Читать книгу Gay Parenting - Cynthia Phillips - Страница 11
ОглавлениеIn the case of surrogacy, a woman gives birth to a child who is intended for someone else from conception. Thus there is a surrogate womb. Most of the time, surrogacy includes the genetic material (sperm or egg) from at least one of the intended parents, although in some cases both an egg donor and a sperm donor are utilized.
Surrogacy is commonly used by both gay male couples and heterosexual couples with fertility problems. There are two main types of surrogacy: traditional and gestational. The difference involves the egg source – in traditional surrogacy, the surrogate is fertilized using sperm from the intended father, and carries to term a child who is genetically related to both her and (one of) the intended father(s). In gestational surrogacy, eggs from an egg donor (or mother with infertility problems) are fertilized with sperm from the father (or donor sperm), and then implanted in a surrogate who will carry to term a child to whom she is not biologically related.
Choosing between traditional and gestational surrogacy in the case of heterosexual or lesbian couples involves a major decision. In the traditional case, the intended mother will not be biologically related to the child, while in the gestational case she will be. For a gay male couple, however, the difference is not as large – in either case, the sperm of one of the intended fathers will be used, with either an egg from the surrogate herself (in the traditional case) or from an egg donor (in the gestational case). Of course, choosing which man will be the biological father can become a huge issue for gay male couples, just as choosing which mother will be the egg donor can become an issue for lesbian couples.
Another difference between the two types of surrogacy is the level of fertility procedures required – traditional surrogacy often requires only basic medical procedures, while gestational surrogacy requires a much higher level of procedures and therefore costs. This is because in gestational surrogacy, similar to IVF (in-vitro fertilization, see Chapter Five), the egg donor must have eggs extracted, requiring fertility drugs to stimulate the production of multiple eggs and to synchronize her cycle with the gestational surrogate’s. Then the surrogate has the eggs implanted, and must be on a variety of fertility drugs to help increase the chances of implantation. In addition to the increased costs, gestational surrogacy also comes with all the risks of IVF, including a higher risk of miscarriage and a longer recuperation time between cycles.
From the point of view of the intended parents, there is the possible increased risk of a disruption in the process due to the biological relationship between a traditional surrogate and the child she carries. While such disruptions are very rare, they do happen and in a custody dispute the courts might be more likely to rule in a surrogate’s favor if she is biologically related to the child she carried than if she isn’t. In the case of gestational surrogacy, the only biological claim on the child will be from one of the intended fathers, thus providing a bit more legal protection.
CONSIDER A SURROGATE EVEN IF YOU DON’T HAVE A PARTNER
Gil, a single gay man, very much wanted to be both a parent and a father. “I’ve been wanting to be a father to a child since I was a kid!” he said. He didn’t want to adopt, because he wanted to have a child that was “his” – for him, biology was a very important factor. “When I was young, people always told me how much I looked like my father. I was so proud to resemble this great man, one that I looked up to every day. I want that sort of familiarity, that connection, with my own child.” Single gay men who wish to become parents may be especially drawn to surrogacy, though there may not be much of a cost savings compared to adoption.
A major emotional decision to make, in the case of a couple, will be the issue of whose sperm to use. In the case of a single man, there will be no one to consult or haggle with about the many decisions involved. For single men, surrogacy may actually be easier from a legal perspective than adoption. Surrogacy provides a clear alternative, albeit with many pros and cons.
VARIATIONS ON SURROGACY
In addition to gay male couples, some lesbian couples suffering from infertility also choose surrogacy. It is an excellent way to incorporate one’s genes into a child that one then plans to raise, even though neither individual will physically carry the child to term. With gay male couples or singles, a variety of options are possible in addition to the typical “traditional” and “gestational” routes. The usual procedure is for one man to donate sperm, which will be used in fertilizing the egg of an anonymous donor. This embryo is then implanted into a surrogate, using regular IVF procedures. Nine months later, with luck, the couple will have their own biological child.
Variations on this procedure are also possible. In some cases, where a gay couple doesn’t wish to know who the biological parent is, they may ask for their sperm to be mixed before being used to fertilize an egg. Some fertility specialists think that this actually cuts down on the chances of conception because the sperm from the two men “compete” with each other. Most specialists think it is preferable to pick one man to be the sperm donor.
