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Race and the New Reproduction (Chapter 6 of Killing the Black Body)

by Dorothy RobertsKilling the Black Body: Race, Reproduction and the Meaning of Liberty (New York; Pantheon, 1997)

A friend of mine recently questioned my interest in a custody battle covered on the evening news. A surrogate mother who had agreed to gestate a fetus for a fee decided she wanted to keep the baby. "Why are you always so fascinated by those stories?" he asked. "They have nothing to do with Black people." By "those stories" he meant the growing number of controversies occupying the headlines that involve children created by new methods of reproduction. More and more Americans are using a variety of technologies to facilitate conception, ranging from simple artificial insemination to expensive, advanced procedures such as in vitro fertilization (IVF) and egg donation.*

In one sense my friend is right: the images that mark these controversies appear to have little to do with Black people and issues of race. Think about the snapshots that promote the new reproduction. The always show white people. And the baby produced often has blond hair and blue eyes -- as if to emphasize her racial purity. The infertile suburban housewife's agonizing attempts to become pregnant via IVF; the rosy-cheeked baby held up to television cameras as the precious product of a surrogacy arrangement; the complaint that there are not enough babies for all the middle-class couples who desperately want to adopt; the fate of orphaned frozen embryos whose wealthy progenitors died in an airplane crash: all seem far removed from most Black people's lives. Yet it is precisely their racial subtext that gives these images much of their emotional appeal.

Ultimately my attraction to these stories stems from my interest in the devaluation of Black reproduction. As I have charted the proliferation of rhetoric and policies that degrade Black women's procreative decisions, I have also noticed that America is obsessed with creating and preserving genetic ties between white parents and their children. This chapter explores the reasons for the racial disparity that marks the new reproduction, as well as the impact of race on the right to recreate children by technological means.

LIBERATING TECHNOLOGY OR PATRIARCHAL TOOL?

New means of procreating are often heralded by legal scholars and social commentators as inherently progressive and liberating. In this view, reproduction-assisting, technologies expand the procreative options open to individuals and therefore enhance human freedom. These innovations give new hope to infertile couples previously resigned to the painful fate of childlessness. In addition, the new reproduction creates novel family arrangements that break the mold of the traditional nuclear family. A child nay now have five parents: a genetic mother and father who contribute egg and sperm, a gestational mother who carries the implanted embryo, and a contracting mother and father who intend to raise the child. One of the new reproduction's most influential proponents, John Robertson, opens his book Children of Choice by proclaiming that these "powerful new technologies" free us from the ancient subjugation to "the luck of the natural lottery" and "are challenging basic notions about procreation, parenthood, family, and children."

New reproductive technologies promise to fulfill couples' yearning to have genetically related children. They also make it possible to use new genetic knowledge to create children with superior traits. Pregnant women may choose to abort a fetus determined, through amniocentesis, ultrasonoraphy, or other diagnostic techniques, to have a genetic defect. Sperm and egg donation allows parents to select gametes from donors who possess favored qualities. With IVF (fertilization of the egg in a petri dish followed by transfer to the uterus), parents can screen test-tube embryos for defects before implantation -- "nipping it in the embryo," as a newspaper headline proclaimed. In the future, doctors will be able to tinker with genes contained in the embryo to enhance their encoded messages or remedy genetic disorders.

My impression of these technologies, however, is that they are more conforming than liberating. they more often reinforce the status quo than challenge it. True, these technologies often free unconventional parents from the constraints of social custom and legal stipulations. They have helped single women, lesbians, and gay men whom society regards as unqualified to raise children to circumvent legal barriers to parenthood. Informal surrogacy arrangements between women, for example, may provide a means of self-help for women who wish to have children independently of men; and they require nogovernment approval, medical intervention, or even sexual intercourse. Under this arrangement, a fertile woman would informally promise an infertile woman who wants a child to impregnate herself with a donor's sperm and to give the baby to the infertile woman for adoption.

But these technologies rarely achieve their subversive potential. Most often they complete a traditional nuclear family by providing a married couple with a child . Instead of disrupting the stereotypical family, they enable infertile couples to create one. Most IVF clinics accept only heterosexual married couples as clients, and most physicians have been unwilling to assist in the insemination of women who depart from this norm. They routinely deny their services to single women, lesbians, welfare recipients, and other women who are not considered good mothers.

The new reproduction's conservative function is often imposed by courts and legislatures. Laws regulating artificial insemination contemplate use by a married woman and recognition of her husband as the child's father, and recent state statutes requiring insurance coverage of IVF procedures apply only when a wife's eggs are fertilized using her husband's sperm. On the other hand, courts have been willing to grant parental rights to sperm donors against the mother's wishes "when no other man is playing the role of father for the child," such as when the mother is a lesbian or unmarried.

Radical feminists have powerfully demonstrated that the new reproduction enforces traditional patriarchal roles that privilege men's genetic desires and objectify women's procreative capacity. They make a convincing case that new reproductive technologies serve more to help married men produce genetic offspring than to give women greater reproductive freedom. High-tech procedures resolve the male anxiety over ascertaining paternity: by uniting the egg and sperm outside the uterus, they "[allow] men for the first time in history, to be absolutely certain that they are the genetic fathers of their future children." Some feminists have questioned the forces that drive so many women to endure the physical and emotional trauma entailed in IVF. The arduous process involves stimulating ovulation with daily hormone infections, retrieving the eggs from the ovaries, and inserting the fertilized embryos into the uterus, usually followed by heartbreaking disappointment. In extreme cases, IVF has caused long-term, and even lethal, harm to women s reproductive organs, such as the growth of ovarian cysts.

The desire to bear children is influenced by the stigma of infertility and the expectation that all women will become mothers. Added to this is the desire to produce a genetically related child. Despite very low rates of live births resulting from IVF (on average, only about 20 percent), some women feel a "duty" to undergo the ordeal before they give up on the possibility of genetic parenthood. But many women who undergo IVF are themselves physiologically fertile, although their husbands are not. These women could therefore become pregnant using a much safer and cheaper process -- artificial insemination, for example. Underlying women's desire to undergo IVF, then, is often their husbands' insistence on having a genetic inheritance. Because this technology inflicts so much distress on women's bodies for the benefit of men, feminist author Janice Raymond calls it a form of "medical violence" against women.

Surrogacy also fulfills the father's desire to pass his own genes onto a child. In the typical arrangement, a man whose wife is infertile hires a fertile woman, or surrogate, to bear a child for the couple. The surrogate is impregnated with the husband's sperm and carries the fetus to term. She agrees to relinquish parental rights to the child, whom the wife subsequently adopts. The surrogate's service, then, allows the husband to have a child who is genetically related to him, despite his wife's infertility. William Stern, the contracting father in the well-publicized Baby M case, explained that, as the only survivor of a family that had been annihilated in the Holocaust, he wanted a genetically related child in order to perpetuate his family's bloodline. "The desirability of having his own biological offspring became compelling to William Stern, thus making adoption a less desirable alternative," the New Jersey trial judge acknowledged in upholding the surrogacy contract.

