Queering reproduction in transnational bio-economies

Abstract

In this commentary, I consider how scholars, practitioners and those seeking to have babies via assisted reproductive technology (ART) might be accountable to 21st century family-making in ways that attend to reproductive stratifications (the uneven support for people to conceive and raise children), and yet refuse to renaturalize or valorize certain forms of reproduction or reproduction by certain categories of persons [e.g. lesbian, gay, bisexual, transgender and gender queer (LGBTQ)/non-normative people]. I offer a queer reproductive justice (QRJ) framework that joins the shift in feminist politics from advocating safe, affordable and equitable access to ART to imagining other ways of doing and making kinship, care and children. QRJ suggests that kinship can be queered via choice and ART without succumbing to either a binary choice between queerness and normativity or without being unaccountable to oneself, others within systems of power, and the very systems that make our choices legible. QRJ neither marginalizes nor valorizes LGBTQ desires and practices for inclusion in reproductive biomedicine, and refuses to renaturalize or valorize certain forms of reproduction over others. Instead, QRJ posits queer kinship as a social formation that variously challenges and reinforces the values of neoliberal, future-oriented reproductivity and the global biological market economies in which these increasingly take shape. QRJ encourages kinship forms that include multiple possibilities for intimacies, belonging and making kin.

Political projects in the USA often reflect ideological debate about how to arrange and care for social kin in increasingly privatized economies, especially since the 1970s (Briggs, 2017). From the demonization of Black single mothers as ‘welfare queens’ to the so-called perversions of ‘sexually excessive’ gay men, political battles often focused on the lives and practices of those residing either outside of hetero-reproductivity or seen as outlaws within its bounds (racially, socially, economically, or deemed too young, unmarried, etc.). Political battles reflect not only a ‘culture war’, in the nomenclature of the 1990s, but also struggles over how to arrange social life – its legal dimensions, intimacies and care for one another. The politics surrounding human reproduction – from abortion and contraception to assisted reproductive technology (ART) – reflect these contestations around the very organization of social life, from kin and family to support and care, as well as the presumed ‘naturalness’ of family-making.

In this commentary, I consider how scholars, practitioners and those seeking to have babies via ART might be accountable to these broader politics of 21st century family-making, and do so in ways that attend to the rhetorical and material stratifications shaping human reproduction, and that refuse to renaturalize or valorize certain forms of reproduction or certain family-makers. The politics of ART, I argue, are constitutive of a broader politics of gender and sexual normativity made possible through the biological-economies (bio-economies) in which these are situated. I offer a framework of queer reproductive justice (QRJ) as a bio-ethical suggestion for how to be accountable to oneself and the people that make assisted reproduction possible without renaturalizing certain forms of reproduction in calls to curtail ART use. To be accountable, I argue, is to understand the structural and interpersonal inequities inherent in and productive of the global bio-economy of assisted reproduction, referring to the ways in which biological materials, bodies and bodily labours are commoditized and exchanged via cross-border transactions. As Vora (2015) has argued, biological materials and bodies are today essential to global capitalism. Practices of ART, as well as the technologies themselves, are part of and often reinforce power relations of capitalism, racialization, imperialism, and gender and sexual hierarchies. Today, intended parents and suppliers of biological labour and biological materials are enrolled in ART at an unprecedented pace, often consistent with what scholars term ‘stratified reproduction’, referring to the ways in which reproduction and child-raising follow power lines where the lives of the most privileged economically, socially and politically are supported with social policies, as well as with the labour of those least privileged economically and socially (Ginsburg and Rapp, 1995). In today's bio-economy, this support often comes through the material and labour extractions of those most ‘vulnerable’ around the world (Nahman, 2013). Such (re)enforcement of power relations is often conjoined with the reproduction of normativity that occurs despite the identities, social status positions, and ways of living of the intended parents and recipients of ART. This technology remakes life (and kinship) in familiar ways (Franklin, 1995, Franklin, 1997, Franklin and Ragone, 1998, Yanagisako and Delaney, 1995), and has been instrumental in reconstituting normativities of binary gender, nuclearity, biological ties and dominant forms of kin-making. While scrutiny and debate surround many of the uses, technologies and structural contours of ART, a concern of this commentary is the ways in which non-heterosexual, lesbian, gay, bisexual, transgender and gender queer (LGBTQ) people who (also) figure in the making of families via ART (along with heterosexual couples and persons) are often called forwards politically by various conservative movements, feminist and otherwise, as reason for closing the barn door and enacting new regulations.

