet i 1987, sker det også med det specifikke formål at rådgive
Folketinget efter Indenrigsministeriets rapport'Fremskridtets Pris' med et billede af Adam, Eva og
det forbudte æble på forsiden havde formanet til lovgivning om nye reproduktionsteknologier.
»Kvinder er ikke beregnet til at lægge æg«
Men mens der ikke laves regler for, hvor længe sæd kan opbevares i fryseren, blev ubefrugtede æg
set som sårbare størrelser, der havde brug for særlig beskyttelse.
Ordfører Henriette Kjær (K) udtaler således ved 1.
behandlingen af 1997-loven om kunstig befrugtning, at
»det er tanken om det kunstige, der skræmmer mig, hvor
man to eller tre år efter, at ægget er blevet nedfrosset,
tager det frem igen ( ... ) man kan spørge sig selv, om
æggene er i god nok stand. De fødevarer, vi fryser ned,
kan jo ikke engang holde så lang tid.«
Ordfører Margrethe Auken (SF) følger op: »Vi er
bekymrede for, hvad der sker, når det æg kommer ud af
kvinden, for når vi ser, hvad der derefter kan findes på, er
vi faktisk tilbøjelige til at sige, at kvinder ikke er beregnet
til at lægge æg, og derfor vil vi ikke have det.«
Ønsket om at kontrollere æg betød, at de heller ikke
måtte forlade landet, alt imens salget af sæd efterhånden
blev til en national eksportsucces.
Livmoderhals
Vagina
Æggeledere
Æggestokke
Livmoder
I
Uværdigt at have et 'barn' i
fryseren
Kvindens æg udvikles i æggestokken,
hvorefter det føres til livmoderen
gennem æglederen. Hvis
ægget befrugtes, sætter det sig fast i
livmoderens slimhinde og danner et
foster. (Illustration: CDC, Mysid)
Nedfrysning af kvindens arveanlæg bliver i lovgivningen og de etiske debatter indflettet i en bestemt
kønnet værdighedsforståelse. Det Etiske Råd har i deres redegørelse fra 2004 et separat afsnit, der
handler om etik og nedfrysning.
I afsnittet diskuterer Rådet alene ubefrugtede og befrugtede æg. Nedfrysning bliver set som
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Kvinde, hvor mange æg har du i banken?
https://videnskab.dk/krop-sundhed/kvinde-hvor-mange-aeg-har-du-i-banken
»uværdigt,« og Rådet ser bekymret på den »voksende industrialisering og teknologisering af den
menneskelige forplantning.«
Det ser på det tidspunkt helt anderledes ud med sæden. Nedfrossen eller ej - så bliver sæd set som
en »klat« (donerede) celler. Kvindens æg er derimod indlejret i en række kulturelle og ret kønnede
forståelser.
Hendes arveanlæg er nemlig ikke 'bare' kønsceller. De er
i højere grad gjort til fremtidige børn. Og i debatterne
bliver det potentielt uværdigt at have sine fremtidige
børn liggende i fryseren. Det er tydeligt i den meget
glidende overgang, der finder sted i Det Etiske Råds
redegørelser mellem ubefrugtede og befrugtede æg.
Et bekymret Råd ser nedfrysningsteknologierne som en
måde at kunne »overplanlægge« og »suspendere livet«
på. Nedfrysning af æg bør derfor, skriver Rådet,
»forvaltes efter forsigtighedsprincippet, det vil sige efter
de samme regler som for fosteranlæg.«
L
I---
_
1.030XV&
/1
Både sæd og æg fryses ned ved hjælp
af flydende nitrogen. (Foto:
Shutterstock)
12006 udvides opbevaringsperioden på befrugtede og
ubefrugtede æg dog til fem år. Det primære hensyn er
dog her ikke kvindens råderet over egne æg. Det er til gengæld hendes mulighed for at få barn
nummer 2 og derved en etablering af kernefamilien, der udtrykkelig anføres som baggrunden for
ændringen ved ministerens fremsættelse.