Surrogacy arrangements devalue the mother's biological relation-ship to the child in order to exalt the father's. Harvard law professor Martha Field points out that the very term "surrogate" emphasizes the arrangement's purpose -- allowing a man to be a genetic father rather than enabling a woman to become a mother: "The woman is a surrogate's surrogate uterus or a surrogate wife -- to carry his genes." Most surrogate mothers intentionally donate their genetic material, as well as their wombs, to bear a child who will not be legally theirs. Not surprisingly, then, most of the money the surrogate receives pays for the surrender of her parental rights -- her legal claim to the child arising from their biological bond. The contract Baby M's mother signed provided: "$10,000 shall be paid, to MARY BETH WHITEHEAD, Surrogate, upon surrender of custody to WILLIAM STERN, the natural and biological father of the child born pursuant to the provisions of this agreement..." Whitehead would have received only $1,000 for her services if she had delivered a stillborn child.

In custody disputes that arise when the surrogate mother refuses to relinquish the baby, enforcing the contract would mean denying her genetic claim to legal maternity. Yet surrogacy advocates contend that holding surrogates to their bargain is necessary to protect contracting couples' interests and to ensure the viability of the practice. John Robertson even argues that procreative liberty includes a constitutional right to state enforcement of surrogacy agreements. Even judges who refuse to enforce surrogacy contracts, and base custody instead on the best interests of the child, tend to grant custody to the contracting couple in part because of their class advantages. The high court in the Baby M case, for example, awarded the Sterns joint custody of Melissa largely because of the couple's financial security and ability to provide the child with such luxuries as piano lessons. Meanwhile a parade of expert witnesses disparaged Whitehead's fitness as a mother based on her "myopic" and "narcissistic" efforts to get Melissa back.

The law should favor gestational mothers who decide they want to keep the baby, not because the mother's genetic tie is more important than the father's but because the mother has already established a relationship with the baby. Instead, surrogate mothers are valued for their service to the biological father -- facilitating his more important genetic connection to the child.

HOW RACE SHAPES THE NEW REPRODUCTION

While acknowledging that poor women of color are the most vulnerable to reproductive control, the feminist critique identifies male domination as the central source of the oppressive use of reproduction-assisting technologies. But these technologies reflect and reinforce a racist standard for procreation, as well. Similar to technologies that prevent births, the politics of technologies that assist births is shaped by race.

One of the most striking features of the new reproduction is that it is used almost exclusively by white people. Of course, the busiest fertility clinics can point to some Black middle-class patients; but they stand out as rare exceptions. Only about one-third of all couples experiencing infertility seek medical treatment at all; and only 10 to 15 percent of infertile couples seeking treatment use advanced techniques like IVF. Blacks make up a disproportionate number of infertile people avoiding reproductive technologies. White women seeking treatment for fertility problems are twice as likely to use high-tech treatments as Black women. Only 12.8 percent of Black women in the latest national survey used specialized infertility services such as fertility drugs, artificial insemination, tubal surgery, or IVF, compared with 27.2 percent of white women.

As my story that opened this chapter reflects, media images of the new reproduction mirror this racial disparity. Most of the news stories proclaiming the benefits of the technology involve infertile white couples. When the 1986 Baby M trial propelled the issue of surrogacy to national attention, major magazines and newspapers were plastered with photos of the parties (all white) battling for custody of Melissa.

Ten years later, in January 1996, the New York Times, launched a prominent four-article series called "The Fertility Market." The front page displayed a photograph of the director of a fertility clinic surrounded by seven white children conceived there. The continuing page contained a picture of a set of beaming IV'F triplets, also white.

The following June, Newsweek ran a cover story entitled "The Biology of Beauty" reporting scientific confirmation of human beings' inherent obsession with beauty. The article featured a striking full-page color spread of a woman with blond hair and blue eyes. The caption asked rhetorically: "Reproductive fitness: Would you want your children to carry this person's genes?" The answer, presumably, was supposed to be a resounding, universal "Yes!

When we do read news accounts involving Black children created by these technologies, they are usually sensational stories intended to evoke revulsion precisely because of the children's race. Several years ago a white woman brought a highly publicized lawsuit against a fertility clinic she claimed had mistakenly inseminated her with a Black man s sperm, instead of her husband's, resulting in the birth of a Black child. The woman, who was the child's biological mother, demanded monetary damages for her injury, which she explained was due to the unbearable racial taunting her daughter suffered. Two reporters covering the story speculated that "[i]f the suit goes to trial, a jury could be faced with the difficult task of deciding damages involved in raising an interracial child." Although receiving the wrong sperm was an injury in itself, the fact that 'it cane from someone of the wrong race added a unique dimension Of barm to the error. This second harm to the mother was the fertility clinic's failure to deliver crucial part of its service -- a white child.

In a similar, but more bizarre, incident in The Netherlands in 1995,a woman who gave birth to twin boys as a result of IVF realized when the babies were two months old that one was white and one was Black. The Dutch fertility clinic mistakenly fertilized her egg sperm from both her husband and a Black man. A Newsweek article subtitled "A Fertility Clinic's Startling Error" reported that "while one boy was as blond as his parents, the other's skin was darkening and his brown hair was fuzzy." A large color photograph displayed the two infant twins, one white and one Black, sitting side by side -- a racial intermingling that would not occur in nature. The image presented a new-age freak show, created by modern technology gone berserk.

The stories exhibiting blond-haired blue-eyed babies born to white parents portray the positive potential of the new reproduction. The stories involving the mixed-race children reveal its potential horror.

REASONS FOR THE DISPARITY

These images, along with the predominant use of fertility services by white couples, indisputably show that race affects the popularity of reproductive technologies in America. What are the reasons underlying this connection between race and the new reproduction?

First, it has nothing to do with rates of infertility. Blacks have an infertility rate one and one-half times higher than that of whites. (The racial disparity may actually be greater due to underreporting of infertility by married Black women.) While the overall infertility rate in America was declining, the infertility rate of young Black women tripled between 1965 and 1982. The reasons for the high incidence of infertility among Black women include untreated chlamydia and gonorrhea, STDs that can lead to pelvic inflammatory disease; nutritional deficiencies; complications of childbirth and abortion; and environmental and workplace hazards.

In fact, the profile of people most likely to use IVF is precisely the opposite of those most likely to be infertile. The people in the United States most likely to be infertile are poor, Black, and poorly educated. Most couples who use IVF and other high-tech procedures are white, highly educated, and affluent.

Besides the new reproduction has far more to do with enabling people to have children who are genetically related to them than with helping infertile people to have children. Baby M and other well-known surrogacy cases involved fertile white men with an infertile wife who hired a surrogate so they could pass on their own genes to a child. Moreover, as many as half of the women who undergo IVF are themselves fertile, although their husbands are not. Both scenarios involve fertile people who use new reproductive technologies to create genetic offspring. In short, use of high-tech fertility treatment does not depend on the physical incapacity to produce a child.

Instead, the racial disparity appears to stem from a complex inter-play of financial barriers, cultural preferences, and more deliberate professional manipulation.

Economic Barriers

The high cost of high-tech procedures places them out of most Black people's reach. The median cost of one IVF cycle is about $8,000; and, owing to low success rates, many patients try several times before having a baby or giving up. Using donor eggs makes the procedure even more expensive -- $10,000 to $20,000 for each attempt. (Ironically, eggs from Black donors may be the most costly because they are so scarce.) Most medical insurance plans do not cover IVF, nor is it included in Medicaid benefits. Medicaid, moreover, will not reimburse the full cost of covered infertility services, making most private physicians unwilling to serve Medicaid recipients. Half of the specialized fertility centers surveyed by the Alan Guttmacher Institute refused patients on Medicaid.

