In a colorful album that lives on the arm of our green sofa, there are dozens of pictures of us and our family. There’s me and my husband Andy with my Russian godmother at Longwood Gardens. There’s a few of us posing with our niece on New Year’s Eve 2019. Photos of the many kids who call us uncles. Childhood pictures from trips to Disney World. Some holiday photo collage cards. And then towards the end of the collection, right across from a picture of me and my sister hugging Mickey Mouse, is a small gray and white print that takes some difficulty deciphering. It’s a small polaroid containing our names and the date it was printed. “Brandon Ambrosino + Andrew Swiatowicz, 8-3-22.” Above the wording is a picture of a blastocyst, the one we transferred into our gestational carrier last August, the one that didn’t survive to full term.
I often wonder whether it’s silly to include the photo in our family album. Maybe my therapist will one day encourage me to remove it. But for now, it’s there. She’s there. The doctors performed genetic testing on the embryo, so a nurse called to tell me the sex. I was happy to tell my husband when he came home from work that he was going to get his wish and become a Girl Dad. That’s what I wanted, too. Still do.
Our wish hasn’t been granted yet. We keep working, however, to bring it to fruition. As of January 2022, in the hopes of bringing a child into the world, we’ve worked with three fertility doctors, two therapists, dozens of nurses, three egg banks, four attorneys, and countless labs, all to the tune of more than $100,000. Of the forty eggs we purchased and fertilized, only three resulted in embryos that were healthy enough to transfer into our carrier. The first time, the embryo didn’t implant. The second time, it did — she did — but then, for whatever reason, didn’t make it.
The term used to describe our relationship to the children we hope to have is “intended parents.” My husband and I intend to be parents, regardless of how elusive that goal may seem. And it does, by this point, seem almost hopeless. Our reproductive narrative, as Danielle Tumminio Hansen would put it, has not gone according to plan. We have, despite doing what the expensive experts told us to do, suffered loss. Suffered trauma. Perhaps this was why I was eager to host a symposium on Hansen’s book Conceiving Family: A Practical Theology of Surrogacy and Self — I wanted to find new ways to understand and process and hopefully begin to heal the reproductive trauma my husband and I have experienced. To that end, engaging with Hansen’s book has been deeply rewarding. Her reflections on the possibilities of writing new endings to narratives of reproductive loss are encouraging, as is her acknowledgement that “there can be multiple endings to the reproductive story beyond the one initially assumed” (28).
I also appreciate the challenges Hansen issues to the popular American understanding of the nuclear family, which is the current dominant model for parent/child relationships in the US. Instead, Hansen argues, family might be better understood as “a unit of social belonging that utilizes consonant dependency care in order to ensure that each member can thrive as a self-composed of body, desire, and agency” (129). By moving away from a “patriarchal understanding of reproduction as a genetic connection,” as well as essentialist arguments about gendered reproductive roles, Hansen aptly and provocatively suggests that all reproduction is assisted and all children must be adopted into the families that care for them (110). At the end of the day, Hansen tells us, there are many ways to conceive family. Heterosexual intercourse, or technologies that offer “the closest possible alternative,” (107) are not the only or even best options, even though popular cultural assumptions might lead us to believe otherwise.
Hansen’s book also offered me language to discuss my relationship with our carrier, a relationship that does certainly have to navigate some murky ethical terrain. (Our carrier is a family member. I will refer to her as Z.) It was important to me and Andy that Z never feel exploited or used by us or our doctors. We have always understood her to be giving us an invaluable gift, and we strive to explicitly honor the gift and giver. Early on in our fertility journey, I shared some reflections on IVF and ethics on social media. Immediately, a group of people accused me of working to bring about a Handmaids Tale-esque dystopia in which I forced certain women to carry my babies for a stipend. I was devastated because I didn’t understand my relationship to our carrier as one of power, but one of allyship—my husband and I and a woman who love us are working together to bring a new child into the world. In Hansen’s framework, while exploitative forms of surrogacy, which she calls injurious and resistive, do happen, what we were practicing was constructive surrogacy. We view our carrier as “a subject who desires to influence another’s reproductive narrative in a particular way”(73). And so while I understand the concern, voiced eloquently in a response by Melanie Jones, that because of the power dynamics at play, constructive surrogacy is difficult if not impossible to put into practice, my own experience in working with Z has shown me that it can be done.
Given how much I’ve benefited from interacting with Conceiving Family, I echo Grace Kao’s sentiments and wish that Hansen would have included same-sex couples in her theological analyses. I understand Hansen’s reasoning for focusing on heterosexual couples: in contrast to same-sex couples, heterosexual couples only turn to third parties for assistance with procreation when their “original plan” doesn’t work out (6). And yet, as my husband and I are painfully aware, gay couples, too, know what it’s like to have our “original plans” for fertility thwarted. Andy and I never expected that almost four years after we cut our first check to a fertility clinic, our carrier wouldn’t yet be pregnant. Time and again, we have had our reproductive assumptions disrupted. Like many heterosexuals who will read Hansen’s book, Andy and I know what it’s like to feel helpless, disempowered, confused, and angry over our reproductive traumas. By bringing these feelings into dialogue with the similar ones felt by heterosexuals, perhaps a fuller picture would have emerged about human struggles with infertility.
Further, the line between heterosexual loss and same-sex loss is blurry to me. Although there are salient differences in our respective experiences, my husband and I experienced the same reproductive loss as our carrier. We all lost our embryo. I sat with Z on both transfer days as we waited for the call. We shared the same hopes, the same prayers, the same devastation. We processed our grief in the same real time. Z experienced that loss in her body, and I, sitting next to her with my arm around her, experienced that loss in my body, too. These experiences cause me to wonder, along with Susan Reynolds, what becomes of the relationship between intended parents and carrier when the “‘functioning womb’ has become yet another site of loss” for all hopeful parties. “Can this yet-wider circle of grief open up to accompaniment?” she asks. I believe it can. Z and her husband have shared our burden of grief, and we have in turn shared theirs. Our vulnerabilities, as Hansen would say, are connected. Rather than seeing this reproductive trauma as limited either to the intended parents or the carrier and her husband, we understand that grief wounds everyone within its reach.
Reynolds also shares that she “suffered three miscarriages before ultimately giving birth to three daughters.” At early stages of that journey, Reynolds “equated future healing with the birth of a living child.” And yet, as she discovered, “when that hoped-for day finally came … I realized with surprise that the sting of loss remained.” Perhaps Andy and I will learn this ourselves when, at some point in the future, we add pictures of our child to the album that contains a photograph of the one we never got to meet. Maybe by that time, we will have language to fully describe our relationship to the picture taken August 22, 2022. Right now, though, words fail us. We simply say something like, “This a picture of our embryo the day we transferred her into our carrier. She didn’t make it to full term.” But even this is inadequate for expressing the kaleidoscopic range of emotions we experienced from the moment we were given the photo to the moment we learned the pregnancy failed. As Reynolds notes, a ritual says to those in mourning, “We have been here before. Come: let us show you what to do.” But, sadly, no one has shown me and Andy what to do. And therefore, I agree with Reynolds when she claims, “Without a socially recognized way of drawing such losses into a larger communal story, the pain of loss is compounded by isolation, loneliness, questions of meaning, and an aching sense that one’s grief is illegible to [their] community.”
While Reynolds focuses on the role of liturgy in healing after reproductive trauma, Karen O’Donnell turns her attention to the body’s role in “post-traumatic remaking of the self.” Like Hansen, O’Donnell resists “cultural assumptions about the significance of genetics in producing family,” and therefore does not think that bodies wounded by reproductive loss can be reconnected with merely by, say, “physically touching the surrogate’s belly.” Rather, she argues, “the primary way in which the bodies of those who have been traumatised through reproductive losses can be reconnected with and retrained, is through the embodied nurture that creates a familial bond.” This nurturing, she rightly asserts, may or may not be genetically linked. It may also extend beyond families and take place in whatever communities to which the traumatized belong, as Hansen notes in her response to O’Donnell. I hope our reproductive narrative ends in parenthood, but it might not, and if it doesn’t, it’s important that we find creative ways to reconnect with our bodies and the bodies of those who nurture us. We are already off to a good start. Thankfully we are surrounded with family and friends and nieces and nephews and godchildren who shower us with love and affection on a regular basis. I pray we never forget how extraordinarily blessed we are to experience a wealth of embodied love.