In other cases, sperm from one of the men can be used to fertilize an egg from a woman related to the other member of a couple, such as a sister or other close female relative. By going this route, the child has a biological connection to both men. If such a connection is important to both members of the couple, then it can be an excellent avenue to explore. However, it relies on both the willingness and availability of female family members.
Miguel and Robert, one gay couple, used a family member as a surrogate. Miguel’s sister, Maria, and her husband, already had two children, and Maria had had easy pregnancies with both. When Miguel and Robert approached Maria about being a surrogate, she was a bit hesitant at first – the idea of being a surrogate had never occurred to her, though she knew how much Miguel and Robert loved children and how they were devoted uncles to her two girls. After discussing the idea with her husband, Maria decided to go ahead with the procedure. Robert provided sperm, and Maria became pregnant after only two tries. She had an easy pregnancy again, and Robert and Miguel were there at the delivery and got to hold their new daughter Rebecca right after she was born. Miguel says, “Robert and I were lucky to have a close relative who was willing to be a surrogate for us – this way, Rebecca is really part of both of us. And Rebecca has an especially close relationship with her two cousins, as well – we see them all the time, and she knows that Auntie Maria carried Rebecca in her tummy, because her daddies couldn’t get pregnant themselves!”
PROS AND CONS OF SURROGACY
To Gil, it was be important to pass on the family name, as well as genes, to the next generation. Gil says, “Surrogacy is clearly an extremely personal decision of a highly emotional nature, and only you and your partner, if you have one, can make these choices together.
In surrogacy, the child is planned from the very beginning. The eventual parents can be involved in the pregnancy from the very earliest days. It allows a degree of control and reassurance for the parents – they know that the surrogate is getting good prenatal care, isn’t smoking or using drugs and is otherwise taking care of herself during the pregnancy. If all parties agree, the intended parents can even attend medical appointments with the surrogate, hear the heartbeat and see the baby on ultrasound. They may also be allowed to be present during the birth. This degree of access is sometimes available in an open adoption situation, but in many cases is not.
The decision to place a child for adoption is often emotionally charged. With a surrogate, the woman decided to go into the procedure; the surrogate may not consider the child as hers, whereas a woman giving her child up for adoption is always considered the birthmother. Also, in the case of adoption, the birthmother usually has the option to change her mind about giving up her child. With surrogacy, there is little doubt that the contractual parent will receive his child once the baby is born.
One disadvantage of surrogacy is that it is an extremely medicalized process with many interdependencies. There are medical exams and procedures for just about every party involved, and all aspects of the concerned party’s health will be examined and subject to scrutiny. The least intrusive route possible, using a traditional surrogate and doing at-home inseminations with fresh sperm, is still somewhat invasive and may make some surrogates uncomfortable. Remember, though, that a gay man’s part of the process will actually be fairly limited. Once the sperm sample is taken, assuming that there aren’t any fertility problems on the man’s side, the man shouldn’t need any more medical contact. The rest of the medical procedures (egg harvesting to embryo implantation, pregnancy and birth) will all involve the woman.
If you’re a particularly private person, or can’t tolerate multiple doctor’s visits and probing questions about your health, adoption may be a better choice (though of course, adoption comes with its own intrusions in the form of court petitions, the home study, etc.).
WHAT ARE THE LEGAL PITFALLS?
Surrogacy usually involves a legal contract wherein the surrogate relinquishes any and all parental rights toward the child. Surrogacy is not the same as adoption, and the surrogate mother is not usually considered a “birthmother.” It is a type of legal transaction.
When considering surrogacy be aware that this is one area of reproductive technology in which the law has not yet caught up to society. Surrogacy laws are highly variable from state to state (and region to region) in the United States. Because of this uncertainty, it is very important to consult with a local lawyer, preferably one who has experience with surrogacy contracts, before proceeding. A summary of laws in each state can be found in Appendix 1; more details on laws in various states are available at www.surrogacy.com or www.hrc.org.