Between 1985 and 199 1, ten states passed laws requiring insurance coverage of infertility services, eight of which included IVF. But the trend toward mandatory inclusion seems to have come to a halt. Of course, these provisions do not assist the millions of uninsured Americans whose incomes fall barely above the Medicaid level, a group that is disproportionately Black. Without some form of subsidy, only a tiny minority of Black Americans have the means to pay for these expensive procedures.

The government could increase Black people's access to new reproductive technologies by expanding public funding. "Although black couples are twice as likely as white couples to be infertile," bioethicist George Annas has noted, IVF is "not promoted for black couples, nor has anyone openly advocated covering the procedure by Medicaid for poor infertile couples." To the contrary, state lawmakers have recently begun eliminating state subsidies for any fertility service in any effort to lower costs and keep poor women from having more children. In the last few years, at least eight states have prohibited Medicaid coverage for fertility drugs and therapies in response to taxpayer protest against paying these costs. A bill introduced in New York in 1994 also proposed excluding reimbursement for the reversal of a tubal ligation.

Treating infertility at public expense, critics assert, conflicts with the ongoing campaign to reduce the numbers of children born on welfare. They are right: it does not make sense for a state to provide a poor woman fertility treatment only to deny her benefits to care for the child. Even liberal senator Ted Kennedy (the ninth child of the Kennedy family, columnist Ellen Goodman reminds us) voted to rescind government aid for fertility drugs. "Our goal in using tax dollars wisely is to reduce welfare dependency, not create more of it," he asserted. Under present constitutional doctrine, the government has no obligation to provide fertility services to those who cannot afford them.

High-tech approaches such as IVF require not only huge sums of money, but also a privileged lifestyle that permits devotion to the rigorous process of daily hormone shots, ultrasound examinations, blood tests, egg extraction and implantation, travel to and from a fertility clinic, and often multiple attempts -- a luxury that few Black people enjoy. As Dr. O'Delle Owens, a Black fertility specialist in Cincinnati, explained, "For White couples, infertility is often the first roadblock they've faced -- while Blacks are distracted by such primary road-blocks as food, shelter, and clothing." Black people's lack of access to fertility services is also an extension of their more general marginalization from the health care system.

Racial Steering

There is some evidence that fertility doctors and clinics deliberately steer Black patients away from reproductive technologies. Physicians import their social views into the clinical setting and may feel that fertility treatment is inappropriate for Black women who they think are unable to care for their children. As a genetic counselor confessed to anthropologist Rayna Rapp, "It is often hard for a counselor to be value-free. Oh, I know I'm supposed to be value-free, but when I see a welfare mother having a third baby with a man who is not gonna support her, and the fetus has sickle-cell anemia, it's hard not to steer her toward an abortion. What does she need this added problem for, I'm thinking." Georgetown law professor Patricia King similarly concludes that the racial disparity in the use of clinical genetic services may be related to physician referrals.

But racial steering is more likely to occur on a less conscious level. It is frequently dressed up in medical garb. The very diagnosis of infertility depends on social factors. To begin with, the definition of infertility -- the inability of a couple to conceive after twelve months of unprotected intercourse -- is a social determination as much as a physiological condition. In some cultures, the meaning of infertility involves a woman's failure to bear sons. Courts are split on the issue of whether infertility qualifies as an illness and disability for purposes of coverage under insurance policies and the Americans with Disabilities Act of 1990.

Second, doctors' diagnoses of the cause of infertility often depend on race. Doctors characterize endometriosis, the abnormal growth of uterine tissue outside the uterus, which can cause infertility, as a white, "career woman's disease." Endometriosis is commonly treated as part of infertility therapies. Although epidemiologists find no higher incidence of the ailment in this group of women, many gynecologists insist on associating endometriosis with a middle-class, professional lifestyle. Niels Lauersen, a New York Medical College obstetrics professor, seemed to blame the victim when he claimed the disease strikes women who are "intelligent, living with stress [and] determined to succeed at a role other than 'mother' early in life.

The flip side of this attribution is doctors' view that Black women are unlikely to suffer from endometriosis. According to Dr. Donald Chatman, "most textbooks of gynecology are, in agreement that endometriosis is rare in the indigent, nonprivate patient and, therefore, by inference ... uncommon in the black woman." Instead, gynecologists are more likely to diagnose Black women as having pelvic inflammatory disease, which they often treat with sterilization. In 1976, Dr. Chatman found that over 20 percent of his Black patients who had been diagnosed as having pelvic inflammatory disease actually suffered from endometriosis. Calling endometriosis the "career woman disease" has a dual effect. It stigmatizes white women's careerism for causing infertility (that can be treated with new reproductive technologies) and it excludes Black women, who are less likely to be professionals, from the class of women whose infertility is treatable.

Socioeconomic screening criteria not based specifically on race exclude Black women, as well. Prospective IVF patients must pass eligibility tests that include such nonmedical factors as "a 'stable' marriage, sufficient education to comply with treatment regimens, and the financial resources to provide 'adequately' for a child." All of these criteria tend to eliminate Blacks.

For example, since most Black children in America today are born to single mothers, a rule requiring clients to be married works disproportionately against Black women desiring to become mothers. One IVF clinic addresses the high cost of treatment by offering an egg donor program that waives the fee for patients willing to share half of their eggs with another woman. The egg recipient in the program also pays less by forgoing the $2,000 to $3,000 cost for an egg donor. I cannot imagine that this program would help many Black patients, since it is unlikely that the predominantly white clientele would be interested in donations of their eggs.

The Sickle-Cell Screening Disaster

In fact, where new reproductive technologies have been directed toward Blacks, they have been used to restrict procreative freedom, not increase it. The history of sickle-cell screening and reproductive counseling for Blacks is a telling example. Sickle-cell anemia, a painful and disabling blood disease, is a recessive inherited condition that disproportionately affects Blacks, as well as several other ethnic groups. Only children who receive copies of the affected gene from both parents will have sickle-cell disease; carriers of only one copy of the gene (called sickle-cell trait) exhibit no symptoms at all. Having sickle-cell trait confers resistance to malaria, a notable benefit to people native to equatorial Africa, where the gene is most prevalent. While 1 in 10 Black Americans is a carrier for sickle-cell trait, only 1 in 500,000 has two copies of the sickle-cell gene and is therefore likely to develop symptoms of sickle-cell anemia. A blood test that can detect sickle hemoglobin has been used since the 1960s. A more reliable test that can detect the sickle-cell gene itself became available in the early 1980s.

Around 1970, proposals for sickle-cell screening programs gained support in both the medical establishment and the Black community. Like others at risk for genetic disorders, Black people deserve available information about their risks, the disease, and treatment so that they can make informed decisions about their procreative future. Initially, the influential Journal of the American Medical Association called for a program to screen Blacks of marriageable age so that couples who discovered that both carried the sickle-cell trait could consider the one-in-four risk that their children would suffer from the disease. President Nixon pledged to reverse the nation's "sad and shameful" neglect of sickle-cell anemia. Seventeen states instituted wide-scale screening programs, and in 1972 Congress passed the National Sickle-Cell Anemia Control Act, which provided for research, screening, counseling, and education. By 1975, there were more than 250 screening programs around the country, which tested almost half a million Blacks.

