Religious and non-religious issues of medically assisted reproduction in France: Sexuality, incest and descent

Abstract

It is generally held that assisted reproductive technology has dissociated procreation from sexuality — just as the advent of the pill dissociated sexuality from procreation. My study will show, on the contrary, that sexuality in all its dimensions, including the physical dimension of the circulation of bodily substances as well as the psychological dimension of fantasy, is far from having been removed from new methods of reproduction, even if they do indeed dispense with sexual intercourse, because sexuality cannot be reduced to the sexual act. The circulation of gametes has an often-denied sexual dimension which is revealed in the questions raised by monotheistic religions concerning these techniques. I analyse the position of Sunni Muslim jurists with regard to different reproductive techniques. Using a cross-disciplinary approach, I combine this specific study with a comparative analysis from a religious viewpoint, putting Sunni Islam into perspective with other monotheisms, specifically Judaism and Roman Catholicism, as well as the other branch of Islam represented by Shi’ism. As an anthropologist, I performed a field survey in France on medically assisted reproduction, particularly at the Centre for the Study and Preservation of Human Eggs and Sperm in Paris on the donation of gametes. I will show that the questions raised by monotheist religions regarding medically assisted reproduction are very often the same questions that individuals resorting to these techniques in France ask themselves about the concepts of adultery, incest and descent, particularly when the reproductive process involves a third-party donor.

Introduction

While it appears at first glance that assisted reproductive technology (ART) has dissociated procreation from sexuality, my research shows that this view is mistaken. New techniques have in no way removed the sexual dimension inherent in procreation — a dimension implicitly recognized by monotheistic religions.

ART involves gametes (sperm or egg) being detached from the rest of a person’s body, primarily to enable their extraction for in-vitro reproduction in the laboratory rather than in-vivo reproduction through sexual intercourse. It provides the technological means to preserve gametes in liquid nitrogen at a temperature of −196 (particularly sperm, which are easier to preserve than eggs using cryopreservation), and then to implement their circulation.

The circulation of gametes has an often-denied sexual dimension which is revealed in the questions raised by monotheistic religions concerning ART. It is commonly held (Baldwin, 2012, Chin, 1996, Tain, 2013) that ART has dissociated procreation from sexuality — just as the advent of the pill dissociated sexuality from procreation (Fortier, 2011b). My study will show, on the contrary, that although ART does indeed dispense with sexual intercourse, the physical dimension of sexuality related to the circulation of bodily substances is far from having disappeared from these new modes of reproduction. Furthermore, sexuality is not actually confined to a physical level involving the meeting of bodies or even the meeting of bodily substances. It also comprises a level of psychological mechanisms that are still present in these modes of procreation. I use the concept of sexuality in its psychoanalytic meaning with its implications of adultery and incest, which I have found significant in understanding the social and personal stakes involved in medically assisted reproduction (MAR).

In addition, I will show that the questions raised by monotheist religions regarding MAR are very often the same questions that individuals resorting to ART in France ask themselves — whatever their religious affiliation or non-affiliation — about the concepts of adultery, incest and descent (Fortier, 2018b), particularly when the reproductive process involves a donor.

This study focuses on Sunni Islam, the subject of much of my work, whilst also comparing the situation with that of other monotheisms (Inhorn et al., 2010, Inhorn, 2014). I analyse the position of Sunni Muslim jurists (fuqaha) with regard to different reproductive techniques. Using a cross-disciplinary approach, I combine this specific study with a comparative analysis from a religious viewpoint, putting Sunni Islam into perspective with other monotheisms, specifically Judaism and Roman Catholicism, as well as the other branch of Islam represented by Shi’ism.

As an anthropologist, I performed a field survey in France between 2012 and 2016 on MAR, particularly at the Centre for the Study and Preservation of Human Eggs and Sperm (CECOS) in Paris on the donation of gametes.

My ethnographic study included field observations and interviews. I interviewed the medical staff implementing these techniques and the couples having recourse to these techniques. I conducted interviews with biologists (n = 8) as well as psychologists (n = 10). The couples requesting ART are required to consult a psychologist from CECOS and obtain an expert assessment of their motivations. I also held comprehensive interviews with 50 couples. Interviews were conducted at CECOS, and usually lasted between 1 h and 5 h. The couples I interviewed included Muslims (n = 9), Jews (n = 6) and practising Catholics (n = 7). They are the main focus of this article, although the questions that Islam, Judaism and Catholicism raise with regards to MAR may be valid for any couple, religious or not. As Taragin-Zeller (2019) stated in her work on ART in Israel:

Constructing ‘religious people’ as a separate entity, while distinguishing and demarcating these experiences from those of ‘secular people’, is a project that has been largely criticized (e.g. Asad, 2003).

