Fertility Treatment in Same Sex Male Couples - Report Example

Introduction Fertility treatment is the medical term used to cover the medical techniques used to assist men and women to have children (Robertson, 2004). There are many types of fertility treatments in the world today which range from in vitro fertilization (IVF), intra-cytoplasm sperm injection (ICSI) and donor insemination (DI) (Robertson, 1995). Fertility treatment is done in the form of treatment cycles meaning it happens after duration of time. For same sex parents fertility treatment is a topic under discussion and construction. They are yet to receive the most out of it since there are still barriers to accessing this treatment. Even though they have a desire to be parents some laws and regulations have been too harsh to allow the process for same sex male couples to fulfill their desires (Ethics Committee of the American Society for Reproductive Medicine, 2009). Some of the fertility treatment that has given same sex couples the opportunity to have biologically related children includes artificial insemination, surrogate mothers, IVF. Artificial Insemination Artificial insemination requires same sex male couples to provide a sperm sample to donors so that it can be used to fertilize donor eggs (Robertson, 2004). The sample may be taken from one of the partners or both partner sperms could be used. In some cases, twins have been born but in other cases a DNA is required to determine whose sperm fertilized the egg (Wykes, 2012). A surrogate mother is required to carry the pregnancy top term. Under UK law surrogate mothers still have the right to determine what happens to the child; after all she is biologically related to the child (Daar, 2008). This can lead to complications or misunderstandings down the line. It is advisable to involve a solicitor and to have a clear understanding of what the surrogate wants before commencing the process (Robertson, 2004). IVF is a procedure that involves extracting the eggs directly from the follicles and mixing them with sperm in a Petri dish (Robertson, 2004). This is then incubated to form embryo, which is then implanted into the uterus hoping for an implantation in the womb (Daar, 2008). Same sex male couples prefer this method as compared to adoption because it gives them a connection to the child. The law allows same sex to have similar rights in this treatment like heterosexual couples. In IVF the egg donor should not be more than 36 years of age because of the viability of the egg. Other considerations made top when getting eggs are the health and genetic history of the donor. This is why before any donation; the candidate must undergo a screening test so as to reduce the risks of passing over deformities and diseases to the resultant child (HFEA, 2012). The donor can be a family member or a known individual. Donation in the family line to some is considered unethical as under normal circumstances it would be incest. However, it is great as it maintains a genetic link and helps the recipients to avoid long waiting lists. Mixing of sperms and eggs between family members poses a risk of disorders for the children but it is legal (HFEA, 2012). The law argues that the most important thing in upbringing of a child is a loving and caring environment not sexual orientation (Waaldijk, 2004). ICSI In ICSI, a single sperm is selected to be injected directly to the egg. This is recommended by the clinic if one person has low sperm count. Genetic tests are required before the process to avoid passing genetic disorders to the child (HFEA, 2012). For same sex male couples IVF is the better option since several sperms are given the option to fertilize the egg. In case both partners’ sperms are infertile, then an ICSI would be advisable. Previous Legal Positions on Same Sex Parenting The law that relates to same sex parenting is complicated and diverse. In areas concerning family law for example, access to assisted conception and surrogacy arrangements the power is retained by the states (Waaldijk, 2004). For many years, it has been a common phenomenon for lesbian couples to get pregnant through alternative measures like using donor sperm for insemination (Robertson, 1995). Same sex men on the other hand, have been forced to rely on adoption, but still it has to be indirect as one partner poses as a single straight man rather than a homosexual (Greenfeld, 2007). However, this is changing as more men are learning that they can have their own biological children through gestational surrogates and egg donors (Robertson, 2004). There is still limited publication on same sex male couples using this assisted reproductive treatment to have families. As the societal views change, same sex male couples have been able to embark on the parenthood journey (Nachtigall et al., 1997). Historically, there have been negative societal attitudes towards same sex males as well as inadequate physicians willing to treat them thus fewer such couples have had access to fertility services (Greenfeld, 2007). The world health organization says that all couple has a basic right to freely and responsibly make a decision on the timing, spacing and number of children they want to have as well as be able to access information and means to do so (Waaldijk, 2004). It also describes the right to make decisions on reproduction without discrimination, violence or coercion. No person is allowed to deny the other the right to have children of their own and no individual should be discriminated against because they made a decision to do so (Waaldijk, 2004). Just because homosexuals are attracted to same sex does not mean that the desire to have children is not in them (Benson, Silverstein, & Auerbach, 2005). As noted by DeLair (2000) they want to build families and have a lineage, as well as meaning for their lives. Denying them the right to procreate is therefore denying them a fundamental right in the society and denying them a human basic right (Daar, 2008). In the past negative attitudes like heterosexism and homophobia has been the kind of oppression that same sex male couples have had to live with. Heterosexism is communicated through media, language and religion that have been actively discriminating against homosexuality (Friedman, 1987). Since the implementation of gay rights, the attitudes of the British people have changed. Fertility