November 19, 2018
With Responses From
Emre downplays the issues of safety, effectiveness, and ethics.
In her essay, Merve Emre declares that “all reproduction . . . is assisted.” Few feminists of any wave or stripe would disagree. But if the statement that none of us go it alone is solid, some of Emre’s other moves put her on shaky ground. In her opening volleys, she skips lightly across fifty years of feminist thinking about reproductive technologies, leaping from Shulamith Firestone to Adrienne Rich to xenofeminism, with a brief stop at Donna Haraway’s “A Cyborg Manifesto” (1984). She arrives at a diagnosis of contemporary reproductive culture: it is infected, she says, by “the discourse of the natural.” She takes contemporary feminism to task for this state of affairs, suggesting that it has not been sufficiently enthusiastic about high-tech reproduction and asserting that it “has not done a good enough job articulating what alternate strategies of reproduction may be.”
Emre’s commitment to the emancipatory power of reproductive technologies is untroubled by her own accounts of unsatisfactory endings.
Is that really a fair critique of feminism today? Most feminists have long been aware that simplistic appeals to nature can justify anything, including gender inequalities and oppression. And while questions about “nature” and “technology” are very far from settled, little recent feminist theory or practice turns on naïve notions of “the natural.” In the twenty-first century, marketers of breakfast cereals, cosmetics, and prenatal vitamins—not feminists—are the main purveyors of the naturalistic fallacy.
The bulk of Emre’s essay is occupied with presenting four vignettes, recounted with sympathy and in some detail, about people whose efforts to form families involve various technological procedures. Most of them experience discrimination in their reproductive pursuits, and none of the technologies work very well. With her focus on stories, Emre seems to acknowledge that the vexing questions raised by technologically assisted reproduction cannot be resolved by theory alone. I agree.
Unfortunately, her commitment to the emancipatory power of reproductive technologies is untroubled by her own accounts of unsatisfactory endings. Despite multiple examples of reproductive technologies that deliver not babies but disappointment (and in some cases, physical and emotional harms), Emre is strangely incurious about what might be amiss. She does not say so, but perhaps she assumes that one day soon, when the technologies improve, they will set us free. In her conclusion, she appropriately mentions the need to address the “vast structural inequalities among women.” But the main lesson she appears to draw is that liberation lies in disdain for “the natural” and deference to the technological.
Let’s take a quick look at Emre’s treatment of egg retrieval, on which her first two stories center. Women undergo this invasive and often arduous procedure whether they are trying to get pregnant immediately, selling their eggs to someone else, or—increasingly over the past several years—freezing their own eggs for possible later use. Emre’s informant B, who plans to use her eggs to produce her own baby, experiences ovarian hyperstimulation syndrome, the symptoms of which include debilitating pain and a heartbeat “so fast . . . that she worried she might have a heart attack.” Emre tells us all this, but does not ask how often this syndrome occurs, how dangerous it is, or what it means for weighing the risks and benefits of egg retrieval in various circumstances.
In her profile of S, who works for a biotech company that covers the costs of egg freezing for its employees, Emre briefly mentions feminist critiques of this practice. But she does so only in a short strung-together list of objections: “its classist and anti-feminist politics, its shoddy scientific underpinnings, and its antagonism to a natural timeline of motherhood” (emphasis added). Since we already know about Emre’s hostility to “the natural” in relation to motherhood, and since she says nothing further about the other concerns, the implication is that none are valid. When she reports S’s belief that her fifteen frozen eggs are “a happy product of Silicon Valley’s marriage of capitalist competition and social justice,” she makes no comment. And when she writes that S calls the eggs her “insurance policy,” she does not note that this is the marketing language of the multibillion-dollar fertility industry, which is understandably delighted that egg freezing has opened up a large new customer base of women who have no particular problem with infertility.
Emre is on target in criticizing unequal access to reproductive technologies, whether the disparities are due to out-of-pocket expense or to discrimination against people from queer communities. But access and affordability are far from the only problems. Notwithstanding her stories’ less-than-happy endings, she manages to avoid an entire thicket of thorny issues about safety, effectiveness, and ethics. These include grossly understudied and under-acknowledged health risks of egg retrieval, even after hundreds of thousands of women have endured it over the past forty years; often stark power imbalances in assisted reproduction arrangements that involve third-party egg providers and gestators, especially when borders are crossed; widespread misunderstanding, cultivated by rose-tinted marketing, of just how often in vitro fertilization (IVF) fails; and commercial dynamics in the lucrative fertility industry that add to assisted reproduction’s risks and costs.
Emre’s enthusiasm for high-tech reproduction seems connected less to the evidence she presents than to animus for her straw-feminist politics of “the natural.” Despite her theoretical references, she bypasses basic insights about the politics of science and technology that are now widespread in feminist and social theory, and implicit in much progressive practice: that “nature” and “technology” are inextricably entangled with each other; and that they reflect and are shaped by power relations, social structures, and political dynamics.
For the people whose lives are touched by or created with the help of assisted reproduction, a lot rests on getting this right. And for all of us, the stakes are about to get much higher. We are currently in the midst of a heated global controversy about the prospect of coupling assisted reproduction with emerging gene editing tools, such as CRISPR, to control the genes and traits passed on to future children and generations. If reproductive gene editing were to move into use, IVF would serve as its technological, commercial, and ideological platform.
Advocates of reproductive gene editing typically justify it as a way for those at risk of transmitting inherited disease to have children who are unaffected and also genetically related to both members of a heterosexual couple. But this argument is tenuous at best, since an embryo screening procedure that has been available for decades provides an alternate and safer means to the same ends. Meanwhile, the likely societal consequences of reproductive gene editing are dire. If allowed for any reason, it would almost certainly be adopted in the service of “human enhancement.” It is all too easy to envision fertility clinics advertising genetic upgrades to upscale clients, and genetically modified children being treated as superior—whether or not their biological alterations made any physiological difference. Not far off from there, a dystopian world like the one in the science fiction film Gattaca (1997) could take hold: a society of genetic “haves” and “have-nots” in which new forms of discrimination and inequality are layered on top of the already existing ones.
For these and related reasons, reproductive gene editing is currently prohibited by some forty countries and a binding Council of Europe treaty. But advocates for permitting it have become increasingly active since the development of CRISPR. Some think its use can be restricted to a few circumstances; some uncritically embrace full-out efforts to create genetically enhanced humans. Concerns about social consequences are often smeared by invoking arguments similar to Emre’s call to reject “the natural.”
Both the pitfalls of assisted reproduction as currently practiced and the perils ahead counsel caution in the face of powerful new reproductive technologies, especially those developed in the context of profit incentives. It seems clear that we need to be every bit as wary of the techno-fix as of naïve appeals to nature. Any biopolitics—and any emancipatory feminism—adequate to our time surely needs to start there.
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