Collecting and editing this Syndicate collection has been challenging, not least because we were trying to get the symposium ready during a global pandemic. But on a personal level, whenever I sat down to work on this collection, I was confronted with my own reproductive narrative. Not being a parent brings me an enormous amount of pain—pain that is exponentially compounded when I wonder whether I will ever get to hold a child of my own. I’m angry and heartbroken at my current childlessness. And because I am a Christian, I bring my anger and heartbreak to God and I hurl it at him and I curse him for seeming to not do anything about it. But then, because I’m a Christian theologian, I wonder if there’s anything God can do about my childlessness, and whether and to what extent he is even involved with my reproductive story in the first place. I then read Kao’s words—“I do not believe the experience of infertility ‘should’ be the type of thing that leads someone to question either the existence or goodness of God”—and wonder if I’m too capricious and melodramatic to be a good Christian theologian.
Of course, Kao is right. The childlessness I experience because of, among other things, my homosexuality is not God’s “fault,” and therefore it does not call God’s goodness into question. I know this to be true. And yet, as she acknowledges, “the painful experience of infertility nonetheless does lead” me to question God’s goodness. What I’m left struggling with, then, is whether framing infertility in terms of theodicy is helpful or hurtful. I agree with Kao that such a framing can be and often is harmful, particularly when punishment/reward language is deployed. However, I also agree with Hansen that there is value in being “curious about our lives,” which means being curious about how God relates to the good and bad in our lives.
So what is the best way to theologize God’s relation to what I experience as one of the “bads” in my life? First and most importantly, rather than theologize in ways that push toward any outcome intended to explain or justify our struggle to become parents, I choose to stay curious about how God is accompanying us while we creatively respond to our reproductive trauma—a trauma which, I believe, took God by surprise, too.
I think Hansen’s suggestion to Kao is instructive here: that in theologizing infertility, we might “shift the emphasis from outcome to process,” from answers to questions. I know that God is still abundantly compassionate despite my struggle with childlessness. But what I really want to know is whether God wants me to have children, if God thinks I’ll be a good dad, if God got excited when we first got the “you’re pregnant!” phone call, if God cried when we got the second call. What I really want to know is whether God likes the name we picked out for the daughter that we’ll never get to meet or if God thought we should have gone with the other name. What I really want to know is whether God hates the discriminatory structures that are rigged against LGBT intended parents, that throw up barriers in front of us at every step of our reproductive journeys.
I also really want to know if Jesus longed to be a parent, and if he introduced that longing into the Godhead. Jesus spoke glowingly of children. The gospels remember him inviting children to himself and focusing some of his key teachings on the kids who were playing nearby. He explicitly taught “the reign of God as a children’s world,” where children are the “model recipients” and moral exemplars of the Basileia tou theou.1 When Jesus says, “Let the children come to me, and do not hinder them,” I hear his desire, his eagerness to be surrounded by kids. Of course, he is relativizing what we think of as family relations: “Whoever does the will of my father in heaven is my brother and sister and mother.”2 But it’s notable that he doesn’t include children in this metaphor. Maybe that’s because he sees all of us—himself included—as children of the Father in Heaven. Or maybe it has something to do with the pain that he feels about his own childlessness, a pain that is too visceral to be assuaged with a simple theological reflection on chosen family. At the end of his life, when he hung dying on a cross, did Jesus regret and mourn the fact that he never had the chance to hear children address him the way that he addressed his own abba? Perhaps, one might reason, these thoughts are too this-worldly, too low to be ascribed to the man called Christ. And yet even the highest Christology has childlessness right at its heart: the Son will never, ever, regardless of his desire, be the Father. So maybe God understands me after all.
Why did our carrier suffer a biochemical pregnancy? Why didn’t a day-seven embryo survive? When and where will our reproductive journey end? I don’t need theological answers to these questions because the medical ones are sufficient. But the questions about God’s accompaniment, about God’s emotional solidarity with all of us on this emotional roller coaster, about God’s relationship with the embryo that is perhaps maturing even now in God’s own eternity—these are questions that I find valuable in bringing before God, even if God has nothing to offer me except the quiet assurance that he understands … that he understands …
I am grateful for the opportunity to wrestle with these and other questions with five thoughtful and gracious scholars. I am confident the essays collected in this symposium have much wisdom to offer our theological communities as we continue to think through the complicated issues that emerge when reproductive technologies come to bear on our understandings of personhood, family, and human belonging.
Conceiving Family and Facing Hard Truths
In her latest TIME article, “The Hard Truth About My Surrogacy Journey,” an excerpt from her latest book, You Got Something Stronger, actor Gabrielle Union tells the long-awaited story of her struggles of love, loss, and surrogacy.1 When the title first popped up in my daily news notifications, I took a deep sigh because I knew even before reading that Union would force me to confront some hard truths about my journey of conceiving family as a single Black woman and pre-tenure academic. Like most Black women, Union’s love story is complicated. I remember all too well the numerous gossip columns and sensational paparazzi reports of her partner and former NBA champion Dwayne Wade conceiving a child with another woman just before the couple married less than a decade ago. I heard of Union’s numerous challenges with miscarriages and reproductive technologies through the celebrity rumor mill. I watched Union embody this gut-wrenching narrative and play the part of a Black professional woman surviving infertility on BET’s Being Mary Jane with soul-stirring scenes that felt more real than a made-up television drama. I celebrated Union and Wade on the birth of their daughter, Kaavia James Wade, with no signs of Union physically pregnant days or months before her Instagram debut. I could only imagine that Union made or accepted a hard choice of surrogacy as a final option to actualize her dreams of family. If Union, a Black woman like me, though worlds apart economically, could choose surrogacy, then maybe, if necessary, I could too.
In Conceiving Family: A Practical Theology of Surrogacy and Self, feminist practical theologian Danielle Tumminio Hansen identifies the majority profile of intended parents who can access surrogacy belong to the upper-middle or upper class and are often white. Hansen writes to this audience to think theologically about surrogacy “as a metaphor for the enactment of power in the United States”(2) and to examine “how human beings use the resources available to them in order to write a narrative that transforms pain into joy” (2). For many, conceiving a family is the ultimate test of faith. Hansen argues, “surrogacy is rarely one’s preferred ending to the reproductive story; rather, it is more often the last chance to reconstruct a story of loss as a story of gain, a story of conceded hope as one of hope restored” (2). As a subject for practical theology, Hansen explores the integration of the practice of choosing surrogacy with faith as a way of interrogating the theological claims of self in community.
Chapter One addresses human reproduction and the construction of the self through three characteristics: body, desire, and agency. Hansen’s starting point for theological anthropology is Genesis 1:27 and the enduring challenge to articulate what it means to be made in the image of God, especially when tied to the subsequent divine command in Genesis 1:28 to be “fruitful and multiply.” Theological anthropology, a locus in Christian theology that attends to the relationship of God, self, and community, raises these questions: How does reproduction determine assumptions and values about what it means to be human or experience human fulfillment? Does God call humans to reproduce? Does reproduction equate to humanity’s right standing with God? Is reproduction the primary pathway for the salvation of the human species? Whatever the responses to these questions, Hansen frames infertility or the inability to reproduce as an early factor of human suffering beginning in Genesis and narrated throughout the Hebrew Bible and New Testament. Infertility poses critical theological questions about the problem of the body when humans are unable to create new life. While the biblical stories do not suggest infertility as a sign to identify one as less than human, Hansen characterizes a utilitarian valuing within some Christian traditions of certain bodies over others because of their abilities to reproduce.
Chapter Two outlines the cultural construction of surrogacy in the modern context of the United States, India, and Israel. Hansen focuses on the United States “because it is the country with the highest annual usage of third-party reproduction and because it executes surrogacy in ways that make it distinct from other nations” (3). According to data cited by Hansen, the average American surrogate is a “working class, white, Christian, twenty-seven-year-old high school graduate, married with three children” (40). These women likely have no intention of making their families larger and “view surrogacy as a calling or vocation” with “an interest to help infertile couples procreate” (40). While money holds power in settling the business contract between the surrogate and intended parents, the value is much higher as the surrogate produces life and plays an indelible role in the child’s origins. On the other end, the average profile of the intended parents in the U.S. are usually highly educated couples whose annual income exceeds $100,000. The class power differential exists because “intended parents have money to pay for surrogacy; surrogates are usually not affluent enough to hire a surrogate themselves” (42). The contemporary U.S. surrogate also possesses the power to leverage her fertility, womb, and connection to the child as a “source of benevolence or exploitation” with the intended parents (45).
Surrogacy is big business that constructs transactional relationships between all parties involved: intended parents, surrogates, healthcare professionals, fertility agencies, and corporations. The role of surrogacy agencies and programs function to mediate transactions between the parties and “mitigate the relational difficulty” (42). Union recounts her introduction to the surrogate marketplace to find a surrogate.