Dissociating procreation from sexual intercourse

ART developed in the West has been adopted by numerous Muslim countries such as Egypt, Morocco, Tunisia, Turkey, the Arab states of the Persian Gulf (Qatar, Bahrain), Jordan, Lebanon, Turkey and Iran (Inhorn, 2015, Inhorn et al., 2017). The fact that the religious authorities of these countries have accepted these new reproductive techniques attests to the fact that dissociating procreation from sexual intercourse is not, in itself, a problem in Islam, because, as in Judaism, sexuality can be for the purpose of seeking pleasure rather than procreation. This is not so much the case in Roman Catholicism, which closely associates sexual intercourse and procreation, and consequently forbids all forms of MAR, whether between spouses or involving third parties. The instruction to believers issued in 2008 justified the forbidding of MAR for this reason, replacing the term ‘sexual intercourse’ with the circumlocution the ‘conjugal act’:

It is ethically unacceptable to dissociate procreation from the integrally personal context of the conjugal act (Congregation for the Doctrine of the Faith, 2008).

Pope Jean-Paul II declared, moreover, that sterility could even be a source of spiritual fruitfulness:

Spouses who find themselves in this sad situation are called to find in it an opportunity for sharing in a particular way in the Lord’s Cross, the source of spiritual fruitfulness (Congregation for the Doctrine of the Faith, 1987).

Despite the Vatican’s prohibition, a number of Catholics felt that they were following their faith in resorting to ART to create a family (Mathieu, 2013a, Mathieu, 2013b), quoting Genesis (I, 28) commanding us to ‘be fruitful and multiply’.

The way that Catholicism treats misfortune, including misfortune relating to infertility, as a spiritual trial is foreign to Sunni Islam (Fortier, 2003) and Judaism. In Judaism, even the most orthodox rabbis authorize the use of MAR, insofar as it can relieve the suffering caused by a couple’s sterility (Kahn, 2000). Moreover, these techniques are seen as a means to respect the commandment of Genesis (I, 28).

Taking into account the social importance of genealogy in the Arab-Muslim world (Fortier, 2001), it is essential to have children, especially boys, to perpetuate the patrilineal descent and keep alive the genealogical chain of one’s forebears. Moreover, having children — particularly boys — enables the progenitors to attain a new social status, that of mother and father. This progeny enhances the image of the man’s virility associated with his power of procreation (Fortier, 2005b, Fortier, 2013a, Inhorn, 2005, Inhorn, 2006c, Inhorn, 2009, Inhorn, 2012a, Inhorn, 2012b, Inhorn, 2014), and the woman’s femininity associated with her fertility (Fortier, 2017).

Masturbation for the purpose of procreation

The necessary stage of masturbation required in MAR is often misunderstood insofar as it reveals the recourse to a sexual practice in a reproductive process where one may not expect it to be used. However, masturbation is the simplest method that doctors have found to collect the sperm that will be used for fertilization.

MAR between spouses raises no major problems in Sunni Islam, except for the stage of sperm collection involving masturbation (Fortier, 2010b). Although it requires no sophisticated technology, masturbation may be psychologically difficult for the man performing it because it is directly associated in Islam with forbidden sexual pleasure (Inhorn, 2007).

In France, the man collects his sperm in a small room that very often contains pornographic magazines or has erotic pictures on the walls, for example nude paintings, intended to facilitate the masturbatory act. The presence of erotic or pornographic images suggests that doctors (who are themselves often male) recognize the need to introduce sexuality, including its fantasy dimension, for medical purposes. However, the experience of being offered pornographic magazines is far from trivial for some men (Moore, 2007, Moore, 2009).

