What are the implications of assisted conception with donors for kinship theory or practice?
Kinship, in its most common understanding, refers to blood relationship. Yet, it can also allude to the sharing of characteristics or origins. Kinship understood in this way builds on the notion of kinship in important ways. For instance, it extends beyond blood, or biological, relations, to include shared characteristics, which can be understood as biologically or genetically shared characteristics, but also as values, qualities, ways of being, doing, or thinking.
To ask what the implications of assisted conception with donors might be for kinship theory or practice contends with conceptualisations of kinship and how kin relations may come to be actualised or challenged.
This essay will outline what assisted conception with donors entails in relation to kinship theory or practice. It will first look at the biological underpinnings of notions of kinship. Then it will focus on negotiations of kinship at times where biological understandings of kinship are challenged. Lastly, it will assess the extent to which kinship can be seen as social rather than biological, as chosen rather than given.
Parenthood is often associated with procreation, with parents seen as the origin of the genetic makeup of their offspring. This is deeply ingrained in Euro-American contexts to the extent that to some, parenthood is contingent on procreation. Weston in Families We Choose (1997) notes that Stephen Richter, a gay man in his fifties at the time of the interview, attributed never having become a father to not having been in a relationship with a woman. Envisioning ‘parenting and procreation only in the context of a heterosexual relationship’ and regarding the two as ‘completely bound up with one another’, had led him never to consider having children an option. Similarly, Clarke in New Kinship, Islam, and the liberal tradition (2008) highlights how, in Lebanon, parenting and procreation are generally acknowledged to be intrinsically linked to the extent that practices in which a third party is introduced, for instance a surrogate, are extremely rare. When surrogacy is pursued, the transaction often involves a ‘domestic servant [or] a maid, who would be an immigrant from a less well-off country … living with the family, who could be hidden during pregnancy’. These examples show how biology in the creation of kin is of paramount importance. ‘Real’ kin are understood to have biological ties, to be genetically related in some way.
Hence, the introduction of assisted reproductive technologies (ARTs) which include, but are not limited to, in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), cryopreservation of gametes, present a challenge to readily understood notions of kinship based on biological relatedness. For instance, Clarke mentions that in the case of the pursuit of donor treatments in Lebanon, ‘the potential confusion of kinship relations is obviated [by] attributing paternity and maternity to the originators of the sperm and egg’. However, this ruling has inconvenient consequences for those pursuing donor treatments insofar as adoption is formally forbidden to Muslims, placing them in a sort of limbo where they are at once not technically the biological parents and unable to adopt the child as their own, rendering ARTs a contentious issue in Lebanon.
Due to a context of expected kinship and offspring, juxtaposed with the expectation for kinship to be biologically founded, many still resort to ARTs, albeit secretively. With recourse to ARTs at times being assimilated to ‘adultery’, patients often keep treatment a secret from ‘friends, family, even their spouses’. One Christian doctor working in Beirut relates how a Muslim woman who had travelled to Lebanon for treatment (in her case, donor eggs) from Kuwait, had asked if there was any possibility of anyone finding out. Upon hearing that a ‘subsequent genetic test might reveal the truth, she had a hysterical fit, and later aborted a successfully implanted embryo’. Here, infertility carries a stigma such that no one would want to seem ‘afflicted or abnormal’, nor would they want to be the subject of rumours insofar as, in Lebanon, Clarke emphasises that ‘the opinion of ‘the neighbours’ [as well as] gossip are much feared’. This leads many to base their choice of donor on looks and behaviour, with many opting for family or friends. As one Shiite doctor summarises, ‘they get eggs from family and friends. They must be known, because of illnesses, and also their behaviour, because they might sleep with lots of people, then they might have diseases like AIDS. And they prefer somebody who looks the same’.
Interestingly, in spite of how ARTs might enable new conceptualisations of kinship, Inhorn (2003) remarks on how ‘the pre-existing Islamic imperative regarding ‘pure’ lineage, coupled with Islamic prohibitions against adoption, not only privilege, but, in fact, mandate biological as opposed to social construction of families … biogenetic relatedness … is an absolute imperative’. Thus, while some may rely on ARTs, the insistence on fundamentally biological nature of kinship in Lebanon stays at the forefront.
