A friend of mine recently questioned my interest in a
custody battle covered on the evening news. A surrogate mother who had
agreed to gestate a fetus for a fee decided she wanted to keep the
baby. "Why are you always so fascinated by those stories?" he asked.
"They have nothing to do with Black people." By "those stories" he
meant the growing number of controversies occupying the headlines that
involve children created by new methods of reproduction. More and more
Americans are using a variety of technologies to facilitate conception,
ranging from simple artificial insemination to expensive, advanced
procedures such as in vitro fertilization (IVF) and egg donation.*
In one sense my friend is right: the images that mark these
controversies appear to have little to do with Black people and issues
of race. Think about the snapshots that promote the new reproduction.
The always show white people. And the baby produced often has blond
hair and blue eyes -- as if to emphasize her racial purity. The
infertile suburban housewife's agonizing attempts to become pregnant
via IVF; the rosy-cheeked baby held up to television cameras as the
precious product of a surrogacy arrangement; the complaint that there
are not enough babies for all the middle-class couples who desperately
want to adopt; the fate of orphaned frozen embryos whose wealthy
progenitors died in an airplane crash: all seem far removed from most
Black people's lives. Yet it is precisely their racial subtext that
gives these images much of their emotional appeal.
Ultimately my attraction to these stories stems from my interest in
the devaluation of Black
reproduction. As I have charted the proliferation of rhetoric and
policies that degrade Black women's procreative decisions, I have also
noticed that America is obsessed with creating and preserving genetic
ties between white parents and their children. This chapter explores
the reasons for the racial disparity that marks the new reproduction,
as well as the impact of race on the right to recreate children by
technological means.
LIBERATING TECHNOLOGY OR PATRIARCHAL TOOL?
New means of procreating are often heralded by legal scholars
and
social commentators as inherently progressive and liberating. In this
view, reproduction-assisting, technologies expand the procreative
options open to individuals and therefore enhance human freedom. These
innovations give new hope to infertile couples previously resigned to
the painful fate of childlessness. In addition, the new reproduction
creates novel family arrangements that break the mold of the
traditional nuclear family. A child nay now have five parents: a
genetic mother and father who contribute egg and sperm, a gestational
mother who carries the implanted embryo, and a contracting mother and
father who intend to raise the child. One of the new reproduction's most influential proponents, John Robertson, opens his book Children of Choice
by proclaiming that these "powerful new technologies" free us from the
ancient subjugation to "the luck of the natural lottery" and "are
challenging basic notions about procreation, parenthood, family, and
children."
New reproductive technologies promise to fulfill couples' yearning to
have genetically related children. They also make it possible to use
new genetic knowledge to create children with superior traits. Pregnant
women may choose to abort a fetus determined, through amniocentesis,
ultrasonoraphy, or other diagnostic techniques, to have a genetic
defect. Sperm and egg donation allows parents to select gametes from
donors who possess favored qualities. With IVF (fertilization of the
egg in a petri dish followed by transfer to the uterus), parents can
screen test-tube embryos for defects before implantation -- "nipping it
in the embryo," as a newspaper headline proclaimed. In the future,
doctors will be able to tinker with genes contained in the embryo to
enhance their encoded messages or remedy genetic disorders.
My impression of these technologies, however, is that they are more
conforming than liberating. they more often reinforce the status quo
than challenge it. True, these technologies often free unconventional
parents from the constraints of social custom and legal stipulations.
They have helped single women, lesbians, and gay men whom society
regards as unqualified to raise children to circumvent legal barriers
to parenthood.
Informal surrogacy arrangements between women, for example, may provide
a means of self-help for women who wish to have children independently
of men; and they require nogovernment approval, medical intervention,
or even sexual intercourse.
Under this arrangement, a fertile woman would informally promise an
infertile woman who wants a child to impregnate herself with a donor's
sperm and to give the baby to the infertile woman for adoption.
But these technologies rarely achieve their subversive
potential. Most often they complete a traditional nuclear family by
providing a married couple with a child .
Instead of disrupting the stereotypical family, they enable infertile
couples to create one. Most IVF clinics accept only heterosexual
married couples as clients, and most physicians have been unwilling to
assist in the insemination of women who depart from this norm.
They routinely deny their services to single women, lesbians, welfare
recipients, and other women who are not considered good mothers.
The new reproduction's conservative function is often imposed by courts
and legislatures. Laws regulating artificial insemination contemplate
use by a married woman and recognition of her husband as the child's
father, and recent state statutes requiring insurance coverage of IVF
procedures apply only when a wife's eggs are fertilized using her
husband's sperm. On the other hand, courts have been willing to grant
parental rights to sperm donors against the mother's wishes "when no
other man is playing the role of father for the child," such as when
the mother is a lesbian or unmarried.
Radical feminists have powerfully demonstrated that the new
reproduction enforces traditional patriarchal roles that privilege
men's genetic desires and objectify women's procreative capacity.
They make a convincing case that new reproductive technologies serve
more to help married men produce genetic offspring than to give women
greater reproductive freedom. High-tech procedures resolve the male
anxiety over ascertaining paternity: by uniting the egg and
sperm outside the uterus, they "[allow] men for the first time in
history, to be absolutely certain that they are the genetic fathers of
their future children." Some feminists have questioned the forces that drive so many women to endure the physical and emotional trauma entailed in IVF.
The arduous process involves stimulating ovulation with daily hormone
infections, retrieving the eggs from the ovaries, and inserting the
fertilized embryos into the uterus, usually followed by heartbreaking
disappointment. In extreme cases, IVF has caused long-term, and even
lethal, harm to women s reproductive organs, such as the growth of
ovarian cysts.
The desire to bear children is influenced by the stigma of
infertility and the expectation that all women will become mothers.
Added to this is the desire to produce a genetically related child.
Despite very low rates of live births resulting from IVF (on average,
only about 20 percent), some women feel a "duty" to undergo the ordeal before they give up on the possibility of genetic parenthood. But many women who undergo IVF are themselves physiologically fertile, although their husbands are not.
These women could therefore become pregnant using a much safer and
cheaper process -- artificial insemination, for example. Underlying
women's desire to undergo IVF, then, is often their husbands'
insistence on having a genetic inheritance. Because this technology
inflicts so much distress on women's bodies for the benefit of men,
feminist author Janice Raymond calls it a form of "medical violence"
against women.
Surrogacy also fulfills the father's desire to pass his own genes onto
a child. In the typical arrangement, a man whose wife is infertile
hires a fertile woman, or surrogate, to bear a child for the couple.
The surrogate is impregnated with the husband's sperm and carries the
fetus to term. She agrees to relinquish parental rights to the child,
whom the wife subsequently adopts. The surrogate's service, then,
allows the husband to have a child who is genetically related to him,
despite his wife's infertility. William Stern, the contracting father
in the well-publicized Baby M
case, explained that, as the only survivor of a family that had been
annihilated in the Holocaust, he wanted a genetically related child in
order to perpetuate his family's bloodline.
"The desirability of having his own biological offspring became
compelling to William Stern, thus making adoption a less desirable
alternative," the New Jersey trial judge acknowledged in upholding the
surrogacy contract.
Surrogacy arrangements devalue the mother's biological relation-ship to
the child in order to exalt the father's. Harvard law professor Martha
Field points out that the very term "surrogate" emphasizes the
arrangement's purpose -- allowing a man to be a genetic father rather
than enabling a woman to become a mother: "The woman is a surrogate's
surrogate uterus or a surrogate wife -- to carry his genes."
Most surrogate mothers intentionally donate their genetic material, as
well as their wombs, to bear a child who will not be legally theirs.
Not surprisingly, then, most of the money the surrogate receives pays
for the surrender of her parental rights -- her legal claim to the
child arising from their biological bond. The contract Baby M's mother
signed provided: "$10,000 shall be paid, to MARY BETH WHITEHEAD,
Surrogate, upon surrender of custody to WILLIAM STERN, the natural and biological father of the child born pursuant to the provisions of this agreement..." Whitehead would have received only $1,000 for her services if she had delivered a stillborn child.
In custody disputes that arise when the surrogate mother refuses to
relinquish the baby, enforcing the contract would mean denying her
genetic claim to legal maternity. Yet surrogacy advocates contend that
holding surrogates to their bargain is necessary to protect contracting
couples' interests and to ensure the viability of the practice. John
Robertson even argues that procreative liberty includes a
constitutional right to state enforcement of surrogacy agreements.
Even judges who refuse to enforce surrogacy contracts, and base custody
instead on the best interests of the child, tend to grant custody to
the contracting couple in part because of their class advantages. The high court in the Baby M
case, for example, awarded the Sterns joint custody of Melissa largely
because of the couple's financial security and ability to provide the
child with such luxuries as piano lessons. Meanwhile a parade of expert
witnesses disparaged Whitehead's fitness as a mother based on her
"myopic" and "narcissistic" efforts to get Melissa back.
The law should favor gestational mothers who decide they want
to keep the baby, not because the mother's genetic tie is more
important than the father's but because the mother has already
established a relationship with the baby. Instead, surrogate mothers
are valued for their service to the biological father -- facilitating
his more important genetic connection to the child.
HOW RACE SHAPES THE NEW REPRODUCTION
While acknowledging that poor women of color are the most
vulnerable to reproductive control, the feminist critique identifies
male domination as the central source of the oppressive use of
reproduction-assisting technologies. But these technologies reflect and
reinforce a racist standard for procreation, as well. Similar to
technologies that prevent births, the politics of technologies that assist births is shaped by race.
One of the most striking features of the new reproduction is that it is
used almost exclusively by white people. Of course, the busiest
fertility clinics can point to some Black middle-class patients; but
they stand out as rare exceptions. Only about one-third of all couples
experiencing infertility seek medical treatment at all; and only 10 to
15 percent of infertile couples seeking treatment use advanced
techniques like IVF.
Blacks make up a disproportionate number of infertile people avoiding
reproductive technologies. White women seeking treatment for fertility
problems are twice as likely to use high-tech treatments as Black women.
Only 12.8 percent of Black women in the latest national survey used
specialized infertility services such as fertility drugs, artificial
insemination, tubal surgery, or IVF, compared with 27.2 percent of
white women.
As my story that opened this chapter reflects, media images of
the new reproduction mirror this racial disparity. Most of the news
stories proclaiming the benefits of the technology involve infertile
white couples. When the 1986 Baby M
trial propelled the issue of surrogacy to national attention, major
magazines and newspapers were plastered with photos of the parties (all
white) battling for custody of Melissa.
Ten years later, in January 1996, the New York Times,
launched a prominent four-article series called "The Fertility Market."
The front page displayed a photograph of the director of a fertility
clinic surrounded by seven white children conceived there. The
continuing page contained a picture of a set of beaming IV'F triplets,
also white.
The following June, Newsweek ran a cover story
entitled "The Biology of Beauty" reporting scientific confirmation of
human beings' inherent obsession with beauty.
The article featured a striking full-page color spread of a woman with
blond hair and blue eyes. The caption asked rhetorically: "Reproductive
fitness: Would you want your children to carry this person's genes?"
The answer, presumably, was supposed to be a resounding, universal
"Yes!
When we do read news accounts involving Black children created
by these technologies, they are usually sensational stories intended to
evoke revulsion precisely because of the children's race. Several years
ago a white woman brought a highly publicized lawsuit against a
fertility clinic she claimed had mistakenly inseminated her with a
Black man s sperm, instead of her husband's, resulting in the birth of
a Black child.
