A New French Revolution Is Brewing ... in Fertility

Why you should care

Because a new recommendation to extend IVF to gay couples could be just the beginning.

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Last year, while fighting the French presidential campaign he would ultimately win, Emmanuel Macron was forced to defend his family. Married to a woman 24 years his senior, he has no biological children, a fact that became a point of ridicule for the far-right National Front (now called the National Rally) against whom he contested the election. But when opponents suggested that a man with “no children” couldn’t truly care about the future, he struck back with passion: “I have children and grandchildren of the heart.”

Perhaps that devotion to families that don’t quite conform to traditional nuclear ideals was partly behind Macron’s promise to extend the right to state-sponsored in vitro fertilization to lesbian couples and single women. Last week, the change was recommended by France’s highest court. While the executive branch is making no promises — it cautioned that the court’s recommendation isn’t binding, and is likely wary of a conservative backlash to such a move — it could portend a major step forward for equality in reproduction. It also is expected to further deepen social and political fissures on a subject that remains acutely sensitive in France. The legislation is expected by the end of the year, with a parliamentary debate soon after.

France has lagged behind other Western European countries when it comes to progressive ideas about assisted reproductive technologies, a fact some have blamed on its deeply Catholic roots, despite its vocal commitment to secularism. French women who need more than the four rounds of IVF allotted by the French health system, or who aren’t currently entitled to IVF at all due to not being heterosexual or part of a couple, routinely hop over the border to Spain or Belgium for treatment. Legal changes allowing lesbian couples or single women to use IVF promise to change that. But proponents of the changes will need to overcome stiff resistance first.

French legislators are now starting to wake up to the reality.

Marcin Smietana, University of Cambridge

A particularly sticky part of the debate is surrogacy. Before the court ruling, France’s conference of bishops warned that allowing gay couples and single women to use IVF would inevitably lead to legalization of surrogacy, which is currently illegal in most of Europe except for Portugal, Greece and the U.K. Even in these three, only altruistic surrogacy — meaning the birth mother can’t be compensated except for medical expenses, and no agencies can profit — is allowed, and in Portugal and Greece only straight married couples can seek a surrogate in the first place. France’s health minister shot back that IVF and surrogacy are separate, and pleaded for a “not hysterical” debate on the subject. But others actually want surrogacy to be part of the debate, and perhaps even to be legalized in some circumstances. As Marcin Smietana, a research associate at the Reproductive Sociology Research Group (ReproSoc) of University of Cambridge, explains: Wealthy French couples already have access to surrogacy, because they have the means to travel to the U.S. and return with a baby conceived under, for example, California’s comparatively lax laws.

“French legislators are now starting to wake up to the reality,” says Smietana.

The difference in laws on IVF and surrogacy between the U.S. and large parts of Western Europe — including France — has to do with the way the debate has historically been framed in each of these places. While the U.S. remains a very expensive Wild West when it comes to reproductive technology, “Europeans have had more vigorous debate about biocapitalism,” says France Winddance Twine, author of Outsourcing the Womb and a professor of sociology at the University of California, Santa Barbara. Concerns about the commodification of women’s bodies remain strong in most of Western Europe. “In the United States, if you can afford it, you can do it,” says Twine. “But in France, there’s been a conversation about what should be allowed and whether it’s ethical.”

Still, French couples who look across the Atlantic Ocean for help in producing kids don’t return with horror stories, says Laëtitia Poisson Deleglise of the Maia Association, a support organization for those struggling with infertility in France. “When we listen to our members who have used surrogacy in North America, we don’t hear stories of exploitation or commodification, but of an incredible human adventure,” she says, advocating for legalization of altruistic surrogacy in France, under certain medical conditions.

The reality that restrictions on IVF or surrogacy most harm only those who can’t afford to travel elsewhere for treatment is also increasingly hard to ignore for France, says Smietana. After all, Macron or no Macron, French women have been traveling to Spain to get IVF they couldn’t obtain in their home country. Similarly, while many still rail against surrogacy as inevitably dehumanizing for the women involved, the European Court of Human Rights recommended in 2014 that France recognize transnational surrogacy. “It’s not binding, but it’s treated as a very important recommendation,” says Smietana, and it could change laws in formerly die-hard anti-surrogacy jurisdictions like France and Germany. Still, he thinks Spain is likely to legalize surrogacy before France — and points out that altruistic surrogacy isn’t uncontroversial either, as some insist that having a baby is (literally) labor and women should be compensated for their work.

As for whether Macron has been the driving force behind France’s new push toward progressive policies on reproduction, it may be more that extending IVF access fits in with Macron’s generally liberal policy project. But having an unconventional family doesn’t hurt: “It turns out that many people have personal stories that tie into the changing character of family,” Smietana says. “He is not the only one.”

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