Nonetheless, biological assumptions regarding kinship are further challenged in the face of infertility. Bonaccorso in Conceiving Kinship (2008) points out that the shock of infertility is usually expressed in terms of ‘why has this happened to me’. She outlines how, when confronted with the news of infertility, feelings are often of loss, ‘for discovering what one always takes for granted: a fertile body, able to reproduce others like oneself’, and disillusion, when realizing that ‘one is living a different life from the one he/she had imagined for oneself and one’s partner’. Infertility, as such, is so shocking insofar as it challenges readily accepted notions of kinship as biological. It disrupts taken for granted expectations such as ‘settling down, starting a family, having children with and from the partner couples say they have chosen for life’. This outlook denotes an inherently biological component in imagining future offspring. As Matilde, one of Bonaccorso’s informants, suggests, ‘I am waiting for egg donation and have already had an IVF cycle. It failed. If the American treatment becomes available in Italy I will go for that. Even if it is still experimental. Not because genes are really important in themselves, but because my genes are a part of me and my husband married me for what I am, he did not marry somebody else’ (emphasis added). Yet, Ragone (1998) stresses that with the introduction of ARTs, ‘seemingly simple yet nonetheless culturally bound assessments of what constitutes family, motherhood, and fatherhood … can no longer be taken for granted. ARTs have served to defamiliarize what was once understood to be the natural basis of human procreation and relatedness’.
In coming to terms with infertility, one also comes to envision and embrace different meanings and understandings of kinship. To make sense of a ‘third party’, here a donor, in the kin relation, those pursuing donor treatments imagine donors as innately altruistic. Bonaccorso (2008) notes that ‘donors are imagined as people committed to the cause of infertility, willing to help those incapable of autonomous procreative capacity [and are] mostly believed ‘to be able to feel’ what it must be like not to be able to have one’s own baby’. Interestingly, donors are thus believed to be motivated by a ‘moral call’ rather than reward for the donation. Despite doubts and fears concerning donation, ‘couples always locate the donation of gametes in the arena of the ‘gift’’. This is especially important as time passes and a progressive effacement of the donor ensues. Strathern (1992) writes that distance and depersonalisation is increasingly created between couples and donors, turning ‘donors from persons of high moral status, motivated by very good intentions, into body parts, namely body cells’. A strategic dissolution of persons happens during the time of conception to birth in such a way that, proportionally to the length of treatment, donors are less and less mentioned, until their role is ‘de-emphasised and minimised until images of total irrelevance are produced’ with the donated gametes gradually treated as ‘belonging to non-persons’.
Of note is how this effacement of donors often leads to a form of secrecy. Novaes (1989) claims that ‘minimising the donor’s contribution and eliminating all traces of his participation have always seemed a positive attitude permitting the couple eventually to forget the procedure and lead a normal family life’. One of Bonaccorso’s (2008) informants echoes this in saying ‘we have discussed it several times and reached the conclusion, after talking to the doctor too, that it would only be harmful to the baby and the family to tell the truth. This is a kind of truth that would only cause pain and harm. The baby may feel unwanted and may be looking for the real mother forever’ (emphasis added). This brings to forefront a salient issue of ARTs: biology is difficult to eclipse from conceptions of kinship. Strathern (1992) points out that ‘today’s problems are the (“natural”) parents. For the (“social”) child is bound to want to know, it is said, what its biological antecedents really are’. And, although the couple shares with their future offspring 50 percent of biogenetic make-up, ‘they find it difficult to think in those terms, just as they seem to find it difficult to think consistently that, beyond the biogenetic tie, they will have built over time powerful social relations, powerful ties of love and care’ (emphasis mine) (Bonaccorso 2008).
The question of what relationships count as kinship has become particularly prominent with the advent of ARTs. Carsten in Cultures of Relatedness (2000) contends that ‘the more nature is assisted by technology, and the more the social recognition of parenthood is circumscribed by legislation, the more difficult it becomes to think of nature as independent of social intervention’.
Weston (1997) draws attention to how representations of what kinship entails can be exclusive. For instance, representations excluding lesbians and gay men from ‘the family’, invoke what Blanche Wiesen Cook (1977) has called ‘the reduction of lesbians and gay men to sexual identity, and sexual identity to sex alone’. Weston asserts that to claim that ‘straight people ‘naturally’ have access to family while gay people are destined to move toward a future of solitude and loneliness, is not only to tie kinship closely to procreation, but also to tie gay men and lesbians as members of a non-procreative species set apart from the rest of humanity’. Yet, the existence of gay families asserts that ‘people who claim non-procreative sexual identities and pursue non-procreative relationships can lay claim to family ties of their own without necessary recourse to marriage, child-bearing, or child rearing’.
More broadly, studies of gay and lesbian families have shown various ways in which biology (or nature) appears as a technicality alongside a more important aspect of nurture, with kinship being reconceptualised as optative rather than given, as well as malleable, and negotiable. In the words of Bonaccorso’s informant, Clinician Arancione, ‘I [make sure the couple] are okay, that there is no problem with the idea of donation. I explain that it may look different because they come in here in the clinic, to have their baby, but it is really not that different, the donation of gametes does not change their being parents. In a sense it is a technicality’ (emphasis added). What is more, Clinician Blu argues, ‘I am not only a doctor here, but also a kind of psychologist: I always explain to couples that what makes a person is the social environment. It is important to be good parents, to be good mothers and good fathers. Genetic inheritance plays a minimal role. I always point out to them the case of two twins who are separated at birth and live with different parents. They will be different. It is the family that matters, the parents and the relatives’ (emphasis added).
