When We Talk Reproductive Justice, We Need to Talk About Surrogate Parents

Feature image via Solar Navigator

Surrogacy affords many people an alternative way to bring a child into the world. Whether a person is infertile or cannot deliver a baby without medical risk, or a couple is biologically unable to reproduce together without medical intervention — as may be the case for some queer couples — surrogacy enables a person with a uterus to carry a child on behalf of the child’s intended parents. Since 1976, when a surrogate and a married couple made the first modern-day recorded surrogate agreement in the United States, the Organization of Parents Through Surrogacy show an estimated 25,000 surrogate births across the country.

Surrogacy takes different forms. Some pairs use a family or a friend as a surrogate, though a method that is becoming increasingly preferred is the use of a surrogacy agency. Surrogacy agencies act as intermediaries, linking intended parents with a surrogate parent, making arrangements, and collecting fees passed between the two parties. Many people opt to work with a surrogacy agency because the third party can help to simplify legal concerns about parental rights.

However, surrogacy agencies outside of the United States are profiting from poor women and women of color by selling the use of their services to Americans who would rather not pay the high costs of assisted reproductive technology (ART) in their home country or who look to other countries to avoid legal limitations on ART. In countries like Thailand, Ukraine, Mexico, and India, surrogacy agencies are collecting a very pretty penny in reproductive endeavors that circumvent U.S. legal stipulations. For example, estimates suggest that India’s surrogacy agencies have built a $445-million-a-year enterprise. The services benefit these foreigners who, for example, may pay an Indian agency $12,000 versus the $70,000 they would need to pay a U.S. surrogacy agency. In return, the women of color employed as surrogates earn $5,000 to $7,000 for their services, although their U.S. contemporaries earn anywhere between $30,000 to $40,000 depending on their experience. For many surrogates who come from impoverished communities, the $5,000 to $7,000 they can earn for carrying a baby often surpasses even a year’s income from their local jobs, and some do establish wonderful relationships with the baby’s intended parents. Unfortunately, not all agencies and intended parents treat surrogate parents with the care and respect they deserve; moreover, because these operations are not always closely regulated, the surrogates’ rights are left undefended.

Recently, Planet Hospital, a medical tourism company based in California, came under fire for deceiving its U.S. clients, who had hoped to head overseas to hire a surrogate parent. Planet Hospital’s surrogacy services claimed to connect U.S. Americans with surrogates in India, Thailand, and eventually Mexico but essentially would take people’s money and run. The New York Times article focused on the heartbroken couples and agency employees who were outraged at Planet Hospital’s elaborate scam, only mentioning the surrogates’ experience as an afterthought. As horrible as it is that people lost thousands of dollars, human health and wellness has to be a priority. The fact that the agency would disregard the surrogates’ health, like when they authorized the implantation of embryos into an 18-year old woman who had just had uterine cysts removed the day before — and that the surrogates’ struggles are not at the forefront of this debate — suggests that the health particularly of the women of color employed by international ART businesses is not necessarily prioritized.

In Thailand, a number of problems with surrogacy agencies has led the nation to pursue banning commercial surrogacy. Even though commercial surrogacy is against the Medical Council of Thailand’s code of conduct, regulations cover only doctors and medical institutions, leaving surrogacy agencies to exploit the system. In early August, it came to the Thai authorities’ attention that an Australian couple allegedly had abandoned a child diagnosed with Down’s syndrome that was carried by 21-year old Thai mother Pattaramon Janbua, even though the couple took the child’s healthy twin. To make matters worse, the Australian father is a convicted pedophile and Australian authorities are unable to find the couple and the healthy child. At the heels of this scandal followed accusations that a Japanese businessman has fathered nine children through a surrogate agency but has left them all to the care of nannies in a Bangkok condominium. Thai officials stated that on August 6th that “the draft of a law banning surrogacy has been submitted to the junta’s head of legal and justice affairs and will be forwarded to the newly-established interim legislature for consideration next week.” Rarinthip Sirorat, an executive from Thailand’s Social Development and Human Security Ministry, asserted that a legal ban on commercial surrogacy is designed “to give maximum benefits to the surrogate babies,” an important need, but it is troubling that the government does not seek to protect surrogate mothers like Janbua, whose entire life can be upset by irresponsible intended parents or shady surrogacy agencies.