My goal in advocating QRJ is to highlight some of the many linkages of reproductive justice and queer politics. I do so first to emphasize the ways in which justice itself is about how people are treated and how societies are constituted, and how personhood and our social relationships are made legible within systems of social norms (Butler, 2001); and second, to refuse the continued telling of natural reproduction as a story of heterosexual, dyadic, nuclear and/or biogenetic relationships. Reproductive justice and queer politics share concerns about how people are treated differentially and the criteria used to establish difference, as well as personhood, relationships and what constitutes intimacies. It follows to ask: how might we, as scholars and practitioners of ART, recognize the ways in which queer people and queerness are materially and representationally part of the bio-economies and stratifications of this new technology? How might we be ethically accountable to the ways in which some people's reproductive choices are supported by other people's lives, and in ways that take account of the many histories of racialization, capitalism and imperialism reflected in the control of bodies, reproduction and social lives, and the ways in which such choices are made legible through valorization and normalization of some people's biodesires and biodreams? In what ways might we reframe reproductive justice to ensure ethical accountability to others and oneself (e.g. by recognizing the very systems that make our reproductive choices appear self-made) while we simultaneously refuse a politics of (bio)reproductive exclusions for some over others? Finally, how might we expand considerations to include the conditions that enable support for normative and other ways to organize, care for and arrange kin-making without wholesale disavowal or acceptance of bio-kin-making and the stories of natural reproduction?

Questions of justice emerge, in part, from the shift in feminist politics in the USA from demanding reproductive rights and its assumed emphasis on individual choice towards reproductive justice and its emphasis on gaining group-based and community-level conditions of social justice. Moving from rights to justice emphasizes a right to reproduce (or not) with safe, affordable, accessible and equitable technologies, and with the social-political-economic conditions necessary to have and raise children or live in various arrangements of what is called ‘child-free’. The questions posed above also emerge from queer politics (and theory) that insist on valorizing a concept of nature over techno-making, even as all stories are made to justify certain positions. Queer politics refuses the natural, normality, normalization and normativity. Many under this umbrella of queer seek to challenge the bounds of presumed legitimacy and respectability, while others claim inclusion in these representational politics of belonging to normativity; for example, the fight for marriage and other forms of socially recognized ‘respectability’.

In previous research (Mamo, 2005, Mamo, 2007a, Mamo, 2007b), I examined the structural politics and interpersonal engagements of lesbians in the USA as they sought reproductive freedoms through ART. I examined their use, the larger economic and organizational structure of fertility biomedicine, and the technologies of assisted reproduction for both the ways these might reproduce normativities and non-normativities and, specifically, how intended parents participate in ways that might subvert norms of family, gender, sexuality and kinship. Queering Reproduction understood lesbian women's pathways to parenthood as ‘choices’ situated in historical and contemporary politics of gender and sexuality that include discrimination and structural exclusions in major institutions (legal, medical, social, etc.). Lesbian reproductive practices, I found, were shaped by the technoscientific, legal and social organization of ART, as well as lesbian and gay sexual rights and feminist social movements in and around the turn to the millennium. Their conjoined gender and sexuality mattered, I argued, to the shape, meaning and rights of their family-making, as did their economic/class, race and other social status positions in American structures. As Briggs (2017) recently argued, and I showed empirically in Queering Reproduction, much of the unfolding demands of lesbians were demands to protect parental rights, to live free from having children removed in custody or other legal battles due to their sexual status, and to subvert the family norm of a male parent. Nonetheless, as lesbians engaged in making families, several things were being produced along with humans: (i) a consumer marketplace of biomedicine that stratified users by those who could pay (and providers who needed payment); (ii) a biomedical and legal structure (although laws lag) that supported biological relatedness, intention to parent, and heterosexual biomedical and legal definitions of infertility, parents and what constitutes a family; and (iii) a sentiment of belonging made possible through ‘a politics of respectability’ (Eng, 2010, Gould, 2009, Ward, 2008).

Yet all was not a reinforcement of normativity. With the feminist, lesbian and gay politics of the 1970s–1990s came building ‘families of choice’ (Weston, 1991) that included both queer collective households and families resembling nuclear forms. Some family forms included women and men coming together to seek pregnancies, and others were organized as same-sex parents. These shared a necessity to find ways to get pregnant and to raise children in a context that barred gays and lesbians from commercial sperm banks and threatened their parental rights. Alternative and non-profit health movements and community-driven informational practices soon emerged and led the way to more formal and commercial health centres, sperm banks and professional societies that supported and protected the increasing number of lesbian and gay families. I found that by the mid-1990s and into the 2000s, lesbian reproductive ‘choice’ was increasingly shaped by and constrained within what had emerged as a biomedicalized menu of technological offerings. In other words, their access and use of ART was increasingly structured by biomedical organizations and their technological offerings. Choosing a male friend and expanding relationships to include co-parenting, special uncles or bio-dads was fast disappearing from their reproductive possibilities. Instead of choices shaped within LGBT and feminist politics, they were shaped by biomedical organizations, healthcare insurance policies, and a culture of future-oriented reproductivity and family-making. The practices of sperm banks to freeze, quarantine and anonymize sperm protected people relying on sperm donation from paternalistic parental claims to their future children.

