Abstract
Scholars have long debated the relationship between morality and the market. Some argue that morality tempers market interests, while others argue that the market has its own moral order. Meanwhile, feminist scholars have argued that a false binary between altruism, family, and intimacy on the one hand, and the cold calculus of the market on the other, is based in gender ideologies. Norms around motherhood, in particular, emphasize self-sacrifice, love, and altruism in opposition to self-interested market logics. Commercial surrogacy blurs the line between family and commerce and is therefore an ideal setting for studying tensions between altruism and profit. Drawing on ethnographic research and interviews with 114 actors in the Mexican surrogacy industry, I demonstrate that treating altruism and commercialism as dichotomous can further market interests by preserving the moral palatability and profitability of the industry while perpetuating power asymmetries rooted in gender, race, class, and nationality between surrogate mothers and intended parents.
In 1992, Sharon Anleu identified the core criticism of surrogacy as “the economic issue of whether a woman should be paid for this service” (31). Many legislators and bioethicists express concern that surrogacy payments may be a form of undue enticement. However, Anleu argued that the moral distinction between altruistic and commercial surrogacy rests on deeply held gender norms about the proper division between love and money. More than 25 years later, the issue of payment remains central to moral and legal debates regarding surrogacy. 1 Over the past decade, surrogacy has expanded into a multimillion-dollar transnational industry in which intended parents hire women in other countries to gestate and birth children for them. The expansion of the surrogacy market into countries such as India, Thailand, and Mexico, where there is a significant socioeconomic gap between intended parents and surrogates, has exacerbated moral concerns about paying women to gestate, birth, and relinquish children (Markens 2012; Rudrappa and Collins 2015). Building on Anleu’s (1992) critique of the moral distinction between altruistic and commercial surrogacy, I use empirical evidence to demonstrate that the distinction is not only gendered, but also reflects and reinforces power asymmetries between intended parents and surrogate mothers that are shaped by gender, race, class, and nationality. This article demonstrates how notions of maternal altruism not only structure the organization of reproductive markets but actually enable the market to exist by simultaneously producing moral palatability and profitability.
Surrogacy agencies, for-profit companies that arrange surrogacy programs for their clients, go to great lengths to present surrogacy as morally palatable to participants and the public (Rudrappa and Collins 2015). These efforts have not always been successful, as evidenced by the recent wave of restrictions on transnational surrogacy. I examine the international Mexican surrogacy market that emerged largely in response to these restrictions; it is especially useful for an examination of how market actors work to make surrogacy both morally palatable and profitable.
Since 2012, there have been major shifts in the global marketplace for surrogacy. First, India restricted access to married heterosexual couples (Schurr and Militz 2018). Then Thailand and Nepal, two of the largest transnational surrogacy destinations, banned commercial surrogacy (Schurr and Militz 2018). Mexico’s surrogacy market emerged as a direct result of these shifts in the global surrogacy marketplace. The Mexican surrogacy industry was established by international surrogacy agencies to meet market demand for “low-cost” surrogacy options, especially for same-sex couples and single intended parents. In light of increased regulation and volatility, how do market actors in this controversial industry preserve the seemingly incompatible goals of moral palatability and profitability?
A close examination of actors’ experiences in the market reveals the important role of gender, race, and class, in shaping a rhetoric of altruism that allows surrogacy agencies to preserve moral palatability and profitability simultaneously. Drawing on ethnographic research and interviews with 114 actors in the Mexican surrogacy industry, I find that surrogacy agencies draw on a perceived altruism/commercialism dichotomy—which I define as a framing of altruism as contradictory to and in tension with profit, market logics, and commodification—to facilitate market exchanges in two key ways: by rendering it morally palatable to consumers, and in disciplining surrogates to create a docile and compliant labor force. Together, these mechanisms render the industry profitable. Taking up Fourcade’s (2007, 1028) call to theorize the ways “different types of class, gender, and racial relations are not only expressed in but constituted by and reproduced through market/nonmarket and commodity/noncommodity boundaries,” I argue that actors in the Mexican surrogacy industry draw boundaries between altruism and commercialism in ways that both reflect and reinforce power asymmetries based in gender, race, class, and nationality between surrogates and intended parents.
Morals and Markets
The relationship between markets, morals, and society is a long-standing topic of sociological inquiry. There are three principal approaches to analyzing this relationship. The pro-market approach argues that markets, operating through supply and demand, are the best way for all goods to be distributed in a society (Becker and Elias 2007; Landes and Posner 1978).
A second approach argues that money contaminates social relationships, and therefore certain goods and services, especially those related to intimate life, should not be bought, sold, or priced by the market (Dickenson 2008; Walzer 1983). From this perspective, which Zelizer (2005) called the “hostile worlds view,” profit-driven markets lead people to see each other as means rather than ends (Hochschild 2003). In contrast, voluntary or altruistic giving is considered a less exploitative way of distributing certain goods and services. In bioethical debates on blood and organ donation, Healy (2010, 21) found that whether an exchange is deemed morally acceptable “rests overwhelmingly on the moment of individual choice, the decision to give or sell, and its moral implications are measured in terms of the amount of autonomy possessed by the donor.” The underlying assumption is that money creates an undue enticement, degrading the seller’s autonomy and leading to an exploitative exchange. This focus, Healy (2010) argued, misses the organizational and social processes that occur outside of the “moment of individual choice” (21). From a “hostile worlds” perspective, altruism is not only morally superior but yields superior goods and services (Zelizer 2005). Titmuss (1970, 158), for example, argued that a for-profit blood exchange would entice “skid row” suppliers and lead to an unsafe blood supply. More recently, Heyes (2005) argued that increasing nurses’ pay would lead to an influx of profit-driven rather than altruistic nurses and, thus, result in inferior care for patients.