The woman, who was the child's biological mother, demanded monetary
damages for her injury, which she explained was due to the unbearable
racial taunting her daughter suffered. Two reporters covering the story
speculated that "[i]f the suit goes to trial, a jury could be faced
with the difficult task of deciding damages involved in raising an
interracial child."
Although receiving the wrong sperm was an injury in itself, the fact
that 'it cane from someone of the wrong race added a unique dimension
Of barm to the error. This second harm to the mother was the fertility
clinic's failure to deliver crucial part of its service -- a white
child.
In a similar, but more bizarre, incident in The Netherlands in
1995,a woman who gave birth to twin boys as a result of IVF realized
when the babies were two months old that one was white and one was
Black. The Dutch fertility clinic mistakenly fertilized her egg sperm from both her husband and a Black man. A Newsweek
article subtitled "A Fertility Clinic's Startling Error" reported that
"while one boy was as blond as his parents, the other's skin was
darkening and his brown hair was fuzzy."
A large color photograph displayed the two infant twins, one white and
one Black, sitting side by side -- a racial intermingling that would
not occur in nature. The image presented a new-age freak show, created
by modern technology gone berserk.
The stories exhibiting blond-haired blue-eyed babies born to
white parents portray the positive potential of the new reproduction.
The stories involving the mixed-race children reveal its potential
horror.
REASONS FOR THE DISPARITY
These images, along with the predominant use of fertility
services by white couples, indisputably show that race affects the
popularity of reproductive technologies in America. What are the
reasons underlying this connection between race and the new
reproduction?
First, it has nothing to do with rates of infertility. Blacks have an infertility rate one and one-half times higher than that of whites.
(The racial disparity may actually be greater due to underreporting of
infertility by married Black women.) While the overall infertility rate
in America was declining, the infertility rate of young Black women
tripled between 1965 and 1982.
The reasons for the high incidence of infertility among Black women
include untreated chlamydia and gonorrhea, STDs that can lead to pelvic
inflammatory disease; nutritional deficiencies; complications of
childbirth and abortion; and environmental and workplace hazards.
In fact, the profile of people most likely to use IVF is
precisely the
opposite of those most likely to be infertile. The people in the United
States most likely to be infertile are poor, Black, and poorly educated. Most couples who use IVF and other high-tech procedures are white, highly educated, and affluent.
Besides the new reproduction has far more to do with enabling people to
have children who are genetically related to them than with helping
infertile people to have children. Baby M
and other well-known surrogacy cases involved fertile white men with an
infertile wife who hired a surrogate so they could pass on their own
genes to a child. Moreover, as many as half of the women who undergo
IVF are themselves fertile, although their husbands are not. Both
scenarios involve fertile people who use new reproductive
technologies to create genetic offspring. In short, use of high-tech
fertility treatment does not depend on the physical incapacity to
produce a child.
Instead, the racial disparity appears to stem from a complex
inter-play of financial barriers, cultural preferences, and more
deliberate professional manipulation.
Economic Barriers
The high cost of high-tech procedures places them out of most Black
people's reach. The median cost of one IVF cycle is about $8,000; and,
owing to low success rates, many patients try several times before
having a baby or giving up. Using donor eggs makes the procedure even
more expensive -- $10,000 to $20,000 for each attempt. (Ironically,
eggs from Black donors may be the most costly because they are so
scarce.) Most medical insurance plans do not cover IVF, nor is it
included in Medicaid benefits. Medicaid, moreover, will not reimburse
the full cost of covered infertility services, making most private
physicians unwilling to serve Medicaid recipients. Half of the
specialized fertility centers surveyed by the Alan Guttmacher Institute
refused patients on Medicaid.
Between 1985 and 199 1, ten states passed laws requiring insurance
coverage of infertility services, eight of which included IVF.
But the trend toward mandatory inclusion seems to have come to a halt.
Of course, these provisions do not assist the millions of uninsured
Americans whose incomes fall barely above the Medicaid level, a group
that is disproportionately Black. Without some form of subsidy, only a
tiny minority of Black Americans have the means to pay for these
expensive procedures.
The government could increase Black people's access to new
reproductive technologies by expanding public funding. "Although black
couples are twice as likely as white couples to be infertile,"
bioethicist George Annas has noted, IVF is "not promoted for black
couples, nor has anyone openly advocated covering the procedure by
Medicaid for poor infertile couples."
To the contrary, state lawmakers have recently begun eliminating state
subsidies for any fertility service in any effort to lower costs and
keep poor women from having more children. In the last few years, at
least eight states have prohibited Medicaid coverage for fertility
drugs and therapies in response to taxpayer protest against paying
these costs. A bill introduced in New York in 1994 also proposed excluding reimbursement for the reversal of a tubal ligation.
Treating infertility at public expense, critics assert, conflicts with
the ongoing campaign to reduce the numbers of children born on welfare.
They are right: it does not make sense for a state to provide a poor
woman fertility treatment only to deny her benefits to care for the
child. Even liberal senator Ted Kennedy (the ninth child of the Kennedy
family, columnist Ellen Goodman reminds us) voted to rescind government
aid for fertility drugs.
"Our goal in using tax dollars wisely is to reduce welfare dependency,
not create more of it," he asserted. Under present constitutional
doctrine, the government has no obligation to provide fertility
services to those who cannot afford them.
High-tech approaches such as IVF require not only huge sums of
money, but also a privileged lifestyle that permits devotion to the
rigorous process of daily hormone shots, ultrasound examinations, blood
tests, egg extraction and implantation, travel to and from a fertility
clinic, and often multiple attempts -- a luxury that few Black people
enjoy. As Dr. O'Delle Owens, a Black fertility specialist in
Cincinnati, explained, "For White couples, infertility is often the
first roadblock they've faced -- while Blacks are distracted by such
primary road-blocks as food, shelter, and clothing."
Black people's lack of access to fertility services is also an
extension of their more general marginalization from the health care
system.
Racial Steering
There is some evidence that fertility doctors and clinics
deliberately steer Black patients away from reproductive technologies.
Physicians import their social views into the clinical setting and may
feel that fertility treatment is inappropriate for Black women who they
think are unable to care for their children. As a genetic counselor
confessed to anthropologist Rayna Rapp, "It is often hard for a
counselor to be value-free. Oh, I know I'm supposed to be value-free,
but when I see a welfare mother having a third baby with a man who is
not gonna support her, and the fetus has sickle-cell anemia, it's hard
not to steer her toward an abortion. What does she need this added
problem for,
I'm thinking."
Georgetown law professor Patricia King similarly concludes that the
racial disparity in the use of clinical genetic services may be related
to physician referrals.
But racial steering is more likely to occur on a less conscious level.
It is frequently dressed up in medical garb. The very diagnosis of
infertility depends on social factors. To begin with, the definition of
infertility -- the inability of a couple to conceive after twelve
months of unprotected intercourse -- is a social determination as much
as a physiological condition. In some cultures, the meaning of
infertility involves a woman's failure to bear sons. Courts are split
on the issue of whether infertility qualifies as an illness and
disability for purposes of coverage under insurance policies and the
Americans with Disabilities Act of 1990.
Second, doctors' diagnoses of the cause of infertility often
depend on race. Doctors characterize endometriosis, the abnormal growth
of uterine tissue outside the uterus, which can cause infertility, as a
white, "career woman's disease." Endometriosis is commonly treated as
part of infertility therapies. Although epidemiologists find no higher
incidence of the ailment in this group of women, many gynecologists
insist on associating endometriosis with a middle-class, professional
lifestyle. Niels Lauersen, a New York Medical College obstetrics
professor, seemed to blame the victim when he claimed the disease
strikes women who are "intelligent, living with stress [and] determined
to succeed at a role other than 'mother' early in life.
The flip side of this attribution is doctors' view that Black women are
unlikely to suffer from endometriosis. According to Dr. Donald Chatman,
"most textbooks of gynecology are, in agreement that endometriosis is
rare in the indigent, nonprivate patient and, therefore, by inference
... uncommon in the black woman."
Instead, gynecologists are more likely to diagnose Black women as
having pelvic inflammatory disease, which they often treat with
sterilization. In 1976, Dr. Chatman found that over 20 percent of his
Black patients who had been diagnosed as having pelvic inflammatory
disease actually suffered from endometriosis.
Calling endometriosis the "career woman disease" has a dual effect. It
stigmatizes white women's careerism for causing infertility (that can
be treated with new reproductive technologies) and it excludes Black
women, who are less likely to be professionals, from the class of women
whose infertility is treatable.
Socioeconomic screening criteria not based specifically on race
exclude Black women, as well. Prospective IVF patients must pass
eligibility tests that include such nonmedical factors as "a 'stable'
marriage, sufficient education to comply with treatment regimens, and
the financial resources to provide 'adequately' for a child." All of these criteria tend to eliminate Blacks.
For example, since most Black children in America today are born to
single mothers, a rule requiring clients to be married works
disproportionately against Black women desiring to become mothers. One
IVF clinic addresses the high cost of treatment by offering an egg
donor program that waives the fee for patients willing to share half of
their eggs with another woman.
The egg recipient in the program also pays less by forgoing the $2,000
to $3,000 cost for an egg donor. I cannot imagine that this program
would help many Black patients, since it is unlikely that the
predominantly white clientele would be interested in donations of their
eggs.
The Sickle-Cell Screening Disaster
In fact, where new reproductive technologies have been directed
toward Blacks, they have been used to restrict procreative freedom, not
increase it. The history of sickle-cell screening and reproductive
counseling for Blacks is a telling example. Sickle-cell anemia, a
painful and disabling blood disease, is a recessive inherited condition
that disproportionately affects Blacks, as well as several other ethnic
groups. Only children who receive copies of the affected gene from both
parents will have sickle-cell disease; carriers of only one copy of the
gene (called sickle-cell trait) exhibit no symptoms at all. Having
sickle-cell trait confers resistance to malaria, a notable benefit to
people native to equatorial Africa, where the gene is most prevalent.
While 1 in 10 Black Americans is a carrier for sickle-cell trait, only
1 in 500,000 has two copies of the sickle-cell gene and is therefore
likely to develop symptoms of sickle-cell anemia.
A blood test that can detect sickle hemoglobin has been used since the
1960s. A more reliable test that can detect the sickle-cell gene itself
became available in the early 1980s.
Around 1970, proposals for sickle-cell screening programs
gained support in both the medical establishment and the Black
community. Like others at risk for genetic disorders, Black people
deserve available information about their risks, the disease, and
treatment so that they can make informed decisions about their
procreative future. Initially, the influential Journal of the American Medical Association
called for a program to screen Blacks of marriageable age so that
couples who discovered that both carried the sickle-cell trait could
consider the one-in-four risk that their children would suffer from the
disease. President Nixon pledged to reverse the nation's "sad and
shameful" neglect of sickle-cell anemia. Seventeen states instituted
wide-scale screening programs, and in 1972 Congress passed the National
Sickle-Cell Anemia Control Act, which provided for research, screening,
counseling, and education. By 1975, there were more than 250 screening
programs around the country, which tested almost half a million Blacks.
What began as a strategy to improve the health of Blacks soon
turned into an instrument of medical abuse. Because screening programs
often provided no counseling, there was rampant confusion between
carriers of the trait and those who had the disease. Many people who
had only sickle-cell trait were mistakenly convinced that their health
was in jeopardy. Even the preamble of the federal law stated
erroneously that 2 million Americans had sickle-cell disease, rather than the trait.
Instead of offering the tests as a voluntary source of information,
fourteen states made them mandatory for Blacks enrolling in school,
obtaining a marriage license, or confined in mental institutions and
prisons.