By the turn to the 21st century, much of LGBTQ politics had shifted towards demands for inclusion in heteronormativity, nuclearity and the rights that came with legal marriage. While this included the right to follow one's desires to participate in the enduring and valued social norm of nuclear parenthood, it also included the right to lay claim to one's children and to care for a sick or disabled child or partner without another laying claim to your kin. LGBT mainstream politics were a bitter pill for many, given the ways that this reinforced normativity and endorsed the privatized politics of exclusion that were fast shaping social worlds, as Briggs (2017) argued. Families as private entities that were once protected by welfare state policies were fast becoming responsible for their own, individual economic weight. While challenging marriage exclusions and advocating for inclusion into normativity through access to institutions such as marriage, family, the military, and biomedical and health care was a welcome project for some, others found it to be a necessary means to protect their chosen kin even as they did so in lieu of advocating for more universal public policy protections. This included the legal right to adopt, birth and name same-sex parents on birth certificates, and parent children and to do so with the institutional and cultural recognition of their heterosexual peers. By the mid-1990s, major shifts in information technologies and the internet allowed people to engage in commerce, networks and communications as never before. Lesbian family-making was fast becoming a biomedicalized (Clarke et al., 2010, Mamo, 2007b), commodified and neoliberal set of family-making practices (Mamo, 2007a, Mamo, 2007b), enabled by the hard-won support of medical, economic and social inclusions.

Lesbian family-making also included expansion of who and what makes a parent – a ‘mother’, a ‘father’ tied to norms of gender – as well as what constitutes a ‘family’ – tied to norms of sexuality. Lesbians' practices were able to disrupt the assumed naturalness of gender and sexuality in the social positions and practices that constituted lesbian family-making. While sexual norms are displaced due to the configuration of the social dyad, gender norms are nonetheless re-enforced by their very reproductive practices and bodily alignment. I found also that many lesbians were at the forefront of denaturalizing kinship and constructing relatedness anew with ART by rethinking the assumed linkage of bio-ties, gender norms and practices of mothering. Some constructed families as including multiple parents created by donor dads, uncles or friends, and later by ‘willing-to-be-known’ donors. These families recognized that providers of biomaterials were not necessarily dads, nor their biosubstance grounds for a family tie, but instead that these were variously materially significant and grounds for social story-making and meanings of their own (even as if haunted by the concept and norm of ‘nature’). Some were also at the forefront of extending ‘family’ to include donor siblings with shared sperm providers, and thus family ties created anew. Communities were reformed at times into networks of lesbian-identified or queer families. ‘Affinity-ties’, as I came to refer to them, were brought forwards from the perspectives of users (recipients of ART) and the meanings they bring to their reproductive situations, even as these were increasingly dominated by biomedical ART. Queer kinship was forged in ART and captured the ways in which lesbians, in selecting donors, donor sperm and imagining futures of relatedness, conjoined social and genetic ties and reconfigured family relations (Mamo, 2005). Queering Reproduction examined these actions and their stratifications as situated in cultures of making families in economies termed ‘Fertility Inc.’, a largely USA-based economy of assisted reproduction and a politics of stratified reproduction (Ginsburg and Rapp, 1995).

Charis Thompson and Marcin Smietana, the editors of this symposium volume, assert a needed, yet-to-be realized conversation among transnational surrogacy and egg donation, queer kinship and reproductive justice. They recognize, as I do, that much has changed in ART since Queering Reproduction was published in 2007. The speed and scale of transnational flows has been profound. Today, making families is constituted in a ‘world that is not flat’ (Franklin, 2011); a transnational (bio)economy of technosciences, biological materials, embodied and bodily labour, and information services. Fertility Inc. now reflects unbounded, transnational expansions (Rudrappa, 2015, Twine, 2010, Vora, 2015) shaped by different national contexts. Life itself is channelled across the globe as a growing menu of biomedical and technoscientific offerings including cross-border options, and expanded demands for reproductive biomaterials and reproductive labours. As Vora (2015) asserted, bodies and their labours are not only commodities but essential components of global capitalism. What exists today is a differentially structured patchwork of regulations shaping multidirectional transnational flows of global assisted reproduction where labour is called upon to support life in one place at the potential expense of the lives in another. Technosciences of ART are increasingly embroiled in contemporary and past colonial, gender and racial politics (Bhatia, 2018). In many ways then, ART reflects how societies are constituted, how people are treated, and what constitutes personhood and social relations in late modernity.

