A Critical Approach to Surrogacy

Reproductive Desires and Demands

Damien W Riggs, Clemence Due, Damien Riggs

• Publisher: Routledge
• Year: 2019
• Print ISBN:
  9781138123656
• eBook ISBN:
  9781317301950
• Topic: Psicología
• Subtopic: Psicología aplicada

This comprehensive text makes an important contribution to the study of surrogacy, developing a novel theoretical framework through which to understand the broader social contexts as well as individual decisions at play within surrogacy arrangements.

Drawing on empirical research conducted by the authors and supplemented by secondary analyses of media, legislative and public accounts of surrogacy, the book engages with the key stakeholders involved in the practice of surrogacy. Specifically, it canvases the standpoints of women who act as surrogates, intending parents who commission surrogacy arrangements, children born through surrogacy, clinics that facilitate the arrangements, and politicians and journalists who engage with the topic.

Through a focus on capitalism as a means of orientating ourselves to the topic of surrogacy, the book highlights the vulnerabilities that potentially arise in the context of surrogacy, as well as the claims to agency invoked by some parties in order to mitigate vulnerability. In so doing, the book demonstrates that the psychology of surrogacy must be broadly understood as an orientation to particular ways of thinking about children, reproduction and economies of labour.

1
BECOMING (DIS)ORIENTED

Faced with the topic of surrogacy, we are required to make a decision. The call to make a decision comes from many quarters: from the voices of women who act as surrogates, from feminist voices that have spoken both for and against surrogacy, from people who see surrogacy as their only route to becoming parents, from those whose religious affiliations lead them to hold a particular stance on the practice of surrogacy, from media representations of women who act as surrogates, from surrogacy agencies seeking to increase their revenue, and no doubt from many other quarters. Each of these calls to make a decision hails us in differing ways: as subjects expected to hold a moral position on surrogacy, as consumers, and as citizens invested in a particular relationship to the state. Yet, as can be seen in these differing calls, the possible decisions available to us are often competing, and difficult to encapsulate in one specific or consistent position.

Sara Ahmed’s (2006) work on queer phenomenology provides us with one way through which we may map out a response to the multiple voices that shape contemporary understandings of surrogacy. Focusing on what it means to have an orientation, Ahmed suggests that one’s orientation towards any given object or topic shapes and is shaped by how we inhabit the world around us. In order to see that we are indeed oriented in particular ways, however, first we must experience disorientation. In other words, and as Ahmed suggests:

We might think that we reach for whatever comes into view. And yet, what ‘comes into’ view, or what is within our horizon, is not a matter simply of what we find here or there, or even where we find ourselves as we move here or there. What is reachable is determined precisely by orientations that we have already taken.

(p. 55)

To see one’s own orientation towards any given topic, and particularly if one’s orientation aligns with the dominant or normative orientation made intelligible by the world around us, is difficult precisely because it is often an orientation that we have taken implicitly, with little consideration of what that orientation brings. To see one’s own orientation, then, requires us to fall from perspective, a perspective that for many of us is imbued with a claim that our own perspectives are ‘normal’, a ‘given’, and hence are taken for granted. To fall from perspective, as Fiona Nicoll (2000) suggests with regard to whiteness, is to acknowledge that the vantage point from which one is oriented is always partial, even if for (white, middle-class) people such as ourselves as the authors of this book, that partiality disappears through claims to the position of the universal subject.

For us, the topic of surrogacy – which we have written about for over half a decade – evokes multiple forms of disorientation, many of them induced by our explicit focus on the positions from which we speak, which bring together experiences of disadvantage and privilege. For Damien, as a parent to children with whom he does not share a genetic relationship, many of the narratives that circulate with regard to surrogacy are less than intelligible, and indeed can be marginalizing. As we shall see in the chapters to come, genetic relatedness is often (though not always) a valorized narrative amongst people who become parents through surrogacy. Also for Damien, a feminist critique of the commodification of women’s bodies contributes to a sense of unease about the topic of surrogacy. Competing with these concerns, however, is a genuine respect for people’s desire to have children, even if that desire may for many people be shaped by pronatalist discourses and the privileging of genetic relations. For Damien, then, the topic of surrogacy produces a disorientation that to date has stymied a desire to orient himself in ways that are respectful to all involved in the practice of surrogacy.

