International Commercial Surrogacy Research Articles

Claire Achmad, Children’s Rights in International Commercial Surrogacy

Claire Achmad, Children’s Rights in International Commercial Surrogacy

International gestational surrogacy in the United States, 2014–2020

To describe characteristics, trends, and outcomes of international gestational surrogacy cycles in the United States (US). Retrospective cohort study. All assisted reproductive technology cycles in the US reported to the Society for Assisted Reproductive Technology Clinic Outcome Reporting Systems that included an embryo transfer to a gestational carrier from 2014 to2020. International vs. US intended parents. Cycle characteristics, geographic distributions, and obstetrical outcomes. Of 40,177 embryo transfers to a gestational carrier from 2014 to 2020, 32% were for international intended parents. The number and percent of international intended parents' gestational carrier cycles increased each year from 2014 (n = 2758, 22.0%) to 2019 (n = 4905, 39.8%) with a decrease in 2020 (n = 4713, 31.8%). Compared with cycles for US intended parents, there was a larger decrease in gestational carrier cycles between 2019 and 2020 for international intended parents (3.9% vs. 32.2%). International intended parents were more likely to be male sex (41.3% vs. 19.6%), older than 42 years (33.9% vs. 26.2%) and identify as Asian race (65.6% vs. 16.5%). International intended parents were largely from China (41.7%), followed by France (9.2%) and Spain (8.5%). Gestational carriers for international intended parents were more commonly younger than 30 years (42.8% vs. 29.1%) and identified as Hispanic race (28.6% vs. 11.7%) compared with gestational carriers for US intended parents. Cycles with international intended parents were more likely to use donor eggs (67.1% vs. 43.5%), intracytoplasmic sperm injection (72.8% vs. 55.4%), and preimplantation genetic testing (79.0% vs. 55.8%). Cycles with international and US intended parents had similar obstetrical outcomes, including live birth (adjusted risk ratio 1.01, 95% confidence interval 1.00-1.03) and multiple pregnancy (adjusted risk ratio 1.00, 95% confidence interval 0.94-1.06) rates. An increasing number of international intended parents are utilizing gestational surrogacy in the US and more frequently using cost-enhancing specialized treatment techniques. This increase is potentially because of restrictive international commercial surrogacy laws and the increased availability of reproductive medical expertise. Given this growing demographic, continued examination of the volume of cross-border reproductive treatment, as well as the legal and ethical considerations, is warranted.

Global justice in the context of transnational surrogacy: an African bioethical perspective

The ongoing debate on how best to regulate international commercial surrogacy defies consensus, as the most cogent normative and jurisprudential grounds for and against non-altruistic surrogacy remain controversial. This paper contributes to the debate by focusing on social justice issues arising from transnational, moneymaking surrogacy, with a focus on the Global South. It argues that existing theoretical perspectives on balancing interests, rights, privileges, and resources in the context of cross-border surrogacy—such as cosmopolitanism, communitarianism, liberal feminism, radical feminism, and neorealism—are not sufficient to treat the question of justice underpinning transnational surrogacy in the Global South. An Afro-communal theory of social justice is proposed as an alternative model for addressing the shortcomings in existing global justice theories. Building on Thaddeus Metz’s construction of Afro-communal social theory and a bioethic of communion, this article reveals the fundamental nature of injustices in the Global South surrogacy foray. This approach provides prima facie grounds for making commercial surrogacy more just in the evolving global order.

Discordant Expectations of Global Intimacy: Desire and Inequality in Commercial Surrogacy

Gestational surrogacy – carrying someone else’s baby (or babies) to term and giving birth to them – is perhaps one of the most intimate acts a human being can perform for others. However, the proliferation of commercial surrogacy has drawn concern and criticism, with many scholars arguing that it both creates and exacerbates global social and economic inequalities. Commercial surrogacy thus raises both the possibility of global intimate connection and the specter of reproductive exploitation. I therefore explore the various, shifting, and often discordant desires for intimate connection between the intending parent(s), the surrogate mother, and the resulting child(ren) in commercial surrogacy. I then examine how those intimacies intersect with commercial surrogacy’s socioeconomic inequalities. Weighing commercial surrogacy’s driving desires and intimate practices against its commercialization, I end with a reconsideration of the procreative desires and intimate practices that spur current international commercial surrogacy (ICS), urging an emphasis on reproductive justice.