What began as a strategy to improve the health of Blacks soon turned into an instrument of medical abuse. Because screening programs often provided no counseling, there was rampant confusion between carriers of the trait and those who had the disease. Many people who had only sickle-cell trait were mistakenly convinced that their health was in jeopardy. Even the preamble of the federal law stated erroneously that 2 million Americans had sickle-cell disease, rather than the trait.

Instead of offering the tests as a voluntary source of information, fourteen states made them mandatory for Blacks enrolling in school, obtaining a marriage license, or confined in mental institutions and prisons. Of course, five-year-olds had no need for test results designed to help couples make reproductive decisions. Nor were the tests helpful to adults in the absence of accurate information about the disorder and acceptable options for avoiding the disease in their children.

Hysteria over the sickle-cell trait also led to widespread discrimination. Autopsies of four Black army recruits who died during basic training revealed severe sickling of the red blood cells. The possibility that carriers' blood might sickle at high altitudes was used to justify denying Blacks entrance to the Air Force Academy. Almost all of the major commercial airlines fired or grounded Black pilots and flight attendants with sickle-cell trait. Major corporations also screened Blacks applying for jobs. Sickle-cell carriers were charged higher premiums by some insurance companies or denied insurance altogether.

Sickle-cell screening was also the basis for proposals to restrict Black women's procreative liberty. Carriers were often counseled simply not to have children. In an article about counseling patients with sickle-cell disease published in a major medical journal in 1971, white members of the Department of Obstetrics and Gynecology at the Tennessee College of Medicine advocated sterilization for women with the illness. The article concluded that "the expected rate of reproductive success, when considered in conjunction with the negative attributes concerning motherhood, does not justify a young woman with sickle-cell disease being exposed to the risk of pregnancy. We advocate primary sterilization, abortion if conception occurs, and sterilization for those that have completed pregnancies."

Henry Foster, chairman of the Department of Obstetrics and Gynecology at Meharry Medical College in Nashville, whose nomination for surgeon-general was derailed in 1995, sharply disputed the recommendation of sterilization. Foster argued that the high maternal mortality rate the authors reported resulted from inadequate prenatal care. He believed that if Black patients were provided accurate screening, informed counseling, and proper clinical management, they would have alternatives to sterilization. Foster stressed how race affected the type of reproductive counseling that doctors give pregnant women regarding the implications of sickle-cell disease. Advice provided to Black patients, Foster wrote, often "is highly inadequate, misleading, and, on occasion, dangerous." He pointed out that certain complicating risks, such as premature rupture of the membranes, experienced by women with sickle-cell disease in other hospitals had not occurred at Meharry, under the care of Black physicians.

Dr. Foster was clearly correct that race influences medical judgments concerning new reproductive technologies. Sickle-cell carriers are not the only identifiable carriers of genetic disease and Blacks are not the only ethnic group associated with a genetic disorder. In fact, carriers of at least fifty genetic disorders could be identified at the time of the sickle-cell testing programs. Yet none experienced the degree of institutionalized abuse visited upon Black carriers of the sickle-cell trait. Once again, racism worked to convert technology into a means of denying rather than promoting reproductive liberty.

Black Culture and the New Reproduction

The racial disparity in the use of reproductive technologies may be partly self-imposed. Although economics plays a major role, it does not provide the complete explanation for Black people's avoidance of these means of procreation. Even Black couples who can afford a nice home, car, and other amenities of a middle-class lifestyle are not turning to high-tech fertility services in the same proportions as their white cohorts. It would also be possible for Black women to enter into informal surrogacy arrangements with Black men without demanding huge fees.

One reason may be the extent to which Blacks have bought into stereotypes about their own reproductive capacities. The myth that Black people are overly fertile may make infertility especially embarrassing for Black couples. One Black woman who eventually sought IVF treatment explained, "Being African-American, I felt that we're a fruitful people and it was shameful to have this problem. That made it even harder." Blacks may find it more traumatic to discuss the problem with a physician, especially considering the paucity of Black specialists in this field.

In addition, Black people may be less likely to seek a technological fix for natural circumstances beyond their control. Infertile couples' reliance on advanced technologies reflects a confidence in medical science to solve life's predicaments. According to Elaine Tyler May, author of Barren in the Promised Land, a history of childlessness in America, America's obsession with reproduction began after World War II when "a heightened faith in science and medicine gave rise to the belief that everyone should be able to control his or her private destiny with the help of professional experts." The contemporary white women May quotes frequently express an expectation of controlling their reproductive lives through medical intervention. One explained, "There is a tremendous amount of medical help available and I feel guilty not doing everything in my power to achieve pregnancy." Sociologist Arthur Greil similarly observes that the affluent white couples he interviewed "embraced the pursuit of medical/technical solutions as the most plausible approach to dealing with the problem of infertility."

Some researchers have linked the contrasting response of infertile Black women to their spiritual or psychological outlook on adversity. "If infertility is one in a series of negative, seemingly irreversible events in a woman's life," sums up public health expert Elizabeth Heitman, "she may be more likely to attribute it to fate or God's will than seek to address it in science. " There may be a more rational explanation for this reluctance, as well. Considering the history of sickle-cell screening, the Tuskegee syphilis experiment, and other medical abuses, many Blacks harbor a well-founded distrust of technological interference with their bodies and genetic material at the hands of white physicians. Rayna Rapp interviewed a Black secretary, for example, who rejected prenatal genetic testing because the laboratory form included a release to use discarded amniotic fluid for experimentation. Her husband worried that the amniocentesis might make the family vulnerable to abusive medical research.

This theory would explain why Blacks are likely to request high-tech life-sustaining treatment for a hospitalized family member even though they tend to refrain from high-tech fertility services. In the former case, Blacks may rely on technological intervention even in the face of a physician's recommendation to discontinue treatment because of a distrust of the doctors' appreciation of their loved one's life. Both responses, then, are consistent with a suspicion of the medical profession born out of a history of disrespect and abuse.

While stories about infertility have begun to appear in magazines with a Black middle-class readership, such as Ebony and Essence, these articles conclude by suggesting that childless Black couples seriously consider adoption. The ethic of dealing with infertility differs drastically between Blacks and whites. Infertile white couples are expected to turn to adoption only as a last resort, after exhausting every available means of producing a genetically related child. The Black community, on the other hand, expects its financially secure members to reach out to the thousands of Black children in need of a home.

Blacks' Rejection of Genetic Marketing

Blacks may also have an aversion to the genetic marketing aspect of the new reproduction. When infertile couples pay for the services of surrogate mothers and egg or sperm donors, they are purchasing the genetic material of their future children. When they undergo IVF, they are buying the assurance that their offspring will receive the parents' own genetic components. Black folks are skeptical about any obsession with genes. They know that their genes have been considered undesirable and that their alleged genetic inferiority has been used for centuries to justify their exclusion from the economic, political, and social mainstream. Only recently The Bell Curve was a national best-seller, reopening the public debate about racial differences in intelligence and the role genetics should play in social policy. In a society in which Black traits are consistently devalued, a focus on genetics will more likely be used to justify limiting Black reproduction rather than encouraging it.