For Clemmi, the topic of surrogacy has similarly created disorientation. Clemmi is the mother of two children to whom she gave birth while in a heterosexual relationship with their father. As such, her family structure places her firmly within the norm concerning family. Clemmi’s family structure therefore raises questions for her when engaging with any critique of the privileging of genetic relationships. That is, while she finds this aspect of many surrogacy discourses concerning, she also recognizes that – being a part of the ‘norm’ – it is important that she listens to the voices of others. However, as a full-time working mother, and a mother with experience of postnatal depression, Clemmi is also outside the norm of what is typically expected of mothers. This experience of being situated outside the norm of motherhood has meant that she has been able to interrogate discourses of ‘good’ mothering, which also come to the fore in relation to surrogacy – sometimes in relation to the intending parents, and sometimes in relation to the woman acting as a surrogate. As such, Clemmi also has found surrogacy to produce a disorientation around both family and parenting, and like Damien, she has struggled to find an orientation which will result in a respectful engagement with all those involved.

As two people who have thought long and hard about the topic of surrogacy, and thus for whom the topic is often salient, Ahmed’s (2006) invitation to become disorientated has been useful in that it has led us to writing this book as a way to develop a mode of orientation that speaks to the many differing stakeholders invested in surrogacy. Albeit in highly differentiated ways, and as we shall see in the chapters to come, disorientation too shapes their entry into the world of surrogacy. The norm of reproductivity as a privileged mode of neoliberal citizenship, for example, potentially evokes disorientation for those who cannot (but wish to) fulfil the demand to genetically reproduce. For women who act as surrogates, the competing demands to provide for their children but gestate and hand over a child to other people potentially produces a disoriented relationship to norms of womanhood and motherhood. No doubt for many other stakeholders (including those whose primary focus is revenue), the competing demands of surrogacy – often framed within a binary of love or money – potentially produces other disorientations in relation to what it means to desire and to have a child.

For most of us, disorientation is not necessarily a desirable experience. As a counter to disorientation, most people are likely to seek ways to settle upon a way of being oriented. As we suggested above, writing this book is at least in part a means through which we may become oriented to the topic of surrogacy. For those who are disorientated by what is often framed as a ‘failure’ to reproduce, surrogacy may provide an orientation to reproductivity that affords them a claim to a place within the norm. For women who act as surrogates, the disorientation that may arise from the injunction to love or money is managed in complex (and often competing) ways that allow for an orientation to a morally defensible position, as we shall see below and further in Chapter 3.

Yet as Ahmed (2006) suggests in the quote above, the ways that we orient to particular objects are not accidental. Rather, they are shaped both by those orientations which are normalized or naturalized within the world around us, in addition to the orientations to which we then direct our attention. As we noted above, reproductivity is a norm to which neoliberal citizens are expected to orient, what Turner (2001) refers to as ‘reproductive citizenship’. To be a good citizen is to reproduce, which requires an orientation to, or investment in, all that this entails. For many people this typically includes finding a partner with whom to have children, planning for a pregnancy, finding ways to achieve a pregnancy if this proves to be medically difficult (or is physically not possible if the couple are both cisgender and not heterosexual), and more broadly orienting one’s life towards these goals. Whilst, as we will explore in greater detail below and in subsequent chapters, there is nothing natural or automatic about such an orientation, it is the fact that it is made to appear entirely natural and expected that forms one of the threads through which surrogacy becomes a viable orientation.

Another, and as we argue in this book, key, orientation that produces surrogacy as an intelligible means through which to have children is the logic of capitalism. It is common within writing on surrogacy to trace the practice of surrogacy back to biblical times (due to references made to surrogacy in the Bible). However, this, we feel, is something of a red herring, as it locates surrogacy within a very particular (altruistic, communal) understanding of the practice of women bearing children for others to raise. Certainly it could be argued that the trajectory through which surrogacy has become intelligible as a market commodity involves many orientations, some of which may be altruistic and premised upon caring relationships between or by women. This, however, is not the orientation that we believe dominates the field of surrogacy at present. Rather, and as we will argue in greater detail below, it is through a capitalist logic that surrogacy has become increasingly intelligible in modern societies.