In concluding Queering Reproduction, I only began to speculate on these complex and expanded stratifications and their implications for queer kinship and LGBTQ participation in global bio-economies of ART. I speculated about the domestication of lesbian families as their gendered performance and nuclearity would garner respectability, as well as a potential backlash of the increased participation and visibility of gay men in the ART industry, especially as recipients of surrogacy services. In later work, my co-author and I (Mamo, 2013, Mamo and Alston-Stepnitz, 2014) examined the ways in which biomedicine produces ethical and justice debates as its technologies and landscapes burgeon into a transnational fertility marketplace with third-party biomaterials (e.g. eggs and sperm) and women (serving as gestational surrogates) extending intimacies, transactions and other social relationships within and across borders. While this emergent bio-economy includes people coming to the USA for fertility services and people leaving the USA for less expensive options, it increasingly includes supporting some people's reproductive needs and wants at the expense of others. Today, gay men, trans people and gender queer people increasingly join lesbians who engage in baby-making in ways that might ‘queer the fertility clinic’ (Epstein, 2017, Mamo, 2013), and might also further consolidate social inequalities. A conversation as the one called forwards by Thompson and Smietana can guide different forms of ethics accountable to all participants and practices of ART in this bio-economy. Many lesbians, gay men, people with trans experience and others so often defined by gender and sexual non-normativity continue to want into one of the most enduring social norms, identities and experiences in (American) culture: (bio)parenthood. This ‘choice’ is part of all politics in that it includes struggles surrounding how to organize and live our social relations in a social world punctuated by real and imagined scarcity; increased commodification and privatization; and racial, class, sexual, gender, national and other power struggles. Reproductive choice is made legible by the norms that structure how we recognize ourselves and others as persons, parents and relatives, as well as how we value and define social relationships.

The practices of family-making among LGBTQ people as well as the stories they tell of their so-called naturalness or normativity are constitutive of this context. While pressure and concern about affordable, accessible and equitable inclusion in assisted reproduction may be necessary, the very value systems that give meaning to and perpetuate the bio-economies of ART must also be interrogated for how these operate, construct stories and make meaning. By value systems, I refer most broadly to the ways in which normativities are contained within ideas of kinship – the exceptionalism of biological relatedness, nuclear reproductivity and families, and binary gender and sexuality, enabled by ART that often legitimize (and render knowable) what makes a parent, including the LGB and queer people who participate in these exchanges. These values reflect the many normativities contained within neoliberal economies and neoliberal queer politics and their privatization of the family (Berlant, 2011, Duggan, 2002, Duggan, 2003, Eng, 2010, Halberstam, 2011). Yet I hold the imaginary that while normalization is contained in the ideas of nuclear reproductivity as currently marketed, these technologies and practices of ART have the potential to subvert norms and contribute to the expansion of kinship ties, the implosion of gender structures, and the collapse of what is considered ‘natural’ and normative biological reproduction (e.g. through the generation of three parents, parents by intent, and other social categories). Such achievements are not made without extracted biomaterials, labours and other resources.

Again asking questions: how might those who participate in ART be accountable to themselves and to those who supply the biomaterials and embodied labours necessary (and take the unknown risks) to fulfil the needs of those who are often the most economically and socially advantaged, be they gay, lesbian, bisexual, straight, gender normative or gender queer? How might this accountability acknowledge the rights and positionalities of queer people as well as non-normative forms of reproduction? And, how might scholars, health professions and recipients be accountable to the self in ways that refuse neoliberal future-oriented forms of reproduction that continue to invest in scarcer children, stories of natural reproduction, and some people's children over others?