Whittington Hospital NHS Trust v XX [2020] UKSC 14 : The Cost of International Commercial Surrogacy Recoverable as Damages: A Step in the Right Direction?

Whittington Hospital NHS Trust v XX [2020] UKSC 14 : The Cost of International Commercial Surrogacy Recoverable as Damages: A Step in the Right Direction?

The impact of the COVID-19 pandemic on intercountry adoption and international commercial surrogacy

The COVID-19 pandemic has created unprecedented economic, health and social impacts as it has swept the globe. Intercountry adoption and international surrogacy are practices immediately affected, furthering vulnerabilities of children and vulnerable adults. This short report calls attention to heightened risks, raises awareness for practitioners in these fields and asserts the need for caution.

‘Rainbow Statelessness’ — Between Sexual Citizenship and Legal Theory: Exploring the Statelessness–LGBTIQ+ Nexus

This article responds to the literature gap within both discourses on ‘sexual citizenship’ and statelessness studies on the nexus between statelessness and sexual orientation, gender identity and expression, and sex characteristics (‘SOGIESC’). It explores the intersectional experiences of stateless lesbian, gay, bisexual, transgender, intersex and queer plus (‘LGBTIQ+’) individuals as well as circumstances in which discrimination on SOGIESC grounds can cause statelessness for LGBTIQ+ persons or their children. In addition to rare reports of arbitrary deprivation of citizenship from LGBTIQ+ persons, the non-recognition of post-transition statuses and intersex realities may lead to situations of statelessness. Finally, complex legislation and administrative practices around assisted reproductive technology — and especially international commercial surrogacy — can leave children born within ‘rainbow families’ at particular risk of statelessness. In arguing that a global nexus does indeed exist between SOGIESC and statelessness, this article calls for further empirical research in order to provide greater nuance and context-specific understandings of the intersectional experiences and causes of statelessness for LGBTIQ+ individuals around the world.

International Commercial Surrogacy as a New Head of Tortious Damage: XX v Whittington Hospital NHS Trust [2018] EWCA Civ 2832.

In XX v Whittington Hospital NHS Trust [2018] EWCA Civ 2832, the Court of Appeal recognised commercial surrogacy in California as a permissible head of damage in a case of negligently inflicted infertility. Due to changing public policies and judicial opinion regarding the practice, and by incorporating the three-part test of illegality developed for civil claims by the Supreme Court in Patel v Mirza [2016] UKSC 42 into tort law, the Court of Appeal held that the principle of restorative justice required a departure from the precedent established in Briody v St Helens and Knowsley AHA [2001] EWCA Civ 1010.

Removing Harmful Options: The Law and Ethics of International Commercial Surrogacy.

Focusing on the UK as a case study, this article argues that having the choice to enter into an international commercial surrogacy arrangement can be harmful, but that neither legalisation nor punitive restriction offers an adequate way to reduce this risk. Whether or not having certain options can harm individuals is central to current debates about the sale of organs. We assess and apply the arguments from that debate to international commercial surrogacy, showing that simply having the option to enter into a commercial surrogacy arrangement can harm potential vendors individually and collectively, particularly given its sexed dimension. We reject the argument that legalizing commercial surrogacy in the UK could reduce international exploitation. We also find that a punitive approach towards intended parents utilizing commercial rather than altruistic services is inappropriate. Drawing on challenges in the regulation of forced marriage and female genital cutting, we propose that international collaboration towards control of commercial surrogacy is a better strategy for preserving the delicate balancing of surrogate mothers' protection and children's welfare in UK law.