Policy Evolution Initially, the Human Fertilization and Embryology Act was a major barrier to same sex couple being allowed to obtain fertility treatment as it stated that the resulting child right to a father or mother. It was believed to be unnatural for a child to have two mothers or two fathers, since it was against traditional family values of a nuclear family. This presumption is a stereotype that many homosexual parents still live with. It is assumed that children brought up by homosexual parents are at risk of having psychological development problems (Nachtigall, Tschann, Quiroga, Pitcher, & Becker, 1997). However this is not true as a child brought up by heterosexual parents suffers the same risk of emotional issues. The main problem that these children face is homophobic attitudes. Society views it as a way of turning children into lesbians or homosexual males since they do not have some one to guide them. Homosexuality is associated with sexual abuse for the children or molestation. This claim has little evidence to support it since the quality of parenting is the factor that contributes to child development (Tasker, 2005). The legislation was therefore ruled to be discriminatory and it restricted same sex parents from accessing fertility treatment. Even after the ruling out of this legislation same sex couples did not gain access to fertility treatment because it was only given to people with who were proven to have sub fertility issues. The definition for infertility is being unable to conceive after twelve months of continuously having unprotected sex; this definition is difficult to apply to same sex couples. Despite improvement in equality, there are still barriers in accessibility. For example, same sex couples have the fear of being discriminated in public hospitals, thus they have to make arrangement to visit private doctors who they feel are more encouraging in offering same sex fertility treatment (Greenfeld, 2007). These treatments could be expensive and unaffordable for couples. In 2005, the civil partnership act was enacted in the UK (Waaldijk, 2006). This act allowed same sex couples to have legal recognition in their relationships. This led to subsequent joint adoption proceedings by both gay and lesbian couples. The laws regarding assisted reproduction technology were amended in December 2008 when the Human Fertilization and Embryology Act received royal assent. Despite these changes there are still challenges faced since same sex couple parenting is still not fully accepted by society (DeLair, 2000). Research has showed that most discrimination for homosexual parents occurs in health and social care services. They feel embarrassed to disclose their true sexuality to clinicians because they fear being stigmatized (Benson, Silverstein, & Auerbach, 2005). Since April 2010, the law has made it possible for same sex couples to be treated as the parents of the born child (Ryan & Berkowitz, 2009). This allows changing of the original birth certificate with a new birth certificate that names both intended parents instead of the surrogate parent; both men in the relationship are recorded as the biological parents of the child (Ryan & Berkowitz, 2009). These changes combined with equality act 2010, have the ability to secure great fairness for same sex male couples and other same sex couples as well as bisexuals in the UK (Waaldij, 2004). In terms of equality, there is a debate to allow surrogate parents to get adoption pay and be eligible for parental leave. This context in UK law may encourage most people to follow a heteronormative way to parenthood despite their sexual orientation (Waaldij, 2004). Surrogacy as an Option for Same Sex Male Couples Surrogates can be known family members or unrelated known individuals. The phenomenon of same sex male couples seeking surrogacy is beats previous reports on assumptions that women are the drivers or pursuant of parenthood (Benson, Silverstein, & Auerbach, 2005). Surrogacy agreements give the opportunity to one of the male couple to be biologically related to the child by taking his sperm and use it in the fertilization process where both male couple can be fathers. This also gives homosexual males the opportunity to raise a child from birth, however apart from very high profile cases in British media, there is less known about experiences of homosexual men in the surrogacy process. Law and Regulation in Surrogacy According to DeLair, (2000), there are so many legal stipulations on surrogacy on the international platform. In many European countries, surrogacy is illegal including France, Germany, Italy and Spain. Contrary to that, other countries like India and Ukraine have few restrictions on this field. They also accept commercial surrogacy where the commissioning parents pay the surrogate (Family Law Week, 2012). In USA commercial surrogacy is accepted. So many organizations have come up in this country to help couples contact surrogates and assist them to follow the legal procedures of contracts involved. However as stated by Robertson (2004), this kind of surrogacy is prohibited in the UK following Surrogacy Arrangements Act of 1985. Since the first official surrogate birth in Britain in 1985, there is a limitation by the law to pay for only reasonable expenses like income loss (Waaldij, 2004). In UK it is illegal to announce your willingness or advertise the need to enter into a surrogate agreement (Bergman, Rubio, Green, & Padron, 2010). This is because these arrangements are not legally enforceable even with the signing of a contract and all expenses have been paid. For same sex male couples choosing to have a surrogate arrangement outside the legal brackets would mean that the child is entitled to the biological mother, and one of the partners has no legal right towards the child (Human Fertilization and Embryology Act 1990). Under the law in UK, the surrogate becomes the outright legal mother but the father may fail to be regarded as the legal father depending on marital status of the surrogate (Waaldijk, 2004). This is an unfair law that discourages same sex male couples from getting surrogates as they might end up not raising the child they so much desire (Human Fertilization and Embryology Act 1990). Until a transfer is made to the same sex parents, the surrogate remains the legal mother. Obtaining a parental order that allows