Ægfrysning er nu et frynsegode i
USA
Når det handler om den kvindelige reproduktion, har
lovgivningen arbejdet ud fra et naturligheds- og
forsigtighedsprincip. Assisteret reproduktion (tidligere
benævnt som 'kunstig befrugtning') skulle nemlig helst
ligne den 'naturlige'forplantning mest muligt.
Fakta
Ice
Age-projektet
Og mens fryseteknologien var veletableret i forhold til mandens sæd, var den i 1990'erne og i
starten af det 21. århundrede i forhold til kvindens arveanlæg fortsat ny.
Det er ikke længere tilfældet.
12012 slog The
American
Society for
Reproductive Medicine
(ASRM) fast, at nedfrysning af æg ikke
længere er en eksperimentel behandling. Det er i dag muligt at nedfryse (og optø) ubefrugtede såvel
som befrugtede æg på formentlig ubestemt tid - ideen er at nedfryse, mens æggene er biologisk
'unge og friske', enten for at bruge dem efter endt kræftbehandling, der ødelægger fertiliteten eller
senere i livet, når det passer i kvindens livsplaner.
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Kvinde, hvor mange æg har du i banken?
https://videnskab.dk/krop-sundhed/kvinde-livor-mange-aeg-har-du-i-banken
Facebook,
Apple
og Pentagon tilbyder nu ægfrysnings-pakker som en del af deres frynsegoder.
Amerikanske fertilitetsklinikker har ikke overraskende også fået øje på det store marked og afholder
'cocktails and cryo' informationsaftener, hvor frysemulighederne bliver forklaret til en gruppe af
fertilitets-bevidste men også bekymrede kvinder.
Vi hylder de gamle fædre, men skoser de ældre mødre
Den danske lovgivning fastholder derimod en 5-års regel,
der gælder for kvindernes æg, men ikke for mandens
sæd. Samtidig er der en øvre aldersgrænse for
behandling af kvinder, mens mænd kan blive fædre i alle
aldre. Hensynet kan dog ikke længere kun være
forbundet med et medicinsk forsigtighedsprincip.
Fakta
Forskerzonen
Det handler snarere om kuldegysninger forbundet med
det kommercielles'indblanding' i forplantningen,
bekymring forbundet med, at nedfrosne æg stikker kvinder blår i øjnene om deres fremtidige
frugtbarhed og så risikoen for, at gamle kvinder bliver mødre.
For mens gamle danske fædre hyldes som højtprofilerede mænd, der kører sportsvogn og har'vind i
håret', fastholder mediedebatterne og lovgivningen en forståelse af det respektable moderskab som
tilhørende kvinden, der er yngre end 45.
I modsætning til de spanske, britiske, amerikanske og svenske kvinder (samt de danske mænd), har
danske kvinder således i dag ringe mulighed for at få deres arveanlæg i banken.
Kilder
O Charlotte
Kroløkkes profil
(SDU)
O
Janne
Rothmar Herrmanns
profil
(KU)
O
'Eggs on Ice: Imaginaries of Eggs and Cryopreservation in Denmark', Nordic Journal of
Feminist and Gender Research (2018) DOI: 10.1080/08038740.2018.1424727
O
Forskningsprojektet
Ice Age
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Hvorfor må mænds sæd være nedfrosset i en uendelighed, mens kvinder...
https:Hvidenskab.dk/forskerzonen/kultur-samfimd/hvorfor-maa-maends
-...
Hvorfor må mænds sid være
nedfrosset i en uendelighed, mens
kvinders æg skal destrueres efter
fem år?
BOGOMTALE: Vi danskere er vilde med lighed. Alligevel giver loven mænd
langt bedre mulighed for at få børn.
Et af argumenterne imod en forlængelse af nedfrysningstiden af kvinders æg er, at det er
synd for barnet at have en ældre mor. Men er det virkelig så slemt? Det er et af de spørgsmål,
Thomas Søbirk Petersen diskuterer i artiklen. (Foto: Shutterstock)
Thomas Søbirk Petersen
Professor, Institut for Kommunikation og
Humanistisk Videnskab, Roskilde Universitet
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Hvorfor må mænds sæd være nedfrosset i en uendelighed, mens kvinder...
https:Hvidenskab.dk/forskerzonen/kultur-samfund/hvorfor-maa-maends
-...
