Reproductive Tourism: Equality Concerns in the Global Market for Fertility Services

Abstract

Assisted reproductive technology (ART) lures people across borders. The willingness to travel for ART access and the practices that facilitate fertility travel are known as “reproductive tourism.” The supply side of reproductive tourism has formed into a sprawling commercial enterprise that is sophisticated in some respects and crude in others.

The first task of this Article is to set out a snapshot account of reproductive tourism. ART commerce across jurisdictional lines is fluid. The participants on both the demand and the supply side of the global fertility market change based on legal, medical, and normative innovations (or regressions). Participants include prospective patients, States, countries, providers, health care facilities, sperm banks, egg donors, surrogates, agencies, and brokers. When legal rules, technology, or social norms change, the destination spots and departure points of reproductive tourism change as well. The geographic shifts echo in the identities of the human participants.

The dominant narrative of reproductive tourism speaks of the private sphere desire for family formation. This narrative characterizes reproductive tourism as the fortuitous means of achieving the dream of parentage. This Article challenges the way in which the narrative separates family and market. It examines how the human need of family formation interacts with commerce, and how geopolitical differences shape that interaction.

This Article also examines the material and normative equality concerns embedded in reproductive tourism. Some of the concerns arise from geopolitical differences between the destination spots and points of departure. Others arise from the use of women as third party sources of gestation and eggs. This Article examines the effects of reproductive tourism on health care priorities and resources in destination spots, the unequal allocation of health risks to women in reproductive tourism, reproductive tourism’s perpetuation of reproductive entitlement, and racial alignment/racial distancing effected by reproductive tourism’s practices.

Keywords: Assisted reproductive technology, fertility, bioethics, health, women’s health, health disparities, critical race theory