Parenté et techniques de reproduction assistée : les enjeux contemporains au regard du genre
Directed by Jérôme Courduriès, Cathy Herbrand
Gender, kinship and assisted reproductive technologies: future directions after 30 years of research
Jérôme Courduriès, Cathy Herbrand
This volume of Enfances Familles Générations (Childhood Families Generations) looks at the current issues raised by the advent and proliferation of assisted reproductive technologies with a particular focus on kinship and gender. In the contemporary globalised world, a range of reproductive possibilities are now available, many of which raise important socio-anthropological questions related to the balance of power inherent in such interactions, the different practices and regulations involved in the delivery of ART and the individual and cultural significance of these practices. These issues have generated a rich and extensive body of literature over the past thirty years, particularly in English language scholarship. This introductory paper provides a reminder of these debates and seeks to foster dialogue with respect to work across different disciplines, by underscoring their respective contributions, particularly those in English- and French-language literature. Beginning with the summarizing of the major issues and contributions stemming from ART studies with respect to gender and parenthood, we shall underline the issues that are yet to be resolved and that, in our opinion, warrant further investigation. The main line of our argument is that, based on available literature and on social science research, emphasis must be placed on gender as inextricably linked to the experience and the study of assisted reproductive technologies.
The "biological clock" of women: a naturalistic model in question
The increase in age-related infertility in advanced industrial societies has led to an increase in demand for assisted reproductive technology (ART) and caused each society to question its norms and practices. In France, this debate reveals the specificity of the bio-ethical model that regulates ART and the growing tensions and contradictions in this model. What makes this model particular is the fact that it is strictly “therapeutic” and based on the notion of “pathological infertility.” But the apparently simple distinction between pathology and personal reasons is called into question by age-related infertility : it invites a more complex approach to infertility, with both somatic and social aspects. Using a survey of professionals who work with infertility, we will show the pervasiveness of this therapeutic model in their practice. We will also show how the contemporary socio-demographic context is changing the concept of infertility and casting doubt on the validity of this model as a reference. In addition, new techniques such as the cryopreservation of oocytes further call into question the bio-ethical model and lead to new ways of thinking about the pathology–personal reasons duality on which it is based. The question is whether this model can evolve into a more complex, less ideological view of infertility. This will be an important issue for French society in the coming years, and the issue involves much more than just access to technology that encourages this evolution.
Aging ovules, ageless mothers?
I will examine the impact of extending female fertility, possible through oocyte donation, and more specifically the impact on the meaning of an age limit for maternity in Switzerland, where this technology is prohibited. By focusing on the experiences of women who turn to oocyte donation because of age-related infertility, I will show how this technology opens the door to disputes and discussions on the biological limits of fertility. In the first section, I will examine how biological and statistical standards on the decline in fertility are used for diagnosis. In the second section, I will show how the meaning of age limits is transformed as assisted reproductive technology (ART) develops. In the third section, I will highlight some of the techniques used to reset the biological clock.
The human embryo in medically assisted procreation, elements for a relational approach
Social anthropological analysis of family relations in assisted reproduction lends a certain status to the embryo, whether we realize it or not. Still, this status remains a weak point in social sciences discourse. Extensive anthropological analysis has been dedicated to how certain technology, especially ultrasound, has contributed to the image of the embryo as an “isolate”— a separate entity from the woman’s body in which it was formerly enclosed and embedded (Strathern, 1992). Assisted reproductive technology (ART), including cryopreservation and in vitro fertilization, has further accentuated this representation. However, ethnographic observation of ART practices reveals that the embryo is still a part of networks of relations (Thompson, 2005). On the one hand, the embryo is related to professionals who, at a given time, because of their status, have the power to select, destroy, or preserve it. On the other hand, and more importantly, it has family relations to all the people involved in its genetic reproduction, gestation, and social parenting, and who therefore also have a set of rights and responsibilities as regards the embryo. For this article, we conducted semi-structured interviews with 70 ART professionals with the goal of analyzing the embryo in assisted reproduction using a relational approach inspired by Mauss’ analysis of gender and family relations (Théry, 2007). This approach provides an alternative point of view on ART and explains how the embryo is given a different status—from potential child to simple organic matter—depending on the system of established relations under which it is considered. Our hypothesis is that such an approach will provide new insight into the sometimes acute dilemmas facing “parents” of surplus cryopreserved embryos and the four main options under French law: keep, donate to research, donate to another couple, or destroy.