Above all, it is the solitary practice of masturbation that poses a problem for Muslims, as this is forbidden in Islam. In Paris, where I carried out my research, some Muslim men ask to be accompanied by their wives during sperm collection so that they do not have to masturbate themselves. Most Sunni Muslim scholars allow masturbation if it is not solitary but carried out by the wife within a conjugal context. Furthermore, some scholars also allow the sperm to be collected for MAR after coitus interrompus (tazal) between the couple — a practice also recommended in Judaism by certain Orthodox rabbis (Kahn, 2000). However, as Susan Kahn (2000) demonstrates, because of strict prohibitions about masturbation for Jewish men (Goldberg, 2009, Kahn, 2000), in Israel, non-Jewish sperm is flown from the USA to inseminate Jewish women.

If this conjugal solution for sperm collection is not possible, some Sunni Muslim scholars consider it acceptable for the man to masturbate himself to collect his sperm as it is not for pleasure but to have a child. The same logic operates in Judaism, where, although masturbation is forbidden, it is tolerated by certain rabbinic authorities within the context of MAR, insofar as the aim is to have children, provided that the sperm is collected after sexual intercourse with the wife (Lasker, 1988), and the sperm is collected using a condom, preferably perforated (Frydman, 1997), or extracted from the woman’s cervical canal with a spatula (Ivry, 2014). In Catholicism, on the contrary, masturbation is strictly forbidden, whatever the purpose.

In Islam, the higher objective (maqṣûd) represented by the prospect of procreating authorizes exceptional recourse to a practice that is forbidden in other circumstances — masturbation. One of the five higher objectives (or purposes) of Islamic law (Sharî‘a) is the preservation of one’s lineage, which all Muslims must respect even if certain transgressions may be tolerated (in this case, masturbation in the context of MAR). Here, the Islamic legal principle (uṣul al-fiqh) ‘necessity knows no law’ transforms masturbation — a practice that is usually forbidden (ḥarâm) — into one that is permitted because it is not used as an end in itself but a necessary means to collect sperm. This principle of necessity (ḍarûra), which allows a certain degree of pragmatism (Fortier, 2003), is drawn from a verse of the Qur’an (VI, 119):

[…] He hath explained to you in detail what is forbidden to you — except under compulsion of necessity (trans. Arberry) (Fortier, 2010c).

Consequently, far from rejecting MAR, Islam accepts it insofar as it enables Muslims to meet the higher objective of having children. If, in order to achieve this, one must resort to the usually forbidden sexual practice of masturbation for the purpose of procreation, Muslim jurists take a pragmatic approach in much the same way as rabbis proceed in Judaism (Lasker, 1988).

Discrepancies between biological and social descent

The Sunni position with regard to MAR consists of authorizing all reproductive techniques performed by a married couple, but forbidding the use of gametes from anyone outside the couple. On the contrary, any form of procreation involving a third person is related to adultery (zinâ), and any child born from this method is regarded as illegitimate (zinâ). This explains why egg or embryo donation and surrogate motherhood (Shabana, 2015) are also forbidden in Sunni Islam.

Although in Islamic jurisprudence, as in many other cultures and legislations, the father is presumed to be the mother’s husband, the fact that the child comes from the father’s sperm is decisive with respect to the representation of descent, as this substance constitutes the essential biological support of patrilineal descent (Fortier, 2001, Fortier, 2007, Fortier, 2018a).

In the case of procreation with a sperm donor, the fact that the child does not come from the sperm of the mother’s husband but of another man creates a ‘mixture of lines of descent’ (ikhtilâṭ al-ansâb), completely contradictory from the point of view of Sunni Islam. In this expression, it is certainly the ‘mixture of sperm’ that is in question, and especially the ‘mixture of lines of descent’, given that the two types of descent co-exist in this context without intersecting: the biological line, based on sperm, and the social line, referring to the matrimonial union of the father with the mother’s child.

Conception using a sperm donor constitutes an aporia for Sunni Islam because it generates a disjuncture between the two types of descent: social and biological (Fortier, 2010a). Whereas in the case of natural procreation (or non-gamete-donation procreation), the correspondence between these two types of descent, even if it does not exist in fact, is always presumed. In the case of procreation by sperm donor, in which conception depends upon a third party and is controlled by doctors, there is an inadequacy of biological and social correspondence in the determination of descent (Fortier, 2009, Fortier, 2011, Fortier, 2011b).