I begin with the social movement for reproductive justice that, as defined largely in the USA, conjoins reproductive rights with social justice and emphasizes the intersectional structuring of power and oppression, and the social, political and economic inequalities among different communities that shape and constrain everyday life, including, but not exclusively, reproductive life (Ross and Solinger, 2017). As framed by Asian Communities for Reproductive Justice, reproductive justice must account for ‘… the regulation of reproduction and exploitation of women's bodies and labour [as] both a tool and a result of systems of oppression based on race, class, gender, sexuality, ability, age and immigration status’ and demands a broadening from ‘choice’ and rights to include broader socio-economic conditions, and a focus on women and girls of colour, and the communities and social structures in which they reside (Asian Communities for Reproductive Justice, 2005). This framework explicitly reconciles individual rights and autonomy principles, specifically a right to self-determine reproductive futures – to have children, to not have them, to time them and space them, free of coercion, patriarchy, racist policies, heterosexual mandates, etc., with social justice principles which ensure that all people cannot only have and raise children in a context of economic, educational and just resource allocation, but also live in conditions free of oppression. Its application to the current bio-economies of ART makes immediate sense. Markets in human eggs and surrogacy services exist across the world, with different configurations and consequences, and with far too many ethical and legal consequences from adverse health events to outright corruption. Such ‘outsourcing’ of intimate life through surrogate services, egg donors and women surrogates – often drawn from the world's most ‘vulnerable’ filling this need – has come under social scrutiny. The issue of compensation is one way of engaging with this economic landscape. Another way to move towards justice is to understand women's reproductive labour as a form of work to be paid for, protected and organized around as labour. Bio-economies include ‘health’ and what we know and do not know about bodily risks to women providing eggs and/or being gestational carriers. The unregulated and patchwork policies surrounding transnational and US-based surrogacy prevent basic data collection. This raises compelling gender and transnational feminist questions; perhaps exactly those that Bhatia (2018) suggested when she urged new theorization into the ways technosciences often get embroiled in colonial, gender and racial politics. From a reproductive justice lens, questions include:

• •Who will provide the eggs and the wombs necessary to enable family-making around the world?
• •From what towns, communities and countries will the biomaterials be drawn?
• •Will these services follow capitalism to secure the bodies and labour necessary to fulfil our ‘American Dream’?
• •How can we be accountable to the ‘collaborative reproducers’ who provide biomaterials, wombs and labour necessary to fulfil these demands?
• •What are the needs, perspectives and experiences of those women who provide materials and labour?

Our institutions, practices and policies have yet to ensure safety, ethical practice or moral guidelines for the women who supply their biomaterials, bodies and labour. As Canada, India and other countries embark on policies to regulate gamete industries, surrogate markets and other family-making industries that include the technological lift-off from in-vitro fertilization to other technosciences such as pre-implantation genetic testing and the imaginary of gene-editing technology, Fertility Inc. includes expanded personnel serving as gestational surrogates and egg donors, and new organizational entities such as brokerage agencies. How might the interests of those who contribute substantially to family-making – egg donors, sperm donors and surrogates – be foregrounded, for example, in the politics surrounding ART (Baylis and Cattapan, 2017)? That is, to be accountable to the people and their social conditions – their health, their communities, their children, and their rights not only to self-determination, but also to economic and social well-being – that enable this bio-economy.

In bringing queer theory and queer kinship to this framing of justice, I seek to highlight the criterion of normativity that makes personhood, social relationships, and kin care legible. LGBT people, their conditions, and their practices and self-determination to make families are also tied to this transactional bio-economy. While records are not maintained on the sexuality of consumers of ART, as early as a decade ago, the media began to take note of what they called ‘fatherhood by a new formula’, often implicating gay men in surrogacy outsourcing demands (Boodman, 2005). The media also notes trans-family formation, from the 2008 announcement of the first transgender pregnancy in the gay media outlet, The Advocate (Beatie, 2008) to the more recent declaration of transgender men as the next frontier of fertility biomedicine in The New York Times (Richards, 2014). However, while heterosexual couples constitute the vast majority of users of these services, LGBT people are often the subject of scrutiny (and calls for regulation) for their use. While LGBTQ rights and justice issues are less often considered as part of reproductive politics, people with these social identities are often a familiar trope deployed in arguments about the expanding demands and ethical boundaries of ART.

A QRJ lens, then, links these movements and examines not only how LGBTQ people figure in the bio-economy of ART, but also how queer politics can be mobilized to transform intimate life, forms of relatedness and kinship itself.1 A QRJ framework asks:

• •Who are the users demanding inclusion in ART? In what ways do their multiple and intersecting social positions – sexual, class, race, national and otherwise – shape the meanings and social forms produced by their use?
• •In what ways do the gender and sexual subjectivities of various users – cis, hetero, lesbian, gay, gender queer, or trans people – participate in the reproduction of values and other social forms?
• •What are the reproductive (and non-reproductive) practices that subvert, normalize or negotiate gender, sexual and nuclear norms in these transnational bio-economies?
• •What are the social relations that, while often hidden, make up the social organization of ART?
• •What emergent social relations might be created in queer kinship?