The third approach, proposed by Zelizer (2005), advocates for studying commodification as a dynamic social process shaped by organizational practices and participants’ social location. Building on her work, economic sociologists have documented the complex and diverse ways that markets are organized and relationships are negotiated through monetary exchange. A “hostile worlds view” assumes that intimate relationships can be separated from money and market logics, but empirical research demonstrates otherwise. In the exchange of organs and blood (Healy 2010), reproductive material (Almeling 2011), and sex and care work (Boris and Parreñas 2010), monetary exchanges are imbued with social and moral meaning as a way of signifying certain relationships.
Feminist scholars argue that gender norms influence the creation of boundaries between markets and intimate life by positioning the self-interested, public world of men against the altruistic, private world of family and women (Nelson and England 2002). For example, in her study of the U.S. market for eggs and sperm, Almeling (2011) found that fertility clinics de-emphasize the commodification of eggs by using the term “donation” and appealing to a gendered discourse of motherly altruism. Men were not expected to define the sale of their reproductive material as an altruistic act.
Surrogacy markets present a challenge to these perceived boundaries. Commercial surrogacy violates numerous social norms, including the separation of intimate family life from the market, the noncommodification of children, and the sanctity of maternal–child bonds (Jacobson 2016; Smietana 2017). The discomfort with surrogacy is not just with the commodification of human life but also with women profiting financially from the use of their reproductive capacities (Anleu 1992). Gestating and birthing a child for profit is seen as an affront to proper motherhood (Jacobson 2016). Accordingly, commercial surrogacy is an important case for studying the negotiation of tensions between altruism and profit. How do surrogacy agencies, intended parents, and surrogates manage these tensions so as to render the industry both morally palatable and profitable?
The Mexican Surrogacy Industry
I focus on the Mexican surrogacy market, a precarious market that developed as a result of increased scrutiny and regulation of other transnational surrogacy hubs, including India and Thailand. Although surrogacy had been legal in Tabasco, Mexico, since 1997, Mexico did not become a global destination for surrogacy until 2013. With the announcement in 2012 of increased restrictions on surrogacy in India, transnational surrogacy brokers began to search for other options—especially for gay men and single individuals who are banned from hiring surrogates in many other countries. Market demand for Mexican surrogates grew even more when Thailand banned commercial surrogacy (Schurr 2016). This particular history makes Mexico’s surrogacy industry a useful case for understanding how market actors attempt to maintain the moral palatability of a precarious and controversial market.
For many years, Tabasco was the only Mexican state with legislation explicitly permitting surrogacy. The 92nd article of Tabasco’s civil code, added in 1997, requires that the birth certificate of a child born through surrogacy list the names of the intended parents, not the surrogate. This short article does not specify who can contract a surrogate or under what conditions. Furthermore, there is no oversight of the Mexican surrogacy industry. There are no accounts of how many women are involved, how many agencies exist, or how many children have been born through surrogacy in Mexico (Fulda and Tamés 2017, 266). 2 In December 2015, the Congress of Tabasco passed new regulations that limit the availability of surrogacy to heterosexual Mexican couples. Currently, no state in Mexico permits foreigners to contract surrogates. This article is based on data collected prior to December 2015, although my broader research continued after the legal changes.
The Mexican surrogacy industry relies on advanced medical technologies, an existing tourism infrastructure, and selectively porous borders. Women from across the country travel to fertility clinics in Mexico City, Cancun, and Villahermosa, the capital city of Tabasco, to participate in surrogacy. Although some surrogates undergo the entire process in Tabasco, most undergo in vitro fertilization in Cancun or Mexico City and then travel to Villahermosa for their last two months of pregnancy, as the surrogate must give birth in Tabasco for the state’s surrogacy law to apply. Meanwhile, because of the desire for “white” babies, egg donors are often flown in from the United States, South Africa, and Ukraine (Schurr 2016). The global circulation of bodies and body parts is not only technically complex, it highlights the global, racial, and gendered politics of borders that undergirds the transnational surrogacy industry.
Race and class shape the Mexican market in many, profound ways. In an incisive analysis of the Mexican surrogacy industry, Schurr (2016, 241) demonstrated how racialized access to the surrogacy market, the selection of egg donors, and the division of reproductive labor in the surrogacy industry reflect and reinforce “(post)-colonial imaginaries of white desirability.” Through the surrogacy industry, the fecundity of poor Mexican women, which has been decried by advocates of population control for decades (Braff 2013; Browner 1986; Smith-Oka 2013), has been marketed and sold to surrogacy clients. “By using the reproductive capacities of those women whose children are not desired as citizens of the Mexican nation for gestating the babies of (white) commissioning parents,” the Mexican surrogacy industry reproduces post-colonial racial hierarchies along with white bodies (Schurr 2016, 258). In this context, “whiteness not only stands for a certain skin color but rather serves as a surrogate for the economic status, financial affluence, nationality and class belonging in this market” (258).