Of course, five-year-olds had no need for test results designed to help
couples make reproductive decisions. Nor were the tests helpful to
adults in the absence of accurate information about the disorder and
acceptable options for avoiding the disease in their children.
Hysteria over the sickle-cell trait also led to widespread
discrimination. Autopsies of four Black army recruits who died during
basic training revealed severe sickling of the red blood cells. The
possibility that carriers' blood might sickle at high altitudes was
used to justify denying Blacks entrance to the Air Force Academy.
Almost all of the major commercial airlines fired or grounded Black
pilots and flight attendants with sickle-cell trait.
Major corporations also screened Blacks applying for jobs. Sickle-cell
carriers were charged higher premiums by some insurance companies or
denied insurance altogether.
Sickle-cell screening was also the basis for proposals to
restrict Black women's procreative liberty. Carriers were often
counseled simply not to have children. In an article about counseling
patients with sickle-cell disease published in a major medical journal
in 1971, white members of the Department of Obstetrics and Gynecology
at the Tennessee College of Medicine advocated sterilization for women
with the illness.
The article concluded that "the expected rate of reproductive success,
when considered in conjunction with the negative attributes concerning
motherhood, does not justify a young woman with sickle-cell disease
being exposed to the risk of pregnancy. We advocate primary
sterilization, abortion if conception occurs, and sterilization for
those that have completed pregnancies."
Henry Foster, chairman of the Department of Obstetrics and Gynecology
at Meharry Medical College in Nashville, whose nomination for
surgeon-general was derailed in 1995, sharply disputed the
recommendation of sterilization. Foster argued that the high maternal
mortality rate the authors reported resulted from inadequate prenatal
care. He believed that if Black patients were provided accurate
screening, informed counseling, and proper clinical management, they
would have alternatives to sterilization. Foster stressed how race
affected the type of reproductive counseling that doctors give pregnant
women regarding the implications of sickle-cell disease. Advice
provided to Black patients, Foster wrote, often "is highly inadequate,
misleading, and, on occasion, dangerous."
He pointed out that certain complicating risks, such as premature
rupture of the membranes, experienced by women with sickle-cell disease
in other hospitals had not occurred at Meharry, under the care of Black
physicians.
Dr. Foster was clearly correct that race influences medical
judgments concerning new reproductive technologies. Sickle-cell
carriers are not the only identifiable carriers of genetic disease and
Blacks are not the only ethnic group associated with a genetic
disorder. In fact, carriers of at least fifty genetic disorders could
be identified at the time of the sickle-cell testing programs. Yet none
experienced the degree of institutionalized abuse visited upon Black
carriers of the sickle-cell trait. Once again, racism worked to convert
technology into a means of denying rather than promoting reproductive
liberty.
Black Culture and the New Reproduction
The racial disparity in the use of reproductive technologies may be
partly self-imposed. Although economics plays a major role, it does not
provide the complete explanation for Black people's avoidance of these
means of procreation. Even Black couples who can afford a nice home,
car, and other amenities of a middle-class lifestyle are not turning to
high-tech fertility services in the same proportions as their white
cohorts. It would also be possible for Black women to enter into
informal surrogacy arrangements with Black men without demanding huge
fees.
One reason may be the extent to which Blacks have bought into
stereotypes about their own reproductive capacities. The myth that
Black people are overly fertile may make infertility especially
embarrassing for Black couples.
One Black woman who eventually sought IVF treatment explained, "Being
African-American, I felt that we're a fruitful people and it was
shameful to have this problem. That made it even harder."
Blacks may find it more traumatic to discuss the problem with a
physician, especially considering the paucity of Black specialists in
this field.
In addition, Black people may be less likely to seek a
technological fix for natural circumstances beyond their control.
Infertile couples' reliance on advanced technologies reflects a
confidence in medical science to solve life's predicaments. According
to Elaine Tyler May, author of Barren in the Promised Land,
a history of childlessness in America, America's obsession with
reproduction began after World War II when "a heightened faith in
science and medicine gave rise to the belief that everyone should be
able to control his or her private destiny with the help of
professional experts."
The contemporary white women May quotes frequently express an
expectation of controlling their reproductive lives through medical
intervention. One explained, "There is a tremendous amount of medical
help available and I feel guilty not doing everything in my power to
achieve pregnancy."
Sociologist Arthur Greil similarly observes that the affluent white
couples he interviewed "embraced the pursuit of medical/technical
solutions as the most plausible approach to dealing with the problem of
infertility."
Some researchers have linked the contrasting response of infertile
Black women to their spiritual or psychological outlook on adversity.
"If infertility is one in a series of negative, seemingly irreversible
events in a woman's life," sums up public health expert Elizabeth
Heitman, "she may be more likely to attribute it to fate or God's will
than seek to address it in science. "
There may be a more rational explanation for this reluctance, as well.
Considering the history of sickle-cell screening, the Tuskegee syphilis
experiment, and other medical abuses, many Blacks harbor a well-founded
distrust of technological interference with their bodies and genetic
material at the hands of white physicians. Rayna Rapp interviewed a
Black secretary, for example, who rejected prenatal genetic testing
because the laboratory form included a release to use discarded
amniotic fluid for experimentation. Her husband worried that the amniocentesis might make the family vulnerable to abusive medical research.
This theory would explain why Blacks are likely to request high-tech
life-sustaining treatment for a hospitalized family member even though
they tend to refrain from high-tech fertility services.
In the former case, Blacks may rely on technological intervention even
in the face of a physician's recommendation to discontinue treatment
because of a distrust of the doctors' appreciation of their loved one's
life. Both responses, then, are consistent with a suspicion of the
medical profession born out of a history of disrespect and abuse.
While stories about infertility have begun to appear in magazines with a Black middle-class readership, such as Ebony and Essence, these articles conclude by suggesting that childless Black couples seriously consider adoption.
The ethic of dealing with infertility differs drastically between
Blacks and whites. Infertile white couples are expected to turn to
adoption only as a last resort, after exhausting every available means
of producing a genetically related child. The Black community, on the
other hand, expects its financially secure members to reach out to the
thousands of Black children in need of a home.
Blacks' Rejection of Genetic Marketing
Blacks may also have an aversion to the genetic marketing aspect of
the new reproduction. When infertile couples pay for the services of
surrogate mothers and egg or sperm donors, they are purchasing the
genetic material of their future children. When they undergo IVF, they
are buying the assurance that their offspring will receive the parents'
own genetic components. Black folks are skeptical about any obsession
with genes. They know that their genes have been considered undesirable
and that their alleged genetic inferiority has been used for centuries
to justify their exclusion from the economic, political, and social
mainstream. Only recently The Bell Curve
was a national best-seller, reopening the public debate about racial
differences in intelligence and the role genetics should play in social
policy.
In a society in which Black traits are consistently devalued, a focus
on genetics will more likely be used to justify limiting Black
reproduction rather than encouraging it.
Blacks have understandably resisted defining personal identity
in biological terms. In America, whites have historically valued
genetic linkages and controlled their official meaning. As the powerful
class, they are the guardians of the privileges accorded to biology and
they have a greater stake in maintaining the importance of genetics.
The legal regulation of racial boundary lines during the slavery era,
for example, concerned whites,
not Blacks: "The statutes punishing voluntary interracial sex and
marriage were directed at whites; they alone were charged with the
responsibility for maintaining racial
purity."
Blacks by and large are more interested in escaping the constraints of
racist ideology by defining themselves apart from inherited traits.
They tend to see group membership as a political and cultural
affiliation. Whites defined enslaved Africans as a biological race.
Blacks in America have historically resisted this racial ideology by
defining themselves as a political group. By the turn of the twentieth
century, Black Americans had developed a race consciousness rooted in a
sense of peoplehood that laid the foundation for later civil rights
struggles.
With the exception of an extreme version of Afrocentrism that links
Africans' intellectual and cultural contributions to the genetic trait
of melanin (the pigment in dark skin), "blackness" is gauged by one's commitment to Black people.
Black family ties have traditionally reached beyond the bounds of the
nuclear family to include extended kin and non-kin relationships. Terms
that connote genetic relationships -- "brother," "sister," and "blood"
-- are used to refer to people linked together by racial solidarity.
Black people's search for their ancestral roots has focused on cultural
rather than genetic preservation. Their "ancestors" are not necessarily
connected to them by a bloodline; they are all African people of a
bygone era.
Most Blacks downplay their white genetic heritage to identify
socially with other Blacks. Even children of interracial couples
(having one Black and one white parent) tend to identify themselves as
Black, often as a political choice.
Others refuse to identify with one race or the other, preferring to
define themselves as both Black and white, mixed, or simply human. This
identification, too, is often a refusal to base identity on biological
inheritance. For most Blacks, ethnic identity is a conscious decision
based primarily on considerations other than biological heritage. "The
choice is partly cultural, partly social, and partly political, but it
is mostly affectional," writes Yale law professor Stephen Carter.
This distinction between cultural and genetic unity is reflected in Black opposition to transracial adoptions.Some
Blacks take the position that Black adoptive children should be placed
only with Black families to ensure the transmission of Black cultural
traits. The National Association of Black Social Workers (NABSW), for
example, has long opposed transracial placements because "Black
children belong, physically, psychologically, and culturally in Black
families in order that they receive the total sense of themselves and
develop a sound projection of their future."
These children are not genetically linked to their new families, but,
according to this view, they should be tied to the Black community.
When the NABSW condemned placements with white families as a "form of
genocide," it was speaking of a cultural, not a biological,
annihilation.
A Black parent's essential contribution to his or her children
is not passing down genetic information but sharing lessons needed to
survive in a racist society. Black parents transmit to their children
their own cultural identity and teach them to defy racist stereotypes
and practices, training their children to live in two cultures, both
Black and white.
Some feel they must cultivate in their children what W. E. B. Du Bois
described as a double consciousness; others see their task as preparing
their children "to live among white people without becoming white
people."
Some Black sociologists have opposed transracial adoption on the ground
that only Black parents are capable of teaching Black children these
necessary "survival skills."
This aspect of blackness is contradicted by the fact that some Blacks
have valued particular genetic traits, such as light skin color and
straight hair, because of their desire to look whiter. In some Black
bourgeois communities, whiter features signified higher social standing.
The Black elite of Washington, D.C., at the turn of the century, for
example, was well known for requiring a white appearance for entry into
its circle. Despite Black people's sorry history of color
consciousness, however, sharing genetic traits seems less critical to
Black identity than to white identity.
The notion of racial purity is foreign to Black folks. Our
communities, neighborhoods, and families are a rich mixture of
languages, accents, and traditions, as well as features, colors, and
textures. Black life has a personal and cultural hybrid characteristic.
There is often a melange of physical features -- skin and eye color,
hair texture, sizes, and shapes -- within a single family. We are used
to "throwbacks" -- a pale, blond child born into a dark-skinned family,
who inherited strange genes from a distant white ancestor. My children
play with a set of twins who look very different from each other. The
boy has light skin, green eyes, and "kinky" sandy-colored hair; the
girl has dark skin, brown eyes, and long black wavy hair. Of course,
there are physical differences among white siblings as well, but those
differences do not have the same social import. We cannot expect our
children to look just like us.
Blacks' view of genetic relatedness is tempered as well by the
importance of self-definition, which escapes the constraints of
inherited traits. if personal identity is not dependent on one's
biological "race," then it must be deliberately chosen. In fact, the
image of the individual shackled to his genetic destiny conflicts with
the basic tenets of liberalism; it contradicts a definition of
personhood centered on the autonomous, self-determining individual and
denies the possibility of individual choice. As constitutional scholar
Laurence Tribe observed, "one's sense of 'selfhood' or 'personhood,'
and the related experience of one's autonomous individuality, may
depend, at least in some cultural settings, on the ability to think of
oneself as neither fabricated genetically nor programmed
neurologically."