Today, from all across the world, those who can pay – gay or straight, gender conforming or gender queer parents-in-waiting – buy eggs, locate surrogates and surf their way to meet their reproductive desires to join in on one of the most enduring social identities and human practices – parenting and kinship formation. In these actions, various social organizations, technologies, biological materials, people, communities and values are brought together to fulfil these demands. Any Google search for gay parenting will reveal commercial surrogacy agencies catering to gay men from Singapore, Mumbai, Las Vegas and San Francisco. These join the myriad lesbian-friendly sperm donor clinics that continue to thrive. Academics are increasingly joining writers and activists to theorize and document these new family forms, shaped with or without ART (Pfeffer, 2012, Pfeffer, 2017). These reproductive labours are today part of the global biopolitics of increasing privatization and limited resource availability to enable support and care for oneself and loved ones. Reproductive labour is bought and sold across a global marketplace demanding attention from reproductive rights and justice movements as well as queer social justice movements. The same Google search that allows intended parents to choose sperm, find eggs and locate surrogacy services also lands on films such as ‘Eggsploitation’ depicting the first-hand accounts of egg donors harmed medically, or ‘Made in India’ about the market in women as surrogates there.

The demand for women's eggs, and for their labour as surrogates, will exist with or without LGBT participation in the fertility landscape, yet LGBT participation in making families increasingly includes both the demonization of LGBT people and the perpetuation of racial, class and national structural inequalities. Such inequalities are embedded not only in the power dynamics among recipients and sellers, but also within the patchwork of ‘family law’ that structures who and what makes a family. When lesbians began turning to physicians to perform inseminations, they were ensuring their own parenthood rights and not the sperm donor's rights. The donor's parenthood was replaced with a physician performing the act of insemination. In many states in the USA, either or both of the intended parents or a genetic contributor are recognized as legal parents. Without the ART marketplace, many of these families formed may not be possible, and in all likelihood would not be possible. This, in many ways, is what sociologist Gamson (2015) asserted, as he recounted and interpreted his own experience of ‘conceiving and creating’ his family through surrogacy: ‘Although I was constantly aware of and wary of the role of the market elements of the process, I was also aware that without those transactions I would remain excluded from biological reproduction.’ Gamson recognized how his choice for biological reproduction existed in systems of power.

In Queering Reproduction (Mamo, 2007b), I argued that as advanced, high-tech biomedical options were becoming routine, standard practices, these options were constructed as not only the ‘best’ option but as the only valid approach to making babies with a new grounding assumption, ‘If you can achieve pregnancy, you must procreate’. Biomedicine as a sociotechnical imaginary constructed biological pregnancy as an attainable and thus desirable end, and something to be worked towards, achieved and valued. The pressure of ‘having to try’ resonates with the ethnographic findings of women undergoing in-vitro fertilization (Franklin, 1997). Reaching towards pregnancy, then, was increasingly structured by the options offered on the biotechnical marketplace whether one's sexual status was as lesbian, gay, bisexual, heterosexual or something else. Family formation had become a cultural expectation despite an absence of full legal, social and biomedical inclusion. Attaining inclusion in normativity via parenting was constrained by sexuality, gender, and economic and cultural capital. Biogenetic ties have not lost their hold; instead, they have re-embedded in the technological offerings of biomedicine. This embedded value of biogenetic relatedness and its close association with normative kinship is disturbing for queer politics. Franklin added that ‘it's not having children but trying to have them that is the new normativity and provides a sense of belonging’ (Franklin, 2013).

Normativity now includes trying or imagining the achievement of biological relatedness through fertility biomedicine and the broader bio-economies of ART. This new normativity to make babies has expanded to niche fertility markets such as fertility preservation for transgender people and egg freezing for women employed in the technology sector. As newly incorporated users of fertility biomedicine, transgender men and women are imagined and real recipients of ART. Recent guidelines of the World Professional Association for Transgender Health (WPATH) (2011) include a section on reproductive health, not only acknowledging that ‘many transgender, transsexual, and gender nonconforming people will want to have children’, but also recommending appropriate healthcare practices and consumer information (WPATH, 2011). Part of the biomedical guideline of transitioning by WPATH recommends early decisions about reproduction because of the fertility-limiting (or sterilizing) effects of feminizing/masculinizing hormone therapy. As puberty-suppressing drugs become routine for young transgender people, infertilities will rise. As a result, men and women with trans experience are also included into fertility biomedicine and made to be parents-in-waiting as the fertility clinic becomes an obligatory passage point on their route to the men and women they know they are. Will these be a first step up a ladder of increasingly technoscientized and transnational routes to pregnancies and to securing a place of belonging? Such self-making and family-making practices are both desired by many people and are part of gender, sexual and reproductive normativities that embed values into technologies making having children part of a politics of respectability. For trans men and women, having children takes place in conditions of heightened exclusion as their bodies, lives and ways of forming kinship are scrutinized, and as legal policies, including the USA ‘conscience clauses’, pave the way for continued discriminations. Research is needed into the ways that people with transgender experience participate in or refuse fertility preservation and ART to understand what may be emergent issues of reproductive rights and justice.