In Mexico, race “manifests along a flexible social spectrum of skin color, class, power, and region” and “ascriptions of race in practice are dynamic, contingent, and relational” (Braff 2013, 126, emphasis in original). Race in Mexico is further complicated by the ideology of mestizaje, a nation-building project of mixture between indigenous and colonial people that masks inequalities by denying the existence of racial categories (Figueroa 2010, 390). Intended parents are marked as white by virtue of their participation as consumers (Schurr 2016). Conversely, Mexican surrogates are marked as non-white, or racialized as others, due to their position as paid, gestational laborers. The separation of genetics from gestation in gestational surrogacy creates a racialized division of labor between gamete providers and surrogates while enabling “whiteness” to be reproduced at discount rates (Schurr 2016).
At the time of this research, Mexico was one of the only places in the world where foreigners, regardless of marital status, could contract a surrogate. For several years, Mexico was billed as the only “affordable” alternative to the United States for same-sex couples and single intended parents. 3 Mexico’s surrogacy industry had the exact characteristics that were most criticized in other markets: a largely foreign clientele of gay and single men who were evading bans on surrogacy in their home countries by going abroad and/or seeking a “discount” alternative to the United States by contracting a surrogate in a developing country. Having witnessed the wave of bans on surrogacy in other countries, surrogacy agencies operating in Mexico were acutely aware of the need to combat criticism to avoid the same fate. Many of the surrogacy agencies operating in Mexico, were owned and managed by the very same people who had previously operated agencies in India and Thailand. Surrogacy agency owners sought to maximize their business opportunities in Mexico, in part by staving off criticism to hinder, or at least delay, restrictive regulations. The intended parents, who contracted surrogates in Mexico, were also well aware of the critiques of transnational surrogacy that had spurred regulatory changes in former “low-cost” surrogacy hubs and were proactive in countering the narrative that surrogacy is exploitative.
The Mexican surrogacy market, at the time of this research, was a precarious market. Actors in the Mexican surrogacy industry understood that they have limited opportunities, given the restrictions on markets in India and Thailand, and sought to protect those opportunities. This precarity makes the tensions between morality and market especially clear, and helps illustrate how actors manage these tensions in order to produce moral palatability. My analysis is especially useful because data were collected when the Mexican market was still open to single, same-sex, and international intended parents.
Methods
Data for this article are part of a larger global ethnography of the Mexican surrogacy market that examines how “global flows of people, technologies, and political agendas shape reproduction” (Browner and Sargent 2011, 6; Burawoy 2000). Between 2014 and 2017, I conducted ethnographic research in Tabasco, Quintana-Roo, and Mexico City, Mexico, with supplementary research in Spain and the United States. Through observation, interviews, and archival research, I collected information about the history and organization of the Mexican surrogacy industry, the key actors, and the everyday processes through which commercial surrogacy is negotiated and experienced.
Rather than conducting the ethnography at one site, I used an iterative approach and a “snowball sampling of sites rather than populations” (Erikson 2011, 28). I observed a variety of participants in the surrogacy industry as they conducted their daily business. For example, I shadowed a Mexican surrogacy coordinator, who works for an international agency based in Europe, as she visited surrogates to deliver medications, met with a lawyer to discuss contracts, and spoke with intended parents via Skype. During fieldwork, I conducted observations at, among other sites, a house for surrogates in Cancun, a fertility clinic in Villahermosa, a congressional symposium in Mexico City on regulating surrogacy, and conferences in San Francisco and Los Angeles for intended parents considering surrogacy. I accompanied surrogates to medical appointments, to meetings with surrogacy agencies and intended parents, and during various day-to-day activities. I went with intended parents to pediatricians, the civil registry office, meetings with lawyers, and social events with other intended parents. Through observations at a wide variety of sites and with a range of participants, I collected information about the everyday negotiations and practices involved in the operation of the transnational surrogacy industry.
In addition to observation, I conducted in-depth, semistructured interviews with 114 participants, including 45 surrogates, 26 intended parents, 15 surrogacy agency staff members, 15 government officials, and eight doctors. Interviews ranged in length from 30 minutes to five hours. Of the participants, 111 were interviewed in person at least once and the remaining three interviews were conducted via Skype. Sixteen participants became key informants and were interviewed multiple times over a three-year span. Interviews were conducted in Spanish, English, or Hebrew, depending on the participant’s wishes. All but five of the formal interviews were audio-recorded and transcribed. The remaining participants asked not to be audio-record. For those five interviews, I took detailed notes. Many of the formal interviews led to more informal discussions that are included in my field notes. All translations are my own. Names and some identifying information have been changed to protect participants’ anonymity.
Surrogates and intended parents were found using snowball sampling through personal connections and calls for participation on Facebook and Twitter. I specifically sought out the intended parents who hired the surrogates I had interviewed and vice versa. Separately interviewing each party in a surrogacy arrangement allowed me to compare their narratives and understandings of the process. I contacted surrogacy agency owners and staff, doctors, government officials, and staff at nongovernmental organizations using contact information I found on the Internet or through other participants.
I used an abductive data analysis approach based on Tavory and Timmermans’s (2014) extension of the “constructivist” grounded theory approach (Charmaz 2006) because my fieldwork took place during visits of varying length over the course of three years. After each visit to the field, I coded the new data, wrote memos, and adjusted my research plan and interview questions to account for emerging themes and to investigate unexpected findings.