Blacks have defied the inferior status of blackness that whites
attached to their biology by inventing their own individual identities.
The quest for self-definition in a racist society is the
preeminent focus of Black intellectual thought. In the 1960s, Lerone
Bennett, Jr., declared,
Identified as a Negro, treated as Negro, provided with
Negro interests, forced, whether he wills or no, to live in Negro
communities, to think, love, buy and breathe as a Negro, the Negro
comes in time to see himself as a Negro.... He comes, in time, to
invent himself.
Bennett's words are reminiscent of Du Bois's classic description of Black Americans' striving for a self-created identity:
It is a peculiar sensation, this double-consciousness,
this sense of always looking at one's self through the eyes of others,
of measuring one s soul by the tape of a world that looks on in amused
contempt and pity. One ever feels his twoness, an American, a Negro,
two souls, two thoughts, two unreconciled strivings; two warring ideals
in one dark body, whose dogged strength alone keeps it from being torn
asunder.
The history of the American Negro is the history of this strife,
this longing to attain self-conscious manhood, to merge his double self
into a better and truer self.
The theme of willful self-creation is especially strong in the writings of Black women.
The fiction of authors such as Zora Neale Hurston, Toni Morrison, and
Alice Walker revolves around Black female characters who learn to
invent themselves after breaking out of the confines of racist and
sexist expectations. Black women's autobiographical accounts also
describe the process of self-creation, exemplified by Patricia
Williams's statement, "I am brown by my own invention... One day I will
give birth to myself, lonely but possessed."
Denied self-ownership and rejected from the dominant norm of womanhood,
Black women have defined themselves apart from the physical aspects of
race.
THE IMPORTANCE OF THE GENETIC TIE
I have suggested that the suspicion of genetic marketing and the
appreciation of self-definition in Black culture may help to explain
Blacks' aversion to high-tech reproduction. Conversely, race may also
influence the importance whites place on IVF's central aim -- producing
genetically related children. Using technology to create genetic ties
focuses attention on the value placed on this particular form of
connection.
Of course sharing a genetic tie with children is important to
people of different races and in cultures that have no racial
divisions. It seems natural for people to want to pass down their genes
to their children. We perceive a special relationship created by a
shared genetic identity. When a new baby enters a family, one of the
first responses is to figure out whom she resembles. Most parents feel
great satisfaction in having children who "take after" them. Bringing
into the world children who bear their likeness gives many people both
the joy of creating another life and the comfort of achieving a form of
immortality passed down through the generations. Joe Saul, the
protagonist of John Steinbeck's play Burning Bright, expressed his tormenting desire to have a child in terms of an eternal charge:
A man can't scrap his blood line, can't snip the thread
of his immortality. There's more than just my memory. More than my
training and the remembered stories of glory and the forgotten shame of
failure. There's a trust imposed to hand my line over to another, to
place it tenderly like a thrush's egg in my child's hand.
In our society, people often see the inability to produce one's own
children as one of nature's most tragic curses. Infertile people often
suffer horribly, and even people who have voluntarily decided to remain
childless often refuse to cut off the possibility of creating children
through sterilization. The desire to have children of one's own is so
intense that it is commonly attributed to nature. Thus, the opening
paragraph of a popular guide to infertility treatment declares: "Call
it a cosmic spark or spiritual fulfillment, biological need or human
destiny -the desire for a family rises unbidden from our genetic souls."
Some legal scholars have argued that an individual's interest in having
offspring of his own genes is so great that it amounts to a
constitutionally protected procreative liberty.
Many also believe that certainty about one's genetic heritage benefits
children. According to this view, genetic derivation is a critical
determinant of self-identity, as well as biological makeup. Adopted
children may struggle not only with the question, "Who are my real
mother and father?" but also with the more profound inquiry, "Is
genetic relatedness necessary for an authentic sense of self?" Taken to
its extreme, this perspective defines personhood according to genetic
attributes.
This conception of identity rooted in genetic heritage
underlies the most extreme rhetoric of advocates who support adoptees'
searches for their birth parents.
Critics of adoption claim that adopted children suffer from
"genealogical bewilderment" -- a condition stemming from ignorance of
their genetic origins. Adoptee Betty Jean Lifton writes of feeling
"extruded from ... her own biological clan, forced out of the natural
flow of generational continuity... forced out of nature itself."
This insecurity may also trouble children whose genetic fathers are
anonymous sperm donors. Margaret Brown, the nineteen-year-old product
of artificial 'insemination, lamented, "I feel anger and confusion, and
I'm filled with questions. Whose eyes do I have? Why the big secret?
Who gave my family the idea that my biological roots are not important?
To deny someone the knowledge of his or her biological origins is
dreadfully wrong."
Some scientists also see identity defined b genetics. One Harvard
biologist, for example, declared that understanding human genetic
composition is "the ultimate answer to the commandment, 'Know thyself.'"
Recent years have witnessed a resurgence of public interest in genetics
that has intensified the genetic tie's social importance. A 1994 issue
of the New York Times Book Review,
for example, reviewed five books concerning the link between genetics
and human behavior. Its cover displayed a face woven into a model of
DNA and the question "How Much of Us Is in the Genes?"
Numerous scholars have noted a trend in science, law, and popular
culture toward "genetic essentialism," "geneticism," "geneticization,"
and a "prism of heritability" that erroneously reduces human beings to
their genes.
Contemporary society increasingly looks to genetics for explanations of
human behavior, accepting the view that "personal traits are
predictable and permanent, determined at conception, 'hard-wired' into
the human constitution."
The Human Genome Initiative, an ongoing government-sponsored project to
map the complete set of human genetic instructions, is the largest
biology venture in the history of science. The U.S. Department of
Energy projects costs of $200 million a year for about fifteen years.
Scientists are attempting to detect genetic markers that indicate a
predisposition to complex conditions and behaviors, as Well as
single-gene disorders. They anticipate creating genetic tests that will
be able to predict a person's susceptibility to hemophilia, mental
illness, heart disease, and alcoholism. This possibility was dramatized
by Jonathan Tolins's 1993 play, The Twilight of the Golds,
which portrayed the catastrophic fallout when a family learns through
genetic testing that the daughter's unborn child will be gay.
More disturbing, researchers claim to have discovered not only
the genetic origins of medical conditions, but also biological
explanations for social conditions. Even happiness, a recent New York Times story tells us, is dictated by our genes.
Our ability to tinker with the genes children inherit, as well as the
belief that these genes determine human nature, exaggerates the
importance of genes in defining personal identity and, consequently,
the importance of genetic connections.
Yet we also know that the desire to have genetically related
children is a cultural artifact. The legal meaning of the genetic tie
offers telling insight into its indeterminacy. For example, the
institution of slavery made the genetic tie to a slave mother critical
in determining a child's social status, yet legally insignificant in
the relationship between male slaveowners and their mulatto children.
Although today we generally assume that genetic connection creates an
enduring bond between parents and their children, the law often
disregards it in the cases of surrogate mothers, sperm donors, and
unwed fathers. The importance of genetic connection, then, is
determined by social
convention, not biological edict.
A number of feminists have advocated abandoning the genetic
model of parenthood altogether because of its origins in patriarchy and
its "preoccupation with male seed."
The norm of fatherhood grounded in genetic transmission sees mothers as
fungible receptacles of male gametes and devalues the importance of
social bonds. Men seem to be more invested than women in the quest for
a genetic connection with their children. The man who entered in the
first formal surrogacy contract made this distinction: "I guess for
some women, as long as they have a child, it's fine. But... I need to
know that he's really mine."
Most scholarship on the new reproduction, however, fails to consider
the tremendous impact that the inheritability of race has had onthe
meaning of genetic relatedness in American culture. Although race is
really a social construct, it has been treated as an inherited status
for centuries. In this society, perhaps the most significant genetic
trait passed from parent to child is race. How important is race to the
desire to create genetically related children? It is impossible to tell
the decision to have children is influenced by a multitude of social,
cultural, and biological factors. But surety the inheritability of race
plays some role in the degree of importance whites invest in genetic
ties with their children.
The social and legal meaning of the genetic tie helped to
maintain a racial caste system that preserved white supremacy through a
rule of racial purity. The colonists maintained a clear demarcation
between Black slaves and white masters by a violently enforced legal
system of racial classification and sexual taboos. The genetic tie to a
slave mother not only made the child a slave and subject to white
domination; it was also supposed to pass down a whole set of inferior
traits.
For several centuries a paramount objective of American law and
social convention was keeping the white bloodline free from Black
contamination. Before high-tech procedures were available, husbands
guaranteed a genetic relationship to children by enforcing their wives'
fidelity. Under a racial caste system, female marital fidelity was
doubly important: it ensured not only paternity but also racial purity.
Since only white women could produce white children, they were
responsible for maintaining the purity of the white race. While white
men impregnated Black women with impunity, the law ensured that white
women had children only with their husbands so that their children
would be pure white. William Smith, a professor at Tulane University,
explained in 1905 that fornication with a Negro was a greater crime for
a white woman than for a white man because "he does not impair, in any
wise, the dignity or integrity of his race; he may sin against himself
and others, and even against his God, but not against the germ-plasm of
his kind."
The first laws against interracial. fornication arose from legislators'
"particular distaste that white women, who could be producing white
children, were producing mulattoes."
As early as 1662, Virginia amended its law prohibiting fornication to
impose heavier penalties if the guilty parties were from different
races. By being faithful to their husbands, white women were also
faithful to their race.
The law punished with extra severity white women who gave birth
to mulatto children. Because a child took on the status of the mother,
mulattoes born to white mothers were free. But these children were
treated more harshly than free Black children; those with white mothers
were generally required to become indentured servants until they
reached thirty years of age. Unlike the racially mixed child:- n of
Black women, they represented a corruption of the white race.
Antimiscegenation laws also made sure that white women bore genetic offspring for white husbands. As W. J. Cash explained in The Mind of the South
in 1941, whites enacted laws against interracial marriage to protect
"the right of their sons in the legitimate line, through all the
generations to come, to be born to the great heritage of the white
race." It was only in 1967 that the U.S. Supreme Court in Loving vs. Virginia
ruled that antimiscegenation laws, designed to keep the races from
intermingling, were unconstitutional. To this day, one's social status
in America is determined by the presence or absence of a genetic tie to
a Black parent. Conversely, the white genetic tie -- if free from any
trace of blackness -- is an extremely valuable attribute entitling a
child to a privileged status, what legal scholar Cheryl Harris calls
the "property interest in whiteness."
Ensuring genetic relatedness is important for many reasons, but, in
America, one of the most important reasons has been to preserve white
racial purity.
CREATING WHITE BABIES:THE VALUE OF BIOTECHNICAL CHILDREN
The new reproduction also graphically discloses the disparate
values placed on children of different races. By trading genes on the
market, these technologies lay bare the high value placed on whiteness
and the worthlessness accorded blackness. New reproductive technologies
are so popular in American culture not simply because of the value
placed on the genetic tie, but because of the value placed on the white
genetic tie. The monumental effort, expense, and technological
invention that goes into the new reproduction marks the children
produced as especially valuable. It proclaims the unmistakable message
that white children merit the spending of billions of dollars toward
their creation. Black children, on the other hand, are the object of
welfare reform measures designed to discourage poor women's
procreation.
The panic over white infertility is not only a private tragedy.