Importantly, then, and following Jack Halberstam (2005), as we orient ourselves towards capitalism as a structuring logic of contemporary surrogacy practices, we must ultimately also seek to orient ourselves away from capitalism. This is not to suggest that, in unpacking what we see as the capitalist logic underpinning surrogacy, we can simply do away with capitalism. Rather, it is to suggest that our aim is not to deify capitalism as the only way to orient ourselves to the topic of surrogacy. Importantly, nor is it to replace a capitalism-focused account of surrogacy with one more akin to the biblical, altruistic, account mentioned above. Instead, by unpacking how capitalism frames both the desire to have genetically related children and surrogacy as one mode of achieving this, our aim is to create space for the possibility of other ways of thinking about citizenship – reproductive or otherwise. We explore this aim in greater detail in the final chapter of this book.

In what follows in this first chapter, we outline in further detail the orientation we propose with regard to the topic of surrogacy, acknowledging that it holds the potential to be disorienting, precisely for the ways in which it directs a magnifying glass at the operations of capital and fantasy that we suggest dually position surrogacy as intelligible within contemporary neoliberal contexts. Certainly, emphasising a capitalist logic is nothing new with regard to the topic of surrogacy. At the same time, however, there is a degree to which, at least in our reading, capitalism is often relegated to the sidelines of understandings of surrogacy practices, even when it is at the same time acknowledged as a driving force. It is perhaps unsurprising that this is the case, particularly since an emphasis on capitalism can both promote and undermine a particular position simultaneously (for example, capitalist arguments can be used to both validate and undermine the choices made by women who act as surrogates, or to validate and undermine the choices made by people who commission surrogacy arrangements).

We of course acknowledge that capitalism reproduces itself in nefarious ways, and that we are potentially complicit with this by endorsing an approach that orients itself towards capitalism. We are also mindful that having acknowledged the importance of falling from perspective, we are nonetheless advocating for a particular perspective on surrogacy (i.e. in taking up capitalism as a useful lens through which to consider surrogacy practices). Yet, as we will argue in this chapter and the one that follows, to state that capitalism is a structuring logic of surrogacy is not to make one singular claim. Rather – and where we think this book differs from those which have come before – we see capitalism as underpinning a diverse (and often competing) range of claims. Orienting ourselves to capitalism, then, is to consider the histories through which surrogacy comes to be rendered intelligible. In doing so, we aim to engage with some necessarily difficult questions concerning how the increasing number of surrogacy arrangements build upon ways of being oriented to oneself and to others that may in many ways be contrary to the desire to have a child ‘of one’s own’.

Notes on language

Before turning to the substantive aspects of this chapter, it is important for us to address the question of language with regard to surrogacy. Indeed, it could be argued that the language we use regarding surrogacy is constitutive of how we orient ourselves to the topic, and that in and of itself language is a substantive topic worthy of ongoing focus amongst those of us who study surrogacy. Certainly, those who have written on the topic previously have drawn attention to the fraught nature of the specific terms used. Over two decades ago Sharyn Roach Anleu (1992), and more latterly Marilyn Strathern (2003), have suggested that the word ‘surrogate’ itself is differentially used and understood. While commonly understood to refer to women who carry a baby for other people, Roach Anleu suggests that this is an incorrect use of the term, especially if the term ‘mother’ is appended to the word. Instead, Roach Anleu suggests instead that the correct use of the term ‘surrogate mother’ is in reference to a woman who commissions a surrogacy arrangement and intends to raise the child. Similarly, Helen Ragoné (1994) uses the term ‘adoptive mother’ to refer to women who commission surrogacy arrangements, although it should be noted that Ragoné’s choice of language arose from the fact that at the time of her data collection surrogacy arrangements primarily involved women gestating children conceived from their own eggs, hence requiring that the intended mother adopt the child after they were born. Ragoné’s use of the term ‘adoptive mother’ and Roach Anleu’s use of the term surrogate mother to refer to women who commission a surrogacy arrangement align to a certain degree with the use of the term ‘surrogate mother’, both historically and still at times in the present, to refer to mothers who raise children who were not born to them (i.e. foster or adoptive mothers).