Producing Moral Palatability and Profitability
Surrogacy agencies draw on an altruism/commercialism dichotomy that is shaped by gender norms, along with race and class, to facilitate the surrogacy market by rendering it both morally palatable and profitable. My data demonstrate that surrogacy agencies and intended parents distinguish good surrogates from morally suspect surrogates on the basis of their motivations. In turn, surrogates’ motivations become a barometer for the moral acceptability of the entire industry. Surrogacy agencies draw on a narrative of altruism that is shaped by gender, race, and class to produce moral palatability by countering fears that surrogates are exploited or will exploit intended parents. Meanwhile, the agencies’ enforcement of an altruistic orientation serves to discipline surrogates into a docile and compliant labor force.
Intended parents attempt to preserve their moral self-concept while participating in the precarious Mexican surrogacy market by insisting that their surrogate is not poor and therefore is not driven to surrogacy by financial need. In response, surrogacy agencies manage intended parents’ fears through their selection of surrogates. The selection process reflects a dichotomous view of altruism and commercialism in which altruistic motivations are deemed morally superior and more appropriate for the feminine project of surrogacy than commercialism. After surrogates are selected, agencies continue to draw on an altruism/commercialism dichotomy by promoting a narrative of surrogacy as an altruistic endeavor in which the goals of intended parents are paramount. I demonstrate that gender and class, which in the Mexican context is closely intertwined with race and nationality, shape this altruism/commercialism dichotomy. These processes both reflect and reinforce power asymmetries in the surrogacy industry that are based in gender, race, class, and nationality.
The relationship between intended parents and surrogates is shaped by power asymmetries that are rooted in gender, race, class, and nationality. Intended parents are generally of higher socioeconomic standing than Mexican surrogates. The majority of intended parents I interviewed are white, professional-class gay men from relatively high-income countries such as France, Israel, Spain, and the United States, mirroring findings from other studies (Fulda and Tamés 2017; Schurr 2016; Schurr and Militz 2018). Meanwhile, Mexican surrogates are generally working-class mestiza women with young children and few employment options. While my data speaks most directly to the way economic inequalities between intended parents and surrogates shape perceptions of moral palatability, as Schurr (2016) demonstrates, class is intimately entangled with race and nationality in the Mexican surrogacy industry.
Countering Exploitation Narratives
Intended parents are aware of the narrative that surrogacy is exploitative and take measures to counter or separate themselves from this narrative. Almost every intended parent I interviewed raised the issue of exploitation unprompted. Intended parents attempted to counter the exploitation narrative by stating that their surrogate was economically stable and therefore was not compelled to be a surrogate by financial need. When I asked intended parents what they looked for in a surrogate, one of the most common answers was economic stability. To some extent, economic stability was a stand-in for health and hygienic living conditions, but it was also a way for intended parents to preserve their moral self-concept by indicating that the process was not exploitative. For example, when I asked Manuel, a Spanish intended parent, what he and his partner looked for in a surrogate, he responded, “We wanted a person who was financially stable. . . . Not a person that is begging, but a person who lives in a house, hygienic and clean, a person who . . . of course, none of them live in a house like this [referring to the home he was renting while in Mexico], right? But . . . at least they should have a stable life.” Manuel acknowledged that none of the surrogates in Mexico were living in a home as expensive as his, but was adamant about selecting a surrogate who was not poor. He stated, “In the media they treat this issue as . . . the exploitation of women . . . the poor versus the rich, right? But, for example, I consider that my process is a voluntary process.” By “my process” he is referring to the surrogacy arrangement, which he believes is unlike the exploitation of poor women by the wealthy that he sees in media portrayals of surrogacy.
Later, Manuel implied that surrogacy in India is exploitative because of the level of poverty: “To go to India, which is a third-world country where people live on the street and pay money to a lady [to be a surrogate], it just doesn’t fit.” Manuel differentiated exploitative from nonexploitative surrogacy by the poverty of the surrogate, which speaks to her degree of voluntary participation. By using India as an example of morally unpalatable surrogacy, Manuel was arguing that Mexican surrogates are not as impoverished as Indian surrogates and therefore are capable of voluntarily choosing to be surrogates. More broadly, Manuel’s words illustrate that the discussion of moral palatability is shaped by economic location.
Manuel’s comments resonate with Healy’s (2010) assertion that most discussions of exploitation focus on a singular decision moment and an individual’s autonomy in that moment. From this perspective, voluntary exchanges, based on autonomous choice, are not exploitative. According to Manuel, economic stability allows women to autonomously choose surrogacy such that the exchange is voluntary and not exploitative. Conversely, poor women are burdened by financial needs that limit their ability to make autonomous decisions. Hiring a poor surrogate is thus seen as automatically exploitative. This normative view disadvantages Mexican surrogates, who must conceal their financial needs from intended parents and agencies to be deemed morally acceptable surrogates. Surrogates cannot request additional money from intended parents without risking upsetting intended parents’ moral self-concept and desire to see the exchange as nonexploitative. Mexico’s place in the global economy allows Mexican surrogacy to be a more “affordable” option for intended parents from high-income countries, but this also means that the specter of exploitation looms large.
Selecting “Proper” Surrogates
While intended parents are concerned with being seen as exploiting financially needy surrogates, surrogacy agencies are concerned that monetarily motivated surrogates might exploit intended parents. Surrogacy agencies draw on a dichotomous view of altruism and commercialism to establish a hierarchy—shaped simultaneously by gender, race, class, and nationality—between properly feminine, altruistic surrogates and exploitable and exploitative profit-driven women. Surrogates with purely monetary motivations could be forced into surrogacy by economic necessity or may exploit intended parents for more money. Both scenarios are morally problematic. Therefore, surrogacy agencies either reject or reorient prospective surrogates who express monetary motivations. Meanwhile, this altruism/commercialism dichotomy increases the profitability of surrogacy by discouraging surrogates from negotiating their wages lest they be deemed unfit for surrogacy.