17 september 2020
FORSKERZONEN
(BØRN
& UNGE)
(ETIK
& FILOSOFI)
(POLITIK) (SAMFUND) (BØGER) (RUC)
I Danmark tilslutter vi os et centralt etisk princip, der gør det klart, at alle borgere, uanset alder,
religion, politisk orientering, seksuel orientering eller etnicitet har lige adgang til sundhedsvæsenets
ydelser.
Der eksisterer dog mindst en iøjnefaldende undtagelse:
I følge dansk lovgivning (lov om assisteret reproduktion m.v. §23, stk. 5) er det tilladt for mænd, at få
nedfrosset deres sæd, lige så længe de måtte ønske. Også efter en mands død.
Men ifølge samme lovgivning (§15) er det kun tilladt for kvinder at nedfryse deres æg i fem år. Efter
fem års nedfrysning er der ingen kære mor, og æggene skal i følge loven destrueres.
Hvis kvinder er alvorligt syge, kan nedfrysningstiden dog blive forlænget.
Hvis en læge eller jordemoder i Danmark hjælper en rask kvinde med at nedfryse kvindens æg i
mere end fem år, kan de risikere fængsel i op til fire måneder.
Fire måneders fængsel for at give kvinder de sammen muligheder som mænd med hensyn til at
kunne benytte sig af sundhedsvæsenets ydelser!
Ny bog diskuterer assisteret reproduktion
At denne forskelsbehandling i en dansk lovgivning er etisk rimelig, er svært at få øje på. Og det er vel
og mærke en lov, der langt fra er udbredt i andre lande.
Udover Danmark og Norge er det kun lande som Rumænien og de Forenede Arabiske Emirater, der
har en lignende femårs-grænse for nedfrysning af kvindes kønsceller.
For kort tid siden varjeg med til at udgive den tværvidenskabelige bog'The Cryopolitics of
Reproduction: A New Scandinavian Ice Age', der beskriver og kritisk diskuterer de skandinaviske
landes love om assisteret reproduktion.
I bogen udfordrer vi, blandt mange andre emner, den del af dansk og norsk lovgivning, der
omhandler femårs-grænser for nedfrysning af kvinders æg.
I det følgende vil jeg kort præsentere (og udfordre) nogle af de argumenter for og imod §15 i lov om
assisteret reproduktion, som vi kunne observere i diverse etiske råd fra de skandinaviske lande.
Lad mig begynde med at præsentere to argumenter for at ophæve femårs grænsen for nedfrysning
af kvinders kønsceller. Herefter følger en kritisk diskussion af argumenter, der forsvarer gældende
lov på området.
Kvinder bør kunne bestemme over egen krop
Hvem, synes du, skal bestemme over en voksen kvindes krop - kvinden selv eller staten?
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Hvorfor må mænds sæd være nedfrosset i en uendelighed, mens kvinder...
https://videnskab.dk/forskerzonen/kultur-samfund/hvorfor-maa-maends
-...
jeg tror, at de fleste vil mene, at det skal kvinden selv.
For en fundamental etisk rettighed er, at vi ejer os selv,
og at vi kan gøre, hvad vi vil med vores krop - bare vi ikke
skader andre. Og kvinder skader ingen ved at få
nedfrosset deres æg i mere en fem år.
Tværtimod kan en lovændring for længere
nedfrysningstid øge chancen for, at børn bliver født med
færre alvorlige genetiske sygdomme.
Hvis en kvinde nedfryser sine æg som eksempelvis 25-
årig og igen anvender dem som 40-årig, er risikoen for, at
barnet har genetiske sygdomme mindre, end hvis man
anvendte den 40-årige kvindes 'nutidige' æg.
Det skyldes, at en 25-årig kvinder æg i gennemsnit er
mindre disponeret for genetiske sygdomme end en 40
årig kvindes æg.
Fakta
Om Forskerzonen
Denne artikel er en del af
Videnskab.dk's Forskerzonen,
hvor forskerne selv formidler
deres forskning, viden og
holdninger til et bredt publikum -
med hjælp fra redaktionen.
