Hughes: What are reproductive rights?

IEET executive director James Hughes has posted some of his responses to a journalist’s questions about reproductive rights. Highlights:

Do you really think there will be equal access for this technology? Why wouldn’t it create a caste system of the enhanced and the non-enhanced?

Equal access to any technological enablement is the result of ongoing political struggle. Societies with stronger civil liberties, trade unions and social democratic parties will provide better universal technological access, from sewers to the Net to gene therapy. In other more unequal societies genetic therapies may exacerbate inequality. The difference in outcomes will be determined by the strengthen of democratic movements and parties, however, not by policies governing the access to technologies. Because of the growth of medical tourism banning access to a technology will simply restrict access to the wealthy, and will not stem the emergence of a two-tier society.

Why do you dislike the term “designer babies”?

“Designer babies” impugns the motivations of parents, who are generally trying to ensure the best possible lives for their children. If parents provide food, exercise and education for children to ensure that they are smart and healthy we praise them as responsible. When they try to ensure the same goods for their children with reproductive technology we imply that they have twisted, malign, instrumental values.

Even in the case of reproductive choices which are cosmetic, such as eye or hair color, we do not slander parents for how they dress or groom their children, but we do if they exercise a simple cosmetic choice before birth. We should stop using the term.

Totally agree with J's point about rooting out the 'designer babies' term. It totally trivializes and demeans the pending practice. In its place I've been using the term 'human trait selection.'

More.

The Shifgrethor of Changelings

Athena Andreadis is guest blogging this month.

A slightly different version of this essay appeared in her blog on April 17, 2008. Since then, Thomas Beatie and Nancy Roberts had a daughter and they are expecting a second child.

“Maybe there are only two sexes: men and mothers.”
Alice Sheldon, writing as James Tiptree Jr. to Joanna Russ

A year ago, I caught sight of a headline exclaiming “Pregnant Man!” Intrigued, I read on, only to become more puzzled. I couldn’t figure out the novelty: the future parent, Thomas Beatie, identified and was legally classified as male. However, s/he was chromosomally and somatically female, modified by breast surgery and testosterone injections. So Beatie’s fallopian tubes, ovaries and uterus were intact, making this a conventional pregnancy (and not the first of its kind, either).

For me, the real surprise was how reactions split. With few exceptions, women were positive, whether hetero- or homo-sexual. Most men (again, regardless of sexual orientation) were negative, many virulently so, resorting to utterances that could have emanated from fundamentalist tracts. The transgender community was ambivalent — and amazingly there, too, the division was along lines of gender identification. In essence, the men — born or made — were saying: Why would anyone calling himself a man go through this? That’s what women are for! Could this ever happen to me?? Some said this more or less verbatim. Beatie’s pregnancy pushed the buttons of this issue as forcefully as if the coming child had burst, Alien-like, from a male torso.

While I was pondering this, it dawned on me that unconventional biological and social human genders seem to be predominantly the domain of women in speculative fiction, from singletons (Le Guin’s androgynous Gethenians, Constantine’s hermaphroditic Wraeththu, Slonczewski’s parthenogenetic Sharers) to multiples (Scott’s five-gendered post-FTL humans) to bona fide male pregnancy (in Butler’s Bloodchild). Men tend to stick to dyadic genders and traditional family patterns, even when depicting otherwise exotic aliens.

Biologically, the two gametes of terrestrial lifeforms are a result of evolution once it went down the path of sexual reproduction. There is nothing pre-ordained about this outcome, nor does phenotype mirror genotype: many plants and several animals are unisexual or hermaphroditic, while other animals can switch sexes. Too, biomorphic and behavioral outcomes are not invariably binary. Humans are capable of an enormous repertoire of responses, and I cannot think of one that is completely gender-specific. The troubles start with the relative value assigned to the two genders — and to their behavior, conditioned and enforced by edicts throughout the ages that are as arbitrary as they are punitive.

I can understand the worries of the trans community, whose members are trying to gain acceptance as gay people did before them by adopting rigidly orthodox gender roles. Such stereotyped assignations also occurred in cultures that tolerated intersexes: the North American two-spirited, the Indian hijra. However, the men’s objections reminded me of the “eew” reaction of boys to girls, before the hormonal rise (or is it fall?) of puberty overcomes social conditioning. They highlight a profound and visceral male unease over blurred identities or breached boundaries — in bodies, gender roles, power; a wish to make an absolute, immovable distinction between penetrator and penetrated, implanter and implanted.

In most cultures, men are trained to compartmentalize and make a virtue out of this necessity. Additionally, surgery that accentuates sexual dimorphism draws surprisingly little criticism. Beatie’s biggest transgression was becoming a changeling, someone who cannot be easily pigeonholed. Shapeshifters, from Raven to Loki to Star Trek’s Odo, are never trusted even though all mythologies found it necessary to invent them. What set off the fuses was the perception that Beatie is claiming the perks of both genders — if pregnancy can be viewed as such, considering how dangerous it could be (both physically and socially) before the advent of reliable contraception.