Surrogacy agencies are for-profit entities that hire employees to recruit surrogates and coordinate surrogacy programs. Part of their job, as they see it, is to decide if a woman would be an appropriate surrogate. This is determined in large part by the woman’s motivation for becoming a surrogate. In interviews with agency staff, I was repeatedly told that women who are interested in being surrogates only for financial reasons would not be accepted. Agency staff occasionally acknowledged that poor women were more likely to be interested in surrogacy, but they insisted that money should not be a surrogate’s primary motivation.
Surrogacy agencies view prospective surrogates who are motivated primarily by money as untrustworthy. For example, I asked Laura, the manager of the Mexico branch of an international surrogacy agency, how the agency recruits surrogates. She explained: You know, we have to make sure that it’s a surrogate that can think on her own, someone who . . . says, “Ok, I want to do this,” and not doing it because, you know, “I really need the money.” . . . Yes, there is that factor, there is always that factor, but not the main factor, you know. We don’t want this to be the only thing that’s driving her. . . . There are surrogates that look at all the agencies to see which one financially benefits them most and . . . [the surrogates say,] “These agencies pay me this, you know, can you do the same?” And [if] we always change [the payment], then we are going to get surrogates that are going to want to manipulate us or manipulate the parents. . . . We don’t want at the very end to say, “Oh no, we have a problem because the surrogate doesn’t want to give the baby, or wants money . . . to give up the baby.” You know, we want to avoid that, and to do that we need to make sure that she is not just driven by the money.
Laura stated that money is always a motivating factor for Mexican surrogates, but she did not want money to be “the main factor.” She was critical of women who compare payment across agencies or try to negotiate their wages. Even though comparing wages is common practice in other forms of employment, Laura saw this as a prime indicator that a woman’s motivations were misguided. This reflects a gendered “hostile worlds view,” in which self-interested market logics should be separated from reproductive labor. Laura’s statement also demonstrates that tensions between altruism and commercialism are shaped by class. Laura feared that women who seek to profit financially by being surrogates would blackmail intended parents for more money. The leap from comparing wages to blackmail demonstrates the extent to which financially motivated surrogates are perceived as immoral and untrustworthy women. Additionally, by contrasting a woman who “can think on her own” from a woman who really needs the money, Laura is implying that financial need is at odds with voluntary choice and therefore morally suspect. By rejecting prospective surrogates who compare and negotiate wages and keeping surrogates’ wages low, Laura is producing both moral palatability and profitability.
Similarly, Edgar, a Tabascan agency owner, discussed the importance of using the “correct filters” to select appropriate, trustworthy surrogates. He described other agencies as being less careful in their selection of surrogates and therefore more susceptible to blackmail: “[Agencies] need surrogates fast. They need as many as possible to be available, so they just promote money, money, money and they forget the human part, and obviously it turns into a completely economic idea, and then, [the surrogates] say, ‘I have the power, I have the baby, I want more money.’” Like Laura, Edgar sees it as his job to weed out monetarily motivated surrogates who might blackmail intended parents. According to Edgar, when surrogacy becomes “completely economic,” it loses the “human part.” Even though he runs a for-profit surrogacy business, Edgar described economics as separate from and a threat to the human aspect of surrogacy.
Surrogates have immense power once a pregnancy is confirmed, as the industry’s sole “product” is physically contained within the surrogate’s body. This power is a source of fear for surrogacy agencies and intended parents. In Edgar’s view, women who are financially motivated may act inhumanely and exercise this power to demand more money. Because of surrogates’ embodied control over the means of reproduction, surrogacy has the potential to disrupt the power asymmetries between surrogates and intended parents. By contrasting commodification with humanity, Edgar is attempting to produce a compliant and docile labor force of surrogates who will not seek higher wages or disrupt the preexisting power dynamic.
Despite his concerns about the suitability of monetarily motivated surrogates, Edgar considered it foolish to think that Mexican women are signing up to be surrogates out of love or altruism. In explaining his own selection process for surrogates, he said, “It is important that it’s not all for the money, but it would be dumb to say, ‘They do it out of love.’ No, there are none. It is foolish to tell you that—[there are women who] do it out of pure altruism—excuse me but no.” Although he claimed that none of the Mexican surrogates “do it out of pure altruism,” it is okay “as long as they understand the need of the parents, that is, they can empathize with it, and this does not become a commodity product.”
According to Edgar, treating surrogacy as a commodity exchange indicates that a surrogate is not sufficiently empathetic to intended parents’ plight. This reflects a view of economic transactions as incompatible with empathy and care. Mexican surrogates who seek to benefit financially from the process and take steps to ensure fair wages, such as negotiating fees, are thus deemed immoral. Monetary motivations are seen as a threat to both the moral palatability and profitability of the industry. Next, I demonstrate how agencies counter surrogates’ monetary motivations through a narrative of altruism that privileges the “needs” of intended parents, and in turn, exacerbates existing power asymmetries between intended parents and surrogates.