From the father to the sire and the interested third party: representations of the role played by the known sperm donor in Quebec lesbian parents' families
This article presents the results of research that documents the role of a sperm donor known to the lesbian parent families serviced. The overall objective is to analyse how the various players (the biological mother, the social mother, and the donor) stress and express their ways of envisaging parenthood, kinship and fatherhood in a context where more than two adults are required for the reproduction and education of a child. To carry out this analysis, 9 lesbian couples and the 9 donors to their parental projects were interviewed. The results have shown that the sperm donor acted as the middleman in the creation of parental links, thanks to the mothers having structured an “ontological choreography” (Thompson, 2005). These choreographies work in synergy according to the predominance that the mothers give to the daily structuring of their family, to the distancing or integration of the social discourses as regards the importance of the father’s involvement for the child’s development, along with the creation (or non-creation) of the donor’s paternal identity. Finally, it is this that will determine the role of the donor with the children born of his donations.
The adoption of children and the use of assisted reproduction: interconnections and displacements
The goal of this article is to start a dialogue between two studies : one on assisted reproductive technology (ART) and the other on adoption in Brazil. I will explore the analysis strategies and potential transfer and interaction between these two fields in a context of growth and expansion of the use of ART in Brazil. Using elements from these studies, I will analyze the underlying logic in each of these fields, including the options currently available, the option to choose the desired characteristics of a child, and the symbolic aspect of the experiences of pregnancy or meeting the adopted child. Although the expected end result of each of these processes is the same, namely to have a child, trying ART seems to precede the decision to adopt. The experience of certain infertile Brazilian couples who want children indicates the valorization of ART as part of the process of their qualification for adoption. Their attempts appear to have a ritual, symbolic function of mourning the idea of a biological child, which helps them to affirm the decision to adopt a child who has no genetic link to them.
New medical reproductive technologies in Romania: between women's autonomy and socio-economic inequalities
Eastern Europe is often seen as a vast, deregulated assisted reproduction market for women from the West, providing access even to reproductive bodies. But what is at stake in Eastern European countries for the women and men who live there ? In this article, I will focus on Romania and analyze the field of assisted reproduction and its implementation and development in a society marked by both the pro-natalist policy of the communist era and the lack of legislative framework for assisted reproductive technology (Cutas, 2008). I will attempt to show that in this highly patriarchal context (Kaser, 2008), assisted reproductive technology (ART)—but also abortion—is a means for Romanian women to reclaim their bodies and therefore also their autonomy. Their autonomy is connected to the autonomy of doctors, who view ART as a means of biomedical exploration and excellence. By taking part in assisted reproduction leading to late-life, even post-menopausal, pregnancies, Romanian women are also challenging—almost unintentionally—the social framework that biologizes the differences between men and women (Engeli, 2010 ; Théry, 2010). This autonomy comes with a price, however ; while there are no legal limitations on ART, related fees are not covered either (except under a Ministry of Health pilot program in 2011–2012), which exacerbates socio-economic inequality. This inequality and the erosion of individual rights that it creates have led to the mobilization of Romanian women around the issue of infertility and the Romanian government’s role in dealing with infertility. Social stakeholders are calling on the Romanian government to act against this aspect of reproductive injustice (Bretonnière, 2013) by reinvesting in reproduction in order to guarantee real rights to its citizens, not to control the parameters of human reproduction.
Rethinking the marriage alliance with medically assisted procreation in a migratory context
The purpose of this article is to show the link between having a child and having a family through an ethnographic study on emigrants born in sub-Saharan Africa who have used assisted reproductive technology (ART) in Île-de-France. No matter their nationality, level of education, employment, socio-economic class, or the circumstances and reasons for emigrating, they all made a link between their desire for a child and the fact that they are married or plan on getting married. When it comes to immigration, having a child involves more than just the man and the woman ; the ascendants and collateral relatives of each member of the infertile couple intervene in different ways. In this article, the researchers suggest reconsidering marriage, from a theoretical point of view, starting with the analysis of marriage settlement within the context of ART.
Another way to make kinship?
