Fertility outsourcing is a set of practices that redistribute fertility and reproduction of children across a number of different bodies: for example, in vitro fertilization, artificial insemination, superovulation, and other similar kinds of processes that have been developed within reproductive medicine and applied to human beings since the 1970s.
Now, in the 1980s and early 1990s, we see the development of a business model that arose in the United States, which revolves around commercial gestational surrogacy and oöcyte vending. This business model, through a contractual process, secures the reproductive capacity of surrogates, and oöcyte vendors for the use of ‘intending parents,’ in exchange for fees.
It took quite awhile for the contractual form to be elaborated and to be embedded in a commercially secure way; and certainly it differs from state to state in the United States. California has been the state that has provided the most secure legal and commercial environment for fertility outsourcing, in the sense that it treats surrogacy contracts as enforceable, and it has effectively become the state that has the most elaborated fertility outsourcing industry in the world.
But this business model is being exported. Primarily driven by price competition, of course in California and in the United States more generally, the cost of this kind of purchasing, this kind of gestational and fertility services, has gone up; we are now seeing the development of competition sites elsewhere in the world, such as India. The Indian state is very busily marketing its female population as reproductive laborers and their surplus reproductive capacities as national assets. Since the Indian government became a signatory to the World Trade Organization, to treaties that create intellectual property agreements and the general agreement on tariff and services, it has created a safe commercial environment for medical tourism, which includes reproductive tourism. The External Affairs Ministry has also created a category of medical visa to facilitate medical tourism.
Clinical trials also, are being increasingly conducted off-shore in less expensive sites, rather than in the United States or in Western Europe. Essentially, you can conduct your clinical trial in a much more low-cost environment, where you have much better access to experimental populations who will come forward for a much lower fee, and will make themselves available for clinical trial research to simply get temporary access to health care.
But also, now there have been a number of clinics that have sprung up, which focus particularly on gestational surrogacy. Surrogacy is interesting because it’s a very potentially global industry, in the sense that the surrogate does not make a genetic contribution to the child.
Now, it seems to me that a great deal of what fertility outsourcing is about is the reproduction of whiteness—of course that is not the only thing as there are other groups that will seek surrogacy services, like, for example the Japan/Korea circuit (since closed down after the Hwang scandal). It is the reproduction of whiteness because that is where the money is. So, it’s quite possible to locate your clinic in India, where the government treats commercial surrogacy as enforceable, and have your primary market, for example, in the United States or Australia, where surrogacy is often financially or legally prohibitive.
On a website for a fertility clinic in Mumbai, the thing which is most alarming is that the site is full of photographs of lovely blonde, blue-eyed mothers with lovely blonde, blue-eyed babies. There is not a single photograph of anyone that looks like they live anywhere other than the richest, whitest suburbs of Southern California. You would never in a million years know, looking at the people who are represented on the site, that there was any relationship whatsoever to anyone in India. What strikes me about this is that you have this contractual and genetic arrangement whereby you can travel to India, you can make a baby that looks like you, and you can take the baby home, and there is no trace of the relation to the actual surrogate herself. There is no genetic trace, and there is no contractual trace because the surrogate has no recourse in law. She has no recourse in law because the contracts are treated as enforceable.
If we’re looking at oöcyte vending—again, we really need to move outside the United States—the way in which oöcyte vending has been globalized has been through the development of these transnational fertility clinics that recruit vendors from populations that are phenotypically similar to purchasers, but are divided by regulatory boundaries. For example, in Spain (I think the only country in Western Europe that has commercial oöcyte vending), oöcytes are drawn from the local student populations; but also, from Eastern European women. Eastern Europe has developed a circuit whereby one of the ways you can improve your probably fairly low income is to travel, for example, from the Ukraine to Spain, and spend a month or two undergoing superovulation, being paid about 1,000 Euro or 1,500 Euro, before going back to the Ukraine. There are women who do this maybe three times a year. It may be their primary source of income and in any case is a very substantial source of income for them. There are anecdotally some crossovers with the sex industry as well, where women will go and work in the fertility clinics, and then also work in the local sex industry, and then go home.
So this is what I mean when I say a phenotypically similar population divided by regulatory boundaries: Northern Europeans travelling to Spain because they can purchase eggs from women who have appropriately Northern European features—blue eyes and fair skin. Again, we can see the logics of the reproduction of whiteness working here, because this is where the money is, and I don’t think it takes a huge leap of imagination to see that this is a kind of informal labor.