True, part of the desperation childless white women feel comes from
their personal longing to be a parent. But the high-tech frenzy to
conceive has been whipped up by alarm over the falling birthrate of
white career women. Feminist author Susan Faludi documents a new
pronatalism in the 1980s that was part of a backlash against women's
gains in the workplace.
In February 1982, newspapers, magazines, and television shows gave top
billing to a medical study claiming that women between the ages of
thirty and thirty-five risked a nearly 40 percent chance of being
infertile. Practically overnight the media created an infertility
epidemic plaguing middle-class America. This figure became the basis
for paternalistic editorials and self-help books chastising the women's
movement for creating "a sisterhood of the infertile" and exhorting
women to stop postponing motherhood. Childless middle-aged women were
programmed to feel their "biological clocks" ticking.
The media paid little attention to a federal study released
three years later that showed a far lower (13.6 percent) infertility
rate for the same age group. Instead, women's careers were erroneously
blamed for high rates of endometriosis, miscarriage, and abnormal
babies. (In fact, Faludi astutely points out, "women's quest for
economic and educational equality has only improved reproductive health
and fertility.")
While the media portray irresponsible Black women as overly fertile,
they depict selfish, career-seeking white women as not fertile enough.
As a result, white couples flock to high-tech treatment in record
numbers, despite no evidence of an increase in the incidence of
infertility over the last several decades.
The renewed focus on white women's fertility has eugenic over-tones as well. Ben Wattenberg's The Birth Dearth,
for example, predicted that reproduction in the industrialized world
could not keep pace with population growth in the Third World unless
American women took measures to have more children.
"I believe demographic and immigration patterns inherent in the Birth
Dearth will yield an ever smaller proportion of Americans of white
European stock," Wattenberg warned, making it "difficult to promote and
defend liberty in the Western nations and in the rest of the
modernizing world." Television evangelist and Republican presidential
contender Pat Robertson agreed that "depopulation of the West"
constituted "genetic suicide" and "threatens the power of Western
industrialized democracies."
The Bell Curve presented the 1990s domestic version of this
argument. Instead of predicting a global imbalance, Charles Murray and
Richard Hermstein foretold increasing social disparities within the
United States owing to the higher birthrates of group with inherently
lower intelligence. Like the backlash against professional women's
advances, this new form of eugenics interprets the problem of
infertility as the shortage of white babies. Thus, the backdrop of
infertility that fuels the high-tech fertility business is already
dominated by race.
The public's affection for the white babies that are produced
by reproductive technologies further legitimates their use. Noel Keane,
the lawyer who in 1978 arranged the first public surrogacy adoption,
described how this affection influenced the public's attitude toward
his clients' arrangement.
Although the first television appearance of the contracting parents,
George and Debbie, and the surrogate mother, Sue, generated hostility,
a second appearance on the Phil Donahue Show, with
two-month-old Elizabeth Anne changed the tide of public opinion.
According to Keane, "this time there was only one focal point:
Elizabeth Anne, blond-haired, blue-eyed, and as real as a baby's yell."
He concludes, "The show was one of Donahue's highest-rated ever and the
audience came down firmly on the side of what Debbie, Sue, and George
had done to bring Elizabeth Anne into the world." I suspect that a
similar display of a curly-haired, brown-skinned baby would not have
had the same transformative effect on the viewing public. Imagine a
multi-billion-dollar industry designed to create Black children!
Recall the white woman's lawsuit against a fertility clinic for
mistakenly giving her a Black man's sperm. The case not only evidences
disdain for the technological creation of Black babies; it also
high-lights the critical Importance of producing a genetically pure
white child. The clinic's racial mix-up negated the value of the
mother's genetic tie. I do not mean to depreciate the woman's personal
loss. She wanted a child with her husband, who subsequently died of
cancer. But receiving the wrong white child would have been a far less
devastating experience. In the American market, a Black baby is
indisputably
an inferior product.
While the botched inseminations of white women are presented as
tragedies, the reverse racial blunder was the premise for a Hollywood
comedy. In Made in America,
Whoopi Goldberg plays an Afrocentric single mother whose teenage
daughter was conceived through artificial insemination. Determined to
track down her roots, the daughter raids the sperm bank computer only
to discover that she was fathered by a white man (Ted Danson) as the
result of a mix-up. Glossing over the race issue, the movie finds comic
relief in the unlikely romance between the mother, an eccentric Black
bookstore owner, and the sperm donor, a crass white car salesman.
How could this racial intermingling be so easily dismissed when
the other sperm bank mix-ups seem so serious? Returning to the
colonists' distaste for mulatto children provides a clue. Like the
repudiated colonial women, the white women given the wrong sperm bore
mulattoes "when they could be producing white children." The same loss
did not occur when Black women delivered mulattoes: their children
would be Black slaves in any case.
In the film, in contrast to the real-life sperm bank case, the
daughter's racial composition is inconsequential: she is Black
regardless of which race the sperm depositor turns out to be. Finding
out the father's racial identity has no effect on the mother's (or
society's) view of the child whatsoever. After all, it is not so
uncommon for a Black child to discover a white man somewhere in the
family tree. More important, giving a Black woman the wrong sperm does
not deprive society of a white child. With so little at stake, American
audiences could accept this interracial scenario as a nonthreatening
romantic sitcom.
THE COMPLICATIONS OF TRANSRACIAL ADOPTIONS
Whites have sometimes disputed my claims about the value of
white genetic ties by pointing to barriers to transracial adoptions
Infertile whites are forced to rely on high-tech means, they argue,
because of the difficulties they face in adopting children, including
race-matching policies. This contention distorts the reality Of the
adoption market in two ways. First, most white couples who use IVF
resort to adoption as a second-best alternative only after they fail to
conceive a genetically related child. Those who cannot afford IVF often
try less expensive infertility treatment before pursuing adoption.
Consider Dierdre Kearney's decision to adopt after trying to conceive
for four of five years of marriage, recounted in Barren in the Promised Land:
"I think we experienced every emotion and feeling one
can in dealing with this situation. We have also been through every
fertility test there is." Her husband was on medication for three
years, and his problem was corrected. She had four surgeries,
medication, fertility drugs, and artificial insemination using her
husband's semen. "The only option left for us is IVF. We do not have
the money; what savings we have is going toward adoption."
Lydia Sommer, a white account specialist married to an attorney, told a
similar story. For six of their seven years of marriage, the couple
tried infertility treatment, but they "stopped short of IVF, 'drained
emotionally and financially.'" They finally abandoned high-tech
solutions and adopted a daughter.
Sommer's adoption took a peculiar twist, akin to the sperm bank
mix-ups. Two months after bringing the baby home, the couple realized
she was biracial (the white birthmother had lied about the father's
race). The couple promptly returned the child to the adoption agency
for a refund.
Could these couples have afforded IVF, they probably would have
tried it before resigning themselves to adoption. My point is not that
all infertile whites, or even a majority of them, use
reproduction-assisting technologies. It is that the people who do use
these high-tech means of conception typically view them, and not
adoption, as their preferred way of becoming parents.
Second, the debate over transracial adoption should not
over-shadow the predominant preference for white children. The vast
majority of white adoptive parents are only willing to take a white
child. Even when they adopt outside their race, whites generally prefer
non-Black children with Asian or Latin American heritage. "Of dozens of white adopting parents I have interviewed in three years,' reported Mary Jo McConahay in the Los Angeles Times, "almost all said they would consider adopting a Latino child abroad before a black child at home."
Interracial adoptions, which make up less than 10 percent of adoptions, are primarily of children who are not either Black or white.
The international adoption trade is thriving, and fraught with charges
of Western brokers' exploitation of Third World women and children.
The current recruitment of white couples to adopt Black children stems
from the shortage of adoptable white babies, whose soaring price tag
reflects their market value. In America, a white child can cost twice
as much to adopt as a Black child. In Latin American countries, the
price of an adoption depends on the baby's eye color, skin shade, and
hair texture. In short, genetically related, white children remain most
Americans' first choice.
Besides, white support for transracial adoptions does not
fundamentally alter the rules governing claims to white and Black
children. All of the literature advocating the elimination of racial
considerations in child placements focuses on making it easier for
white parents to adopt children of color. A leading book on the
subject, for example, states that "[i]n the case of transracial
adoption the children are non-white and the adoptive parents are white."
(This definition completely ignores adoptions of white children by
parents of other races, constituting 2 percent of all adoptions.)
Until fairly recently, the law in some states explicitly prohibited
Black parents from adopting white children, while allowing white
parents to adopt Black children. A South Carolina statute, for example,
provided:
It shall be unlawful for any parent, relative, or other
white per-son in this State, having the control or custody of any white
child by right to guardianship, natural or acquired or otherwise, to
dispose of, give or surrender such white child permanently into the
custody, control, maintenance or support of a Negro.
This bias results partly from the disproportionate number of Black
children available for adoption and of white couples seeking to adopt.
A report on a major state foster care system, for example, shows that
54 percent of children available for adoption are nonwhite while 87
percent of prospective adoptive parents are white.
Because the number of Black children awaiting placement far exceeds the
number of available Black adoptive families, there is more pressure for
white couples to take in Black children than for Blacks to adopt white
children. These statistics, however, reflect only formal adoptions and
overlook the prevalence of informal adoptions in the Black community.
Black families who attempt to use formal adoption services face
numerous institutional barriers, including financial requirements and
the cultural insensitivity of predominantly white, middle-class social
workers. In fact, middle-income Black couples adopt at a higher rate than similar white couples. These statistics also raise the question why there are so many Black children wallowing in foster care in the first place.
With so many Black children in need of a home, it is not surprising
that Black families adopt within their race. Indeed, the 1987 National
Health Interview Survey found not a single instance of interracial
adoption by a Black mother.
Still, the very thought of a Black family adopting a white child seems
beyond our cultural imagination. A system that truly assigns children
to adoptive parents without regard to race is unthinkable, not because
Black children would be placed in white homes, but because white
children would be given to Black parents.
Adoption of a Black child by a white family is viewed as an
improvement in the Black child's social status and lifestyle and as a
positive gesture of racial inclusion'. A Black family's dominion over a
white child, on the other hand, is seen as an unseemly relationship and
an injury to the child. As a judge recognized forty years ago, allowing
the adoption of a white child by his mother's Black husband would
unfairly cause the child to "lose the social status of a white man."
Even today, "it is virtually unheard of for an adoption agency to offer
a healthy, able-bodied white child to Black parents for adoption."
Claims about the benefits of racial assimilation are only made about
the advantages Black children will presumably experience by living in
white homes. In her book Family Bonds,
for example, adoption advocate Elizabeth Bartholet argues that
race-matching policies damage Black children by denying them placements
with white adoptive parents. She dismisses, on the other hand, the
contention that Black children belong with Black parents. Bartholet
reaches this conclusion notonly because "there is no evidence that
black parents do a better job than white parents of raising black
children with a sense of pride in their racial background," but also
because Black children reap substantial advantages from a white
environment. Unlike Black children "living in a state of relative
isolation or exclusion from the white world," Bartholet reasons, "black
children raised in white homes are comfortable with their blackness and
also uniquely comfortable in dealing with whites."
Bartholet also acknowledges the benefits white parents gain from
transracial adoptions. White adoptive families develop a new awareness
of racial issues and commitment to a multicultural world that
transcends racial differences. She writes passionately of how the
Peruvian children she adopted enhanced he life: "I revel in the brown
skin and thick black hair and dark eyes and Peruvian features that I
could not have produced." Bartholet implies that Black children are better off
in white homes and that white parents are enriched by raising nonwhite
children; but she finds nothing positive to say about growing up with
Black parents.
