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This places gay men at a disadvantage compared with heterosexual men, and women of any sexual orientation , as their ability to achieve exclusive genetic parenthood is currently entirely reliant on a market. Moreover, as my research has shown, there are fewer clinics and agencies that appear to welcome them.

The geographically clustered surrogacy market for gay intended fathers and the cost associated with these services further compound this disadvantage. Future ethnographic research could explore empirically what this geographically limited market means for individual gay men, especially those outside of surrogacy-saturated markets and of lower socio-economic status. According to my content analysis, the surrogacy market for gay men is limited. Outside of any individual practitioner decision-making, I propose that this limited market is primarily the outcome of two inter-related social factors.

The first are the ways in which normative ideas about gender, sexuality and reproduction shape the industry. Despite the fact that male factor infertility is understood to be as common as that experienced by women, there is a deep history of the conceptualization of infertility as a problem for and about women American Society for Reproductive Medicine, n. The infertility industry is not immune from this cultural conception.

The infertility clinic in the USA is a gendered space in which the biomedicalization of women and women's bodies are primary Barnes, , Thompson, According to my content analysis of websites, women with or without male partners are the primary clients being recruited at infertility clinics and at most surrogacy agencies. The tight focus on women and women's bodies in the field of reproduction is reflected in clinical practices, academic research and cultural understandings Almeling and Waggoner, , Culley et al.

As my research has shown, this results in a stratified market with the majority of clinics focusing their online recruitment campaigns towards women. In other words, gay men may not be recruited because they are men, and men are not the primary market for infertility services in the USA. Another social factor I see shaping gay men's restricted access to surrogacy is the way in which biological constraints play out in the organization of the privatized USA ART market.

While women without male partners e. Sometimes, as I was told by some physicians in the field, the lack of such services for gay men is reflective of practitioners' ideological or religious positions, but not necessarily. Although, for some clinics, gay men may represent an untapped profitable market [especially as, according to CDC data CDC, , success rates with donor eggs are higher than those with non-donor eggs], combined egg donor and surrogacy services marketed to gay men require an involved infrastructure that is perhaps simply beyond the time, energy, money and personnel capabilities of some clinics.

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As others have noted, the reproductive service clinic is often a very busy place Franklin and Roberts, , Rapp, Perhaps, as the nurse whose comment began the research for this paper felt, gay men are understood to be qualitatively different from the usual clientele i. In other words, gay men may not be recruited because they are gay, and, as such, they require intensive and expensive treatment to achieve genetic fatherhood. Ethnographic research on individual clinicians' decision-making about which patients to treat and recruit for surrogacy services would be useful for further understanding the situation for gay men.

The unequal recruitment of gay men by clinics and agencies is demonstrative of the intersection of gender and sexuality in the infertility market. I speculate that gay men are marginalized both because they are men and because they are gay.

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This limited recruitment may have several potential unintended consequences. First, it may impact gay men's procreative consciousness and decision-making about parenting.

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As noted earlier, websites are not only primary sources of information on reproductive services, but, as Murphy argues, are especially important for inspiring gay men to think of themselves as potential parents. Having clinics and agencies in one's community that are supportive of gay family formation may enable gay men to contemplate becoming fathers, and to pursue parenthood within their own city, region or state. The role of local surrogacy providers on the procreative consciousness and parenting intent for gay men would also be an interesting area for further exploration via ethnographic research.

A second unintended consequence of the limited recruitment of gay men as surrogacy clients is the creation of a geographically exclusive niche market. This niche market as niche markets are sometimes apt to do may exacerbate the economic and geographic inequality that underlie the infertility industry in the USA. Some gay men might face more challenges finding practitioners willing to work with them not only compared with heterosexual couples or women but also compared with other gay men.

This might be especially problematic for gay men of lower socio-economic status in areas of the country with few gay-friendly service providers.

While wealthy gay men in southern California should feel supported by the local ART community, and have little trouble accessing clinics and agencies catering to their needs, gay men of lower socio-economic status in middle America may have no local options to support the formation of their families via surrogacy.

I speculate that the reduced market has a potential, therefore, to have a material impact on the ability of some gay men — especially gay men of lower socio-economic status in areas outside of surrogacy-saturated markets — to access not only reproductive services but, in turn, genetic exclusive parenthood. A third potential unintended consequence of the limited gay-friendly surrogacy market relates to solidarity among gay men, and activism around gay family formation and gay family rights. I propose that the economic inequality evident in the infertility industry as a whole, exacerbated by a geographically limited niche market for gay men, has the potential to undermine solidarity between wealthy gay men and working class or poor gay men.