Blacks have understandably resisted defining personal identity in biological terms. In America, whites have historically valued genetic linkages and controlled their official meaning. As the powerful class, they are the guardians of the privileges accorded to biology and they have a greater stake in maintaining the importance of genetics. The legal regulation of racial boundary lines during the slavery era, for example, concerned whites, not Blacks: "The statutes punishing voluntary interracial sex and marriage were directed at whites; they alone were charged with the responsibility for maintaining racial purity."

Blacks by and large are more interested in escaping the constraints of racist ideology by defining themselves apart from inherited traits. They tend to see group membership as a political and cultural affiliation. Whites defined enslaved Africans as a biological race. Blacks in America have historically resisted this racial ideology by defining themselves as a political group. By the turn of the twentieth century, Black Americans had developed a race consciousness rooted in a sense of peoplehood that laid the foundation for later civil rights struggles. With the exception of an extreme version of Afrocentrism that links Africans' intellectual and cultural contributions to the genetic trait of melanin (the pigment in dark skin), "blackness" is gauged by one's commitment to Black people.

Black family ties have traditionally reached beyond the bounds of the nuclear family to include extended kin and non-kin relationships. Terms that connote genetic relationships -- "brother," "sister," and "blood" -- are used to refer to people linked together by racial solidarity. Black people's search for their ancestral roots has focused on cultural rather than genetic preservation. Their "ancestors" are not necessarily connected to them by a bloodline; they are all African people of a bygone era.

Most Blacks downplay their white genetic heritage to identify socially with other Blacks. Even children of interracial couples (having one Black and one white parent) tend to identify themselves as Black, often as a political choice. Others refuse to identify with one race or the other, preferring to define themselves as both Black and white, mixed, or simply human. This identification, too, is often a refusal to base identity on biological inheritance. For most Blacks, ethnic identity is a conscious decision based primarily on considerations other than biological heritage. "The choice is partly cultural, partly social, and partly political, but it is mostly affectional," writes Yale law professor Stephen Carter.

This distinction between cultural and genetic unity is reflected in Black opposition to transracial adoptions.Some Blacks take the position that Black adoptive children should be placed only with Black families to ensure the transmission of Black cultural traits. The National Association of Black Social Workers (NABSW), for example, has long opposed transracial placements because "Black children belong, physically, psychologically, and culturally in Black families in order that they receive the total sense of themselves and develop a sound projection of their future." These children are not genetically linked to their new families, but, according to this view, they should be tied to the Black community. When the NABSW condemned placements with white families as a "form of genocide," it was speaking of a cultural, not a biological, annihilation.

A Black parent's essential contribution to his or her children is not passing down genetic information but sharing lessons needed to survive in a racist society. Black parents transmit to their children their own cultural identity and teach them to defy racist stereotypes and practices, training their children to live in two cultures, both Black and white. Some feel they must cultivate in their children what W. E. B. Du Bois described as a double consciousness; others see their task as preparing their children "to live among white people without becoming white people." Some Black sociologists have opposed transracial adoption on the ground that only Black parents are capable of teaching Black children these necessary "survival skills."

This aspect of blackness is contradicted by the fact that some Blacks have valued particular genetic traits, such as light skin color and straight hair, because of their desire to look whiter. In some Black bourgeois communities, whiter features signified higher social standing. The Black elite of Washington, D.C., at the turn of the century, for example, was well known for requiring a white appearance for entry into its circle. Despite Black people's sorry history of color consciousness, however, sharing genetic traits seems less critical to Black identity than to white identity.

The notion of racial purity is foreign to Black folks. Our communities, neighborhoods, and families are a rich mixture of languages, accents, and traditions, as well as features, colors, and textures. Black life has a personal and cultural hybrid characteristic. There is often a melange of physical features -- skin and eye color, hair texture, sizes, and shapes -- within a single family. We are used to "throwbacks" -- a pale, blond child born into a dark-skinned family, who inherited strange genes from a distant white ancestor. My children play with a set of twins who look very different from each other. The boy has light skin, green eyes, and "kinky" sandy-colored hair; the girl has dark skin, brown eyes, and long black wavy hair. Of course, there are physical differences among white siblings as well, but those differences do not have the same social import. We cannot expect our children to look just like us.

Blacks' view of genetic relatedness is tempered as well by the importance of self-definition, which escapes the constraints of inherited traits. if personal identity is not dependent on one's biological "race," then it must be deliberately chosen. In fact, the image of the individual shackled to his genetic destiny conflicts with the basic tenets of liberalism; it contradicts a definition of personhood centered on the autonomous, self-determining individual and denies the possibility of individual choice. As constitutional scholar Laurence Tribe observed, "one's sense of 'selfhood' or 'personhood,' and the related experience of one's autonomous individuality, may depend, at least in some cultural settings, on the ability to think of oneself as neither fabricated genetically nor programmed neurologically." Blacks have defied the inferior status of blackness that whites attached to their biology by inventing their own individual identities.

The quest for self-definition in a racist society is the preeminent focus of Black intellectual thought. In the 1960s, Lerone Bennett, Jr., declared,

Identified as a Negro, treated as Negro, provided with Negro interests, forced, whether he wills or no, to live in Negro communities, to think, love, buy and breathe as a Negro, the Negro comes in time to see himself as a Negro.... He comes, in time, to invent himself.

Bennett's words are reminiscent of Du Bois's classic description of Black Americans' striving for a self-created identity:

It is a peculiar sensation, this double-consciousness, this sense of always looking at one's self through the eyes of others, of measuring one s soul by the tape of a world that looks on in amused contempt and pity. One ever feels his twoness, an American, a Negro, two souls, two thoughts, two unreconciled strivings; two warring ideals in one dark body, whose dogged strength alone keeps it from being torn asunder.

The history of the American Negro is the history of this strife, this longing to attain self-conscious manhood, to merge his double self into a better and truer self.

The theme of willful self-creation is especially strong in the writings of Black women. The fiction of authors such as Zora Neale Hurston, Toni Morrison, and Alice Walker revolves around Black female characters who learn to invent themselves after breaking out of the confines of racist and sexist expectations. Black women's autobiographical accounts also describe the process of self-creation, exemplified by Patricia Williams's statement, "I am brown by my own invention... One day I will give birth to myself, lonely but possessed." Denied self-ownership and rejected from the dominant norm of womanhood, Black women have defined themselves apart from the physical aspects of race.

THE IMPORTANCE OF THE GENETIC TIE

I have suggested that the suspicion of genetic marketing and the appreciation of self-definition in Black culture may help to explain Blacks' aversion to high-tech reproduction. Conversely, race may also influence the importance whites place on IVF's central aim -- producing genetically related children. Using technology to create genetic ties focuses attention on the value placed on this particular form of connection.