Promoting an Altruistic Orientation
After the selection process, agencies continue to promote an altruistic orientation to surrogacy, which entails elevating intended parents’ goals over surrogates’. This is not to say that Mexican surrogates are not truly altruistic, but rather that the perceived altruism/commercialism dichotomy enables agencies to promote an altruistic orientation as a form of discipline that serves market interests. This altruistic orientation protects agencies and intended parents from accusations of exploitation while curbing surrogates’ negotiating power, thereby simultaneously producing moral palatability and profitability. This orientation both reflects and reinforces power asymmetries, shaped by gender, race, and class.
Each of the 45 surrogates I interviewed discussed both monetary and altruistic motivations, but there was variation as to which motive predominated and initially drew them into surrogacy. Carla, whose story is representative of most surrogates I interviewed, was initially drawn to surrogacy by financial need but came to see it in altruistic terms, likely at the suggestion of agency staff.
Carla is a single mother living in a poor neighborhood of Villahermosa, where surrogacy has become popular among women of reproductive age. Her debts had been piling up when a neighbor came to recruit her. Carla told me she was initially drawn to surrogacy because of the money, but after meeting with the surrogacy agency she “realized” that surrogacy is about much more than money. Although Carla had children unexpectedly at a young age, she, like most Mexican surrogates, considers her children her greatest treasure and expressed a desire to help others become parents. While surrogates expressed both monetary and altruistic motivations, surrogacy agencies present these motivations as dichotomous.
Many of the surrogates I interviewed described entering into surrogacy for monetary reasons but then “realizing” or “learning” to view it as an altruistic act after discussions with agency staff. They also discussed motherhood as their greatest achievement and expressed sympathy for those who had not experienced the joy of parenthood. This expression of maternal altruism meshes well with views of feminine docility that privileged elites project onto working-class “Third World Women” (Mohanty 1988; Salzinger 2003). The language of “helping parents realize their dreams” is so ubiquitous that it is possible that surrogates are simply repeating what they have been told to say or strategically using this narrative to gain the trust of agencies and intended parents. Whether or not surrogates truly believe that surrogacy is more of an altruistic endeavor than an economic one, agencies often enforce an altruistic framing that privileges intended parents’ plight over surrogates’ goals. This framing exacerbates the existing power imbalances, based in gender, race, class, and nationality, between intended parents and surrogates.
During interviews, agency staff repeatedly told me that a good surrogate understands that surrogacy is about creating families, not making money. For example, Katrina, a woman working at the Mexican branch of a surrogacy company, stated that surrogates should view surrogacy as “a voluntary contribution to help a couple create a family, not as a job.” This statement situates surrogacy in the altruistic sphere of family and motherhood, rather than in the self-interested world of the market. In a similar vein, Hugo, manager of the Mexico branch of another international surrogacy agency, explained, “In the end what we want to do is to create families, we’re not encouraging people to make themselves rich by renting their wombs.” In Hugo’s statement, much like in public debates on surrogacy, the figure of the pure, morally righteous surrogate who creates a child out of “maternal love” and a desire to help others is juxtaposed with a money-hungry surrogate who “prostitutes her maternity” (Cannell 1990, 683). Both Katrina and Hugo contended that surrogates should be focused on fulfilling intended parents’ goal of having a child rather than on their own monetary goals. The language they used implies that these two goals are in conflict.
To promote an altruistic orientation, surrogacy agency staff often recount the difficulties intended parents have gone through in their quest to have children, appealing to notions of maternal altruism. For example, Selena, a surrogate, explained during a conversation with two other surrogates: “There are times when we [the surrogacy coordinator and other surrogates] talk about the intended parents’ history and all that they have suffered . . . I think that is when we feel the most obligated and the most like we are helping someone who really wants and yearns for a baby.” For Selena, a focus on intended parents’ plight leads to a sense of obligation and a more altruistic orientation.
While surrogates often express pride in helping others become parents, an altruistic orientation can also be a way of disciplining surrogates and creating a compliant labor force. In a study of egg donation, Curtis (2010, 93) found that “altruistic motivations, in which the needs of others are placed ahead of their own, renders many donors less able to express their concerns and less alert to possible risks than a more ‘selfish’ orientation might foster.” In the case of Mexican surrogacy, I find that an altruistic orientation hinders surrogates’ ability to negotiate their wages, thus rendering Mexican surrogacy more affordable for intended parents and profitable for agencies. Next, I demonstrate how this process serves to discipline surrogates while making the exchange appear morally palatable to intended parents.
Managing Tensions
The moral palatability of surrogacy is tethered to perceptions of surrogates’ motivations. Intended parents are concerned with presenting surrogacy as nonexploitative to preserve their moral self-concept, while agencies present themselves as astute selectors of trustworthy (i.e., not motivated primarily by money) surrogates. The following story, which is representative of agency mediations I either witnessed or heard about during fieldwork, demonstrates how surrogacy agency staff deploy the rhetoric of altruism to render surrogacy morally palatable to intended parents while disciplining surrogates and maintaining the profitability of the industry by stunting surrogates’ wages.
Javier and Ruben are a couple from Spain who contracted Marla, a Mexican woman, to serve as a surrogate for them. Carlos, a Mexican attorney and surrogacy agency owner, introduced Javier and Ruben to Marla, wrote their surrogacy contract, and agreed to manage the surrogacy process and distribute payments to Marla. However, Carlos disappeared soon after Javier, Ruben, and other intended parents paid him. Veronica, an independent surrogacy coordinator, stepped in to help the intended parents Carlos had abandoned, including Javier and Ruben.