Bartholet advocates a "no-preference" policy that "would remove
adoption agencies from the business of promoting same-race placement."
The Multiethnic Placement Act of 1994 prohibited agenciesthat receive
federal funding from placing children according to race but not from
taking race into account. In 1996, Congress changed the law to
eliminate any consideration of race after critics argued that agencies
retained too much discretion to continue the preference for
race-matching. But a "no-preference" policy with respect to race is in
effect a regime that always prefers a white family and accommodates
white famuies' preferences. Although this policy eliminates the
preference for Black parents in adoptions of Black children, it retains
the preference for white parents in adoptions of white children.
Thus,even advocates of transracial adoptions ultimately favor "a system
in which white children are reserved for white families."
Their policies perpetuate a system designed to proviole childless white
couples with babies and with the type of babies they prefer.
When I was a fellow at Harvard University, I passed a
playground in the Cambridge Common every day on my way to my office
overlooking Harvard Square. The diverse group of adults and children
playing in the park appeared at first to represent the multicultural
mix of the university community. But on closer spection I discovered a
disturbing pattern. It seemed as if all of the minor, children had
white mothers -- probably, in most cases, the result of transracial
adoptions. Many of the white children, on the other hand, were tended
by Black women -- not their mothers, but nannies hired by their white
mothers. Despite all the racial intermingling going on, the scene still
represented a clear demarcation between the status of white and Black
women and their claims to children.
Although transracial adoption is painted as a catalyst for
racial harmony, in Bartholet's words "a model of how we might better
learn to live with one another in this society," it does not threaten
the supremacist code of white superiority. It does nothing to diminish
the devaluation of Black childbearing. Nor does it violate the taboo
against interracial sex that might lead to a fertile white woman
bearing a Black child. The fertility business mirrors the adoption
market in catering to the preferences of childless white couples. What
is objectionable about both these systems is not so much white people's
desire for a particular child as the way these markets are structured
solely to fulfill that desire.
RACE AND THE HARM IN SURROGACY
The devaluation of the Black genetic tie helps to explain the
harm in surrogacy. Some feminists have denounced contract pregnancy
arrangements because they exploit women and commodity women's
reproductive capacity. People who hire surrogates are usually wealthier
than the women who provide the service. An adopting couple must be
fairly well off to afford the costs of a surrogacy arrangement --
typically at least $25,000.
Surrogacy is appealing to some low-income women because it pays better
than other unskilled employment and because it is one of the few
available jobs that do not require leaving home. But what is
exploitative about paying a surrogate mother a sum of money she would
not be able to obtain at other work? What distinguishes activities poor
women are induced to perform for money that are exploitative from those
that are not? Economic necessity in general pressures poor women to
accept occupations rich women would not tolerate. Wealthy people hire
poor, unskilled women, for example, to clean their homes and offices.
The claim that poor women are coerced into entering surrogacy
contracts by the promise of large sums of money is meaningless by
itself. For instance, would it be more or less exploitative to increase
the fee paid to surrogate mothers? It has been argued that unpaid
surrogacy may be more coercive than an arm's-length commercial
arrangement with a stranger; yet increasing the payment would heighten
the pressure on a potential surrogate to press her womb into service
for the payer.
The woman's decision to enter into the surrogacy arrangement at least
shows that she found it preferable to her other options for work. Her
decision may be evidence that surrogacy is less exploitative than other
services wealthier people could buy from her-services which the law
does not prohibit despite their harmful or degrading qualities and the
parties' unequal bargaining power.
At bottom, the argument against surrogacy rests on the peculiar
nature of childbearing that makes its sale immoral. Legal theorist
Margaret Jane Radin and other scholars argue that surrogacy
impermissibly alienates a fundamental aspect of one's personhood and
treats it as a marketable commodity. In Radin's words,
"Market-inalienability might be grounded in a judgment that
commodification of women's reproductive capacity is harmful for the
identity aspect of their personhood and in a judgment that the
closeness of paid surrogacy to baby-selling harms our self-conception
too deeply."
Philosopher Elizabeth Anderson argues that using surrogates' bodies,
rather than respecting them, fails to value women in an appropriate way.
Surrogacy treats women as objects rather than as valuable human beings
by selling their capacity to bear children for a price. The practice
places a specific dollar value on the surrogate's personal traits.
Directories display photographs of and vital information (height, hair
color, racial origins) about women willing to be hired to gestate a
baby. Barbara Katz Rothman notes how the term "product of conception,"
often used to describe the fertilized egg to be implanted in a
surrogate mother, reflects this commodification: "It is an ideology
that enables us to see not motherhood, not parenthood, but the creation
of a commodity, a baby."
Moreover, pregnancy impresses a surrogate's body into paid service to a
degree distinct from other work. Unlike most paid laborers, the
surrogate mother cannot separate herself from the service she
per-forms. As Kelly Oliver puts it, "Surrogacy is a
twenty-four-hour-a-day job which involves every aspect of the
surrogate's life... Her body becomes the machinery of production over
which the contractor has ultimate control."
Commercial surrogacy can be seen as liberating when liberation is
measured by the individual's freedom and ability to buy and sell
products and labor on the market. But women's wombs and pregnancy are
not ordinary products or labor. Like children, organs, or sexual
intimacy, women's reproductive capacities should not be bartered in the
market.
The relationship between race and reproduction further illuminates this
market inalienability. It demonstrates how surrogacy both misvalues and
devalues human beings. First, Anderson and Radin argue that surrogacy
values women and children in the wrong way. Why do they conclude that
paying women for their gestational services will produce this harmful
conception of women and their reproductive capacity? It's also
possible, as John Robertson suggests, that we could view gestators as
"worthy collaborators in a joint reproductive enterprise from which all
parties gain, with money being one way that the infertile couple pays
its debt or obligation to the surrogate."
Anderson's and Radin's sense of the immorality of commercial surrogacy
may arise from the features it shares with the American institution of
slavery. The experience of surrogate mothers is not equivalent to
slavery's horrors, dehumanization, and absolute denial of se
determination. Yet our understanding of the evils inherent in marketing
human beings stems in part from the reduction of enslaved Blacks to
their
physical service to whites.
The quintessential commodification of human beings was the sale of
slaves on the auction block to the highest bidder. Slaves were totally
and permanently commodified. Slaves bore all of the legal attributes of
property: just like a horse, a necklace, or a piece of furniture, they
could be "transferred, assigned, inherited, or posted as collateral."
In the words of a slave, he was a "flesh and blood commodity, which
money could so easily procure in our vaunted land of freedom." Surrogacy's use of women's wombs is reminiscent of Baby Suggs's admonition in Beloved
about slavery's objectification of Africans: "And 0 my people they do
not love your hands. Those they only use, tie, bind, chop off and leave
empty."
Slave women were treated as surrogate mothers in the sense that they
lacked any claim to the children whom they bore and whom they delivered
to the masters who owned both mother and child. As the contemporary
surrogate mother takes the place of an infertile wife, the economic
appropriation of slave women's childbearing was the only way for the
slave economy to produce and reproduce its laborers.
It is the enslavement of Blacks that enables us to imagine the
commodification of human beings, and that makes the vision of fungible
breeder women so real.
The issue of race illuminates the harm of surrogacy in a second
way. The feminist arguments against surrogacy focus on the
commodification of women's wombs. Just as critical, however, is the
commodification of the genetic tie, based on a variation of its worth.
In his discussion of egg donation, John Robertson defends recipients'
desire to "receive good genes" from women who "appear to be of good
stock."
He advocates perfecting the technology of egg donation because it will
"enhance the ability to influence the genetic makeup of offspring."
"Eugenic considerations are unavoidable," Robertson concludes, "and not
inappropriate when one is seeking gametes from an unknown third party."
Although this process devalues all women, it devalues Black women in a
particular way.
Feminist opponents of surrogacy miss an important aspect of the practice when they criticize it for treating women as fungible
commodities. A Black surrogate is not exchangeable for a white one. In
one sense, Anderson and Radin are right that marketing babies
misdescribes the way that we value people. Surrogacy, however, is so
troubling precisely because its commercial essence lays bare how our
society actually does value people. We must assess both the liberating
and the oppressive potential of surrogacy, not in the abstract realm of
reproductive choice, but in the real world that devalues certain human
lives with the law's approval.
THE BLACK GESTATIONAL SURROGATE
Gestational surrogacy separates the biological connection
between mother and child into two parts -- the gestational tie and the
genetic tie.
In gestational surrogacy, the hired gestator is implanted with an
embryo produced by fertilizing the contracting mother's egg with the
contracting father's sperm using IVF. The child therefore inherits the
genes of both contracting parents and is genetically unrelated to her
birth mother. This type of surrogate is treated even more like an
"incubator" or "womb for rent" than paid gestators who contribute an
egg to the deal. Gestational surrogacy disconnects the parents'
valuable genes from the gestator's exploited reproductive capacity.
Gestational surrogacy allows a radical possibility that is at
once very convenient and very dangerous: a Black woman can give birth
to a white child. White men need no longer rely on white surrogates to
produce their valuable white genetic inheritance. This possibility
reverses the traditional presumptions about a mother's biological
connection to her children. The law has always understood legal
parentage to arise definitively from female but not male, biology.
The European-American tradition identifies a child's mother by the
biological act of giving birth: at common law, a woman was the legal
mother of the child she bore. But Black gestational surrogacy makes it
imperative to legitimate the genetic tie between the (white) father and
the child, rather than the biological, nongenetic tie between the
(Black) birth mother and the child.
In Johnson v. Calvert, a gestational surrogacy
dispute, the court legitimated the genetic relationship and denied the
gestational one in order to reject a Black woman's bond with the child.
The birthmother, Anna Johnson, was a former welfare recipient and a
single mother of a three-year-old daughter. The genetic mother,
Crispina Calvert, was Filipina, and the father, Mark Calvert, was
white. The press, however, paid far more attention to Anna Johnson's
race than to that of Crispina Calvert. It also portrayed the baby as
white. During her pregnancy, Anna changed her mind about relinquishing
the baby and both Anna and the Calverts filed lawsuits to gain parental
rights to the child.
Judge Richard N. Parslow, Jr., framed the critical issue as
determining the baby's "natural mother." Johnson's attorney relied on
the historical presumption that the woman who gives birth to a child is
the child's natural, and legal, mother. All states except Arkansas and
Nevada apply an irrebuttable presumption of legal parenthood in favor
of the birth mother.
Yet Judge Parslow held that Johnson had no standing to sue for custody
or visitation rights, and granted the Calverts sole custody of the
baby. His reasoning centered on genetics. Judge Parslow described the
Calverts as "desperate and longing for their own genetic product."
He noted the need for genetically related children and compared
gestation to a foster parents' temporary care for a child who is not
genetically hers. (Robertson has similarly argued that the gestational
surrogate is a "trustee" for the embryo and should be kept to "her
promise to honor the genetic bond.")
Judge Parstow also equated a child's identity with her genetic
composition: "We know more and more about traits now, how you walk,
talk, and everything else, all sorts of things that develop out of your
genes."
On appeal, the California court of appeals also saw genetics as "a
powerful factor in human relationships," writing, "The fact that
another person is, literally, developed from a part of oneself can
furnish the basis for a profound psychological bond. Heredity can
provide a basis of connection between two individuals for the duration
of their lives."
The California Supreme Court affirmed this view, reducing the legal
significance of gestation to mere evidence of the determinative genetic connection between mother and child.