In the last few decades, medical advances have made it possible for people to conceive and bear children by assisted reproduction: sperm banks, artificial insemination, in vitro fertilization, surrogate motherhood. Yet all these procedures kept one condition intact: women’s involvement and hence traditional gender roles. Schwarzenegger in Junior notwithstanding, there is no concerted effort to create artificial wombs, which would make childbearing optional for women and possible for men. With the continuing furor over embryonic stem cells, it is unlikely that such an endeavor will be pursued any time soon.

Childbearing and childrearing, even when greatly desired and welcome, take a toll on women individually and collectively, since their investment is much greater. As long as this dichotomy remains, all discussions of true equality (to say nothing of radical social engineering) will remain just vaporous talk. It is possible, of course, that once in vitro pregnancy becomes possible, women will disappear except for a few kept as trophies or specimens — and that humans will designate another group as the perpetual Other. However, I prefer to hope that this will bring true equality, and make everyone able to adopt fluid, flexible identities that, at their best, combine the gentle strength of the Gethenians with the passionate flair of the Wraeththu.

Shifgrethor: to cast a long shadow; prestige, face, social authority (language of Karhide; Ursula Le Guin, The Left Hand of Darkness).

Credits: Top, Shaman by Susan Seddon Boulet;
Bottom, Tilda Swinton as Gabriel in Constantine.

Athena

Starship Reckless

And Ain't I a Human?

When 8 is more than enough: It's time for some meaningful regulation

Like a lot of people last week, I was shocked to find out that Nadya Suleman, the mother of the octuplets born last week in Los Angeles, already has 6 children -- all between the ages of 2 and 7.

And that she is a single mother who has already filed for bankruptcy, and that she is a self-described "professional student" who lives off education grants and parental money.

And that she has a psychological condition which compels her to keep wanting to have more babies.

Now, I'm a huge advocate of reproductive freedoms and equal access to repro-tech, but something clearly failed to happen here. In this case, the fertility clinic that performed the procedure failed to exercise both restraint and common sense. They also showed a complete disregard for guidelines -- a strong indication that, while regulation exists for repro-tech procedures, it's not being enforced strongly enough. This needs to change.

Questionable practices

First off, it sounds like Suleman should have failed the screening test. Prospective parents must undergo an evaluation of their psychological and sociological circumstances before qualifying for IVF treatment. According to R. Dale McClure, president of the American Society for Reproductive Medicine, an investigation had started into the case, but that: "Concerns for confidentiality preclude us from making any additional comments at this time."

Would it be unfair of me to interpret this as an acknowledgment that their investigation failed to raise the necessary warning flags? Or that they lacked the resolve to act on them?

Again, I don't mean to bemoan the desire of some parents to have large families, but it appears that there were extenuating circumstances in this case that would should have precluded the mother from having more babies, namely her questionable mental state and motives for wanting to have more children.

This is more than just an issue of procreative liberty -- it's also a quality of life issue for those children being introduced into the world.

Given that Suleman passed the screening test, it would appear that the assessment criteria and investigative processes should be overhauled

Second, the fertility clinic implanted (at least) 8 viable embryos. Most (responsible) clinics will only implant a pair of embryos to reduce risk (both to mother and children). And this is made all the more troubling considering that Suleman has already delivered twins; the fertility clinic knew she had a predisposition for multiple births, yet they didn't adjust their treatment accordingly.

By implanting 8 embryos in a mother predisposed to multiple births, they put her health at risk and they significantly increased the likelihood of her introducing a multiplicity of babies into a family that was already over-extended.

According to Michael Tucker of the Georgia Reproductive Clinic, Atlanta, clinics are policed by the American Society for Reproductive Medicine, which frowns upon implanting more than two or three embryos at a time. "It is remarkable," says Tucker, "that any practitioner would undertake such a practice."

Well, it would only have been remarkable if the ASRM had the teeth to enforce their policies. If the Suleman case is any indication, their reach and influence is insufficient.

Regulation is only regulation if it is enforced

Looking at this case one gets the feeling that some fertility clinics look upon their patients as nothing more than customers. Given the nature of their work, however, this attitude will simply not do.

A lassez-faire approach to repro-tech won't work to protect the interests of those hoping to use these technologies and to protect those lives that are created as a result. I agree that regulation should be very liberal and accommodating to a diverse set of interests, but complete de-regulation would be both dangerous and facile.

But establishing regulations and guidelines is one thing, enforcing it is quite another.

In some cases, this one included, it would be perfectly reasonable for the state to intervene and deny access, or at the very least compel clinics to follow a strict set of guidelines to prevent this sort of thing from happening. It's time to empower groups like the ASRM -- particularly now as new reproductive technologies are emerging quickly. This way, fertility clinics will be compelled to follow the rules and be held accountable for their actions.

It's clear that this has to happen. Clinics won't regulate themselves.

But why should we have expected them to? They're not the ones who now have to raise these children.