Forskerzonen bliver udgivet
takket være støtte fra
Lundbeckfonden. Forskerzonens
redaktion prioriterer indholdet og
styrer de redaktionelle processer,
uafhængigt af Lundbeckfonden.
Læs mere om Forskerzonens mål,
visioner og retningslinjer her.
Desuden vil kvinder og par i fertilitetsbehandling også
have fordel af en forlængelse af nedfrysningstiden. De
kvinder, der med møje og besvær har gennemgået
hormonstimulerende behandling og bagefter har fået
udtaget nogle æg, kan, hvis vi forlænger nedfrysningstiden, måske nøjes med at få dette gjort en
gang for alle.
Som det er nu, skal kvinder ofte gentage hele molevitten igen eller stresse et forløb igennem for at
få de børn, hun og hendes eventuelle partner ønsker inden for fem år.
Så ved at udvide nedfrysningstiden, kan vi faktisk mindske stress og ubehag for kvinder og par i
fertilitetsbehandling.
LÆS OGSÅ: Kvinde, hvor mange æg har du i banken?
Urimelig forskel i muligheden for at få børn
Udover at krænke kvinders selvbestemmelsesret er §15 i lov om assisteret reproduktion udtryk for
en urimelig ulighed mellem mænd og kvinder.
Ifølge loven har mænd som nævnt mulighed for at nedfryse deres sædceller, så længe de ønsker.
Det medfører, at mænd har bedre mulighed for at få børn ved hjælp af kunstig befrugtning end
kvinder.
For at have sine kønsceller nedfrosset betyder, at man øger sin mulighed for at få børn - skulle man
engang få brug for friske kønsceller, som man måske ikke kan producere længere på grund af
eksempelvis sygdom.
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Hvorfor må mænds sæd være nedfrosset i en uendelighed, mens kvinder...
https://videnskab.dk/forskerzonen/kultur-samfimd/hvorfor-maa-maends
-...
Den forskel forekommer ikke rimelig, når vi her i Danmark hylder og arbejder for, at mænd og
kvinder har samme muligheder for at få et godt liv.
Et liv, der ofte også indeholder, at man har et brændende ønske om at bringe børn til verden og
skabe en familie.
LÆS OGSÅ: Flere kvindelige ledere, men
mændene hjælper stadig ikke meget til i
hjemmet
Fakta
Det Etiske Råds bekymringer er på
videnskabelig glatis
I Det Etiske Råds seneste redegørelse om emnet fra 2015
er der især to bekymringer mod at forlænge
nedfrysningstiden af kvinders æg, som et flertal af rådets
medlemmer tilslutter sig:
Nybog om
reproduktionens
politik
O
Den ene bekymring er hensynet til barnets tarv. Etisk Råd er bekymret for, at de børn, der
kommer til verden ved hjælp at denne teknologi, vil blive syge eller på anden måde skadet på
grund af teknologien.
O
Den anden bekymring handler om, at en forlængelse af nedfrysningstiden vil medføre eller
understøtte en praksis, hvor kvinder får børn i en senere alder, end hvis nedfrysningstiden kun
var fem år.
En central udfordring for disse meget velmenende bekymringer er imidlertid, at de er på glatis i
forhold til den videnskabelige viden, der er på området.
Det er mændene, der forsinker kvinderne
For det første peger forskningen i retning af, at børn, der er kommet til verden ved hjælp af optøede
æg, har færre sygdomme.
Æggene, som børnene stammer fra, er omhyggeligt udvalgte, og de børn, der kommer til verden ved
kunstig befrugtning, er om nogen ønskebørn. Vi vil her i Danmark kunne skabe flere ønskebørn og
familier, hvis loven blev ændret.
For det andet viser forskningen, meget entydigt, at grunden til, at nogle få kvinder først får børn, når
de er omkring 40 år ikke skyldes, at de er vidende om, at de kan få teknologisk hjælp til, at få børn i
en sen alder.
Årsagen er primært, at mens kvinder gerne vil have børn, når de er omkring de 30 år, vil en del
mænd ikke have børn, når de selv er 30 år. Mændene ønsker at vente.
