Comments on Assisted Reproduction Barriers

Sometimes, I read the news. It generally ends badly.

So this morning, I found out that our government, on grounds of austerity (…), plans to cut funding for assisted reproduction. What exactly this will mean is up in the air. They talk about setting limits, and so on, but it’s interesting that, according to the article, the program costs $70 M and they plan to save… $70 M. Not making this up. These must be very solid limits if they bar… everyone.

In fact, it’s pretty typical. We live in a (world-wide and national) climate of “austerity”, and the government is making cuts across the boards, because apparently we’re in a financial disaster or something. That this specific program would be cut is not unexpected, as the current Minister of Health and Prime Minister had both opposed the program of free assisted reproduction. I will leave to others the discussion on “whether we can afford it”. Assuming the question makes sense, in my opinion, it would be impossible to know for lowly citizens such as I. Government figures are generally more or less manufactured to reflect what the government wants to see. In this case, the government wants a financial disaster in order to justify its will to force austerity on us, so that’s what we have. Eh.

Even if we allow that we live in a catastrophic world of state debt, who are they to decide which women should have access to pregnancy or not? All the parties involved are straight men. This seems the mirror case of abortion. Why do you, straight male politicians, think you should be the people judging what women do with their body?

If that’s how they treat cis women, I can’t think what will be when uterus transplants for trans women become a reality.

Anyway.

Instead of doing a substantive article full of my opinions, I decided to read the news, even more news, to find memorable quotes to comment. (All were translated from French.)

In a memoir about this subject, in 2013, the CHUM’ fertility clinic said it noticed “a visible drift from case of medical infertility to a sort of social infertility.” (Source)

Here, “social” seems to be a way to discredit some reasons why people can’t access parenthood as not biological, constructed, invented in people’s mind, or following from social realities (and not from “Nature”). The idea seems to be that only medically infertile women, who are so for biological reasons, should have access to in vitro fertilization and the like.

“Biology” is constructed and social too. What is or isn’t “biological” or “medical” is determined in a specific epistemic context. In practice, here, this means that doctors are the only ones who can say something is or isn’t biological, i.e. valid as a reason. Yet whether a cis-hetero couple is infertile or not is often hard to determine. Diagnosis, in many situations, is informed guess-work. Why should doctors, and only doctors, set the criteria for infertility? Why should they, as a result, be habilitated to say whether a given woman can or cannot carry a child?

This medical criterion doesn’t seem to allow for same-sex couples, or only ambiguously so. It also has the implication that unless you have a medical diagnosis, you can’t have or bear a child without penis-in-vagina sex. As an asexual woman who wants children, I would find it unpleasant to be forced to have sex in order to have children. I don’t think I would give “free and informed consent” to sex if the state forced it upon me to have children. I would be forced — by the state — to have sex to achieve parenthood, even though the very idea of having any kind of sex or such intimate behaviour makes me very anxious. Of course, the state also forces trans people to become infertile if they want legal recognition, so it’s not applicable to me personally, but I’m sure other people, cis or trans, gay or straight, asexual or not, will have similar negative reactions to sex (sexual assault survivors for example). Is it really right that you must have sex to have access to parenthood? Sex and raising children are very different things and are not necessarily related (as non-procreative sex exemplifies).

But it’s not over. The same memoir

expressed that infertile couples were far from the clinic’s only patients, as it saw a stream of single women, women whose husband is abroad, gay couples, even women who wanted to carry a child for their daughter. (Source)

So here, we have a policy with the effect that lesbian couples have access to motherhood. And they don’t even mention we exist. We’re just erased. Homosexual couples are mentioned, but only male couples with a surrogate mother, mostly because some celebrity is doing it. It’s absurd. It’s absolutely impossible to know what will happen to us.

By the way, I had a very hard time to find anything anywhere about lesbian couples. Mostly straight and gay male couples. Really, people?

Oh, and another thing: you won’t save $70 M out of a budget of $70 M by creating barriers for marginal and exceptional cases such as those mentioned.