For weeks, I went down a rabbit hole of books, surrogacy message boards and conversations with our fertility agency. At the top of the surrogate food chain were married, white, American women who have their own kids. The belief is that if they are married, they have a built-in support system, and if they have more than one child, there’s proof they can do the job. On the message boards, people can be anonymous, so they rank surrogates by race. I got the sense a lot of white families-to-be were more comfortable with brown people as surrogates—Latina and South Asian—who were often classified as ‘breeders.’ Now, I am Black, and I am used to hearing how people speak of women of color, but this was some Handmaid’s Tale sh-t.2
As a result of the luxury costs of assisted reproduction, including navigating the problem of the legality of surrogacy across states, Hansen describes some intended parents from the U.S. as having shifted their search for surrogates to nations like India or Israel where the surrogacy laws are less rigid, and the total cost of a surrogate is significantly lower than the United States. For cases in India, Hansen illuminates the image of today’s surrogate as a poor, nonwhite woman desperate to make ends meet who settles for surrogacy as an enduring hope to secure the future of her struggling family—though often this hope is never materialized. For cases in Israel, surrogates serve a different function for some U.S Jewish families to perpetuate both their lineage and faith.
Chapter Three returns to the biblical story of the infertility of the Hebrew wife Sarah and the exploitation of the Egyptian slave-girl Hagar that spawned a life-denying conflict between the slaveholder and the enslaved. Hansen identifies Sarah, Hagar, and Abraham’s reproductive journey narrated in Genesis as “the most developed representation of surrogacy in the Bible” (63). Hansen is sympathetic to the victimization of Sarah in biblical antiquity by the cultural, patriarchal constructions that reduced women to reproduction and the limited, available reproductive technologies that narrowed Sarah’s choices. Hansen laments that perhaps the Sarah and Hagar controversy could have been eliminated if such “preconditions” were radically different (62).
The Genesis account reveals Sarah offered Hagar to Abraham and coerced Hagar to conceive and birth a child to realize the family’s dream. Hansen asserts, “The slave thereby functioned as a solution to the mistress’s inability to enact reproductive agency and provided a way for her to repair what was perceived as a bodily defect because she could use the slave’s body as a proxy for her own” (63). Hansen raises the womanist theology of Delores Williams in Sisters In the Wilderness: The Challenge of Womanist God-talk as a source for explicating the “negative value” or the problem of surrogacy (66). Williams interprets Hagar as a slave-surrogate coerced to conceive a child by the intended slaveholding parents Abraham and Sarah; thus, Hagar faces entrapment in a multi-traumatic predicament of “slavery, poverty, ethnicity, sexual and economic exploitation, surrogacy, rape, domestic violence, homelessness, motherhood, single-parenting and radical encounters with God.”3 What is at stake in the Hagar, Sarah, and Abraham biblical saga is cultural and theological. The birth of a child for Sarah and Abraham represented the fulfillment of a divine promise. Hansen interprets Sarah’s actions as “at the very least comprehensible” as she exercises agency and follows a predictable maneuver to provide for herself and her family (17). For Hansen, Sarah is both victimized by her culture and oppressive to Hagar in the same breath.
I assert that Hansen and Williams have unique concerns about the theology of surrogacy, which may highlight the distinctiveness between feminist and womanist theologies. Hansen interprets the theology of Sarah, a woman of privilege who uses any means necessary – the body of Hagar— to navigate cultural and theological preconditions and support herself and her family. Sarah exerts agency to manifest a divine promise by oppressing and denying the agency of another woman of lower social status. Hansen argues that Sarah and contemporary women (primarily white) in the twenty-first century share a similar reproductive struggle and a defining question: “to what ends will I go to create the child that I am supposed to have?” (66) In contradistinction, Williams interprets the narrative by reading Hagar as a slave surrogate who is left to suffer a forced impregnation and cast into the wilderness to survive a hostile world with a rejected son. Williams coined surrogacy as the distinctive marker of Black women’s oppression in America. Hagar’s story, in particular, resonates with the African American woman who survived the brutal exploitation of her body as an object of production (labor), property, and reproduction for more than four hundred years of U.S. chattel slavery; suffered the role of a nurturing domestic for the available use of white families throughout the antebellum and postbellum; experienced the reality of parenting and single mothering at a young age; and remains victimized by the never-ending cycle of multi-dimensional oppression that keeps her in the wilderness and on the underside of humanity. Williams traces the brutality of U.S. chattel slavery and racial segregation that fortified the sexual and economic exploitation of Black women to fulfill the comforts and fantasies of white families, which can never be erased from any conversation of the American dream or U.S. history. Whereas God does not provide immediate liberation to Hagar, Williams contends Hagar exercises agency “to liberate herself from oppressive power structures” in Genesis 16 and works with the divine to survive in the wilderness in Genesis 21.4
Hansen adopts the story of Hagar to propose three distinctions of surrogacy: constructive, resistive, and injurious. First, constructive surrogacy affirms the subjective agency of the surrogate to achieve the desired outcome she intends with the support of her community. Hansen envisions the constructive surrogate as an “ally” who “is freely using the privilege and power that she possesses—in this case, her reproductive privilege—in the service of those who lack it motivated by faith, hope, and love” (74). There is no point in Hagar’s story where constructive surrogacy is present or possible. Second, resistive surrogacy maintains the surrogate’s agency to choose her path while recognizing the missing systemic support to uphold her desires. Hansen notes the experiences of primarily Indian surrogates with less than favorable conditions from corporate and communal stakeholders who make demands on their bodies while ignoring their wishes. Hagar exercising freedom and agency through resistance (e.g., Hagar on the run in Genesis 16) represents resistive surrogacy that subverts the power structures that seek to stifle her survival. Third, injurious surrogacy denies the agency of the surrogate and traps her with no opportunity to satisfy her basic needs. Hansen interprets Hagar as objectified, silenced, and raped without her consent, marking an injurious surrogacy with Sarah and Abraham.
I wonder whether constructive surrogacy is possible from Hansen’s constructions, given the power relations in play. What circumstances make constructive surrogacy conceivable for both the surrogate and the intended parents? Like Hagar, surrogacy for nonwhite women can never be understood outside power relations; there is no exterior to this power dynamic. The conditions of surrogacy will likely never be favorable for Black women, mainly because of the numerous health disparities facing expectant Black women and the alarming U.S. maternal mortality rates that suggest Black women are three times more likely to die in childbirth than white women. Moreover, Hansen’s proposed distinctions of surrogacy fail to attend adequately to the ethical roles and responsibilities of the intended parents in these scenarios. Intended parents like Sarah and Abraham play a significant part in moving from constructive to injurious surrogacy.
Chapter Four provides a thick description of the cultural misorientations and corporate sins that alienate the intended parents, surrogates, and surrogate children from themselves, the communities to which they belong, and their relationships to the divine. Historical and contemporary constructs of the nuclear family as the normative model with two parents and biological children who live together in a single-family home strangles different possibilities for emerging and evolving families. Not all families are the same; neither do they need to be. Hansen identifies ways surrogate families have unique vulnerabilities and needs for dependency because of infertility, which may require new family arrangements. Chapter Five lays bare Hansen’s constructive vision for “consonant dependency care” that proffers broader family structures to welcome and include surrogates as equal members of the family. Williams argues there is nothing redemptive in surrogacy because of its exploitation, whether coerced or voluntary. Hansen maintains God desires human flourishing and “surrogacy, at its best, manifests the kind of flourishing God wishes for humanity” (142). The question remains: is the God of Hagar and the God of Sarah synonymous?
Conceiving Family is not written for Union or me, though Union and Wade belong to the upper class with greater access to surrogacy and chose a white surrogate couple to birth their daughter. It is not written for queer or trans couples facing oppressive theologies and restrictive legal policies that disavow any possibility for conceiving or raising children. This book is written for the majority—white upper-middle to upper-class heterosexual couples—who have experienced infertility or reproductive loss and choose third-party assistance as a last hope. Hansen rightly captures that the concept of family may mean “something different in nonwhite America than it does in white America” and even more so for “classes that cannot afford surrogates” (5). Surrogacy as a practice of faith is worth analyzing theologically because of its complex linkage to multiple systems of power in contemporary society. I appreciate Hansen’s examination of the practical theology of surrogacy and self as a solid introduction and conversation starter for students, scholars, and religious leaders to engage the relationships of God, self, and community amid unequal dynamics of power (7). Conceiving Family brings into closer view ways dreams fulfilled for some may mean nightmares for others, which is indeed a hard truth in the context of U.S. power relations and the tragic dramas retold in our biblical stories.