Further, the optative, based on choice, rather than given aspect of kinship encourages an interrogation of ‘natural’ biological desires. Paolo, one of Bonaccorso’s informants stresses that ‘if you want to have a child, you need to ask yourself why, where that desire comes from. You cannot just assume that it is OK. As women we are so much expected to want and long for a child that as soon as we feel that desire, we automatically believe that it is OK… But [as] women we must learn to ask ourselves questions, and wonder what we feel and want and why we feel that way’. Her partner Elena builds on this statement by noting how the advent of ARTs has brought potential, and alongside it, interrogation. She says ‘since I have been with Paola I have realised how much we all take for granted our own motherhood. In a lesbian relationship you cannot just say ‘my dear, I want a baby’ and make it. As soon as you say ‘I want it’ you also need to ask yourself ‘why do I want it?’
In the same vein, gay men are also confronted with questions in the face of fatherhood. However, these questions vary greatly insofar as fatherhood is ‘historically less constraining’ and ‘men do not experience equal cultural expectations of paternal fulfilment’; on the contrary, ‘they often claim to have to reassert their wish and even their right to fatherhood’. Bruno, a gay man interviewed by Bonaccorso, states: ‘there was a period that I rejected whatever felt hetero, to become a father seemed undesirable. It has been only recently that I realised how crazy I was. We all were [a group of friends] obsessed with being gay and different. I went into therapy because I started to have contrasting desires: I liked men, but also wanted to have a child and be a father. Now I am finally ready for it, and it does not feel hetero at all’. Chiefly, this suggests that kinship is dependent on one’s conceptualisation of it. The idea of kinship is open and malleable to the extent that meaning can be ascribed to it in accordance with one’s lived reality. Parenthood is not ‘one’ thing; ‘real’ parents are only real insofar as you recognise and allow them to be.
Hence, relatedness, as Carsten (2004) points out, allows ‘to move away from a pre-given opposition between the biological and the social’. Bonaccorso (1997) argues that, ‘Lesbian and gay couples place unknown/known donors and partners in asexual conception in some sort of relationship with the offspring, if not active then potentially so if the child wishes in the future, the assumption being that … the child may at some point in life feel the need to know where it comes from’. In this regard, the contributor of genetic material is ‘since the early days of the pregnancy, thought of and made into a presence’. Thus, such practices of ‘inclusion’, which contrast those of anonymisation and effacement, ‘reflect the relevance assigned to biogenetic ties’, confirming Weston’s idea (1992) that ‘gay kinship ideologies have not contested the dominant paradigm of biogenetic kinship by deconstructing biology’; instead, rather than departing from a kinship model that incorporates biology, they still rely on it, although changing its form and ascribing new meanings and ways of understanding. Bonaccorso stresses that ‘the biogenetic tie is understood and conceptualised in the light of social relations that they wish to be created, or that they believe should be left to be created for their children. Lesbian and gay couples thus generate two synchronic stories whereby biogenetic and social ties are distributed and mobilised between different social actors, in the present or potentially in the future’.
To conclude, kinship, notably through, but not limited to, the advent of assisted reproductive technologies, has been re-conceptualised as extending beyond being based solely on biological ties. These chosen families (including gay and lesbian couples but also those infertile and unable to procreate) offer a template for possible kinship relations insofar as they bring to light aspects of choice, option, negotiation, change.
Kinship theory must keep up with multifarious kinship practices and attend to the particularity, subjectivity and location of ever-changing kinship relations.
Bibliography
Carsten, Janet(ed), 2000 Cultures of relatedness: new approaches to the study of kinship. Cambridge: University Press (Esp Introduction by Carsten, Bodenhorn Hutchinson, Edwards & Strathern).
Clarke, Morgan 2008 “New Kinship, Islam, and the liberal tradition: sexual morality and new reproductive technology in Lebanon.” In Journal of the Royal Anthropological Institute (NS) 14: 153-69.
Bonaccorso, Monica 2008.Conceiving Kinship.Oxford: Berghahn Books. Deomampo, Daisy 2016. Transnational Reproduction: Race, Kinship and Commercial Surrogacy in India.New York: NYU Press
Ragoné, Helena 2003. “Surrogate Motherhood and American Kinship” in David Parkin & Linda Stone (eds), Kinship & Family: An Anthropological Reader.
Weston, Kath 1997. Families We Choose: lesbians, gays, kinship. New York: Columbia University Press.