21-year old mother Pattaramon Janbua holds baby Gammy, who she claims was abandoned by his intended parents. via Aljazeera

21-year old mother Pattaramon Janbua holds baby Gammy, who she claims was abandoned by his intended parents.
via Aljazeera

Of course, the aforementioned cases are often extreme scenarios and there are people in countries around the globe who have positive experiences as surrogate parents, as well as people from the U.S. who have negative experiences. However, we cannot underestimate the forces at hand that make international surrogacy potentially dangerous for women of color. Surrogacy in countries with majority Black and Brown people has increased because Western countries have tightened up their laws. Westerners can profit from poor people who do not necessarily have the financial agency to make demands for their rights, and can engage with agencies that exploit legal loopholes. Additionally, the problematic nature of this reproductive exchange reaches national attention more often when white couples and white babies are hurt.

Surrogacy joins the ranks of reproductive technology like birth control testing, forced sterilization, and state-sanctioned policing of abortion that particularly target women of color and poor folks, often for the benefit of white people, and middle to upper class individuals. Reproductive justice is not limited to defending a person’s right to choose to terminate a pregnancy, or to not become pregnant, but also a person’s right to carry a child without fear of discrimination. If these cases are indicative of anything, it’s not that surrogacy is necessarily wrong but that the lack of regulations puts surrogate parents’ rights at risk. Surrogate parents should have the right to transparent surrogate agreements, and the agency to defend their health, financial compensation, and wellbeing. As we fight for reproductive justice, let us also advocate for surrogate safety, so that assisted reproductive technologies are not simply another system that commodifies and exploits Black and Brown people around the world.

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Helen McDonald is a 20-something Black lesbian feminist living off of pizza, social justice and a lil snark. By day, she's a community educator, teaching young people about healthy relationships. She also discusses the intersections of race, gender, and sexuality on her personal blog sapphosistah.tumblr.com and is a contributing writer at ElixHer.com

Helen has written 40 articles for us.


  1. Great article! I had no idea that loopholes existed to seek surrogate parents overseas and then have the child recognized as one’s own back home (surrogacy is completely illegal where I live).

    I would guess that incidents of ‘oops, changed my mind’ happen more often then expected (split-ups, job loss and the like, and it’s easy to detach oneself from a situation that is overseas and out of sight), and it must be terribly devastating, financially and emotionally, to the surrogate parents.

    There is a small imprecision in the article: «In countries like Thailand, Ukraine, Mexico, and India, surrogacy agencies are collecting a very pretty penny […] In return, the women of color employed […]», in the sense that Ukraine does not feature a majority population of colour.

  2. So. This add was present at the bottom of the article after I had finished reading:

    “Become A Surrogate Mother
    Agency With Unparalleled Expertise. Earn $26,000 to $50,000, Apply Now!”

    I refreshed the page and the ad turned into a Wildfang promotion. Thought this would be something to call AS’s attention to.

  3. I think this issue should also be thought about in relation to the problems of international adoption, where global wealth disparities, in conjunction with a lack of proper regulation, has lead to all kinds of nefarious exploitation in a similar way. I also think we can put the question of poor women performing surrogacy for money in conversation with the debate over sex work; women deciding to make money from their bodily abilities in this way is not necessarily inherently bad or exploitative-they should have the right to choose what to do with their bodies-it is instead about the realities of the context in which they are doing so. These are issues I think queer people in the global North need to think about as it becomes more possible socially for them to have families and they are turning to adoption and surrogacy more; and I think there’s also a really interesting intersection with right-wing Christian politics, because many of them think that surrogacy is wrong (partly because it enables same-sex parenting) and are pushing adoption in their communities really hard, in ways that I think have had scary results (white families with super-disciplinarian gender-policing child-rearing ideologies adopting children of color because they think it makes them good Christians, yikes!). So thank you for this article. I also appreciate your acknowledgement of how well surrogacy can go, because I think conversations about the (massive) problems with both adoption and surrogacy can sometimes end up demonizing infertile or queer people who want children, as if that’s just some kind of first world/white selfishness. The question is how to build queer families ethically. I have infertile straight friends who did surrogacy with a close friend who loves being pregnant and wanted to help, so no agency or fee involved, and it has been a genuinely wonderful experience for all concerned; except for when they were shamed and interrogated by a Republican judge, in particular the woman who carried the child, during what should have been a very routine court hearing. I was like, welcome to being queer, folks! Anyway, sorry, long comment!