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Hvorfor må mænds sæd være nedfi-osset i en uendelighed, mens kvinder...
https://videnskab.dk/forskerzonen/kultur-samfund/hvorfor-maa-maends
-...
Det biologiske ur tikker ikke så hurtigt for mændene.
Så grunden til, at nogle kvinder får eller prøver at få børn omkring de 40 år skyldes især, at
mændene ikke er klar, når kvinderne er klar.
Men hvorfor er det så kvinderne, der skal betale prisen for mændenes nølen og kun må nedfryse
deres kønsceller i fem år?
Er det virkelig så skidt at have en (lidt) ældre mor?
Et tredje argument for gældende lov, man tit hører i debatten, er, at det er synd for børnene, når
kvinderne får børn i en senere alder.
Måske fordi man mener, at børnene har deres mødre i kortere tid, end hvis de kom til verden med
en yngre mor, eller fordi en lidt ældre mor ikke er så fysisk frisk som en 25-årig mor.
Eller, som det hedder i Det Etiske Råds redegørelse, kan man argumentere for en »samfundsmæssig
praksis, der tilskynder kvinder til at få børn tidligere, fordi det alt andet lige fremmer børnenes
livsmuligheder, at mødrene ikke er alt for gamle.«
Men så længe der er tale om børn, der har rigtigt gode liv - og det viser alle undersøgelser, at de har
- er det svært at se, hvorfor det skulle være synd for dem at blive til, eftersom alternativet ville være
aldrig at være blevet født.
Samtidig vil ægfrysning som nævnt mindske risikoen for, at børn bliver født med genetiske
sygdomme, eftersom denne risiko er mindre, når man bruger unge æg.
at få børn tidligt
LÆS OGSÅ:
Studie af 1,5 mio. danske kvinder slår fast: Det koster kassen
Nyt borgerforslag vil forlænge nedfrysningstiden
At kvinder ifølge dansk lov således bliver lagt på is, når der handler om at få børn og selvejerskab
over egen krop, er derfor etisk problematisk.
At man samtidig straffer sundhedspersonale, der vil hjælpe kvinder med at bevare deres nedfrosne
æg, er svært at forstå i et foregangsland som Danmark, hvor vi sætter ejerskab over egen krop højt,
og hvor vi mener, at kvinder og mænd skal have lige adgang til at få de børn, de ønsker at bringe til
verden.
Det er derfor forståeligt, at et nyt borgerforslag, der handler om at forlænge nedfrysningstiden for
ubefrugtede æg, i skrivende stund har modtaget cirka 35.000 støtteerklæringer på under tot
måneder.
LÆS OGSÅ:
Dansk teknologi videoovervåger tusindvis af kvinders æg
LÆS OGSÅ:
Kvinde føder sundt barn efter transplantation af nedfrosset
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Hvorfor må mænds sæd være nedfrosset i en uendelighed, mens kvinder...
https://videnskab.dk/forskerzonen/kultur-samfund/hvorfor-maa-maends
-...
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Kilder
O Thomas
Søbirk Petersens profil
(RUC)
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Hvorfor må mænds sæd være nedfrosset i en uendelighed, mens kvinder...
https://videnskab.dk/forskerzonen/kultur-samfund/hvorfor-maa-maends
-...
O
'The Cryopolitics of Reproduction on Ice: A New Scandinavian Ice Age', Emerald
Publishing Limited (2019)
O
'Opbevaring og brug af ubefrugtede æg: Udtalelse om opbevaring og brug af
ubefrugtede æg', Det Etiske Råd (2015)
O
'In favour of freezing eggs for non-medical reasons', Bioethics (2009), DOI:
10.1111 /j.1467-8519.2008.00679.x
O 'Over 900 oocyte cryopreservation babies born with no apparent increase in congenital
anomalies', Reproductive BioMedicine Online (2009), DOI:
10.1016/S 1472-6483(10)60025-9
O
'Ten pathways to elective egg freezing: a binational analysis', journal of Assisted
Reproduction and Genetics (2018), DOI: 10.1007/s10815-018-1277-3
O
'Motherhood on ice? A media framing analysis of older mothers in the UK news',
Psychology & Health: (2009), DOI: 10.1080/08870440701601625
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