Biomedical imaginaries persist in shaping the problem of increased infertility and offering the world its solutions in the form of more and more technosciences with their embedded values of choice, but not values of justice. In their offerings, biomedical ‘choices’ cling to many of the same respectability politics (Ward, 2008) that erase histories of racial, class and other inequities on their way to gaining legitimacy with binary gender, sexuality and traditional norms of family. A QRJ framework does not (necessarily, nor only) advocate for increased access to and affordability of ART, but instead understands these as constitutive of bio-economies of inequalities. QRJ advocates for self-determination in conditions of social life that value the support of all people to care for who they call kin. This may be through higher wages, shorter working hours or extended family public policies, for example. QRJ understands ART as embedded with the values of global bio-economies: economic scarcity; systems of sexism, racism and colonization; and the social institutions and norms that perpetuate them and render them meaningful (normative kinship and reproduction, gendered structures of parenthood, biomedical norms of technological progress, etc.) that have also historically ostracized and excluded queer and other persons via privatization, market-driven policies and protectionist ways of living one's intimate life. The ethical stakes of ART are great given the ways in which making families is constituted by and within these transnational bio-economies of ART.

Instead of meeting some people's choice at the expense of others, a QRJ lens disavows the very notion of choice, seeing it instead as situated and, therefore, made legible within conditions of inequalities and normative ideals of what and who make a family. As biological relatedness endures as a social want, it is important to de-emphasize its exceptionalism and the ‘at any cost’ economies that are facilitating its metaphorical and material worth. QRJ, then, might shift dialogue to consider the technological ladder of ART both in terms of its technologies and ethical questions (e.g. ‘pronuclear transfer’ and the emergence of what are termed ‘three-parent babies’) and the norms that render these real possibilities for reproducing humans, but at the same time recognizing that technological processes are not all the same nor carry the same ethical weight. For example, while choosing and using sperm from donors raises ethical and justice issues for the men providing biomaterials and the children born from these practices, these are not equivalent to the procedures and health risks of extracting eggs and engaging surrogates. One should not be more unethical than another, but various scales of ethical engagement are required. What is shared, I believe, is that what appears on the menu of one's freedom to choose emerges within political-economic structures. Assisted reproduction has become a predominately commercial exchange within larger systems of biological and labour economies. There is much that a QRJ framework might offer to ensure more equitable reproduction and more imaginative ways of organizing social life: a QRJ framework might advocate for medical and socio-economic policies that support broad forms of bodily care and kin care that include but also extend beyond biogenetic relations. In medicine, health risks are largely unknown; healthcare services could follow longitudinally those serving as surrogates or egg donors to provide the data needed to shape dialogue and social policy. Currently, the industry lacks longitudinal data on bodily harms and health risks, and a patchwork of social policies exist around the legality of payment for (or selling of) gametes (from eggs to sperm to blood) and compensation for women who serve as gestational surrogates. Queer kinship and reproductive rights and justice together might shift policy dialogue so that these policy considerations focus around the short- and long-term social effects of these exchanges. This process would include attention to the ways in which different constituents are harmed or included, and the ways that different norms shape who is recognized as a participant. QRJ policies could, for example, advocate a living wage and adequate labour laws for surrogates (and the conditions that support their families), or they could place value on queer forms of kinship that include not only biological relatedness but also relationships based on an ethic of care.

QRJ is a lens through which to understand experience as intersectional, (e.g. comprising race, class, ability, sexuality, gender and other social categories of experience) and a political movement that demands historical and contemporary attention to the working of structural power. A QRJ approach does not advocate that the best or only way is to opt out of such configurations, nor to disparage technoscience over some concept of ‘natural reproduction’, but finds ways to be accountable to the social relations involved, to be willing to advocate social policies, and also to refuse the erasure of racialized, class, or gender and sexual inequities and politics. As Eng (2010) argued, queer liberalisms are so often depoliticized, reflective of the ways that neoliberalism reduces the public sphere and recasts the histories of race, nation, capital and empire into privatized (e.g. market-dependent) and rescaled apolitical domains of kinship, family and intimacy. QRJ, then, does not follow the path of neoliberalism but instead seeks access and inclusion in market forces while also engaging with how its policies and practices are made legible by values of bio-genetic ties, nuclearity and the privatized family. We might instead recognize the nostalgic forms of kinship at play in ART, and move towards an ethical response to the ways that people are asked to both shoulder their own economic weight and organize their social life within the bounds of normativity. Such directions might include examining the psychic and political dynamics of histories and contemporary practices of adoptions, economically supporting and providing for care work at the social policy level and not only within transnational, market bounds. While assumptions and values can be subverted, the histories and practices must first be opened up to reflection to see precisely how and under what circumstances multidirectional stratifications unfold.