In some states, surrogacy is illegal. In other states, it is legal, but the surrogate cannot be compensated financially for her role in the birth. In many states, surrogates cannot be paid directly for bearing a child to term. If you live in one of these states, other arrangements for compensation will need to be made or you’ll need to find a family member or close friend who will be a “compassionate surrogate” out of the goodness of her own heart. In Miguel and Robert’s case, Miguel’s sister Maria refused to take any money from the grateful couple. Robert reports: “We made sure to offer to babysit Maria’s two girls as often as we could, especially during Maria’s third trimester when she was very tired. We had them over at our place just about every weekend. It gave Maria a break, and definitely helped us get ready for parenthood!”
A workaround to living in a state that doesn’t allow surrogacy is finding a surrogate in another state. You may actually need to have the procedures performed in this other state. You may find, however, that some agencies will refuse outright to work with couples or singles in states where surrogacy is illegal or of an uncertain legal status. In terms of fairly compensating the surrogate, in states where that is allowed, it is legal and permissible to pay them for travel expenses, medical fees, emotional distress and everything else relating to the conception and pregnancy. Some states also allow payment for living expenses while the surrogate is pregnant.
Of course, there are horror stories about surrogacy just as there are about adoption – a few cases over the years have made the news, where a surrogate refused to surrender the child she bore for someone else upon the child’s birth. It is important to investigate the laws of your state and if you live in a state where surrogacy is unregulated or disallowed, be prepared to make alternate arrangements.
WHAT ABOUT THE COST?
Between finding an egg donor, locating a surrogate, fertility procedures, legal fees and pregnancy expenses, having a baby via a surrogate can cost between $25,000 and $50,000 depending on your area of the country. The cost can increase if many IVF attempts are required; remember that payment is due even if pregnancy is not achieved on a particular attempt. There is no guarantee that the surrogate will become pregnant, and there is always a risk of miscarriage or other problems during the pregnancy. Attempting surrogacy without substantial savings is a questionable decision.
Something to be aware of is that, even if the surrogate has health insurance to cover pregnancy, many insurance plans specially exclude coverage for pregnancy by a surrogate. Check into the surrogate’s health insurance policy, so that there are no unexpected bills or claims. Depending on the state, the surrogate may or may not be allowed paid leave after giving birth – California, for example, is one state that allows surrogates the same paid family leave time that women who give birth to their own babies receive.
ARE WE MORE LIKELY TO HAVE TWINS?
In surrogacy, as with IVF for a lesbian couple, the risk of multiple births increases with the number of embryos that are implanted in a particular cycle. However, the situation surrounding surrogacy differs slightly because medical insurance often does not cover the expenses associated with the procedure; if there are pregnancy complications due to multiple fetuses (ranging from bed rest to premature birth to time spent in the neonatal intensive care unit), all of these costs must be borne by the intended parents. These fees can easily reach into the hundreds of thousands of dollars. If you cannot commit financially to these sorts of unforeseen expenses, surrogacy may not be the best option for achieving parenthood.
In Gil’s case, talking with the doctor reassured him. “I wasn’t particularly worried about having multiples, but, as a single gay man, I wasn’t sure I wanted to end up with five children! Mostly, it was financial – I don’t think I could afford to raise that many kids on a journalist’s salary. The fertility team told me about ways to reduce the chance of multiples: mainly, we could transfer fewer embryos at a time.”
HOW DO I LOCATE A SURROGATE?
Finding a surrogate can be a challenging process. Matthew and Damian, a gay male couple living in Massachusetts, decided to use a lawyer for the search. “We had a hard time finding a surrogate, so it seemed that the best way to go was just to find a lawyer,” Matt says. “We met with a few lawyers before settling on one who had worked with surrogates and parents before.” They recommend looking for a lawyer who will work entirely on your behalf, though. “One of the lawyers we met had another surrogacy client at the same time, and we were always sort of worried about having to compete with this other couple for a child. We knew that the one we picked was totally on our side.”
Another good choice is to contact an agency that specializes in surrogacy (see Appendix 2 for some gay-friendly surrogacy agencies). An agency may have broader services, including contacts in different locations (which can be especially useful if you live in a small or conservative town, or want to take advantage of favorable laws in a different state). Agencies take on the brunt of the footwork involved with medical exams for the surrogate, matching of surrogate to parents and legal paperwork. They will also do both medical and financial screening of all involved parties. In Matthew and Damian’s case, this wasn’t an option. “There just weren’t any agencies in our area, or if there were, we couldn’t find them.”