In ‘natural procreation’, Sunni jurisprudence recognizes the mother’s husband as the father of the child (Fortier, 2013b). However, unlike French or American jurisprudence, in Sunni Islam, this principle is not applied in cases of sperm donorship. The participation of a third person and medical intervention contrasts with natural procreation, which occurs without witnesses. The concept of testimony (shahâda), so important in Islamic law, is not explicitly invoked by Sunni jurists to prohibit MAR, but it implicitly determines their choice.

The prohibition of procreation using a sperm donor in Sunni Islam shows that it is through the intersecting relation between social paternity and biological paternity that descent is constituted. The logic underlying this interdiction is completely in keeping with the logic of descent in Sunni Islam; if descent is socially defined, it is, in parallel, based on a biological principle, namely sperm, insofar as this substance is regarded as the vehicle of descent (Fortier, 2001, Fortier, 2007).

In all Sunni countries where these new techniques of procreation are practised, the use of a sperm donor is prohibited. On the other hand, in Shi’a countries such as Iran or in Shi’a communities in Lebanon (Clarke, 2007a, Clarke, 2009, Clarke and Inhorn, 2011), certain minority religious authorities allow it with the restriction that the child born from the sperm of a donor cannot inherit from his infertile social father (Atighetchi, 2010, Atighetchi, 2009, Garmaroudi Naef, 2012, Gürtin et al., 2015, Inhorn, 2003, Inhorn, 2006b, Inhorn, 2006d, Inhorn, 2012b, Tremayne and Inhorn, 2012, Tremayne, 2015). Shi’a Muslims Paradoxically, the child is not attached to those who desired and sought him or her. Thus, certain Shi’a Muslims have gone beyond the implication of adultery in this method of conception (Garmaroudi Naef, 2015). However, it seems that here, the question of descent remains related to biological paternity, as it is the sperm donor who is recognized as the child’s father.

In addition, the fact that adoptive kinship (tabannî) is prohibited in Islam shows the difficulty of considering descent that is not founded on a biological substance — a difficulty that is also shared by the popular Euro-American conception of kinship (Franklin, 2013). More precisely, rather than prohibiting adoption, as is often claimed, Islam prohibits adoptive kinship by limiting the legal effects of the adoption from the point of view of descent. One only has to read attentively the sura of the Qur’an (XXXIII, 4) on adoption:

God has not assigned to any man two hearts within his breast […] neither has He made your adopted sons your sons in fact (trans. Arberry).

This text describes a form of adoption that is clearly opposed to descent.

In effect, the legal consequences of adoption authorized by Islam, known in some Sunni societies (e.g. Morocco, Algeria) as kafala, or in some Shia societies (e.g. Iran) as sarparasti, meaning ‘to take care’ in Persian (Yavari-d’Hellencourt, 1966), are strictly limited to the duty to educate and can be assimilated to what anthropologists call ‘fosterage’. Owing to the implementation of reforms in some Muslim countries — for example, in Iran in 1974 (Yavari-d’Hellencourt, 1996), in Algeria in 1992 and in Morocco in 2002 (Barraud, 2010) — the kafîl child can bear the name of his makfûl father, but does not become his inheritor. Unlike plenary adoption, kafala, as regards these and other cases, does not establish complete ties of descent (Fortier, 2010c, Le Boursicot, 2010). In Islam, the prohibition of plenary adoption or of procreation using a sperm donor shows that ties of descent are partly determined by biological ties, whether these are real or presumed. Descent in Islam is based on the necessary conjunction of social and biological principles, and one cannot be considered without the other (Inhorn, 2006a).

Furthermore, from the point of view of Islamic jurisprudence, the marriage of a kafîl child with his ‘adoptive’ sisters is not prohibited, confirming the hypothesis that matrimonial prohibitions are determined by the ‘biological’ rather than the ‘social’ in Islam. This fact reveals a contrario the necessity of sharing the same biological substrate when determining matrimonial prohibitions, as the analysis of milk kinship in Islam demonstrates. It also shows that no matrimonial prohibition related to the fact of living together, and sharing the same house or food is formally established.

Milk kinship is strictly a Muslim concept that has no equivalent in other religions or cultures. Any union between two people related by milk kinship through breastfeeding is considered incestuous and is therefore prohibited (ḥaram) (Altorki, 1980), as quoted in the Qur’an (IV: 23):

Forbidden to you are […] your mothers who have given suck to you, your suckling sisters […] (trans. Arberry).