Social scientists, professionals, activists and people seeking pregnancies with ART would recognize the complexities and not limit or disparage the inclusion from the margins or conjecture that such inclusions require exclusions. Nor would they celebrate freedoms of some without recognizing past histories and present complexities. Further, a QRJ framework situates practices of ART in the conditions, histories and social relations that make these activities possible. To be accountable to oneself in these situations is to recognize how one's actions are made legible in these contexts as well as how they rely on and affect the lives of others. To find a way to be accountable to both the reproductive labourers and those seeking inclusion in the current bio-market requires expanded ways to imagine and organize social institutions that are not normative, hierarchical or solely in the logic of capital. To engage in queer reproduction, then, would uncover neoliberal future-oriented sentimentalities and forms of intimacy and find ways to be ethically accountable to how these unevenly and differentially call upon people, their bodies and their lives. To bear witness to the health, well-being, and economic and social circumstances of ourselves, the recipients and intended parents, as well as the providers of biomaterials and labours. To seek ways to enhance the well-being of others with the same ferocity as ourselves. Finally, QRJ recognizes and engages politics that no longer affirm the freedoms and family ties of certain queer subjects at the omission of others by race, class, nation or immigration status.

To conclude, a QRJ lens advocates for other ways of conceiving of the future, perhaps first by seeing ART engagements as what Mackenzie referred to as ‘structural intimacies’ (Mackenzie, 2013), where interpersonal lives and social structural patterns collide and are co-produced. It is here where intersectional inequities and their ethical dilemmas reside, as well as the possibilities for expanding, if not for queering, kinship. While calls to enact policies that render illegal the provision or buying of biomaterials and labours, and even calls to ‘make kin not babies’ (Haraway, 2015), may tug at one's feminist and environmental sentiments to protect people and the planet, and to refuse and resist the social and normative order of things, QRJ encourages a queering of family-making and extending kin and care in ways that imagine and create other ways of being, doing intimacy and making kinship altogether. QRJ values non-normativity, even if these practices include making bio-babies. QRJ understands that not all ART is at the expense of ‘vulnerable’ others, but can be formed in mutual reciprocity or in other forms that may yet to be realized. QRJ encourages an accountability of the self, referring not only to the actions of individuals but also to the social contexts and relations that shape these actions and make them legible. Such an ethics of accountability has become increasingly necessary given the expanded and uneven social relations, and their racial, class and national dimensions, productive of contemporary bio-economies and constitutive of ART. With QRJ, kin can mean something other/more than entities tied by ancestry or genealogy, blood and genes, or nuclearity; instead, kin can refer to relations connected by logic, need, choice, context and other means (Haraway, 2015).2 Making kin can be expansive, non-conventional, and may or may not include babies at all. Perhaps as academics, professionals and participants in family-making, we can collectively emphasize making chosen kin without reproducing the ‘colour blindness’ of neoliberalism and its erasure of histories of oppression. Perhaps we might instead make kin, only some of which are bio-babies. To do so would shift the reproductive imaginary towards the conditions of multigenerational care and their social contexts, and entail a re-imagining of the public sphere. Accountability to oneself and others would include an ethical directive to care for one another; to produce, maintain and value non-bio intimacies; and to forge multiple forms of relatedness and an openness to make social connections valuable outside of norms of respectability, capital and legal recognition of nuclearity. This, I believe, might allow more ways to build relationships of care and offer the types of practices necessary to transform the conditions productive of the inequities and stratifications so familiar in the current bio-economies shaping ART.

Biography

Laura Mamo is a sociologist of science, technology and medicine in the Department of Health Education and Associate Director of the Health Equity Institute at San Francisco State University, USA. She is the author of Queering Reproduction: Achieving Pregnancy in the Age of Technoscience (Duke University Press, 2007) and co-editor of Biomedicalization: Technoscience, Health, and Illness in the U.S. (Duke University Press, 2010). She is a founding member of Science FARE (Feminists, Anti-racism, Ethics), a feminist collective challenging science, technology and medicine. Her current research examines the sexual and gender politics of cancer prevention.

Declaration: The author reports no financial or commercial conflicts of interest.