Surrogacy (on each side of the Atlantic)

 Crossing the Atlantic today, to return home from Paris, this story in The Atlantic seems apropos:

Mothers for Sale.  Most of Europe bans commercial surrogacy. The United Nations likens it to slavery. But in the United States, business is booming.  By Helen Lewis

"Since the legalization of same-sex marriage, male couples have become the big growth market for American surrogacy, but the practice is booming among aspiring parents—married or single, straight or gay—who can afford the cost of hiring someone else to carry their child. In 2024, 11,821 embryos were transferred to surrogates in American clinics associated with the Society for Assisted Reproductive Technology, up from 8,461 three years earlier, and the United Nations estimates that the global worth of the industry is almost $15 billion. Most surrogacy in America today is commercial, meaning that the carrier is paid, and gestational, meaning that the carrier has no genetic relationship to the child.

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" many liberal Americans are surprised to discover that their country is an outlier in its enthusiasm for commercial surrogacy. In Britain, where I live, a ban on the practice enjoys substantial support among feminists, who worry about the power differential between paid surrogates and wealthy would-be parents. (Altruistic surrogacy, in which the surrogate carries a baby solely out of generosity, is less controversial and is permitted.) A recent UN report went even further, declaring that commercial surrogacy “constitutes the sale of children, which is a crime,” and that “surrogacy arrangements can amount to or resemble slavery.” 

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"Because so much can go wrong, every country in the European Union has banned commercial surrogacy. France’s centrist liberal president, Emmanuel Macron, has described the practice as “not compatible with the dignity of women.” Italy’s right-wing populist leader, Giorgia Meloni, has enacted one of the strictest anti-surrogacy frameworks in the world. Not only is domestic surrogacy banned, but any Italian citizen who brings home a baby born to an overseas surrogate risks jail and a fine of up to 1 million euros. Many other developed countries have either tightly restricted surrogacy or chosen, as Britain and Canada have, to allow only the altruistic version. Israel allows surrogacy but imposes a raft of conditions: The commissioning parents must not have more than two children already, must not have serious criminal convictions, and must be of the same religion as the surrogate.

"In general, Europeans think of Americans’ enthusiasm for paid surrogacy the way we regard their fondness for guns and capital punishment: inexplicable. The piquant difference, however, is that surrogacy is a cause of the American left rather than the right. Red states tend to have tighter limits on surrogacy. Louisiana, for example, restricts surrogacy to married heterosexual couples using their own sperm and eggs. By contrast, when New York legalized commercial surrogacy in 2020, LGBTQ activists hailed it as a triumph for “fertility equality.”

The debate cuts across political traditions and defies easy categorization. When surrogacy goes well, the result is a happy family that would not otherwise have existed. When it goes wrong, however, it can do so in unpredictable and emotionally crushing ways. At its core, the ethical question is this: How much physical and emotional risk should individuals be allowed to take on in the name of a commercial transaction? 

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"America also stands virtually alone as a rich country that permits incoming surrogacy tourism from elsewhere. Many of these international intended parents are from China, where surrogacy is banned and where, until recently, family size was limited by the one-child policy. These customers have exacting standards. 

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"Look abroad, though, and it’s a different story. Some agencies offer “guaranteed baby” packages for as little as $50,000. Surrogacy destinations pop up anywhere the local laws are lax, such as Northern Cyprus, a territory that exists in a legal limbo and is recognized only by Turkey. (The problem is that babies born there can end up stateless.) For parents from Russia, nearby Georgia is a similar no-questions-asked destination.

"India used to be the most favored low-cost destination, but in 2015, Prime Minister Narendra Modi, citing fears of exploitation, banned commercial surrogacy for foreigners. Ukraine’s appeal as a surrogacy destination has diminished since Russia’s invasion in 2022, although the leading agency there, BioTexCom, told me that the company is still handing off one baby born via surrogacy every day on average, at a cost of about $60,000. A representative of the agency initially told me that it was planning to open a clinic in Kazakhstan, to cater to the growing Asian market. In July, however, that country abruptly banned foreign surrogacy amid concerns about exploitation. "