    • This isn’t an issue of women choosing to do something with their bodies because women aren’t being paid only to get pregnant, they’re paid to sign away their parental rights as well. In every other context, going to a different country and paying people there money in exchange for their children is child trafficking.

      • If the surrogate has no genetic relationship to the child she’s not the parent. A surrogate that agrees to donate a egg to the pregnancy, isn’t a parent. I do understand that upon seeing the child feelings and instincts could change her mind. However, that means we need a law stating the surrogate can’t be both the egg doner and surrogate.

    • I think you’re absolutely right that it needs to be about choice and an informed decision can be made, I just think in cases of extreme poverty people may not have other choices and I doubt they get any counselling over what might be a traumatic handover of the child.

      I’m interested on your thoughts on adoption – do you think it’s a bad idea for any white parents to adopt children of colour? It’s an issue I can’t make up my mind on.

  4. This is so important.
    I am consistently disappointed in how the LGBTQ community treats surrogacy. Gay cis men (and trans women/cis men couples) make up a good chunk of the people using these services. That’s frustrating. Commodifying a woman and her uterus doesn’t really seem all that progressive, and fails to look at all of the ethical dilemmas that are involved with surrogacy. For one, paying a woman pretty much nothing to essentially be your childbearing slave (if you look at the conditions that Indian surrogates are forced to live in while pregnant, it’s enraging) is disgusting, and also, failing to understand that it will matter to your child how they came into the world. Removing an infant from the woman who gave birth to it has been proven to have an effect on that child, and pretending like it doesn’t is just factually inaccurate, whether that child is biologically related to the woman who gave birth to it or not.
    And it does reflect on international adoption and the adoption industry in general, and the corruption therein. The overwhelming idea that one is entitled to a child another person gave birth to is some disgusting dystopian Atwood shit. That child is attached to a real, live woman, with real feelings. That child is going to grow up to be an adult with real feelings. Ignoring that is just going to bite you in the ass.
    I don’t know. I donated my eggs to a European cis couple when I was nineteen, and have since turned down the opportunity to do so again several times, so I do a lot of reading on this subject. It’s pretty depressing.
    I honestly think that a lot of gay/trans couples go into this thinking they’re being progressive, that biology doesn’t always matter, that whose uterus you resided in for nineish months doesn’t matter, etc. But that just negates the humanity of the people involved, and again, it’s just frustrating/depressing.

    • I think the ethical dilemmas can be dressed while still respecting a woman’s right to bodily autonomy. The fact that 5000-7000 dollars was more than the yearly income for these women is important. I do not find it ethical to remove lucrative income stream. Especially, since it benefits the poor.

      Surrogacy is different from adoption. Adoption is primarily a solution for families lacking the ability to provide for a child. Surrogacy is just another way to have a child.

    • Well, ultimately it doesn’t matter whose uterus you came out of, that person may be your biological parent, but not your real parent. There are millions of abandoned kids waiting to be adopted that can testify on that one.
      There is a strong natural need in most people to reproduce. This is why many will opt for various challenging and sometimes morally questionable methods to achieve that, instead of adopting.
      There are also people which don’t feel a strong maternal bond with their child or the child they carry inside them and they are emotionally capable of being surrogates. I see nothing wrong if monetizing those traits brings them and someone else more happiness in life.
      That being said, the article is spot on when it comes to recognizing the exploitation of poor people and/or people of color by using loopholes in the law.

    • I agree that the conditions are horrific and feeling entitled to a child is ridiculous. But the idea that for-profit surrogacy would always be exploitative doesn’t convince me. I think it’s wrong that average Europeans could pay what seems like excellent wages to impoverished women, because there should not be such a massive global wage gap that this should be possible. But while it is, it might still be a good option for many women if some kind of good, enforced regulation is put in which protects them – especially if they create a surrogacy co-op rather than being exploited by a surrogacy company which profits off of their literal labor.

      Once we achieve a world without inequality (really….we have to achieve it, because the human cost is unbearable) then we will see if for-profit sex work and surrogacy still exist, in a world where there can be no possible economic coercion.

    • “(and trans women/cis men couples) make up a good chunk of the people using these services”


  5. I never realized that people could get around surrogacy laws by going out of the country. I always thought of surrogacy in such a positive light because I have a friend who is a surrogate mother and loves it. She has had really positive experiences. Though I do remember her saying that she prefers to carry for straight couples who cannot otherwise conceive over carrying for cis gay men, because of the commitment level.