Gabrielle Union, “Gabrielle Union: The Hard Truth About My Surrogacy Journey,” TIME, September 10, 2021, https://time.com/6096588/gabrielle-union-surrogacy/.↩
Union, “Gabrielle Union.”↩
Delores S. Williams, Sisters in the Wilderness: The Challenge of Womanist God-Talk (Maryknoll, N.Y: Orbis, 1993), 4.↩
Williams, Sisters in the Wilderness, 19.↩
Post-Traumatic Remaking, Embodiment and Family Building
Danielle Tumminio Hansen posits surrogacy as a potential successful ending to a traumatic narrative of reproductive loss within the lives of intended parents. Reproductive loss can be a traumatic experience for some people, although it is worth noting, as Tumminio Hansen does, that not all reproductive losses are traumatic. Trauma has many and varied definitions, often related to concepts of power and powerlessness, the experience of being overwhelmed where ordinary adaptations to life are no longer sufficient, or missed encounters with death. Given the slipperiness of the definitions, it is perhaps more useful to consider the characteristics of a traumatic experience—the loss of bodily integrity, the rupture in language and cognition such that it is difficult—often nigh on impossible—to speak of and thus understand what has happened to you, and ruptures in time as the traumatic past continues to invade the present.1
I know this first-hand. In my twenties, I experienced a series of reproductive losses. Each of these reproductive losses ruptured my bodily integrity. My body contained death within it. I lost blood. I lost consciousness. I lost a fallopian tube. My body was opened up surgically. In my second experience of an ectopic pregnancy, I encountered death as I was rushed into the operating room for life-saving surgery. As I recovered physically after these experiences, my body no longer felt like a safe, impenetrable, invulnerable space. I became afraid of what my body could and could not do. I was terrified of getting pregnant again. I was terrified I would never get pregnant again. My bodily integrity was ruptured.
I had no desire but crucially no ability to talk about what had happened to me. I did not have the right words to articulate my feelings and my experiences. In fact, I struggled to remember quite what had happened. I could not remember the before-time, the joy of discovering I was pregnant. I could not piece together the sequence of events for each reproductive loss. Furthermore, I could not understand why this kept happening to me. It was unfathomable and felt inconsistent with everything I thought I believed about God and about being a person of faith. My language and my cognition were ruptured.
Finally, my experience of time ruptured. I experienced flashbacks and nightmares for many years as the past experiences—of being in hospital, of discovering I was losing another pregnancy—continued to haunt me. These past experiences continued to try make their presence felt in the present. I also felt trapped in some kind of limbo state. Having always wanted to have children and being convinced that was the next step in my life, I suddenly found myself floundering and encountering a future that potentially looked very different from the one I had imagined in the past. Similarly, each time I became pregnant, I found myself imagining a future with that child. Who would it look like? What school would it go to? What gender would it be? What would it be like to raise this child? Each reproductive loss rendered that future impossible.2
Suffice to say, these experiences were traumatic for me. I am intrigued, therefore, by the idea of surrogacy as a potential opportunity for post-traumatic remaking of the self. This language of post-traumatic remaking is mine rather than Tumminio Hansen’s. She prefers to talk about surrogacy, in this sense, as an opportunity in which intended parents (i.e. those who will go home with the newborn child) get to write an acceptable and happy ending to their reproductive narrative. Hansen uses the language of post-traumatic remaking within her analysis as she talks about the potential surrogacy has to offer the intended parents a sense of redemption as their identity as parents is enfleshed and the birth of a child offers opportunity for the restoration of relationships within the family and in the wider society. All of which, of course, helps to reconstruct and complete the reproductive narrative within this family.
As one who works primarily in trauma theology, with a keen interest in reproductive loss as a site of theological discourse, I want to focus here on what is missing in this presentation of surrogacy as a mode of post-traumatic remaking. It is significant that Tumminio Hansen has particularly focused in her book on the heterosexual couple who could potentially have conceived through sexual intercourse but, for whatever reason, cannot and so turn to surrogacy. In contrast, same-sex couples and single people would be far less likely to expect to reproduce in this manner and so are less likely (but not completely unlikely) to have experienced traumatic reproductive losses in their past. The focus on the heterosexual couple and their journey into surrogacy that is likely to be characterised by repeated attempts to get pregnant, puts the embodied experience here at a primacy. The absence in this mode of post-traumatic remaking, at least in the way Tumminio Hansen has outlined it, is the body.
Reconnecting with one’s body—learning to trust it again and retraining the body to regain control over the hyper-alertness that comes with the trauma experience—is a key element of post-traumatic remaking. Given that within surrogacy, the physical experience of being pregnant is out-sourced, is other-bodied, and given that, for many people who experience reproductive losses, their desire is not just to have a child but also to have a successful pregnancy, I query the extent to which surrogacy alone can provide the necessary elements for post-traumatic remaking.
Throughout her book, Tumminio Hansen emphasises the significance of the physical and biological for intended parents. Surrogacy is preferable to adoption not just because of the cost implications.3 Surrogacy is often considered to be preferable to adoption because, as Tumminio Hansen notes, cultural systems perpetuate assumptions around “certain connotations of ‘family,’ and the patriarchal desire to perpetuate one’s genes to the point that perpetuation becomes idolatry.” (81) The connotations of family that are preferable are those of the nuclear family in which biological relationships are at play between parents and children. The physicality and biological drive inherent within surrogacy are significant, particularly given the disembodied nature of the resulting pregnancy. Disembodied to the intended parents; not, of course, to the surrogate.
Tumminio Hansen notes the various ways in which intended parents might try to overcome the disembodied nature of this pregnancy through the wearing of fake pregnancy bellies, the refusal to tell children born of surrogates about their origins, and high level of investment in the physical health of the surrogate. As she indicates, this investment in the physical health of the surrogate can be taken to extremes as in the case in pre-2017 Indian surrogacy arrangements in which the control of the life of the surrogate is largely submitted to the healthcare professionals overseeing the pregnancy with controls over who the surrogate sees, what she eats, where she lives and how she spends her time (50–52). These strategies reinforce the absence of the body and, paradoxically, its persistent presence, within the experience of surrogacy for the intended parents.
What potential is there within surrogacy, therefore, for this bodily element of post-traumatic remaking to be addressed? In keeping with Hansen’s argument, I want to resist cultural assumptions about the significance of genetics in producing family and strategies of understanding surrogacy that reduce the surrogate to an object rather than a subject. I will not argue, for example, that ultimately holding one’s own flesh and blood in the form of a new born child is a sufficient embodied element to this remaking. Nor will I argue that attending every ante-natal appointment with one’s surrogate, physically touching the surrogate’s belly, or being present at the birth, is a sufficient embodied element either, as it reduces the surrogate to physical object rather than subject.
Finding ways of attending to one’s own body in the process of post-traumatic remaking can be difficult. Serene Jones highlights the ways in which she had to turn outside the Christian tradition to find the “liturgies of the flesh”—breathwork, yoga, acupuncture, massage—that ultimately helped her to reconnect to her flesh and through her flesh to those around her.4 I have explored the contribution that sacramental rituals of anointing and the Eucharist might make to post-traumatic remaking.5 But in this regard, if it is surrogacy itself that is the mode of post-traumatic remaking on offer here—the surrogate as the embodiment of a successful theology in whose body is help the cure to the reproductive trauma of the intended parents (40)—then the primary way in which the bodies of those who have been traumatised through reproductive losses can be reconnected with and retrained, is through the embodied nurture that creates a familial bond.
It is important to note that I am not referring only to care for a newborn child who bears the same genetics as the intended parents. In this sense, there is perhaps little difference between the surrogacy experience and adopting a child. It is, in this case, the embodiment of nurture, care, and love that helps to retrain and reconnect with the body in the aftermath of reproductive loss. An embodied response that might manifest across a lifetime of nurture, care, and love for this child regardless of whether any particular biology is shared between parents and child. As Susannah Cornwall notes in her work on adoption: “In some sense, all children, even those born to and brought up by their biological parents, need to be ‘adopted’ into their own families.”6 No child is born “knowing” their genealogy or the legacy of their family; rather, all children are “adopted” into such family narratives. Cornwall goes on to argue that the ways in which all families are made, complicate notions of generativity. Both Cornwall and Tumminio Hansen offer an expanded view of what might make a family, rejecting any sense of biological inevitability as the only or primary marker and highlighting the ways in which cultural imperatives have influenced the kinds of reproductive stories we are able to successfully narrate.