As Strathern (2003) argues, the reversal that has occurred (that is, from intended mothers being ‘adoptive’ or ‘surrogate’ mothers to women who gestate children for other people becoming known as ‘surrogates’) is embedded in at least two orientations to the topic of surrogacy. The first involves moves to disaggregate gestation from mothering. Whilst this move has not solely been taken up within feminist writing, feminist thought has certainly made a significant contribution to how we conceptualize motherhood. Such a contribution is of course important, given its role in deconstructing how motherhood is naturalized and taken as definitive of womanhood (Hays, 1996; Maushart, 1997). Yet as with any orientation, what has come with the denaturalization of motherhood from gestation is a potential devaluing of the intimate labour involved in gestation itself, a concern long raised by radical feminist voices who have opposed all forms of assisted reproductive technology (Cora, 1985).

The second orientation to surrogacy elaborated by Strathern (2003), which has led to the change in language described above, is the increased emphasis placed upon genetic relatedness as a key determinant of kinship. This is a topic that we will explore in further detail in Chapter 2, but suffice it to say here that with regard to the genetic relations between intended parents and the child being carried for them, this relationship is typically seen as more important than the biological relationship between the child and the woman who carries them. Even when both parents are not genetically related to the child, and as Charis Thompson (2005) has so eloquently demonstrated, claims to some form of genetic relatedness (and most certainly intent, which in some cases serves as a proxy for genetic relatedness, as we explore in detail below) are privileged over any claims the woman carrying the child may have.

While our discussion above is largely framed by research or theorising conducted within countries such as the United Kingdom and the United States, it is also important to consider the use of language in non-Western countries. In her research on surrogacy arrangements in Israel, for example, Elly Teman (2010) reports that a literal translation of the Hebrew word for ‘surrogate’ is ‘inn keeper mother’ (p. 21). Similarly, in her research on women who act as surrogates in India, Sharmilla Rudrappa reports that a literal translation of the Kannadese word for ‘surrogate’ is ‘rental mother’ (2015, p. 108). Whilst both of these terms retain the use of the word ‘mother’ (and certainly in both the United Kingdom and United States ‘surrogate mother’ would not be entirely atypical with reference to women who act as surrogates), the word is modified through the adjectives ‘inn keeper’ and ‘rental’. Both these terms, we would suggest, are in many ways contrary to the word ‘mother’ and its normative disassociation from any notion of being temporary or receiving payment.

In addition to debates over how to refer to women who act as surrogates, recent discussions of surrogacy, specifically when such discussion involved intended parents from one country commissioning surrogacy arrangements in another country, have focused on how to describe this travel. As Inhorn and Patrizio (2012) note, such travel has alternately been described as a form of tourism (e.g. reproductive tourism, fertility tourism, procreative tourism), as travel (e.g. reproductive travel, fertility travel), or – most commonly – as ‘cross-border reproductive care’. However, while being the most common term, Inhorn and Patrizio (2009) question the accuracy of ‘cross-border reproductive care’, which evokes an image of patients travelling for treatment – a situation which is not necessarily true of all those who travel. Consider, for example, a heterosexual couple, where the female partner has had a hysterectomy and the male partner produces viable sperm, and where both travel to engage surrogacy services. Which of these individuals is the patient? And if one or both of these individuals are positioned as the patient, what does this mean for the woman they may engage to act as a surrogate?

In contrast to the focus on describing cross-border travel, descriptors for those who undertake such travel are less frequently debated, though Inhorn and Patrizio (2009) note that the term ‘tourist’ to refer to those who undertake cross-border travel may seriously overstate the ‘pleasure’ aspects of such travel. Beyond discussion of the appropriateness of the term ‘tourist’, those who undertake cross-border travel are most typically referred to simply ...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Table of Contents
• Dedication
• Series Editor Preface
• Acknowledgements
• 1 Becoming (Dis)oriented
• 2 Conceptual Tools
• 3 Women Who Act as Surrogates
• 4 Intending Parents
• 5 Children and Surrogacy
• 6 Surrogacy clinics
• 7 Media and Public Discourse
• 8 Ways Forward
• References
• Index