This risk of incest explains why Islam forbids human milk banks, even if the topic is debated between Islamic scholars, especially between Shi’i scholars (Clarke, 2007b). In addition, breastfeeding creates a kin relationship between the infant and the wet nurse’s husband, who is considered to be at the origin of the production of the mother’s milk. If a woman breastfeeds a child that is not her own, this child is prohibited from marrying not only the children of his wet nurse, but also the children of all former wives of his wet nurse’s husband — even though these women did not breastfeed him. The children of the wet nurse’s husband become milk brothers and sisters because they have ingested the ‘milk of the stallion’, according to the expression used in Islamic jurisprudence (Fortier, 2007). The fact that the infant becomes milk kin not only to the wet nurse, but also to her current husband and to the men she may subsequently marry while lactating implies that these men are held to be at the origin of the milk. The relationship emphasized between sperm, milk and agnatic descent further explains why the husband’s brother is also prohibited from marrying the child who receives the milk. It sheds light on the complex relationship between sperm and milk from the moment of conception through lactation itself (Fortier, 2001).

Significantly, in Jewish law, just as in Islamic law, there are no marriage prohibitions between ‘adopted’ children and their ‘adoptive’ parents because descent is essentially considered as biological (Nizard, 2012). In Catholicism, adoption was forbidden for a long time (Goody, 1983), until it was accepted at the beginning of the 20th century and recently proposed as an altruistic alternative to MAR by Pope Jean-Paul II (Congregation for the Doctrine of the Faith, 2008).

The donation of gametes or the fear of adultery and incest

In Judaism, sperm donation is authorized by most rabbis (Lasker, 1988). However, during my fieldwork at CECOS, I observed an apparently surprising requirement of certain practising Jews who asked for the sperm donor to be non-Jewish. This request can be explained in terms of the fear of both adultery and incest. In Jewish law (halakha), adultery is clearly defined as sexual relations between a married Jewish woman and a Jewish man who is not her husband. This definition implies that if the man with whom a Jewish wife has sexual intercourse is not Jewish, there is no adultery in the strictest sense of the term. Transposed to the case of sperm donation, some rabbis therefore conclude that adultery is only committed if the donor is Jewish (Kahn, 2000). Consequently, using sperm from a non-Jewish donor circumvents the problem of adultery in Judaism. However, in the non-religious context of CECOS, where the donor is anonymous, French doctors cannot take this type of religious requirement into consideration. As Whitmarsh and Roberts (2016) assert:

Medicine has been integral to the secular project of making invisible the religious affects and sensibilities of the modern political/biological individual.

Furthermore, if the donor is Jewish, the fact that he is anonymous causes the spectre of incest to hover over children thus conceived, as when they become adult and duly marry a co-religionist, they risk marrying a biological brother or sister born of the same donor, or even the donor himself in the case of girls. Using a non-Jewish donor avoids the risk of incest. Furthermore, according to Irshai (2012), using sperm from a non-Jewish donor primarily rests on the notion that:

If a gentile man and Jewish woman bear a child, paternity is not attributed to the father; the fact that he is the child’s biological father is irrelevant in Jewish law.

This is the position of many rabbis (Irshai, 2012), who ruled that, as most of the Jews living in the USA are non-Jews (i.e. by the standards of Orthodox rabbis; their affiliation with other branches of Judaism does not ‘count’), it is reasonable to assume that most of the sperm donors are also non-Jews. If the donor is not Jewish, there is no chance that a Jewish child conceived from his sperm will marry a Jewish paternal sibling (Lasker, 1988). In this regard, Rabbi Mosha Feinstein ruled:

With the husband’s permission and in the case where [the infertile couple] are suffering considerably, one may permit [donor insemination], but specifically with the sperm of a non-Jew.

In the event of great need, if [the couple] is suffering considerably from their yearning for a child, one may permit artificial insemination specifically with the sperm of a non-Jew (Lasker, 1988).

In the case of egg donation, which is also widely authorized by rabbis to avoid the problems of incest and adultery in the same manner, it is preferable for the donor to be non-Jewish. If the donor is Jewish, she should be single as, in this case, the question of adultery does not arise according to its definition in Jewish law, which only concerns married Jewish women, although the fear of incest remains. This conception of adultery also explains why single women in Israel — unlike France, where single women are not allowed to use donor sperm — can use donor sperm without their children being considered as born of adultery (mazmer) (Kahn, 2000).