Regardless of the way in which a child enters a family—through unassisted conception, through assistive technologies, through surrogacy, through adoption—the new parent(s) have an opportunity to integrate that child into their family narrative. This legacy is dependent upon family story rather than family genes. This integration is an embodied experience in which the child is nurtured by the bodies of those around her. Not by feeding at the breast but rather through the ways in which these bodies around her perform the imago Dei seeking out her flourishing in concrete circumstances and actions throughout her life.7 As Tumminio Hansen notes, there may be a variety of people who perform such modes of being in the child’s life, potentially extending our understanding of family beyond biology even further.
Tumminio Hansen notes that the cultural misorientation of these assumptions that privilege one form of family and type of generativity over another, can also impact on the ways in which those traumatised by reproductive loss process their trauma. If one cannot picture any other kind of successful family save one in which children are biologically related to their parents, then the traumatised person will necessarily be limited in the ways in which they can construct the ending of their trauma narrative.
I note two things in conclusion here. The first is that some (if not most) trauma narratives may never end. No birth of a child, no matter how longed for, wipes away the trauma of reproductive loss (just as the resurrection does not do away with the crucifixion). The trauma survivor may find ways to flourish and survive but the trauma rarely just disappears. And the second is that if this is the case, then the church has a responsibility to foster and encourage a variety of ways in which family might be conceived. It must find a balance between honouring biological families without giving them primacy over all other kinds of families. This requires a multiplicity of generativity narratives that resists the cultural misorientation Tumminio Hansen has, quite rightly, demonstrated as “sinful” in her text.
Karen O’Donnell, Broken Bodies: The Eucharist, Mary and the Body in Trauma Theology (London: SCM Press, 2018), 6–7.↩
I explore the complex relationship between theology and reproductive loss in my forthcoming book on the subject.↩
It is worth noting the costs differences between the UK and US experiences here. In the UK a surrogate may only be paid expenses although there may be some attendant health care costs not covered by the NHS. Adoption, in the UK however, is free. This is a sharp contrast to the US experience.↩
Serene Jones, Trauma and Grace: Theology in a Ruptured World (Louisville, Kentucky: Westminster John Knox Press, 2009), 158.↩
O’Donnell, Broken Bodies, 179–88.↩
Susannah Cornwall, Un/Familiar Theology: Reconceiving Sex, Reproduction and Generativity (London: Bloomsbury T&T Clark, 2017), 119.↩
Alistair McFadyen, “Redeeming the Image,” International Journal for the Study of the Christian Church 16, no. 2 (2016): 111.↩
Selfhood and Its Limits
Danielle Tumminio Hansen has written a probing book, one that has prompted me to consider the practice of surrogacy in new ways. Prior to reading Conceiving Family, I regarded surrogacy as a primarily exploitative enterprise that, as Dolores Williams argues, invariably participates in the legacy of objectification of the bodies of poor women and women of color. Without sacrificing a concern for justice, Hansen offers the possibility of regarding surrogacy as a vocational practice that, at its best, directs our vision toward a more expansive understanding of family. Williams’s critique continues to capture my pessimism about the capacity of a society steeped in market capitalism and white supremacy with almost no social safety net and profound wealth and healthcare disparities to create the conditions necessary for the practice of surrogacy to develop in a just and humanizing way. Nevertheless, I applaud the nuance, care, and meticulous interdisciplinary analysis that Hansen has brought to the consideration of surrogacy from a practical-theological perspective.
I approached this book, and all conversations surrounding birth, motherhood, and reproductive trauma, primarily through the lens of my own prior work on prenatal loss. I’ve examined how the lack of attention to pregnancy loss in Catholic theology and ritual has consequences for the ways that we understand not only reproductive loss, but also pregnancy, childbirth, and women’s bodily experiences more broadly. The three interconnected areas of reflection I will offer in what follows all emerge from the inner conversation Conceiving Family provoked about the question of surrogacy, the phenomenon of miscarriage, and, inevitably, my own experiences of motherhood and loss.
First, after reading Conceiving Family, I was left with questions about the limits of narratives of selfhood, agency, and control as they relate to reproduction. As Hansen explains, many of the would-be parents who seek to have a child through surrogacy do so in the wake of reproductive trauma—infertility, miscarriage, stillbirth, and other negative outcomes. Part of what makes such experiences traumatic is the loss of agency involved (20). A miscarriage, for example, is an experience of consummate helplessness. There is nothing that can be done: no way to stop the bleeding, no medicine or procedure or intervention that would set things back on their course. Most of the time, the cause of the loss remains a mystery. The urge to grasp for explanations, most of which involve significant degrees of self-blame, is in many ways an attempt to reclaim a semblance of agency within a situation rife with wrenching ambiguities. Of course it wasn’t the glass of champagne consumed at the Christmas party before the pregnancy was known that caused the miscarriage—but supposing that it might have been is in some ways less terrifying than the alternative realization that the things we most desire in life lie just beyond our control.
I wonder, then, how a theological engagement with surrogacy might both foreground questions of agency and self-construction, as Conceiving Family does, and at the same time resist the myth of control that distorts American cultural attitudes toward fertility and conception more broadly. Infertility and pregnancy loss are jarring in themselves. Yet the trauma they provoke is magnified because they so deeply defy these cultural expectations of control. Reproductive loss speaks a kind of aching truth about the human condition. Rather than introducing anomalous vulnerability into the otherwise straightforward process of reproduction, such sufferings reveal the fragility that always already haunts the possibility of birth. For this reason, I found myself wondering about the ways in which these vulnerabilities persist within and beyond even the most healthy and fruitful surrogacy relationships. Fertility is always a condition with an asterisk next to it: it’s temporary and capricious, ebbing and flowing and sometimes receding without warning. I wonder what happens, for example, when the surrogate herself experiences the loss of a pregnancy—a situation that, while outside of the norm, can’t be entirely uncommon. What becomes, then, of the relationship between the intended parents and the surrogate? In this case, the surrogate’s ostensibly “functioning womb” has become yet another site of loss for the intended parents, and now for herself as well (41). Can this yet-wider circle of grief open up to accompaniment? Or is there an uncomfortable sense that the terms of a contract have been violated, albeit in ways beyond anyone’s control? Is the surrogate compensated as she would have been had the baby been born alive, her labor now spent shepherding a loss that both is and is not her own? I raise these questions as a way of asking whether the act of welcoming a surrogate into the childbearing relationship should be seen not first and foremost as a solution to a problem but, fundamentally, as a relationship of what Hansen terms “connected vulnerability” (122). Yet to be genuinely loving, this recognition of vulnerability must go beyond shared dependency and the mutual indebtedness that comes from inter-reliance. It seems that the more we are able to resist an overly efficacious, mechanistic understanding of the surrogate’s role in this expanded notion of family, the more successfully we might refuse the exchange-relationship paradigm that lurks dangerously close to this sort of arrangement.
My second area of inquiry is about the relationship between self-construction and intersubjectivity. Here, I will begin with a story from my own life. I suffered three miscarriages before ultimately giving birth to three daughters. Women’s experiences of miscarriage differ in many ways. Mine was was one of devastation. During the miscarriage years, I had equated future healing with the birth of a living child. I felt sure that finally having a baby would assuage my grief and redeem the losses I’d suffered. Yet when that hoped-for day finally came, and the weeks and months that followed, I realized with surprise that the sting of loss remained. The place these losses occupied in my life gradually evolved, but it has never disappeared. In retrospect, what felt at the time like a surprising revelation now seems obvious to me. Good and bad aren’t a math equation, where each unit of joy cancels out each unit of grief and you only feel the difference. These momentary lives and in-between deaths continue to exert their own sort of agency, even in seasons of consolation.
I describe this experience in order to situate a question that emerged for me about parental self-construction and the subjectivity of the child—the one whose hoped-for ingression into the world is the impetus for the surrogacy relationship. Hansen explores the mutual dependency (and thus the connected vulnerability) that exists between parents and child. While we typically think of the infant as the dependent party in the relationship, in fact, Hansen contends, parents are equally dependent on the infant for the construction of their parental identities:
That parental identity is not something they could procure for themselves but rather one that must be procured through the existence of another human being entrusted to their care, such that they are dependent on the child for the creation of it. In this way, the infant directly addresses the desire of each adult to be a parent and transforms the self of the parent into the self that the parent wants to realize (125).