The California courts reduced legal motherhood to the contribution of
an egg to the procreative process. But the law need not place such
primacy on genetic relatedness. There is little doubt, for example,
that a court would not consider a woman who donated her eggs to an
infertile couple to be the legal mother, despite her genetic connection
to the child. By relying on the genetic tie to determine legal
parenthood, the courts in the Johnson case ensured that a Black woman would not be the "natural mother" of a white child.
In Europe, different circumstances have also produced controversy
concerning a Black woman bearing a white child. Black women in England
and Italy have been implanted with a white woman's eggs in order to
bear a child of their own. It was reported that the British woman used
a white woman's eggs because of the shortage of Black women who donate
their eggs to infertile couples. She resorted to eggs of a different
race only after waiting four years for a Black donor. In her mind, the
egg donor's race was not determinative: because the father was of mixed
racial heritage, the child would be of mixed race as well -- regardless
of the egg donor's race. As the clinic director noted, "a you are going
to do by having a white woman's egg is have a slightly paler shade of
coffee colour rather than a darker shade of coffee colour."
In Italy, an African woman's choice of a white woman's egg was far more
momentous. Because her husband, whose sperm fertilized the egg, was
white, her baby was also white. The second woman deliberately selected
the donor's race because she believed that "the child would have a
better future if it were white."
Unlike gestational surrogacy, egg donation and marriage to the father
gave this woman a solid legal claim to the white child she bore. Yet
the shock of a Black woman giving birth to her own white child was
great enough to make international news and to send experts pondering
about the ethics of such "designer babies." A wide spectrum of
commentators condemned even the British woman's selection of a white
egg donor. Conservative British politician Jill Knight maintained that
choosing a child's ethnic identity was "plain and unvarnished genetic
engineering."
The chairman of the British Medical Association's ethics committee
called for Parliament to debate the issue. And a spokesman for the
Catholic media center stated that "the Catholic Church would be opposed
to such interference with the natural processes."
It is regrettable that the woman in Italy refused to give birth to a
Black child. Seduced by the misleading allure of the new reproduction,
she unfortunately sought a technological solution to the problem of
racism. On the other hand, the furor over her racial selection of eggs
overlooked the fact that most white couples also choose to have a white
child when they select the race of a sperm or egg donor or surrogate
mother. Race is the sperm donor characteristic most likely to be
matched to recipient specifications, and virtually all sperm banks are
willing to meet this request.
It was most hypocritical for white ethicists and politicians to lash
out at this Black woman for picking the most popular type of donor
eggs.
Gestational surrogacy invokes the possibility that white
middle-class couples will use Black women to gestate their babies.
Since contracting couples need not be concerned about the gestator's
genetic qualities (most important, her race), they may favor hiring the
most economically vulnerable women in order to secure the lowest price
for their services. Black gestators would be doubly disadvantaged in
any custody dispute: besides being less able to afford a court battle,
they are unlikely to win custody of the white child they bear, as the Johnson
case demonstrates. Writer Katha Pollitt speculates that this legal
advantage might have been the Calverts' motive choosing a Black
gestational surrogate in the first place. "Black women have, after all,
always raised white children without acquiring any rights to them,"
Pollitt notes. "Now they can breed them, too."
Some writers had already predicted a caste of breeders, composed of
women of color whose primary function would be to gestate the embryos
of more valuable white women.
These breeders, whose own genetic progeny would be considered
worthless, might be sterilized. The vision of Black women's wombs in
the service of white men conjures up images from slavery. Slave women
were similarly compelled to breed children who would be owned by their
masters and to breast-feed their masters' white infants, while
neglecting their own children. In fact, Anna Johnson's lawyer likened
the arrangement Johnson made with the Calverts to "a slave contract."
Some white feminists present these images of Black women's degradation
in order to enhance the potential horror of reproductive technologies'
oppression of women. But a strictly gender-focused analysis falls to
confront the racism that makes these images a real possibility. In Gena
Corea's futuristic scenario, for example, white women are equally
exploited as compulsory egg donors in the reproductive brothel.
Corea does not question whether white middle-class women might collude
in their husbands' use of Black women's bodies to produce their own
white, genetically related children.
MAGNIFYING RACIAL INEQUITIES
So far I have argued that use of new reproductive technologies
reflects an already existing racial caste system. High-tech means of
procreation may also magnify racial inequities by enhancing the power
of privileged whites and contributing to the devaluation of Blacks.
With only 40,000 babies in the United States conceived through IVF
since 1981,
the racial disparity in its use will hardly alter the demographic
composition of the country. Rather, the harm occurs at the ideological
level -- the message it sends about the relative value of Blacks and
whites in America. But this is not an imaginary harm: ideology has a
real effect on social policy and consequently on the material
conditions of people's lives. By strengthening the ideology that white
people deserve to procreate while Black people do not, the new
reproduction may worsen racial inequality.
We should not dismiss the possibility of more tangible harms,
however. The ability to select or improve the genetic features of one's
off-spring carries material as well as symbolic advantages. Modern
genetic technologies allow parents who can afford them to secure the
health and physical abilities of their children. Without government
subsidies, this could produce a society where only the poor bear
children with genetic disorders. Concentrating the power of genetic
enhancement in the hands of an already privileged class would
exacerbate differences in the status and welfare of social groups.
While birth control has been the tool for imposing negative
eugenics, the new reproduction is the instrument for achieving positive
eugenics -- increasing the number of births from superior parents.
According to Noel Keane, the doctor who assisted in the first public
surrogacy arrangement explained his participation in terms of eugenics:
"I performed the insemination because there are enough unwanted
children and children of poor genetic background in the world."
The March 1934 issue of Scientific American reported
that each year between 1,000 and 3,000 American women requested sperm
for artificial insemination, a procedure used by women with sterile
husbands since the mid-nineteenth century. Noting that the women
usually wanted the most biologically fit donors, the article extolled
the eugenic potential of this reproductive technology: "Some 10,000
to20,000 babies [could] be born every year from selected sources, while
less than 500 babies per year are now being born to the men of real
talent in our country. What will be the eugenic effect on the race, if
this same tendency grows?"
The eugenic possibilities of artificial insemination were explored most
notably by Hermann J. Muller, a zoologist who won the Nobel Prize in
1946 for his discovery that radiation causes gene mutations. Muller
believed that mankind should take control of the evolutionary process
in order to transform society for the better. In his 1935 classic, Out of the Night: A Biologist's View of the Future,
Muller estimated that artificial insemination could enable 50,000
children to inherit the genes of a single "transcendently estimable
man" and the majority of the population to possess the innate qualities
of such mere as Lenin, Newton, Pasteur, Beethoven, and Marx.
Unlike most eugenicists, Muller rejected the notion that socio lower
classes or less advanced races had genetically inferior intelligence,
attributing differences among groups to their environment. In fact,
Muller condemned social inequalities for hindering eugenic progress; he
advocated a classless society with equal opportunity for education and
welfare that would reveal the population's true genetic variation.
Muller revived his vision of improving mankind's genetic
quality through artificial insemination in a paper presented at a 1959
University of Chicago conference celebrating the hundred-year
anniversary of Darwin's 0rigin of Species.
In 1971, four years after Muller's death, a right-wing millionaire
named Robert K. Graham realized Muller's fantasy by establishing the
Hermann J. Muller Repository for Germinal Choice. (Muller had disavowed
the repository prior to his death because of his concern about biased
solicitations.) Graham originally stocked the bank with sperm donated
exclusively by Nobel Laureates, including William Shockley, but later
began accepting donations from
other scientists.
Singapore provides a contemporary example of a positive eugenics
program. The Singapore government responded to the country's falling
birthrate by investing in the rapid development of new reproductive
technologies, including the world's first egg bank and
micro-insemination sperm transplant (MIST), a technique used to
increase a man's sperm count.
Fueled by concern over Singapore's growing Malay and Indian
populations, the program aims at increasing the fertility of the
educated elite, particularly those of Chinese ancestry. The tax laws as
well as employment and social security benefits provide added
incentives for the affluent to have more children. The state-run Social
Development Unit helps female university graduates find suitable
husbands. Singapore's policy has succeeded in boosting fertility 3.5
percent over the past decade.
WHAT SHOULD WE DO?
What does it mean that we live in a country in which white women
disproportionately undergo expensive technologies to enable them to
bear children, while Black women disproportionately undergo surgery
that prevents them from being able to bear any? Surely this
contradiction must play a critical part in current deliberations about
the morality of these technologies. What exactly does race mean for our
understanding of the new reproduction?
Let us consider three possible responses for social policy.
First, we might acknowledge that race influences the use of
reproductive technologies, but decide this does not justify interfering
with individuals' liberty to use them. Second, we could work to ensure
greater access to these technologies by providing public assistance or
including them in insurance plans. Finally, we might determine that
these technologies are harmful and that their use should therefore be
discouraged.
The Liberal Response: Setting Aside Social Justice
One response to this racial disparity is to note that it stems from
the economic and social structure, not from individuals' use of
reproductive technologies. Protection of individual's procreative
liberty should prohibit government intervention in the choice to use
IVF and other high-tech services, as long as that choice itself does
not harm anyone. Because protecting individual liberty from state
intrusion is so central to liberal philosophy, I call this the liberal
response.
Currently, there is little government supervision of
reproduction-assisting technologies, and many proponents fear legal
regulation of these new means of reproduction. in their view, financial
and social barriers to IVF are unfortunate but inappropriate reasons to
interfere with those fortunate enough to have access to this
technology. Nor, according to the liberal response, does the right to
use these technologies entail any government obligation to provide
access to them. Just as current constitutional jurisprudence recognizes
no right to public funding of abortions or other reproductive health
services, there is no constitutional right to government subsidies for
high-tech fertility treatment. Some prominent liberal thinkers, such as
John Pawls and Ronald Dworkin, have addressed economic inequality in
their accounts of political liberalism. But most, including a majority
of U.S. Supreme Court justices, set aside such concerns. Furthermore,
if for cultural reasons Blacks choose not to use these technologies,
this is no reason to deny them to people who have different cultural
values.
Perhaps we should not question infertile couples' motives for
wanting genetically related children. After all, people who have
children the old-fashioned way may also practice this type of genetic
selection when they choose a mate. It would be hypocritical to condemn
people who resort to new reproductive technologies for having the same
desires for their children as more conventional parents, whose
decisions are not so scrutinized. The desire to share genetic traits
with our children may not reflect the eugenic notion that these
particular traits are inferior to others; rather, as Barbara Berg
notes, "these characteristics may simply symbolize to the parents the
child's connection to past generations and the ability to extend that
lineage forward into the future."
Several people have responded to my concerns about race by explaining
to me, "White couples want white children not because of any belief in
racial superiority, but because they want children who are like them."
Moreover, the danger of government scrutiny of people's motives
for their reproductive decisions may override concerns about racism.
This danger leads some commentators who oppose the practice of using
abortion as a sex-selection technique to nevertheless oppose its legal
prohibition.
As Tabitha Powledge put it, "To forbid women to use prenatal diagnostic
techniques as a way of picking the sexes of their babies is to begin to
delineate acceptable and unacceptable reasons to have an abortion.... I
hate these technologies, but I do not want to see them legally
regulated because, quite simply, I do not want to provide an opening
wedge for legal regulation of reproduction in general."
It would similarly be unwise to permit the government to question
individuals' reasons for deciding to use reproduction-assisting
technologies.
The Distributive Solution
We need not question individuals' reasons in order to question the societal impact of a practice.
My purpose is not to judge individuals' motivations, but to scrutinize
the legal and political context which helps to both create and give
meaning to individuals' motivations. Another approach to procreative
liberty places more importance on reproduction's social context than
does the liberal focus on the fulfillment of individual desires.
Procreative liberty cannot be separated from concerns about equality.