  6. I just read an article in a Swiss newspaper about this case and it said, that Thailand won’t let two Australian same-sex couples leave the country with their biological children. So it gets more complicated, because apparently there’s been comparisons made between the “gay lifestyle” of the adoptive parents and the child molestor. So the reaction to a system that exploits impoverished women (thank you for the eloquent analysis!) is homophobia. Very complex issue…

    • A lot of gay men (and trans women/cis men couples) use Indian surrogacy. Like, they make up a good chunk. With Indian surrogacy, at least one parent has to be biologically related to the child—not sure about Thai surrogacy, whether they require both intended parents to be the biological parents or what.
      The child molester guy who abandoned the baby in Thailand is a legit child molester. He admitted it, too—just said that he had worked past his desires. So it’s gross that people would make comparisons. The guy’s a piece of shit and should never have a kid near him again.

  7. I live in a European country where surrogacy is entirely illegal. This means that even surrogacy which is done for no profit, for example, by a friend of loved one of the couple, is illegal and impossible. This, combined with the illegality of external adoption (adoption of a child not related to either person in the relationship) makes it very difficult for many, many LGBT people to have families. A ban on all surrogacy is certainly not the answer – there will always be a black market, and surrogacy in itself is not harmful. Voluntary, nonprofit surrogacy is obviously not a product of economic coercion. When looking at economic coercion, things become difficult.

    I feel torn about for-profit surrogacy. It seemed that the author was navigating the same struggle as when talking about sex work, or any other kind of work which can be exploitative but which is often still chosen by the worker – to ban or regulate? To see as inherently exploitative, or as a possible free choice? How far can a choice be free under circumstances of poverty, created by a matrix of patriarchal white supremacist capitalism? With all the limited choices and massive exploitation out there, it seems that if there were, for example, a co-op set up by women in order to support themselves by being surrogates, and who set it up so that there was no middleman and they kept 100% of profits, this might be a more ethical alternative to a company exploiting surrogates, siphoning off their money, and harming them – essentially functioning like pimps. It might also be a better and more liberating alternative than not having the option, and having to choose between much lower paying jobs which often don’t keep body and soul together, and which have long, inhuman hours.

    I’m not sure whether banning for-profit surrogacy is ideal, just like banning for-profit sex work might not be ideal, since women should have these options open to them – since we all live in a capitalist economy which can only function due to horrible exploitation and wage slavery, and sometimes other options are far more attractive than this.

    I feel like surrogacy which is exploitative is a great evil, and it’s horrifying that the rights and needs of surrogate mothers are not considered and safeguarded. Legalizing nonprofit surrogacy would mean that siblings, friends, etc could work as surrogates much more safely, and that would help many couples. Otherwise, enforced regulation which values the needs of surrogates more than the consumer demands of people who want children might be an option…? The problem is that existing regulations which are set up to protect workers are way too lax to mean anything, or are strict but not enforced at all (look at NAFTA).

    I’m just not sure that a ban will solve the problem, but having legitimate, safe, ethical co-ops set up by surrogates for surrogates seems like it would be an option. But this needs to happen in the context of a global grassroots movement to end inequality – as it stands, market forces will continue murdering, enslaving, and impoverishing people.

  8. Surrogacy is such a difficult topic. I’m not sure making it illegal is the right thing to do, as the black market would probably be even more dangerous for the women involved.

    At the same time, it’s difficult to set up a commercial arrangement which isn’t open to exploitation. It’s not ethical for women to be coerced into signing away rights, but it’s difficult to set up an arrangement wherein the women are able to opt out at any time without allowing them to walk away with money they accepted for what is effectively a business transaction.

  9. Did you seriously just imply that a baby with Down’s is not healthy? That’s really shitty. It’s a genetic disorder, not a disease.

  10. For those who are interested in pregnancy and surrogate motherhood, there is a good blog. My daughter was born thanks to a surrogate mother we found at the Feskov Human Reproduction Group. We liked our acquaintance with her very much, there is a wide choice of surrogate mothers, all proven and healthy, both physically and mentally. In addition, the price is very good and there are no problems with traveling home and documents. I suggest you also check out their YouTube channel, there are a lot of interesting information.

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