I wonder if attending even more thoroughly to the subjectivity of the infant would deepen reflection about the question of mutuality in the parent-infant-surrogate relationship. Behind the lingering sting of loss I felt, I now realize, was a recognition that it was not simply that my previous attempts to achieve maternal identity had failed, and now at last they had succeeded. It was true that I had been transformed into a mother—the birth of this child had accomplished, or at least set in motion, that particular act of self-construction. I had become a mother to Nora, but there were also the mothers I’d never be, the mother to any one of the babies I’d lost. Pieces of the story I’d previously regarded as static—pregnancy, motherhood, a baby—were all fundamentally intersubjective realities. I wasn’t a mother—I was her mother; a different child would have made me a different mother. I didn’t long for a baby; I longed for this baby, just as I’d longed for each of the babies I’d lost. I still bristle when I hear a child born after miscarriage described as a “rainbow baby,” a colloquialism that has migrated from the blogosphere to the mainstream within the past decade. To me, the term feels like a reduction of the infant to the function that it serves within the parents’ story, as though the birth of one baby somehow redeems the loss of the last one.
Of course, the infant’s role in the familial relationship goes beyond function, beyond parental identity work and the fulfillment of desire (a point on which Hansen undoubtedly agrees). What defines all loving relationships is non-instrumentality, the defiance of the exchange paradigm. Of course, as Hansen notes, no relationship can be healthy if the parties involved do not uphold the subjectivity and agency of the other. But in the final place, a parent’s love for her child isn’t about who the child’s existence enables her to become. The parent loves the infant because the infant exists. I suppose that this is the challenge of surrogacy in general: it plays on the human tendency to instrumentalize human relationships to desired ends, so it takes a particularly robust set of safeguards and dispositions and cultural conditions to ensure that the surrogate is treated as a full subject rather than an object. By contrasting the practice of surrogacy in various global and religious contexts, Chapter 2 of Conceiving Family demonstrates this point vividly. I wonder how a more robust consideration of the selfhood and agency of the infant could make the book’s ultimate vision—a deeper and more expansive notion of family—even more radical and humanizing.
This point also relates to my previous one. In many ways, the newborn becomes the ultimate symbol of the limits of parental agency and control. Whereas the modern parenting complex would have new moms and dads believe that breastfeeding and co-sleeping and homemade baby food and the right preschool will make our children into the kind of people we always imagined they’d be, so much of who a child is and becomes lies utterly beyond our control. I’ll never forget the first time my oldest daughter started humming a song I’d never taught her. Where did she learn that? What else did she know? Barely old enough to walk, she was already a world unto herself. In her world, she was the protagonist and I was a supporting character, if a particularly ubiquitous one. Any sense of selfhood I constructed as a parent had to contend with the recognition that the one upon whose existence this parental self-construction depended—the child, this child—was an Other, a subject, a world unto herself. It was her agency, her selfhood, that would most challenge my own self-construction, calling me to become not the mother I always wanted to be but a different kind of mother entirely, one only she could make me. I love her to the extent that I allow the reality of who she is to supplant the image of who I imagined she’d be—and, in turn, who I imagined I’d be.
My final question is about ritual and community. In both the religious and secular spheres, we lack rituals through which to mourn reproductive loss. We have liturgies and traditions and familial social scripts to turn to when marking life’s clear beginnings and endings. Yet no comparable rituals—religious or secular—accompany parents in those more hidden, ambiguous experiences of death-before-life.1 Ritual is important because it offers a template for weaving a single story into the anthology of a community. A ritual speaks in the language of a community, saying to those who mourn, we have been here before. Come: let us show you what to do. Without a socially recognized way of drawing such losses into a larger communal story, the pain of loss is compounded by isolation, loneliness, questions of meaning, and an aching sense that one’s grief is illegible to her community. I have often considered how ecclesial communities might offer better liturgical care for women and families suffering from miscarriage and other forms of reproductive loss. Conceiving Family has broadened my reflection even further. Calling readers beyond the myopic self-sufficiency myth at the root of emphases on the nuclear family, Hansen evocatively enjoins us to consider the mutual care and connection that are part of any birth: “All reproduction could rightly be termed ‘assisted’” (100). In view of this point, I wonder what it would look like to expand our liturgical and ritual imaginations to encompass an even fuller understanding of the relationships that make a family, including surrogacy, adoption, and other experiences that speak to this more capacious vision.
On this point, see Susan Reynolds, “Catholic Liturgy and Prenatal Loss: Ritual, Ambiguity, and the Miscarrying Body,” in Liturgy & Power, edited by Brian P. Flanagan and Johann M. Vento (Maryknoll, NY: Orbis, 2017), 128–42; and Reynolds, “From the Site of the Empty Tomb: Approaching the Hidden Grief of Pregnancy Loss,” New Theology Review 28, no. 2 (2016): 47–59.↩
Exploring Surrogacy Among Gay Men and as a Theodicy
Exploring Surrogacy Among Gay Men and as a Theodicy
Danielle Tumminio Hansen has written a marvelous book on surrogacy. I say this as someone who not only has a forthcoming book on this same topic, but also once served as a surrogate for a set of friends. I appreciated the three-part typology she constructs for evaluating this method of collaborative reproduction, where the differences between and among “constructive,” “resistive,” and “injurious” surrogacy arrangements lie in the varying ways the participants “exhibit faith, hope and love toward each other” and insofar as the “overarching cultural values of the system affect their ability to do this” (78).
While I have a few quibbles,1 Tumminio Hansen has captured the experiences of the “surrogacy triad” (the commissioning parents, surrogate mother, and resultant child) quite well. This is likely due to her turning to the social scientific literature on surrogacy and to the Austin, TX-based surrogates who “shared their perspectives and indulged [her] abundant questions” (x). Contrary to widespread misperceptions about surrogate mothers bonding with the developing child in utero and thus experiencing deep pain or even regret at the handover, the author correctly describes these women as not ordinarily seeking recognition as the parents of the child they bore for others, but wanting “validation” for their identity as surro-moms and for the “specific contribution they ma[d]e to the reproductive process” (95). Likewise, contrary to popular beliefs that “altruistic” surrogacies are categorically distinct from “commercial” ones because surro-moms are purportedly driven by love in the former only but financial gain in the latter, Tumminio Hansen correctly acknowledges what four decades of surrogacy research has shown: surrogates who receive financial compensation often report a combination of self- and other-regarding reasons for their service. What’s more, just as many in society recognize that teachers or healthcare providers in the “helping professions” can be “motivated by altruism to do any number of things and still receive payment” without concluding that the remuneration has canceled out their benevolent intentions, so the author wonders—as do I in my own work—why surrogates who are paid to become pregnant for others are held to a different standard (93-94).
While there are other matters I could lift up in this review, I will focus my remaining comments on two substantive points. The first concerns a limitation Tumminio Hansen acknowledges—the heteronormativity of her work. The second concerns my ambivalence about her framing of surrogacy as a theodicy.
“Conceiving Family” Privileges the Experiences of Heterosexual Couples
No book the length of this one could possibly cover every sub-topic or variety of surrogacy. Given the tremendous diversity in surrogacy customs and laws across the world, the author’s acknowledged limitation of her focus on surrogacy in the U.S. with some references to practices in two other contexts, Israel and India, made sense to me given her desire to offer a context-sensitive, practical theology. Moreover, given the voluminous scholarly and societal attention already devoted to discussing the morality of pregnancy termination, so did Tumminio Hansen’s acknowledged limitation of engaging various ethical issues surrounding abortion only “tangentially,” particularly given her acknowledgment of abortion’s connection to the IVF or third-party reproduction involved in surrogacy, as each practice may lead to “embryos that do not culminate into a freely breathing newborn” (6).