In fact, the very meaning of reproductive liberty is inextricably
intertwined with issues of social justice. Policies governing
reproduction not only affect an individual's personal identity they
also shape the way we value each other and interpret social problems.
The social harm that stems from confining the new reproduction largely
in the hands of wealthy white couples might be a reason to demand
equalized access to these technologies.
This view also recognizes the social constraints on
individuals' ability to make reproductive decisions. The concept of the
already autonomous individual who acts freely without government
intrusion is a fallacy that privileges decisionmaking by the most
wealthy and powerful members of society. It ignores the communities and
social systems that both help and hinder an individual in determining
her reproductive life.
Obviously, the unequal distribution of wealth in our society
prevents the less well off from buying countless goods and services
that wealthy people can afford. But there may be a reason why we should
be especially concerned about this result when it applies to
reproduction. The same reasons that lead liberals to protect the rights
of privileged individuals to use expensive reproductive technologies
counsel in favor of paying closer attention to reproduction's social
consequences.
Reproduction is special. Government policy concerning
reproduction has tremendous power to affect the status of entire groups
of people. This is why the Supreme Court in Skinner v. Oklahoma declared the right to bear children to be "one of the basic civil rights of Man." This is why in their Planned Parenthood v. Casey
opinion, Supreme Court Justices O'Connor, Kennedy, and Souter stressed
the importance that the right to an abortion had for women's equal
social status. It is precisely the connection between reproduction and
human dignity that makes a system of procreative liberty that
privileges the wealthy and powerful particularly disturbing.
Because procreative liberty is such an important right, so
central to personal identity, to dignity, and to the meaning of one's
life,"
its infringement by forces other than the state should also be
addressed. Why must we adopt the baseline of existing inequalities? Why
should the deepening of these inequalities not weigh heavily in
balancing the benefits and harms of assisted reproduction? Procreative
liberty's importance to human dignity is a compelling reason to
guarantee the equal distribution of procreative resources in society.
Moreover, addressing the power of unequal access to these resources to
entrench unjust social hierarchies is no less important than allowing
wealthy individuals alone to fulfill expensive procreative choices. We
might therefore address the racial disparity in the use of reproductive
technologies by ensuring through public spending that their use is not
concentrated among affluent white people. Government subsidies, such as
Medicaid, and legislation mandating health insurance coverage of
fertility services would allow more diverse and widespread enjoyment of
the new reproduction.
Should We Discourage the New Reproduction?
If these technologies are in some ways positively harmful, will
expanding the distribution of fertility services solve the problem?
Will distributing more of the technologies be enough to redress the
racist social arrangements that make these technologies dangerous?
Political philosopher Iris Marion Young criticizes liberal theories of
distributional justice for ignoring the institutional context that
inhibits people from determining their actions and that helps to guide
distributive patterns.
This distributive approach restricts the meaning of social justice to
the morally proper allocation of material goods among society's
members. Although the more equalized distribution of resources would
alleviate many social problems, it alone cannot eliminate oppressive
social structures. My racial critique of the new reproduction is more
unsettling than its exposure of the maldistribution of technologies. It
also challenges the importance that we place on genetics and genetic
ties. Eradicating the harmful aspects of new reproductive technologies,
then, may require deterring people from using them.
But can we limit individuals' access to these technologies
without critically trampling on individual freedom from unwarranted
government intrusion? After all, government has perpetrated much
injustice on the theory that individual interests must be sacrificed
for the public good. This was the rationale justifying the eugenic
sterilization laws enacted earlier in this century. According to
eugenicists, the law could restrict the reproductive liberty of the
unfit in the interest of improving the genetic quality of the nation.
Even for liberals, individuals' freedom to use reproductive
technologies is not absolute. Most liberals would place some limit on
their use, perhaps by identifying the legitimate reasons for
procreation. John Robertson, for example, concedes that the state may
prevent parents from cloning offspring or using genetic screening to
intentionally diminish the health of their children (intentionally
bearing a deaf child, for example).
He justifies this restriction by arguing that these uses of
reproduction-assisting technologies do not further the core value of
procreation of producing "normal, healthy children" for rearing.
If such a core view of reproduction can limit individuals' personal
procreative decisions, then why not consider a view that takes into
account the new reproduction's role in social arrangements of wealth
and power? If the harm to an individual child or even to a core notion
of procreation can justify barring parents from using the technique of
their choice, then why not the new reproduction's potential for
worsening group inequality? The magnitude of harm that can result from
the unequal use of these technologies, an inequality rooted partly in
racism, justifies government regulation.
Some have concluded that the harms caused by certain
reproduction-assisting practices even justify their prohibition. In
1985 for example, the United Kingdom passed the Surrogacy Arrangements
Act banning commercial contract pregnancy arrangements and imposing
fines and/or imprisonment on the brokers who negotiate these agreements.
The authors of the act reasoned that "[e]ven in compelling medical
circumstances the dangers of exploitation of one human being by another
appears [sic] to the majority of us far to outweigh the potential benefits, in almost every case."
Some Marxist and radical feminists agree that paid pregnancy contracts
should be criminalized to prevent their exploitation and
commodification of women and children. Surrogacy contracts are void and unenforceable in five states in this country; three others prohibit commercial surrogacy.
On the other hand, the government need not depart at all from the
liberal noninterference model of rights in order to discourage or
refuse to support practices that contribute to social injustice.
Even the negative view of liberty that protects procreative choice from
government intrusion leaves the state free to decide not to lend
assistance to the fertility business or its clients. Indeed, liberals
who argue that the state must facilitate the use of these technologies, by enforcing paid pregnancy contracts for instance, contradict their own precepts.
We should therefore question a system that channels millions of dollars
into the fertility business, rather than spending similar amounts on
programs that would provide more extensive benefits to infertile
people. New York Times
reporter Trip Gabriel describes the "$350 million-a-year" fertility
business as "a virtually free-market branch of medicine ... largely
exempt from government regulation and from the downward pressure on
costs that insurance companies exert."
The fact that new reproductive technologies facilitate procreative
decisions is not reason enough to exempt them from government
supervision; obstetrics and abortion services are subject to
regulation. Taking these social justice concerns more seriously would
justify government efforts to reallocate resources away from expensive
reproductive technologies toward activities that would benefit a wider
range of people.
Indeed, we can no longer avoid these concerns about the social
costs and benefits of IVF. Such calculations are now part of the debate
surrounding the advisability of state laws requiring insurance
companies to include the cost of fertility treatment in their coverage.
One as yet unsuccessful couple reported that "insurance has paid for
everything at about $100,000 a year (three years now)."
Covering the costs of expensive high-tech procedures means raising the
price of insurance for everyone. The Massachusetts Association of
Health Maintenance Organizations says its members pay $40 million more
in premiums to cover infertility treatment for 2,000 couples.
The federal Office of Technology Assessment estimates that it would
cost $25 million to extend coverage for IVF under the plan that insures
the nation's 3 million civilian employees of the federal government.
Moreover, providing insurance for expensive fertility treatments but
not adoption (which can also cost thousands of dollars) ironically
makes these technologies the only alternative some people can afford.
A study recently reported in the New England Journal of Medicine calculated the real cost of IVF at approximately $67,000 to $14,000 per successful delivery.
For older couples with more complicated conditions, the cost rose to
$800,000. Unlike the $8,000 cost per IVF cycle, these figures refer to
the costs involved in the birth of at least one live baby as a result
of IVF, including the cost of treatment, delivery, and neonatal
intensive care. (The high incidence of risky multiple births with IVF
dramatically boosts hospital charges.) The authors concluded that the
debate about insurance coverage must take into account these economic
implications of IVF, as well as ethical and social judgments about
resource allocation. Yes, insurance coverage increases access to these
technologies to some degree. But can we justify devoting such
exorbitant sums to a risky, nontherapeutic procedure with an 80 percent
failure rate when so many basic health needs go unmet?
Research designed to reduce infertility, programs that
facilitate adoption, and the general provision of basic human needs are
examples of expenditures that would help a far broader range of people
than IVF.
The federal government has done little to combat the epidemic spread of
chlamydia, an STD that affects millions of people and contributes to
especially high infertility rates among young Black women. It must be
remembered that most high-tech interventions such as IVF do not cure
infertility, the couples who use them remain biologically unable to
bear a child without technological assistance. The medical
establishment has much more to gain from developing expensive
technological interventions that foster a dependent clientele than from
research directed at the causes and prevention of infertility. The IVF
clinic at New York Hospital-Cornell Medical Center, for example,
generates a $2 million annual surplus for the Cornell Medical College
that enables its physicians to earn up to $1 million a year.
This kind of profit creates a strong incentive to push infertile
couples toward repeated attempts at a high-tech solution, despite
abysmal success rates that only drop with each try.
Black women in particular would be better served by a focus on
the improvement of basic conditions that lead to infertility, such as
occupational and environmental hazards, diseases, and complications
following childbirth or abortion. Increasing access to preventive
health care and treatment for STDs would yield a far bigger payoff than
increasing access to expensive fertility treatment. Yet the relative
modesty of financial rewards, combined with disinterest in increasing
Black birthrates, steers medical ventures off this more promising
course. Indeed, as we saw in Chapter 3, more resources are directed
toward developing long-term contraceptives for poor women of color in
the United States and abroad that may lead to an even higher incidence
of infertility-causing STDs and other health problems.
The concentration of effort on the new reproduction diverts
attention from the interests of poorer Black women in another, more
subtle way. Although the "biological clock" metaphor is grossly
exaggerated, one reason for infertility among white, educated,
high-income women is their postponement of childbearing in order to
pursue a career.
The cause of these women's infertility is not biological; rather, it is
a workplace that makes it virtually impossible for women to combine
employment and child-rearing. These women can avoid this social problem
by seeking expensive fertility treatment after achieving some status in
the office. In other words, they can afford to bypass the structural
unfairness to mothers through technological intervention. Similarly,
many affluent white women gained entry to the male-dominated workplace
by assigning female domestic tasks to low-paid dark-skinned nannies.
These luxuries, which most Black women cannot afford, take the place of
widespread reforms that would increase all women's employment options.
Relying on expensive interventions to resolve the tension between
child-raising and work destroys the possibility of unity in women's
struggle for fundamental change in the sexual division of labor.
This reliance on high-tech intervention rather than improving
basic health and workplace conditions hurts not only Black women but
all women and, ultimately, all of our society. We would all benefit
from a health policy that redirected the billions of dollars currently
spent on fertility treatment toward eradicating the causes of
infertility. We would all benefit from a view of family that valued
loving relationships, however created, rather than genes traded on the
market. We would all benefit from a work world that appreciated
mothers' care for children. Once again, America's unwillingness to
attend to the needs of Black citizens stymies the potential for
widespread change that would enrich everyone's life.
* * *
There is no question that the way we view the freedom to create
children technologically, as well as "naturally," is shaped by race.
Racial injustice infects the use of new reproductive technologies no
less than it infects the use of birth control. While too much fertility
is seen as a Black woman's problem that must be curbed through welfare
policy, too little fertility is seen as a white woman's problem to be
cured through high-tech interventions. The new reproduction is designed
for the creation of white babies.
We must address the contribution that this disparity makes to racial
injustice in America. Staunch civil libertarians object that
intervening might unfairly limit the choices of wealthy white people.
I, too, am wary of state interference in reproductive decisionmaking;
after all, Black women are the most vulnerable to such government
abuse. But our vision of procreative liberty must include the
eradication of group oppression, and not just a concern for protecting
the reproductive choices of the most privileged. It is to that
reconception of reproductive liberty that I now turn. |