Of course sharing a genetic tie with children is important to people of different races and in cultures that have no racial divisions. It seems natural for people to want to pass down their genes to their children. We perceive a special relationship created by a shared genetic identity. When a new baby enters a family, one of the first responses is to figure out whom she resembles. Most parents feel great satisfaction in having children who "take after" them. Bringing into the world children who bear their likeness gives many people both the joy of creating another life and the comfort of achieving a form of immortality passed down through the generations. Joe Saul, the protagonist of John Steinbeck's play Burning Bright, expressed his tormenting desire to have a child in terms of an eternal charge:

A man can't scrap his blood line, can't snip the thread of his immortality. There's more than just my memory. More than my training and the remembered stories of glory and the forgotten shame of failure. There's a trust imposed to hand my line over to another, to place it tenderly like a thrush's egg in my child's hand.

In our society, people often see the inability to produce one's own children as one of nature's most tragic curses. Infertile people often suffer horribly, and even people who have voluntarily decided to remain childless often refuse to cut off the possibility of creating children through sterilization. The desire to have children of one's own is so intense that it is commonly attributed to nature. Thus, the opening paragraph of a popular guide to infertility treatment declares: "Call it a cosmic spark or spiritual fulfillment, biological need or human destiny -the desire for a family rises unbidden from our genetic souls." Some legal scholars have argued that an individual's interest in having offspring of his own genes is so great that it amounts to a constitutionally protected procreative liberty.

Many also believe that certainty about one's genetic heritage benefits children. According to this view, genetic derivation is a critical determinant of self-identity, as well as biological makeup. Adopted children may struggle not only with the question, "Who are my real mother and father?" but also with the more profound inquiry, "Is genetic relatedness necessary for an authentic sense of self?" Taken to its extreme, this perspective defines personhood according to genetic attributes.

This conception of identity rooted in genetic heritage underlies the most extreme rhetoric of advocates who support adoptees' searches for their birth parents. Critics of adoption claim that adopted children suffer from "genealogical bewilderment" -- a condition stemming from ignorance of their genetic origins. Adoptee Betty Jean Lifton writes of feeling "extruded from ... her own biological clan, forced out of the natural flow of generational continuity... forced out of nature itself."

This insecurity may also trouble children whose genetic fathers are anonymous sperm donors. Margaret Brown, the nineteen-year-old product of artificial 'insemination, lamented, "I feel anger and confusion, and I'm filled with questions. Whose eyes do I have? Why the big secret? Who gave my family the idea that my biological roots are not important? To deny someone the knowledge of his or her biological origins is dreadfully wrong." Some scientists also see identity defined b genetics. One Harvard biologist, for example, declared that understanding human genetic composition is "the ultimate answer to the commandment, 'Know thyself.'"

Recent years have witnessed a resurgence of public interest in genetics that has intensified the genetic tie's social importance. A 1994 issue of the New York Times Book Review, for example, reviewed five books concerning the link between genetics and human behavior. Its cover displayed a face woven into a model of DNA and the question "How Much of Us Is in the Genes?" Numerous scholars have noted a trend in science, law, and popular culture toward "genetic essentialism," "geneticism," "geneticization," and a "prism of heritability" that erroneously reduces human beings to their genes. Contemporary society increasingly looks to genetics for explanations of human behavior, accepting the view that "personal traits are predictable and permanent, determined at conception, 'hard-wired' into the human constitution."

The Human Genome Initiative, an ongoing government-sponsored project to map the complete set of human genetic instructions, is the largest biology venture in the history of science. The U.S. Department of Energy projects costs of $200 million a year for about fifteen years. Scientists are attempting to detect genetic markers that indicate a predisposition to complex conditions and behaviors, as Well as single-gene disorders. They anticipate creating genetic tests that will be able to predict a person's susceptibility to hemophilia, mental illness, heart disease, and alcoholism. This possibility was dramatized by Jonathan Tolins's 1993 play, The Twilight of the Golds, which portrayed the catastrophic fallout when a family learns through genetic testing that the daughter's unborn child will be gay.

More disturbing, researchers claim to have discovered not only the genetic origins of medical conditions, but also biological explanations for social conditions. Even happiness, a recent New York Times story tells us, is dictated by our genes. Our ability to tinker with the genes children inherit, as well as the belief that these genes determine human nature, exaggerates the importance of genes in defining personal identity and, consequently, the importance of genetic connections.

Yet we also know that the desire to have genetically related children is a cultural artifact. The legal meaning of the genetic tie offers telling insight into its indeterminacy. For example, the institution of slavery made the genetic tie to a slave mother critical in determining a child's social status, yet legally insignificant in the relationship between male slaveowners and their mulatto children. Although today we generally assume that genetic connection creates an enduring bond between parents and their children, the law often disregards it in the cases of surrogate mothers, sperm donors, and unwed fathers. The importance of genetic connection, then, is determined by social convention, not biological edict.

A number of feminists have advocated abandoning the genetic model of parenthood altogether because of its origins in patriarchy and its "preoccupation with male seed." The norm of fatherhood grounded in genetic transmission sees mothers as fungible receptacles of male gametes and devalues the importance of social bonds. Men seem to be more invested than women in the quest for a genetic connection with their children. The man who entered in the first formal surrogacy contract made this distinction: "I guess for some women, as long as they have a child, it's fine. But... I need to know that he's really mine."

Most scholarship on the new reproduction, however, fails to consider the tremendous impact that the inheritability of race has had onthe meaning of genetic relatedness in American culture. Although race is really a social construct, it has been treated as an inherited status for centuries. In this society, perhaps the most significant genetic trait passed from parent to child is race. How important is race to the desire to create genetically related children? It is impossible to tell the decision to have children is influenced by a multitude of social, cultural, and biological factors. But surety the inheritability of race plays some role in the degree of importance whites invest in genetic ties with their children.

The social and legal meaning of the genetic tie helped to maintain a racial caste system that preserved white supremacy through a rule of racial purity. The colonists maintained a clear demarcation between Black slaves and white masters by a violently enforced legal system of racial classification and sexual taboos. The genetic tie to a slave mother not only made the child a slave and subject to white domination; it was also supposed to pass down a whole set of inferior traits.

For several centuries a paramount objective of American law and social convention was keeping the white bloodline free from Black contamination. Before high-tech procedures were available, husbands guaranteed a genetic relationship to children by enforcing their wives' fidelity. Under a racial caste system, female marital fidelity was doubly important: it ensured not only paternity but also racial purity. Since only white women could produce white children, they were responsible for maintaining the purity of the white race. While white men impregnated Black women with impunity, the law ensured that white women had children only with their husbands so that their children would be pure white. William Smith, a professor at Tulane University, explained in 1905 that fornication with a Negro was a greater crime for a white woman than for a white man because "he does not impair, in any wise, the dignity or integrity of his race; he may sin against himself and others, and even against his God, but not against the germ-plasm of his kind." The first laws against interracial. fornication arose from legislators' "particular distaste that white women, who could be producing white children, were producing mulattoes." As early as 1662, Virginia amended its law prohibiting fornication to impose heavier penalties if the guilty parties were from different races. By being faithful to their husbands, white women were also faithful to their race.

The law punished with extra severity white women who gave birth to mulatto children. Because a child took on the status of the mother, mulattoes born to white mothers were free. But these children were treated more harshly than free Black children; those with white mothers were generally required to become indentured servants until they reached thirty years of age. Unlike the racially mixed child:- n of Black women, they represented a corruption of the white race.