As gestational surrogacy is available to wealthy gay men, and only available locally to men in certain areas of the country, is access to this route to fatherhood an issue for gay activism? In other words, does the niche market disable conceptualizations of access to gay-friendly surrogacy providers as a reproductive justice issue for all gay men precisely because it enables such access for wealthy gay men whose voices may be most heard due to the ways in which wealth and privilege intersect? Using a reproductive justice lens to frame the data on surrogacy recruitment necessarily raises these questions as it highlights the uneven landscape for gay men's access to reproductive services and exclusive genetic parenthood compared with women, heterosexual couples and other gay men.

Some might argue that as long as there is a thriving niche market that caters for gay men, unequal recruitment across the industry as a whole is not problematic. They might even argue that a niche market of professionals specializing in gay surrogacy might make the process smoother for gay men, as it is catering specifically to their needs. However, my research adds to that of others Murphy, cautioning the ways in which limited recruitment across the industry could potentially result in not only discouraging a procreative consciousness among potential gay intended fathers, but in the actual exclusion of some gay men from the market — especially financially constrained men from areas of the country without access to geographically close gay-friendly service providers.

The marginalization of men in general and financially constrained gay men specifically from the realm of reproduction reflects the intersectionality of gender, sexuality and social class in the organization of the infertility industry in the USA. Gay men, while welcomed as potential infertility clients in certain clinics and agencies in certain parts of the country, still face disparities in their recruitment into reproductive services. While wealthy gay men may be able to circumnavigate these constraints to access the niche market catering to their needs, working class and poor gay men may struggle to find providers, even more so than their heterosexual counterparts, due to their economic constraints being compounded by both the gendering of the infertility clinic and geographic limitations.

Her research centres primarily on various routes to family formation in the contemporary USA. She is the author of Labor of Love: The author reports no financial or commercial conflicts of interest. This equates to approximately transfers using a surrogate. This figure only covers fresh non-donor cycles, not frozen embryo transfers or embryos either fresh or frozen created using donor eggs.

This is, therefore, not a comprehensive number of surrogacy cycles in the USA, and does not include surrogacies involving gay intended fathers. None of these agencies, however, regulate, monitor or collect comprehensive data on surrogacy per se Jacobson, Eight of those clinics were either out of business or their websites were non-existent or inaccessible. National Center for Biotechnology Information , U. Reprod Biomed Soc Online. Published online Nov Heather Jacobson. Author information Article notes Copyright and License information Disclaimer.

Heather Jacobson: Published by Elsevier Ltd. Abstract Gestational surrogacy via egg donation is an expensive — and sometimes ambivalently undertaken — but increasingly popular route to planned fatherhood for some gay men. Introduction Gestational surrogacy via egg donation in US-based infertility clinics is understood to be an increasingly popular route to planned fatherhood for gay men able to afford these services Berkowitz and Marsiglio, , Dempsey, , Greenfeld, The landscape of surrogacy for gay men My curiosity about the infertility industry's recruitment of gay men as clients was sparked by a comment made to me by a nurse at a small clinic as I was collecting ethnographic data for a larger research project on embryo fate.

Open in a separate window. The geography of surrogacy When surveying infertility clinics and surrogacy websites by state, it became obvious that infertility services in general in the USA cluster geographically. The limited market for gay men My content analysis of clinic and surrogacy agency websites indicates a limited market of providers recruiting gay men.

Unintended consequences of the limited market According to my content analysis, the surrogacy market for gay men is limited. Notes Declaration: References Almeling R. University of California Press; Berkeley, California: Sex Cells: The Medical Market for Eggs and Sperm. More or Less than Equal: How Men Factor in the Reproduction Equation. A Committee Opinion. Appleby J. Richards M. Reproductive Donation: Practice, Policy, and Bioethics. Cambridge University Press; Cambridge: Temple University Press; Philadelphia, Pennsylvania: Conceiving Masculinity: Male Infertility, Medicine, and Identity.

Gay Surrogacy

Social Class and Infertility in America. Berghahn Books; New York: The Online World of Surrogacy.

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The Transition to Parenthood. GLBT Fam. Lexington Books; Lanham, MD: Confronting Social Inequalities. Goldberg A. Innovations in Research and Implications for Practice. Springer; New York: Gay Men: Negotiating Procreative, Father, and Family Identities. Marriage Fam.