Gendering Hybridity: The Womb as Site of Production in Globalization

It is my contention that urgent questions about the politics of the biological body have been displaced in discussions of hybridity – a term that seems to account for the phenomenon of global mixture but routinely defers consideration of its material and physiological dimensions. In this essay I reinsert the biological body into discussions of hybridity in order to explore the growing phenomenon of international commercial surrogacy. The third world woman's rented womb emerges in this reading as an overlooked, unclaimed site of hybridity in the global division of labour, with intriguing precedents in the colonial experience, and opportunities for reviewing the incarnation of global hybridity in live bodies in the present.

A postcolonial framing of international commercial gestational surrogacy in India

The branding and marketing of post-millennial India as a global service provider has been relentless. Indian cities have now been de-exoticized from their previous association to elephants, snake-charmers, and slums, and are now being marketed as the hub of Global North medical infrastructure and scientific advancement, at attractive Global South rates. Legalized only in 2002, international commercial gestational surrogacy (ICGS) in India, a lucrative niche market within the sector of medical and healthcare tourism, has been an industry worth US$ 2.3 billion annually at its peak. Now, however, it stands on the brink of being banned by a bill introduced in the Indian parliament in 2016. This essay advances the argument that the selling points of ICGS have been premised on structural and systemic inequalities of gender and class, as well as of biopolitical power. We further build on Graham Huggan’s early twenty-first-century thesis on the marketing of the postcolonial margins to explore the emergent gendered subjectivities and attendant fictional representations of ICGS and its various actors in the novel The House of Hidden Mothers (2015) by the diasporic British Indian author Meera Syal. Drawing on this novel, we map and examine the perceptions and representations of ICGS, investigating that which facilitates and promotes exploitation to deduce the resultant impact on the stakeholders and active agents in this industry in the space of India and in the West. The essay concludes that, seen through the lenses of re-orientalism, the exploitations within India’s ICGS are not merely along national or ethnic and gender lines, but also class based and geographically enabled.

Baby Markets and Global Inequalities: Conundrums of Commodification, Care and Social Reproduction in International Commercial Surrogacy

Development and ChangeVolume 49, Issue 4 p. 1127-1139 Review Essay Baby Markets and Global Inequalities: Conundrums of Commodification, Care and Social Reproduction in International Commercial Surrogacy Kristen E. Cheney, Kristen E. CheneySearch for more papers by this author Kristen E. Cheney, Kristen E. CheneySearch for more papers by this author First published: 21 May 2018 https://doi.org/10.1111/dech.12421Citations: 1Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Citing Literature Volume49, Issue4July 2018Pages 1127-1139 RelatedInformation

Current perspectives on the ethics of selling international surrogacy support services

This review presents current knowledge on selling surrogacy support services in developing countries. Rather than focusing on dichotomous positions, ethical issues that are present and unresolved are discussed by following the journey of surrogate mothers and highlighting the position of children whose well-being is generally assumed in surrogacy arrangements. Ethical concerns about conflicts of interest, fundamental freedoms, autonomy, informed consent, self-determination, privacy, and protecting children are shared across countries. International commercial surrogacy is predicated on profit made by service providers and intermediaries where producing a healthy, desired child for the consumer of services is the goal. As such, business models conflict with the well-being of women and children. Selling international surrogacy support services presents complex and multi-layered problems that must be understood in the context of a growing body of knowledge to ensure ethical deliberations are not based on fallacious premise or assumed propositions. International surrogacy is not a level playing field. Would-be parents and practitioners need the information and the opportunity to grapple with ethical issues when considering surrogacy arrangements, or enabling or profiting from it.