When I met Veronica, she was preparing for a meeting between Javier, Ruben, and Marla to discuss a disagreement about Marla’s pay. Prior to Carlos’s disappearance, a doctor implanted two of the couple’s embryos in Marla’s uterus. Marla was paid 1,500 MXN, about U.S.$85 at the time, for the embryo transfer. The embryo transfer was unsuccessful, and Marla did not become pregnant. Marla began preparations for a second embryo transfer, which was scheduled to take place a few days after this meeting, and asked Javier and Ruben when she would receive her next payment. Javier and Ruben did not want to pay Marla for undergoing a second embryo transfer. Furthermore, Javier and Ruben found Marla’s requests for additional money distasteful.
Veronica set up a Skype meeting with Ruben, Javier, and Marla to resolve the dispute and invited me to observe. Everyone consented to be audio-recorded. Veronica described the situation as typical of the issues she deals with as a surrogacy coordinator. Marla was late to the meeting, so Veronica discussed the issue with Javier and Ruben first. Javier and Ruben complained that Marla only seemed interested in surrogacy for the money. They found her requests for additional payment, and her text messages generally, cold and off-putting. Veronica explained to Javier and Ruben, “Look, all of them, all, all, all of the surrogates I have now and have worked with are doing it for the money. So, I don’t want you to be offended because she’s requesting her compensation. They’re all like that. Marla lives in a very difficult situation . . . her house is very poor, I’m not taking her side but she’s a good lady.” Javier and Ruben seemed very upset by this information. Veronica continued, “Her level of education is very low, so I am just asking for your patience. You are right that her messages and emails are usually cold, but inside of it all, I think that she is a good person, because she is cooperative, she has a good soul.” Veronica explained that the contract Javier and Ruben signed did not stipulate what to do in the case of a second embryo transfer. She noted that Javier and Ruben had been paying Marla extra money for “family support” above what was required by their contract. Veronica suggested that instead of paying Marla another 1,000 MXN in family support, they should tell Marla that this 1,000 MXN is payment for undergoing a second embryo transfer. This way, Marla would be appeased but the couple would not have to spend more money. Although still visibly upset, Javier and Ruben agreed to Veronica’s plan.
A few minutes after the call with Javier and Ruben ended, Marla arrived at Veronica’s office. Veronica pulled out a copy of Marla’s contract and read it out loud while Marla looked over it. This led to a disagreement about whether Marla should be paid for undergoing a second embryo transfer, and whether the payments for embryo transfers were included in the total sum of 198,000 MXN, approximately U.S.$10,000. Veronica began to write out numbers on a napkin. Marla then pulled out a napkin from her purse with numbers and calculations written on it. To resolve the dispute, Veronica suggested they call a woman who worked at Carlos’s now-defunct agency and was there when Marla signed the contract. Veronica called Carlos’s former employee and confirmed that the embryo transfer payment was part of the total sum and not extra.
Veronica then told Marla that Javier and Ruben had decided to pay her 1,000 MXN for the second embryo transfer because they wanted to make sure she was well taken care of. Veronica emphasized that in doing so, Javier and Ruben were going above and beyond the terms of the contract. Veronica then reminded Marla that the family support payments and cell phone she received from Javier and Ruben were also beyond the terms of the contract. Veronica also reminded Marla of all that Javier and Ruben had gone through in their quest to have a child, including being scammed by Carlos. After they came to agreement on the contract, Veronica gave Marla tips on how to seem less cold in her text messages to Javier and Ruben. She suggested opening with a question such as “How are you?” before getting into details, ending conversations with “thank you,” and using exclamation marks to express excitement. Most importantly, Veronica told Marla that discussions of payment should go through the agency so as not to give Javier and Ruben a “bad impression.”
This story demonstrates how surrogates are disadvantaged when their interests conflict with those of intended parents and agencies. As a surrogacy coordinator, part of Veronica’s job is to manage the relationship between intended parents and surrogates. Veronica must explain Marla’s “cold text messages” in a way that presents Marla as sympathetic, without disrupting Javier and Ruben’s perception of the surrogacy process as mutually beneficial and morally sound. Javier and Ruben were upset to hear that Marla is poor. This indicates they were unaware of her financial circumstances when they originally signed the contract and reflects their discomfort with hiring a poor woman to be a surrogate for them. Veronica’s response that Marla has a “good soul” is an attempt to simultaneously assuage Javier and Ruben’s guilt and convince them that, despite her poverty, Marla chose to be a surrogate for “the right reasons,” that is, to help others, not to get rich. Javier and Ruben’s discomfort with Marla’s poverty reflects a breach of what Smietana (2017, 8) called the “normative expectation of free agency and self-determination” through which a surrogate’s financial situation becomes a proxy for determining whether the arrangement is exploitative. Because Marla is poor, she is perceived to lack the agency to freely choose to be a surrogate, and her poverty is taken as an indication that she might not be trustworthy. This is reflected in Veronica’s response that Marla has a “good soul,” which implies that Marla’s moral character is in question. The discovery that Marla is poor brings into question her suitability as a surrogate and the morality of the whole exchange.
Veronica’s solution to stop Marla’s family support payments and relabel that money as payment for a second embryo transfer is an example of the creativity needed to keep tensions at bay in an industry that blurs the lines between market and nonmarket relationships. Veronica waited until after confirming that Marla was not entitled to payment for a second embryo transfer to tell her that Javier and Ruben had decided, as an act of generosity above and beyond the contract terms, to pay her for the second transfer. This gave Marla the impression that Javier and Ruben had taken her request seriously and were acting generously. By reminding Marla that family support money was not in the contract, Veronica laid the groundwork for Javier and Ruben to discontinue those payments without drawing a direct connection to the embryo transfer payment. Urging Marla to be “nice” in her messages to Javier and Ruben repositions her as properly feminine, docile, and deferential rather than as a market-driven actor.