That said, when I came across Tumminio Hansen’s third and final acknowledged limitation, that “many of the examples in this book draw from the use of surrogacy by heterosexual couples because of the book’s emphasis on infertility and reproductive loss as motivators for it,” I couldn’t help but wish she had decided differently (6, emphasis added). Family expansion via surrogacy is an increasingly popular path to parenthood for gay male couples, and some fertility clinics and surrogacy agencies in the U.S. (and elsewhere) accordingly cater to the distinctive needs of their gay clientele, especially when they are foreign intended parents shut out of access to ART and/or adoption in their home jurisdictions.2 in their desires to have children in ways most heterosexual couples will not. In addition, the real or perceived advantage of biogenetic continuity that surrogacy offers will often lead to complex decision-making among gay couples about which of the two intended fathers will also be the genetic one, which is then not uncommonly followed by intrusive personal questions from intimates and strangers alike about their decision—about which one of them is the “real” dad.3
This latter point about genetic fatherhood simultaneously reveals an area of commonality with their straight counterparts: gay couples also experience pressures to conform to the “biological family model,” where “‘family’ means shared blood” and the couple’s recognition as a “family” increases once they are able to have biological children (29-30). For instance, a study of 40 gay men who had recently become fathers through a California-based surrogacy agency found that most experienced both an enhanced sense of self-esteem in finally being able to have both a loving partner and a child with him and “increased recognition of their family unit after having children” from their families, friends, work colleagues and other acquaintances.4 The research also shows some gay men expending considerable effort to produce children in other ways that conform to the “biological family model,” most especially by arranging for the resultant child to physically resemble both dads. An Australian, interracial couple who selected two egg donors with attributes resembling the (respective) non-genetic father explains the rationale behind their process thusly:
A different path some have called the “gold standard” and pursued by actors/husbands Neil Patrick Harris (among others) involves selecting one egg donor, fertilizing half with one partner’s sperm and the other half with the other partner’s, and then transferring two embryos at a time (the “best quality” from each). If both embryos implant and eventuate in live births, the twins would be biological half-siblings (due to use of the same egg donor) with both partners becoming fathers genetically related to their children at the same.6 as a first choice—as something allowing for biogenetic continuity as well as greater legal certainty of parentage in some contexts over what would be the case if they were to pursue adoption or an informal arrangement with a single woman or lesbian couple.7 Gay couples, in short, usually do not have the “traumas of reproductive loss and of infertility” that Tumminio Hansen aptly describes most heterosexual couples must first put to rest (38). What’s more, the research shows that this absence of reproductive trauma can often lead to smoother relations between surrogates and gay male intended parents in contrast to surrogates and intended mothers, particularly when the infertile women have unresolved feelings of loss, sadness, jealousy, or even “womb envy” and thus may experience more ambivalence and potentially more power struggles with their surrogates. As evident among surrogacy discussion boards I frequented when I served as a surro-mom for my friends, some “repeat” surrogates expressly prefer to work with gay male couples over straight ones for this very reason alone. In ways I expand upon in my own work, heterosexual couples who turn to ART or adoption to become parents have something to learn from queer couples since the latter have been managing the presence of third-parties in reproduction or family-building since the beginning of same-sex headed families.
Surrogacy as a Theodicy?
Pivoting now to the second matter, I confess to feeling ambivalent about Tumminio Hansen’s characterization of surrogacy in terms of a theodicy. Granted, I understood and appreciated the various roles intended parents or society-at-large have cast surrogate mothers in: as “social heroes,” as “allies” to the involuntary childless couples who have long struggled with infertility, and even as social deviants or the “antithesis of culturally normative views of womanhood” for their willingness to “carry the baby of a man who is not her husband” and then relinquish the baby at journey’s end (39). In their “social hero” or “ally” role, I can appreciate how a woman who agrees to become pregnant for an infertile couple can indeed be the “curative to the reproductive trauma experienced by the intended parents” (40). As the surrogacy literature and my own experience confirms, I can also appreciate how surrogates “often become the embodiment of hope for those who experience infertility and reproductive loss” (142). But to accordingly cast surrogate mothers as the “embodiment of a successful theodicy” insofar as it is appropriate to frame “infertility or reproductive loss… in terms of theodicy” and accordingly view surrogates as persons capable of “address[ing] this particular problem of evil directly”? (40, 142). And to suggest that the “children birthed through surrogates may function as a theodicy solution for the parents” (102, emphasis added)? Despite Tumminio Hansen’s intentions to emphasize the way surrogates help intended parents “rewrite the ending of their reproductive story that seems impossible to write, allowing those individuals to restore a sense of agency in the process,” I fear that introducing theodicy language into her analysis will perpetuate biblical notions that fertility and infertility are matters of God’s will, not potential human control. The long biblical tradition of linking intact or restored fertility as a reward for righteousness and infertility (or “barrenness”) as a possible sign of divine disfavor, punishment for sin, or even test of their faithfulness in my judgment should be put to rest.
This is to say I am much more comfortable thinking of infertility as a medical problem than a theological one. I do, of course, appreciate how many Christians today still seek to theologize about the agony of their infertility. My friend and colleague, feminist Catholic thinker Gina Messina, among others, is tempted to curse God for her infertility and has published about drawing comfort from stories of “biblical foremothers who shared her barren state” when personally identifying with Sarai’s anguish and bitterness, Rachel’s envy, and Hannah’s hope in her years long struggle with infertility.8 I appreciate how crying out to God in prayer and supplication is compatible with persons also exploring medical and ART services in response to involuntary childlessness. But to conceptualize surrogacy as a theodicy is to place involuntary childlessness in a larger place than I am prepared to accept. And that’s probably because I do not believe the experience of infertility “should” be the type of thing that leads someone to question either the existence or goodness of God—and yet I acknowledge that for many, the painful experience of infertility nonetheless does lead to such questions.
I am, to be sure, quite comfortable with other ways Tumminio theologizes about surrogacy: about, for example, the surrogate’s freely expressed generosity mirroring the “freely offered generosity of a God who shared God’s self in creation, in the life of Jesus, and through continued commitment to human flourishing” (74). Based on my own research of “repeat” surrogates, I’m even comfortable conceptualizing surrogacy as a “vocation,” believing that some women have a particular “charism” to perform a service that many others simply cannot. But, at least on my reading, framing conception in terms of theodicy might provide some justification to various theologies that chalk up infertility to a facile notion of “God’s will.”
My quibbles include Tumminio’s unsubstantiated claim that surrogates are “more likely to be minorities” when there is no federal statistics to suggest this and even empirical studies to suggest otherwise (i.e., these surrogacy studies show white people being overrepresented on both sides of the surrogacy dyad equation—as surrogate mothers and as intended parents) and her implication that disclosure to surrogate-born children of their origins is not the norm when many empirical studies suggest intended parents disclose to their children the unusual circumstances of their birth at an early age (46-48).↩
What of surrogacy practices beyond straight or gay male couples? Consider “reciprocal IVF,” where two female partners in a queer couple could participate biologically in their child’s birth by retrieving and then fertilizing one partner’s eggs (with donor sperm) and then transferring the resultant embryo(s) into the other partner for gestation and childbirth. Some refer to a woman or trans man in a LGBTQIA+ couple who undergoes this reciprocal IVF process and carries their resultant embryo(s) as a “gestational carrier,” too, since they must undergo the same IVF + heterologous embryo transfer process as gestational surrogates must to become pregnant. Following convention, however, I do not consider use of “reciprocal IVF” as involving surrogacy because that couple would not be undergoing a pregnancy for someone else—the pregnant person would be carrying and delivering a child for themselves (them and their partner) to raise. Of course, if neither women in a same-sex partnership could gestate and deliver their child, they could commission a third-party (surrogate) to do so on their behalf. However, I know of no such cases (anecdotally, in surrogacy discussion boards, or in the published literature) where a surro-mom has been commissioned by two women intended parents.
The research on families who turn to surrogacy shows that the experiences of gay men both overlap with and depart from some common patterns found among infertile heterosexual couples. Had Tumminio Hansen’s book covered both, we readers would not have only received a fuller capture of surrogacy in the U.S., but also a deeper understanding of the experiences of the straight couples she privileges because we would then be able to understand them in comparison to and contrast from the gay couples who likewise have taken this unconventional route to parenthood.
In what ways do the surrogacy experiences of gay men overlap with and depart from those of infertile straight couples? To begin with a key contrast, gay men will likely have had to face gendered assumptions about male incompetence or male inferiority as their hoped-for child(ren)’s primary caregivers, discriminatory “legal barriers at state and federal levels” to parenthood, and possibly even “accusations of paedophilia”[footnote] The social disapproval intended parents feel is so common that even philosopher Kwame Anthony Appiah of the popular New York Times “The Ethicist” column addressed it on Feb 10, 2016 with this title: “Is it Selfish for a Gay Couple to Have Kids via Surrogacy?” For particular challenges facing gay male intended parents, see Dean A. Murphy, Gay Men Pursuing Parenthood via Surrogacy: Reconfiguring Kinship (Sydney, Australia: University of North South Wales Press, 2015) 21–22.↩
Of course heterosexual couples who have used one, but not two, gamete donors will also resultingly have only one of them biogenetically related to their child, though this truth might not be as obvious to the outside world as it will be in the case of same-sex IPs if they are able to find a gamete donor who physically resembles the non-genetic parent (as most attempt to do).↩
Kim Bergman et al., “Gay Men Who Become Fathers via Surrogacy: The Transition to Parenthood,” Journal of GLBT Family Studies 6.2 (2010): 111–41 at 137.↩
See Camisha Russell, “Rights-holders or Refugees? Do Gay Men Need Reproductive Justice?” Reproductive Biomedicine and Society Online 7 (2018): 131–40 at 137. To be sure, the organization Men Having Babies discourages this route in their “Framework for Ethical Surrogacy for Intended Parents” given the increased risks to the babies and the surrogate. See https://menhavingbabies.org/cms-data/depot/docs/MHB_Framework-for-Ethical-Surrogacy_2016_MHB-Handout.pdf.[/footnote] There are other cases of gay men becoming fathers through surrogacy who are both biologically related to one and the same child. This last variant is possible when either the egg donor or their traditional (not gestational) surrogate is a sibling of the non-genetic father. As we can see, gay men may be comfortable with “queering” sexual norms in their same-sex partnership or marriage, but what Tumminio Hansen has aptly described the “primacy” and even “supremacy” of the biological family still holds constant among them.