However, Mrs. Kieffer Balizet [of the Quebec Association of Infertile Couples, ACIQ] says she is conscious that a revision is necessary to clarify “grey areas”. Which ones? The recourse to in vitro fertilization by male couples helped by surrogate mothers, amongst others. “We are ready to collaborate with [M. Couillard] on a certain number of adjustments.”

[…]

In a recent press release, the ACIQ insisted on a selection criterion which could exclude single women and homosexual couples : diagnosed infertility. (Source)

This is an article about infertile couples reacting to the gay celebrity who is having children through a surrogate mother. Such lack of solidarity is sad. Later in the article, they say that lesbian couples asking for artificial insemination are fine because they don’t cost too much. Great, but 1) the focus on “medical” infertility is strange, as I said earlier 2) the case of male gay couples with surrogate mothers is really much the same.

At least, as a trans woman, I’ll be infertile before long, if I’m not already. Technically, my hypothetical future girlfriend and I would be eligible.

Once upon a time, people had children. Today, they have parentality projects. This language drift illustrates rather well the technolofic and technocratic chasm at the bottom of which the natural act of giving live is falling.

A child is not, has never been and will never be a consumption good, like, my car, my kid, my cottage… Since some parents-in-becoming are not intelligent enough to understand it, we need clear barriers. And a generous and loving suppleness in their application. (Source)

Okay, so the fact that we use long abstract words is significant of the fact that we like long abstract words as a society, I give you that. However, preparing when and how one would have children is a project about becoming a parent. It’s exists “since the dawn of time”. Really, we didn’t invent any of this. Although we have more effective techniques today, fertility drugs are not a novelty (just like procreation techniques). The Romans did it, Medieval penitentials mention them (IIRC), and so on. Whether they worked well or not is irrelevant: what matters is that the idea that they could control if and when they would be parents was already on their mind. In effect, they had “parentality projects”.

We should strive for a world where meaningful and important experiences such as parenthood should be accessible to all who want it. It’s not a frivolous desire like having a new car or a cottage. It is something that structures one’s whole life AND one’s place in society.

And clear barriers with generous and loving suppleness are an antithesis.

Oh, and there is no need to naturalize “the act of giving live”. How is any more or less “natural” than anything else? What’s this “nature” anyway?

When he was Minister of Health, Philippe Couillard [now PM] was opposed to free access for all. He judged that having a child was not a right, but a privilege. (Source)

That’s very true. It’s a privilege. Straight privilege, at the very least, which you exemplify. (I’m sure that’s not what Couillard meant when he said privilege. It was just too easy.)

It’s a political and social choice, explained [now ex-minister Bolduc], adding that it pertains to the political authorities to find the balance between everyone’s needs. (Source)

This was said at the time when the program was put in place, and it’s also very true. People talk as if funding assisted reproduction means less of other health services. It’s not what’s going on. This is a social choice, a statement that everyone can access the full experience of parenthood (or as close as possible). It reminds me of what Sir Humphrey, of Yes (Prime) Minister, said of government programs: “You don’t fund them for doing work but to show what you approve of. Most government expenditure is symbolic.” (« The Patrons of the Arts », Yes Prime Minister s. 2 e. 6) Of course, I want effective policies and expenditure, not symbolic wastes of money, but the point still stands. Government money means as much as it does.

All the same, saying that it deprives other people from “essential” health services is besides the point (oh, and it… doesn’t do that). And how are they more “essential”? The effects of being a parent on one’s life are certainly comparable in their scale to that of many surgeries and treatments. What is or isn’t essential is very subjective.

***

In a way, what the final policy will be doesn’t really matter. Well, I’ll be outraged if they only allow it to medically infertile straight couples, but it’s besides the point. At least, adoption will be remain possible, so most of the experience would remain. I just think the discourses are sad, depressing, and oppressive. That is all.

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2 thoughts on “Comments on Assisted Reproduction Barriers

  1. […] June, the Health minister talked about slashing the new program of assisted reproduction by imposing a model of “medical infertility&…, which is highly problematic, especially for same sex couples. It’s a new, so it’s not […]

  2. […] l’accès au programme de procréation médicalement assistée (j’en ai glissé un mot dans un autre article). Comme pas mal toutes les mesures d’austérité, celle-ci touchera plus lourdement les […]

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