The meeting repaired Marla’s relationship with Javier and Ruben, but Marla did not actually receive more money, which was her goal. Veronica’s intervention helped mollify all parties but constitutes a missed financial opportunity for Marla. Not only was Marla told she would be paid extra when in fact an existing payment was just relabeled, she was discouraged from bringing up money again for fear it would reflect poorly on her and threaten the continued viability of the surrogacy arrangement. Marla’s “cold” and direct requests for money threatened to commodify the exchange in ways that would compromise the moral integrity of the process. Veronica could have simply told Javier and Ruben to pay Marla for the second embryo transfer, but that would have further disrupted the balance of power in the surrogacy relationship. Javier and Ruben are Veronica’s clients, and therefore her primary goal is to appease them. Doing so requires maintaining a moral framework of surrogacy as neither exploitative nor the commodification of children. This framework hinges on perceptions of surrogate motivations that are shaped by gender, race, class, and nationality.
This is a concrete example of how surrogates are discouraged from seeing surrogacy as work and are taught to view it as an altruistic act. This helps justify relatively lower wages, while creating “pliable and reliable” reproductive workers (Curtis 2010, 88). Women who do not comply are deemed improper surrogates by agencies and intended parents. The rhetoric of altruism is used to discipline surrogates into quietly accepting the terms of the arrangement. As Curtis (2010, 88) argued in the case of egg donation, “donors who are free to be selfishly motivated may be more likely to be demanding of their doctors, may have higher expectations for patient care, and may require more from recipients.” The rhetoric of altruism in surrogacy both reinforces essential notions of femininity and limits the monetary compensation women receive for their labor. It also perpetuates power asymmetries, rooted in gender, race, class, and nationality, between Mexican surrogates and international intended parents.
Conclusion
Actors engaged in surrogacy draw on moral frameworks of altruism to legitimate the surrogacy market and defend against accusations of exploitation and baby selling. As Rudrappa and Collins (2015) argued, a moral framework that counteracts narratives of exploitation is constitutive of the surrogacy industry because it enables the market to persist. To recruit clients and prevent legislators from outlawing surrogacy, international surrogacy agencies must actively negate criticism of transnational surrogacy as exploitative.
My research builds on these insights to demonstrate how actors in the Mexican surrogacy industry draw on an altruism/commercialism dichotomy that is shaped by gender, race, and class to preserve both the moral palatability and the profitability of surrogacy. My data demonstrate the prevalence of a rhetorical dichotomy between trustworthy, altruistic surrogates and morally suspect, financially motivated surrogates that is shaped by gender norms, as well as race, class, and nationality. This false dichotomy allows surrogacy agencies to keep surrogate wages low by creating a docile and compliant labor force while maintaining the appearance of a morally sound exchange, which in turn perpetuates power asymmetries between Mexican surrogates and international intended parents.
The moral suspicion with which surrogates’ demands for remuneration are met reflects a gendered “hostile worlds view” and class bias. Selfish motivations are considered incompatible with the feminine project of surrogacy, and profiting off a child is seen as an affront to proper motherhood and womanhood. But “squeamishness about money is a luxury” only affordable to those who are not burdened by financial need (Nelson 1999, 49). When surrogates’ motivations are the primary measure of the morality of surrogacy, poor surrogates are automatically morally suspect. The attention on surrogates’ motivations and the circumstances under which women choose to be surrogates also deflects attention from other aspects of the surrogacy process that may be more or less exploitative.
Debates about surrogacy, both academic and legislative, often focus on whether women should be paid to act as surrogates. These debates are often premised on the idea that commercial surrogacy is inherently more exploitative than altruistic surrogacy. But, as this article demonstrates, the very dichotomy between altruism and commercialism can be exploited to produce compliant surrogates and sustain the industry. The rhetoric of altruism as a feminine virtue enables surrogacy agencies to cultivate a docile workforce that cannot advocate for their own financial gain. This has important implications for our understanding of reproductive labor and gender inequality more broadly. As Raymond (1993, 58) argued in her discussion of surrogacy, “The altruistic pedestal on which women are placed is only one more way of glorifying women’s inequality.” The designation of altruism as a feminine virtue dichotomous with self-interest fuels gender inequality by facilitating the devaluation of reproductive labor (Raymond 1993). This article builds on Raymond’s assertion with an intersectional analysis of who profits from the idealization of motherly altruism.
Footnotes
Author’s note:
I wish to thank Rene Almeling, Rachel Einwohner, Katie Hasson, Jennifer Hook, Andrew Lakoff, Lauren Jade Martin, Mike Messner, Kit Myers, Rhacel Parreñas, Jo Reger, participants of the Baby Markets Congress, and the anonymous reviewers for their insightful comments. I am grateful to the research participants for sharing their experiences with me. This research was made possible with support from the National Science Foundation under Grant No. 1656229, the Del Amo Foundation, the Social Science Research Council, and the Andrew W. Mellon Foundation.
Notes
April Hovav is a doctoral candidate in sociology and gender studies at the University of Southern California. Her research examines global markets for reproductive technologies.