Antimiscegenation laws also made sure that white women bore genetic offspring for white husbands. As W. J. Cash explained in The Mind of the South in 1941, whites enacted laws against interracial marriage to protect "the right of their sons in the legitimate line, through all the generations to come, to be born to the great heritage of the white race." It was only in 1967 that the U.S. Supreme Court in Loving vs. Virginia ruled that antimiscegenation laws, designed to keep the races from intermingling, were unconstitutional. To this day, one's social status in America is determined by the presence or absence of a genetic tie to a Black parent. Conversely, the white genetic tie -- if free from any trace of blackness -- is an extremely valuable attribute entitling a child to a privileged status, what legal scholar Cheryl Harris calls the "property interest in whiteness." Ensuring genetic relatedness is important for many reasons, but, in America, one of the most important reasons has been to preserve white racial purity.

CREATING WHITE BABIES:THE VALUE OF BIOTECHNICAL CHILDREN

The new reproduction also graphically discloses the disparate values placed on children of different races. By trading genes on the market, these technologies lay bare the high value placed on whiteness and the worthlessness accorded blackness. New reproductive technologies are so popular in American culture not simply because of the value placed on the genetic tie, but because of the value placed on the white genetic tie. The monumental effort, expense, and technological invention that goes into the new reproduction marks the children produced as especially valuable. It proclaims the unmistakable message that white children merit the spending of billions of dollars toward their creation. Black children, on the other hand, are the object of welfare reform measures designed to discourage poor women's procreation.

The panic over white infertility is not only a private tragedy. True, part of the desperation childless white women feel comes from their personal longing to be a parent. But the high-tech frenzy to conceive has been whipped up by alarm over the falling birthrate of white career women. Feminist author Susan Faludi documents a new pronatalism in the 1980s that was part of a backlash against women's gains in the workplace. In February 1982, newspapers, magazines, and television shows gave top billing to a medical study claiming that women between the ages of thirty and thirty-five risked a nearly 40 percent chance of being infertile. Practically overnight the media created an infertility epidemic plaguing middle-class America. This figure became the basis for paternalistic editorials and self-help books chastising the women's movement for creating "a sisterhood of the infertile" and exhorting women to stop postponing motherhood. Childless middle-aged women were programmed to feel their "biological clocks" ticking.

The media paid little attention to a federal study released three years later that showed a far lower (13.6 percent) infertility rate for the same age group. Instead, women's careers were erroneously blamed for high rates of endometriosis, miscarriage, and abnormal babies. (In fact, Faludi astutely points out, "women's quest for economic and educational equality has only improved reproductive health and fertility.") While the media portray irresponsible Black women as overly fertile, they depict selfish, career-seeking white women as not fertile enough. As a result, white couples flock to high-tech treatment in record numbers, despite no evidence of an increase in the incidence of infertility over the last several decades.

The renewed focus on white women's fertility has eugenic over-tones as well. Ben Wattenberg's The Birth Dearth, for example, predicted that reproduction in the industrialized world could not keep pace with population growth in the Third World unless American women took measures to have more children. "I believe demographic and immigration patterns inherent in the Birth Dearth will yield an ever smaller proportion of Americans of white European stock," Wattenberg warned, making it "difficult to promote and defend liberty in the Western nations and in the rest of the modernizing world." Television evangelist and Republican presidential contender Pat Robertson agreed that "depopulation of the West" constituted "genetic suicide" and "threatens the power of Western industrialized democracies."

The Bell Curve presented the 1990s domestic version of this argument. Instead of predicting a global imbalance, Charles Murray and Richard Hermstein foretold increasing social disparities within the United States owing to the higher birthrates of group with inherently lower intelligence. Like the backlash against professional women's advances, this new form of eugenics interprets the problem of infertility as the shortage of white babies. Thus, the backdrop of infertility that fuels the high-tech fertility business is already dominated by race.

The public's affection for the white babies that are produced by reproductive technologies further legitimates their use. Noel Keane, the lawyer who in 1978 arranged the first public surrogacy adoption, described how this affection influenced the public's attitude toward his clients' arrangement. Although the first television appearance of the contracting parents, George and Debbie, and the surrogate mother, Sue, generated hostility, a second appearance on the Phil Donahue Show, with two-month-old Elizabeth Anne changed the tide of public opinion. According to Keane, "this time there was only one focal point: Elizabeth Anne, blond-haired, blue-eyed, and as real as a baby's yell." He concludes, "The show was one of Donahue's highest-rated ever and the audience came down firmly on the side of what Debbie, Sue, and George had done to bring Elizabeth Anne into the world." I suspect that a similar display of a curly-haired, brown-skinned baby would not have had the same transformative effect on the viewing public. Imagine a multi-billion-dollar industry designed to create Black children!

Recall the white woman's lawsuit against a fertility clinic for mistakenly giving her a Black man's sperm. The case not only evidences disdain for the technological creation of Black babies; it also high-lights the critical Importance of producing a genetically pure white child. The clinic's racial mix-up negated the value of the mother's genetic tie. I do not mean to depreciate the woman's personal loss. She wanted a child with her husband, who subsequently died of cancer. But receiving the wrong white child would have been a far less devastating experience. In the American market, a Black baby is indisputably an inferior product.

While the botched inseminations of white women are presented as tragedies, the reverse racial blunder was the premise for a Hollywood comedy. In Made in America, Whoopi Goldberg plays an Afrocentric single mother whose teenage daughter was conceived through artificial insemination. Determined to track down her roots, the daughter raids the sperm bank computer only to discover that she was fathered by a white man (Ted Danson) as the result of a mix-up. Glossing over the race issue, the movie finds comic relief in the unlikely romance between the mother, an eccentric Black bookstore owner, and the sperm donor, a crass white car salesman.

How could this racial intermingling be so easily dismissed when the other sperm bank mix-ups seem so serious? Returning to the colonists' distaste for mulatto children provides a clue. Like the repudiated colonial women, the white women given the wrong sperm bore mulattoes "when they could be producing white children." The same loss did not occur when Black women delivered mulattoes: their children would be Black slaves in any case.

In the film, in contrast to the real-life sperm bank case, the daughter's racial composition is inconsequential: she is Black regardless of which race the sperm depositor turns out to be. Finding out the father's racial identity has no effect on the mother's (or society's) view of the child whatsoever. After all, it is not so uncommon for a Black child to discover a white man somewhere in the family tree. More important, giving a Black woman the wrong sperm does not deprive society of a white child. With so little at stake, American audiences could accept this interracial scenario as a nonthreatening romantic sitcom.

THE COMPLICATIONS OF TRANSRACIAL ADOPTIONS

Whites have sometimes disputed my claims about the value of white genetic ties by pointing to barriers to transracial adoptions Infertile whites are forced to rely on high-tech means, they argue, because of the difficulties they face in adopting children, including race-matching policies. This contention distorts the reality Of the adoption market in two ways. First, most white couples who use IVF resort to adoption as a second-best alternative only after they fail to conceive a genetically related child. Those who cannot afford IVF often try less expensive infertility treatment before pursuing adoption. Consider Dierdre Kearney's decision to adopt after trying to conceive for four of five years of marriage, recounted in Barren in the Promised Land:

"I think we experienced every emotion and feeling one can in dealing with this situation. We have also been through every fertility test there is." Her husband was on medication for three years, and his problem was corrected. She had four surgeries, medication, fertility drugs, and artificial insemination using her husband's semen. "The only option left for us is IVF. We do not have the money; what savings we have is going toward adoption."