UK Law and International Commercial Surrogacy: 'the very antithesis of sensible'

This article evaluates possible responses to the increased frequency with which UK couples and individuals travel overseas in order to access commercial surrogacy arrangements. It concludes that the ban on commercial involvement in surrogacy arrangements within the UK, and the criteria that must be satisfied before legal parentage can be transferred to the intended parents, do not promote the best interests of children, surrogates and intended parents. By facilitating some oversight of surrogacy before the child is conceived, pre-birth approval for parental orders coupled with greater professional involvement in surrogacy, would not only better meet the needs of all parties, but would represent a more sensible, efficient and effective way to regulate surrogacy.

International commercial surrogacy – how to address ethical implications

International commercial surrogacy – how to address ethical implications

Cross-border reproductive care: an Ethics Committee opinion.

Cross-border reproductive care (CBRC) is a growing worldwide phenomenon, raising questions about why assisted reproductive technology (ART) patients travel abroad, what harms and benefits may result, and what duties health-care providers may have in advising and treating patients who travel for reproductive services. Cross-border care offers benefits and poses harms to ART stakeholders, including patients, offspring, providers, gamete donors, gestational carriers, and local populations in destination countries. This document replaces the previous document of the same name, last published in 2013 (Fertil Steril 2013;100:645-50).

AUSTRALIAN ALTRUISTIC SURROGACY: STILL A WAY TO GO

This article is a first-person narrative of the author’s lived experience as an altruistic surrogate in Australia. The author highlights the complex and emotional difficulties faced by all parties in surrogacy arrangements to advocate for various legislative reforms. Touching on the phenomenon of international commercial surrogacy and the relevance of ensuring personal autonomy for surrogate mothers, the author ultimately paints a picture of an Australia that can approach surrogacy ethically: respecting the rights of children and the dignity of each individual.

Exploitation in International Paid Surrogacy Arrangements.

Many critics have suggested that international paid surrogacy is exploitative. Taking such concerns as its starting point, this article asks: (1) how defensible is the claim that international paid surrogacy is exploitative and what could be done to make it less exploitative? (2) In the light of the answer to (1), how strong is the case for prohibiting it? Exploitation could in principle be dealt with by improving surrogates' pay and conditions. However, doing so may exacerbate problems with consent. Foremost amongst these is the argument that surrogates from economically disadvantaged countries cannot validly consent because their background circumstances are coercive. Several versions of this argument are examined and I conclude that at least one has some merit. The article's overall conclusion is that while ethically there is something to be concerned about, paid surrogacy is in no worse a position than many other exploitative commercial transactions which take place against a backdrop of global inequality and constrained options, such as poorly‐paid and dangerous construction work. Hence, there is little reason to single surrogacy out for special condemnation. On a policy level, the case for prohibiting international commercial surrogacy is weak, despite legitimate concerns about consent and background poverty.

TO PROHIBIT OR PERMIT: WHAT IS THE (HUMAN) RIGHTS RESPONSE TO THE PRACTICE OF INTERNATIONAL COMMERCIAL SURROGACY?

AbstractThe rapid expansion of international commercial surrogacy arrangements has created serious ethical and legal dilemmas with respect to the nationality and parentage of children conceived under such arrangements and the potential exploitation of surrogate mothers. This paper examines these dilemmas through the prism of international human rights law to assess whether a prohibitionist or permissive approach should be adopted with respect to this practice.

Preventing and Addressing Statelessness

Everyone has the right to acquire a nationality. However, situations of statelessness persist. International commercial surrogacy presents a very specific contemporary challenge because in such cases it may be difficult for the child’s legal parentage to be established or recognised. This may result in serious consequences for the child including statelessness. Recognising this lack of harmonisation and potential child rights violations, a variety of actors are currently mapping State approaches to surrogacy. Furthermore, the Secretariat of the Hague Conference on International Law has also been analysing legislation in order to identify existing gaps and to consider possible reforms. There is a need to continue research in this field and to propose practical and feasible solutions. As with individual cases, any measures adopted and implemented to address the challenges presented by international surrogacy should make the best interests of the child a primary consideration and leave no child stateless.