A final notable difference between the experiences of gay, as opposed to straight, couples’ turn to surrogacy is the stage at which the couple turns to collaborative reproduction as their path to parenthood. Among straight couples, given many heterosexuals’ reluctance to involve a third-party in their child-bearing plans, their use of a surrogate mother is often a “last resort,” something pursued only after they have tried and failed at all other options on the “infertility treadmill.” In contrast, same-sex couples know from the start a third-party of some kind must be involved in any route to parenthood (e.g., the birth mother in an adoption scenario, a sperm donor for a lesbian couple) so the turn to ART among LGBTQIA+ couples is neither typically bundled with shame, nor a sense of failure. Not coincidentally, it is not uncommon for gay men to pursue surrogacy “joyfully as a doorway to parenthood” [footnote] Mitchell and Green, “Different Storks for Different Folks,” 82.↩
Mitchell and Green, “Different Storks for Different Folks,” 82.↩
Gina Messina, “Cursing God (Infertility),” in Encountering the Sacred: Feminist Reflections on Women’s Lives, eds. Rebecca Todd Peters and Grace Y. Kao (London: T&T Clark, 2018) 119–31 at 121–22.↩
1.25.23 | Danielle Tumminio Hansen
Response to Grace Kao
I’m tremendously grateful for Grace Kao’s thoughtful analysis, and as I reflect on the richness of her comments, I want to consider two themes. First, I want to affirm and expand upon the distinctions she draws between same-sex couples who turn to surrogates and heterosexual couples who do the same. Second, I want to consider Kao’s suggestion that reproductive traumas are most appropriately framed as medical problems rather than theological ones.
Kao is right that same-sex couples or single individuals choose surrogacy for different reasons than heterosexual couples, and that these reasons often impact the way these individuals interact with the surrogate. For instance, because same-sex couples and single individuals know they will require assistance to start a family, they may start working with a surrogate early on in their attempts to create children. In contrast, heterosexual couples may be more likely to pursue surrogacy after multiple failed attempts to bring a pregnancy to term by other means. This suggests they are more likely to pursue surrogacy having experienced some degree of trauma during the reproductive process, which may impact how they relate to the surrogate and frame the experience.
I chose in my work to limit my explicit analysis to heterosexual couples in part because there was a dearth of studies on the reproductive experience of same-sex, single, and trans individuals. Given my intention to discuss how the experience of reproductive trauma might impact the practice of surrogacy, it made sense at the time to focus on heterosexual couples, since they have been the subjects of most of the (then-existing) studies into surrogacy, IVF, and assisted reproduction. Perhaps I could have more strongly condemned the heterosexual privileging of fertility research. In fact, such privileging, whether intended or not, is a symptom of cultural assumptions about the ideal family, which, in the vocabulary of my book, I call “corporate sin” or “cultural misorientation.” In a culture where insurance payouts and adoption policies are based on accessible data, it is sinful that our heteronormative institutions systematically fail to carefully attend to the realities faced by LGBTQ intended parents.
I also limited my analysis to heterosexual couples because they are more likely to want to adhere to what I refer to as the “idol of the biological family,” by which I mean the assumption that creating a family via biological reproduction is both normative and, in turn, viewed as a superior way to create a family. I suggest that adherence to this idol can result in practices that harm all members of the reproductive system—including surrogates, intended parents, and children—because of the way the idol privileges genetics over relationships and subjectivity. Kao takes a different approach by expanding her analysis to same-sex couples, and her forthcoming book on surrogacy will no doubt be an important contribution to the literature because of its perspective. I look forward to putting our books in conversation at a future date, especially because when I was working on Conceiving Family, there was a dearth of studies about the reproductive experiences of same-sex couples, single individuals, and trans individuals.
Apart from her points about same-sex couples and surrogacy, what stood out to me most in Kao’s analysis was her comment that it is more appropriate to frame infertility and reproductive losses as medical rather than theological problems. As a minister, this comment left me considering what is at stake in this assertion.
I believe—if I am reading Kao correctly—that we both agree that reproductive problems are medical problems. If we reduce the medical only to the theological, then we run the danger of eviscerating the important contributions that medical professionals have made.
I am also going to assume that we agree that questions of theodicy are reasonable ones to raise when life takes a turn for the worse. To do otherwise, I think, is to cede too much epistemic ground to other disciplines. But perhaps more fundamentally, to be human is to be a meaning-maker, to some degree or other, and to be curious about our lives. So when a logical clash results between life itself and one’s belief in a just, good God, we are curious about it. It raises questions of a foundational nature that relate, as Tillich said, to the ground of our being,1 and that allow us, as Marilyn McCord Adams says, to wrestle for blessing.2 If we overlook the value of such questions, then we are ignoring some of the curiosity that makes us human.
Assuming we agree on these points, then what are some viable options going forward? One might be to embrace process theology. This opens up possibilities for divine-human solidarity while alleviating the pressure on the problem of evil because God lacks the power to twist human experience for the worse. However, one problem with this approach, as some critics of process theology have argued, is that lessening God’s power raises fundamental questions about whether this being is still powerful enough to fit the definition of “God.”
Relatedly, one could take a panentheistic approach and argue that God is embedded within human experience such that God is not in the business of intervening in our lives from afar but rather engages in solidarity with our lives from within. Again, this alleviates some of the pressure on theodicy as a question worth asking, but it raises different questions about whether God fundamentally needs creation to exist.
If I am reading Kao correctly, though, neither of these are sufficient, because her concern is less about the ontology of God’s power as it is about the conclusions humans draw from theodicy questions. Specifically, she is concerned about humans concluding that the purpose of infertility or reproductive loss is that God uses these events to punish the person who is experiencing them. I agree that such theologies are highly problematic. To say that one loses a much-wanted pregnancy or cannot conceive because God does not want that individual to have children renders God into a tyrant who is willing to punish individuals for no reason and who relishes in sacrificing the overarching goodness of a person’s life for God’s own purposes.3 The same might be said of suggesting that God gave someone cancer to teach a lesson or that losing a limb in a car accident is meant to punish the person for drug use. This kind of ideology is dangerous and not one that either Kao or I espouse.
So perhaps Kao is right that individuals should not ask the question because one should feel no shame or judgment because of how one’s body functions. Yet because I see humans as fundamentally curious and because I do believe there is value in asking challenging theological questions, I’m hesitant to conclude that a particular way of resolving a theodicy means that theodicy should be taken off the table entirely. Indeed, given that some people do feel shame in the face of their reproductive traumas and are often unsure about how to move forward, I’m convinced that the process of turning to God and wrestling for answers can be valuable. Not only can this questioning provoke healing, but by engaging in it, we have an explicit opportunity to undo some of the theological constructions of infertility and reproductive loss that Kao rightly finds troubling.
What I see as a more productive way forward, then, is to shift the emphasis from outcome to process when it comes to theodicy. I want to affirm the value of curiosity and questioning, in part because I believe we are fundamentally narrative beings, and in part because I see theodicy as an opportunity to disrupt the damaging discourses around infertility and reproductive loss that Kao highlights in her rich response. In focusing on process as opposed to outcome, then, I propose that questions of theodicy remain relevant because they open space for discernment rather than predetermined conclusions. In turn, they enable individuals to continue to write their reproductive stories, to find meaning in their experiences, and to deepen their sense of purpose as they seek to pen a more fitting conclusion to a story that they feel has gone wrong.
Paul Tillich, Systematic Theology, Volume 1 (Chicago: University of Chicago Press, 1951). 156.↩
Marilyn McCord Adams, Wrestling for Blessing (New York City: Church Publishing, 2005).↩
Marilyn McCord Adams, Horrendous Evils and the Goodness of God (Ithaca: Cornell University Press, 2001) 28.↩