the change of parents requires one of the same sex partners to be genetically related to the child (Robertson, 2004). This discourages use of donor sperms for homosexual men as their parenthood is jeopardized by such an action (DeLair, 2000). If a genetic link is not possible, an adoption is the only option for such a couple. The law is also quite unfair as it gives the surrogate the right to change her mind even though the surrogacy is just gestational and the surrogate is not related to the child (Waaldijk, 2006). Even after an agreement the law requires that a full unconditional consent must be given to the same sex couple by the surrogate mother to ensure they get a parental order (Bergman, Rubio, Green, & Padron, 2010). There is however an interesting case where parental order was given to a same sex male couple without the consent of the birth mother, but it is just because the mother was untraceable after the birth (Family Law Week, 2012) There are many legal barriers for men who choose surrogacy especially across borders. There are concerns regarding couples who have been trapped abroad due to complicated legal processes of a child who is termed stateless thus obtaining a passport becomes a problem. Cross border fertility treatment is sought out because of international differences in laws governing surrogacy (Shenfield, et al., 2010). For example, British same sex men may be attracted to overseas surrogate services due to the ready availability of surrogate mothers who offer their services on a commercial basis (Waaldijk, 2004). This is however, expensive for the couple as they have to cater for travelling costs and other expenses along the way. They may also be trapped by the laws in those countries. According to (Shenfield et al., 2010), since 2002 when India legalized commercial surrogacy, there has been an increase in surrogate tourism. In fact it is estimated that about 1000 babies born out of surrogacy last year belonged to British men (Bergman, Rubio, Green, & Padron, 2010). While it is evident that UK laws explicitly recognize same sex male couples’ rights to have access to fertility treatment and assisted reproduction (Robertson, 1995), there is also evidence that most homosexual males are going cross border to find gestational surrogates mostly in India and USA due to legality of same sex couples treatment in those countries and costs of the process (Shenfield et al., 2010). Additionally, Shenfield et al. (2010) states that International surrogacy has some additional benefits like allowing naming of both fathers on the birth certificate as soon as the child is born. This is contrary to the UK law that requires registration of a parental order six months after the birth of the child (Waaldijk, 2004). In California, a law allowing unmarried and same sex couples to access insurance covers for fertility treatments was passed (Ethics Committee of the American Society for Reproductive Medicine, 2009).). According to Robertson, (1995) reproductive treatment is for everybody to benefit from. It is a violation of California’s non discrimination laws if fertility coverage is restricted to heterosexuals alone. It is unfair that the existing laws only allowed insurance cover to kick in after one year of the couple trying to conceive naturally. This leaves same sex male couples to face fertility treatments worth of tens of thousands of dollars to no avail (Robertson, 1995). Societal Reluctance Despite the changes in the law and trends on social media some individuals’ still view homosexuality as immoral thus they oppose facilitating same sex reproduction treatment (DeLair, 2000). This results to fertility programs differing in their willingness to give reproductive services to couples regardless of their sexual orientation or marital status. This reflects administrative complications or personal moral views of working with surrogates and egg donors to assist male couples (Daar, 2008). In the law it is prohibited to deny any one assisted reproductive technology services based on sexual orientation. Ethically speaking, it is the duty of all physicians to treat patients with equal respect despite their sexual orientation thus, homosexual couples deserves the same treatment the heterosexual couples get in fertility programs when determining the right program for them (Ethics Committee of the American Society for Reproductive Medicine, 2009). Unless there are other aspects like doubt of quality parenting, which would apply to heterosexual couples, it is unethical to deny unmarried and same sex couples reproductive services. Conclusion Advances in fertility treatment have blurred the traditional and social boundaries of parenting and reproduction. There is an increase in the numbers of male couples who choose to have children and be biological parents. The timing for this is perfect as same sex couples in the UK are still fighting for their rights of civil partnerships to be recognized as marriages. This paper has offered insights on the evolution that govern same sex couples which has allowed them to have equal rights in fertility treatment like their heterosexual counterparts. From societal stigmatization, to state law, same sex parenthood still has a long way to go. The future of fertility treatment and same sex parenthood becoming commonplace in UK is still uncertain. The laws governing surrogacy as a method of fertility treatment for same sex male couples are too strict, such that men are forced to outsource surrogates from other countries. Social workers on the other hand have an obligation to fight for the acceptance of same sex parenting and equality but at the same time determine whether it is in the best interest of the child. This is because even though the law allows same sex parenting, most of the homosexual males who have become parents over the years encounter prevalent heterosexism and stigma. References Benson, A., Silverstein, L. B., & Auerbach, C. F. (2005). From themargins to the center: Gay father reconstruct the fathering role. J of GLBT Fam Stud, 1, 1-30. Bergman, K., Rubio, R., Green, R., & Padron, E. (2010). Gay men who become fathers via surrogacy: The transition to parenthood. J. GLTB Fam.Stud, 6, 111-141. Daar, J. (2008). Accessing reproductive technologies: invisible barriers, indelible harms. Berkeley Journal of Gender. 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