In Sunni Islam, on the contrary, unmarried women cannot use donor sperm because they would be committing adultery (zinâ) and their children would be illegitimate. Therefore, we see that, unlike many religions and societies that consider adultery as sexual relations outside the bonds of marriage, whatever the woman’s status (married or single) and whatever the partner’s religion (the same or different), the very narrow definition of adultery in Judaism paradoxically allows for the use of a broader range of procreation techniques, which may involve a male or female donor and be accessible to both married couples and unmarried women.

We know that Jewishness is matrilineal, but in the context of MAR where three different women may contribute to the birth of a child (the social mother, the egg donor and the gestational surrogate), which of the three transmits Jewishness? The predominant position, based on biological relations, is that a child’s Jewishness comes from the woman who carries and gives birth to him or her (Kahn, 2005, Kahn, 2000, Seeman, 2010, Zohar, 1991), and not from the woman who donated her egg, and that it is the womb that determines the Jewishness of the child. This explains why egg donors can be non-Jewish, whereas gestational surrogates, authorized in Israel, must be Jewish (Seeman, 2010). In addition, they must be single (including divorcees and widows) to avoid adultery, again in accordance with the definition of this concept that excludes unmarried women. Consequently, a child born to a Jewish woman is necessarily Jewish, even if the child was conceived from an egg donated by a non-Jewish woman (Kahn, 2000).

Some constants, irrespective of religion

Closer observation of the behaviour of certain religious people in the context of MAR reveals implicit attitudes that are also shared by non-believers. While the French medical field tends to desexualize medical acts that do, nevertheless, involve sexuality [e.g. by speaking of ‘sample collection’ (‘prélèvement’) and ‘vials’ (‘paillettes’) rather than masturbation and sperm (Fortier, 2005a], the religious perspective reminds us that these acts are not devoid of any sexual dimension. This is implicitly recognized by the medical profession itself, as the hospital rooms in which the sperm collection takes place contain erotic pictures or pornographic magazines intended to stimulate the man’s desire.

The act of masturbation in such a context poses difficulties for many men, whether or not they are religious, especially as it is not chosen in privacy but imposed in a medical setting. The attempt to isolate a problem that might be characterized as specifically religious is hardly relevant because what is at issue here concerns more widely the incursion of a solitary, pleasure-related sexuality within a marital and medical process whose purpose is procreation.

Therefore, it is clear that ART involves sexuality. Firstly, these techniques rely on a sexual practice — masturbation — here transformed by MAR into a reproductive sexual activity. Secondly, the sexual dimension of these types of reproduction also appears in the fears of adultery and incest, such as they are expressed by each of the monotheistic religions. These anxieties also exist, albeit more implicitly, in many people who have recourse to donor eggs or sperm, regardless of whether or not they are religious.

Insofar as sexuality, including its psychological implications, is inseparable from procreation in general, and specifically from these new methods of procreation, my research in France has revealed that many women consider sperm donation, even anonymous donation, as adultery (Fortier, 2017b), while some of the children born from these techniques wonder about the risk of incest owing to the anonymity of the donation. Women who physically experience donor insemination can, at times, find it difficult to accept this third person in the relationship. Despite the lack of a sexual act and penetration, these difficulties arise from the fact that the sperm of an unknown person has penetrated their bodies, leading some women to experience ‘the intrusion of a foreign body inside them’. Some women claim that they feel ‘soiled’ by this sperm that they have to accept inside themselves instead of and in the place ‘reserved’ for their husband’s sperm. As a result, they experience donor insemination more or less unconsciously as a transgression of the concept of fidelity (Fortier, 2017, Fortier, 2018b).

Although CECOS attempts to diminish the significance of the anonymous donor by referring to him as a mere provider of substitutable genetic material, the donor is, in general, the object of fantasy on the part of the woman being inseminated. As her ability to get pregnant depends on the donation of the donor, he possesses something that her male partner does not, namely fertility, which, in turn, is associated with virility. Some women struggle to cope with the sudden emergence of this type of fantasy, which tends to generate a certain remoteness from their husbands. Indeed, it is not uncommon for couples to separate during MAR or after the birth of a donor-conceived child.