In Western societies, the development of new reproductive technologies (NRT) pushes the limits of the parentage model based on “exclusive bilaterality” (the idea that every individual can have only one mother and one father, from an ascending generation, and from opposite sexes) and the idea that parentage needs to reflect nature as closely as possible. In this article, the researchers show the ambivalent nature of the effects of NRT on the Western parentage model by examining the current state of NRT and by performing an exercise in “sociological fiction” where there is an artificial uterus. Minority views on parentage will not change overnight just because NRT may provide technological solutions to problems that previously seemed unsolvable. There is no such thing as technological determinism. With NRT, parentage has become a political issue.
Quality or quantity: Quebec parents shed light on their strategies to promote "good eating" for their children
Stéphanie Pernice, Marie Marquis
Eating attitudes and behaviours developed during early childhood have a major impact on the future relationship of the eater with regard to food. And it is the parent who has the most influential role in this respect. This study is aimed at bringing out the practices observed and the attitudes adopted by Québec parents of pre-school age children in order to help them “eat properly.” Data was collected using postcards that were distributed around Québec day-care centres where they were handed out to parents. The analysis of the answers to the open-ended question on the postcard was carried out using Jean-Pierre Poulain’s food intake model as a basis. 1257 postcards were used for analytical purposes. The data gathered initially allowed us to understand the way in which parents perceived the idea of “eating properly.” The diametrically opposed notions of quality and quantity were made very clear. This study brings out the range of strategies used by Québec parents at mealtimes. The data gathered, which is extremely relevant to public health, will allow one to determine what key messages need to be passed on to these stakeholders when it comes to developing small children’s eating habits.
Biographical Bifurcations: The Unveiling Experience of HIV-Infected Adolescents in the Perinatal Period
Karène Proulx-Boucher, Mylène Fernet, Martin Blais, Joseph Josy Lévy, Joanne Otis, Jocelyne Thériault, Johanne Samson, Guylaine Morin, Normand Lapointe, Germain Trottier
When HIV transmission from mother to child occurs, one of the major concerns is revealing the diagnosis to the infected children, something that could be experienced as a biographical turning point. The objective is to explore the effect of the disclosure of the diagnosis as experienced by adolescents who have been living with HIV since their birth. Twenty-nine HIV-positive young (aged from 10 to 18) agreed to a semi-structured individual interview focussed on the revelation of their serologic status. The data thus gathered was submitted to a content analysis (Paillé and Mucchielli, 2005; Sabourin, 2008). The disclosure of the serologic status runs through three stages: 1) that of a hidden reality, where the adolescents are unaware of their serologic status; 2) that of a reality which is finally disclosed when, at about the age of 11, they learn that they have an HIV infection; and 3) that of a reality they need to progressively integrate, where its disclosure becomes a participating factor in the construction of their personal and social identities. The disclosure becomes an extension of their biographical continuity by legitimizing their ARV treatments, at a time when they appear to be contemplating gradual changes with respect to their private lives and personal sexuality.
Family and Work: Findings and Proposals of Young Feminists in Quebec
In this article, we will discuss the emerging views of young feminists in Quebec on reproduction work and how it fits in with paid work. Through semi-structured interviews, we will present the young feminists’ observations regarding these two sides of the gender-based division of labour and the suggestions they put forth. The women expose the still unequal division of the so-called invisible work and the pressure mothers have to perform well. They also doubt the success of work-family balance and question paid work as a cure-all to empower women. After discussing these observations, the young feminists contemplated solutions : they discussed part-time work and possible compensation for reproduction work. Influenced by their own experiences in the current workforce, their views on motherhood, and the importance they attribute to family, the feminists strive for greater importance granted to work done in a family and for reorganizing work to respond to the needs and aspirations of as many women as possible. The ideas of these young feminists are in line with the main ideas of the Quebec women’s movement but also break away from them.
Institutional Configurations of Child Protection: Crossing Perspectives of Africa, Europe and North America
Joséphine Wouango, Daniel Turcotte
This article deals with the analysis of three institutional configurations of child protection: those in Burkina Faso, in Belgium, and in Québec. With respect to each configuration, the text explores the changes from situations in which the family had sole control of the child to those where the State played a greater role, and the manner in which the 1989 International Convention on the Rights of the Child has affected such changes. It shows, through a reading of history, that the involvement of the State in child protection has gone through different forms and stages over time and space. The current strategies as regards child protection in the North and in the South—an approach that is largely subject to a legal perspective—represent a challenge both for intervenors and for families, since their application depends on the resources available for helping children and families in difficulty, on the ability of the public institutions to intervene, and on the efficiency of such interventions.