On the other hand, some women who associate donor insemination with adultery equally fear that their husbands will not recognize the child as emotionally theirs, although legally, the husband will already have signed a document confirming paternity. Despite the fact that the husband had supported the decision to have a child by donor insemination, the woman may fear that he will not consider the child his own and will not provide it with all the affection it deserves, or may even reject it.

The shame experienced by these women is, at times, so significant that they are incapable of embracing the openness they would wish regarding the donation and their donor-conceived child as recommended by CECOS. The ideal of openness concerns each phase of donor conception, including willingness to adopt. However, in these cases, the shame they feel about donor insemination may lead instead to their becoming keepers of a secret — the secret of the existence of a third person involved in the reproduction process — fearing that the child may develop a ‘bad impression’ of their mother.

In these cases, the initial fear of being rejected by their partner is replaced by the fear of being rejected by their child for the same reason, feeling guilt about having procreated using the sperm of a man who is not their husband. Some women who have decided to keep their method of conception secret nonetheless fear the child’s rejection; one woman, for example, disclosed her intention to show the medical folder containing the information about the donor insemination to her child as soon as he or she were old enough to understand, in order to prove to the child that she was not ‘at fault’.

This secret may also affect the couple’s family and friends. Most often, even if those close to them are aware of the couple’s difficulties conceiving and their use of medical assistance, they are not aware of the type of technique used for procreation. There are very few couples who admit to their family and friends that they have used a donor to conceive, preferring that they remain ‘in the dark’ or alluding to intramarital IVF.

The actual term ‘insemination’, utilized in the medical expression ‘donor insemination’ and also used in veterinary medicine, has strong sexual connotations; it can lead to the association of the ‘inseminator’ as some kind of stallion or stud. As a result, some women who unconsciously desexualize the act of insemination prefer to describe it as ‘injection’. Similarly, in an attempt to neutralize the implications of certain terminology, the term ‘sperm’ is seldom used by doctors or couples; instead, the word ‘straw’ is used to designate the thin, plastic straw containing the sperm preserved in liquid nitrogen. The use of a synecdoche — in which a description of the whole package is used to designate its contents — illustrates a certain discomfort within the medical profession regarding this substance, which is both considered sacred, in that it is procreative, and disturbing, insofar as it is sexual.

The desire to desexualize perceptions of procreation by donor is equally evident when it comes to talking about the act by which a man donates his sperm. In this instance, the medical profession prefers to use the term ‘sampling’ rather than the word ‘masturbation’ in front of the couples. Despite the procreative goal of donor insemination, it remains difficult for the medical profession to use the term ‘masturbation’ due to its connotations that essentially refer to an auto-erotic, solitary sexual act rather than sexuality between two people for procreative means.

Conclusion

Consequently, although these new methods of procreation are no longer based on sexual intercourse, they have in no way dissociated procreation from sexuality, a dimension that is all the more present in these new reproductive techniques when they have recourse to a third-party donor, anonymous or not, as it is the case in the US context (Almeling, 2007, Almeling, 2011). In my research, issues concerning adultery, incest and descent have been shown to be significant for couples who involve a donor in the reproductive process, because they raise the question of what this third party represents for the couple. Attempts to distinguish ART from sexuality appear to be misguided given that sexuality in all its dimensions, including the physical dimension of the circulation of bodily substances as well as the psychological dimension of fantasy, is far from having been removed from new methods of reproduction, even if they do indeed dispense with sexual intercourse, because sexuality cannot be reduced to the sexual act.

The questions that individuals resorting to these techniques ask themselves in private are the same questions raised by monotheistic religions in public, as my comparative study reveals. In this respect, although social descent prevails over biological descent in France, recent debate about removing donor anonymity raises the question of the donor’s status, and is an implicit testimony to the importance attached to biological relationships. This importance is clearly asserted in Sunni Islam, as demonstrated by the prohibition of procreation by sperm donation and of formal adoption.

Declaration

The author reports no financial or commercial conflicts of interest.

Biography

Corinne Fortier is a cultural anthropologist and a researcher at the French National Centre of Scientific Research (CNRS). She is also a member of the Social Anthropology Laboratory (CNRS-EHESS-Collège de France-Universités PSL, Paris). In 2005, she was awarded the Bronze Medal of CNRS. She has conducted research in France, Mauritania and Egypt on Islamic scriptural sources related to gender, body, kinship and procreation.