Lydia Sommer, a white account specialist married to an attorney, told a similar story. For six of their seven years of marriage, the couple tried infertility treatment, but they "stopped short of IVF, 'drained emotionally and financially.'" They finally abandoned high-tech solutions and adopted a daughter. Sommer's adoption took a peculiar twist, akin to the sperm bank mix-ups. Two months after bringing the baby home, the couple realized she was biracial (the white birthmother had lied about the father's race). The couple promptly returned the child to the adoption agency for a refund.

Could these couples have afforded IVF, they probably would have tried it before resigning themselves to adoption. My point is not that all infertile whites, or even a majority of them, use reproduction-assisting technologies. It is that the people who do use these high-tech means of conception typically view them, and not adoption, as their preferred way of becoming parents.

Second, the debate over transracial adoption should not over-shadow the predominant preference for white children. The vast majority of white adoptive parents are only willing to take a white child. Even when they adopt outside their race, whites generally prefer non-Black children with Asian or Latin American heritage. "Of dozens of white adopting parents I have interviewed in three years,' reported Mary Jo McConahay in the Los Angeles Times, "almost all said they would consider adopting a Latino child abroad before a black child at home."

Interracial adoptions, which make up less than 10 percent of adoptions, are primarily of children who are not either Black or white. The international adoption trade is thriving, and fraught with charges of Western brokers' exploitation of Third World women and children. The current recruitment of white couples to adopt Black children stems from the shortage of adoptable white babies, whose soaring price tag reflects their market value. In America, a white child can cost twice as much to adopt as a Black child. In Latin American countries, the price of an adoption depends on the baby's eye color, skin shade, and hair texture. In short, genetically related, white children remain most Americans' first choice.

Besides, white support for transracial adoptions does not fundamentally alter the rules governing claims to white and Black children. All of the literature advocating the elimination of racial considerations in child placements focuses on making it easier for white parents to adopt children of color. A leading book on the subject, for example, states that "[i]n the case of transracial adoption the children are non-white and the adoptive parents are white." (This definition completely ignores adoptions of white children by parents of other races, constituting 2 percent of all adoptions.) Until fairly recently, the law in some states explicitly prohibited Black parents from adopting white children, while allowing white parents to adopt Black children. A South Carolina statute, for example, provided:

It shall be unlawful for any parent, relative, or other white per-son in this State, having the control or custody of any white child by right to guardianship, natural or acquired or otherwise, to dispose of, give or surrender such white child permanently into the custody, control, maintenance or support of a Negro.

This bias results partly from the disproportionate number of Black children available for adoption and of white couples seeking to adopt. A report on a major state foster care system, for example, shows that 54 percent of children available for adoption are nonwhite while 87 percent of prospective adoptive parents are white. Because the number of Black children awaiting placement far exceeds the number of available Black adoptive families, there is more pressure for white couples to take in Black children than for Blacks to adopt white children. These statistics, however, reflect only formal adoptions and overlook the prevalence of informal adoptions in the Black community. Black families who attempt to use formal adoption services face numerous institutional barriers, including financial requirements and the cultural insensitivity of predominantly white, middle-class social workers. In fact, middle-income Black couples adopt at a higher rate than similar white couples. These statistics also raise the question why there are so many Black children wallowing in foster care in the first place.

With so many Black children in need of a home, it is not surprising that Black families adopt within their race. Indeed, the 1987 National Health Interview Survey found not a single instance of interracial adoption by a Black mother. Still, the very thought of a Black family adopting a white child seems beyond our cultural imagination. A system that truly assigns children to adoptive parents without regard to race is unthinkable, not because Black children would be placed in white homes, but because white children would be given to Black parents.

Adoption of a Black child by a white family is viewed as an improvement in the Black child's social status and lifestyle and as a positive gesture of racial inclusion'. A Black family's dominion over a white child, on the other hand, is seen as an unseemly relationship and an injury to the child. As a judge recognized forty years ago, allowing the adoption of a white child by his mother's Black husband would unfairly cause the child to "lose the social status of a white man." Even today, "it is virtually unheard of for an adoption agency to offer a healthy, able-bodied white child to Black parents for adoption."

Claims about the benefits of racial assimilation are only made about the advantages Black children will presumably experience by living in white homes. In her book Family Bonds, for example, adoption advocate Elizabeth Bartholet argues that race-matching policies damage Black children by denying them placements with white adoptive parents. She dismisses, on the other hand, the contention that Black children belong with Black parents. Bartholet reaches this conclusion notonly because "there is no evidence that black parents do a better job than white parents of raising black children with a sense of pride in their racial background," but also because Black children reap substantial advantages from a white environment. Unlike Black children "living in a state of relative isolation or exclusion from the white world," Bartholet reasons, "black children raised in white homes are comfortable with their blackness and also uniquely comfortable in dealing with whites."

Bartholet also acknowledges the benefits white parents gain from transracial adoptions. White adoptive families develop a new awareness of racial issues and commitment to a multicultural world that transcends racial differences. She writes passionately of how the Peruvian children she adopted enhanced he life: "I revel in the brown skin and thick black hair and dark eyes and Peruvian features that I could not have produced." Bartholet implies that Black children are better off in white homes and that white parents are enriched by raising nonwhite children; but she finds nothing positive to say about growing up with Black parents.

Bartholet advocates a "no-preference" policy that "would remove adoption agencies from the business of promoting same-race placement." The Multiethnic Placement Act of 1994 prohibited agenciesthat receive federal funding from placing children according to race but not from taking race into account. In 1996, Congress changed the law to eliminate any consideration of race after critics argued that agencies retained too much discretion to continue the preference for race-matching. But a "no-preference" policy with respect to race is in effect a regime that always prefers a white family and accommodates white famuies' preferences. Although this policy eliminates the preference for Black parents in adoptions of Black children, it retains the preference for white parents in adoptions of white children. Thus,even advocates of transracial adoptions ultimately favor "a system in which white children are reserved for white families." Their policies perpetuate a system designed to proviole childless white couples with babies and with the type of babies they prefer.

When I was a fellow at Harvard University, I passed a playground in the Cambridge Common every day on my way to my office overlooking Harvard Square. The diverse group of adults and children playing in the park appeared at first to represent the multicultural mix of the university community. But on closer spection I discovered a disturbing pattern. It seemed as if all of the minor, children had white mothers -- probably, in most cases, the result of transracial adoptions. Many of the white children, on the other hand, were tended by Black women -- not their mothers, but nannies hired by their white mothers. Despite all the racial intermingling going on, the scene still represented a clear demarcation between the status of white and Black women and their claims to children.

Although transracial adoption is painted as a catalyst for racial harmony, in Bartholet's words "a model of how we might better learn to live with one another in this society," it does not threaten the supremacist code of white superiority. It does nothing to diminish the devaluation of Black childbearing. Nor does it violate the taboo against interracial sex that might lead to a fertile white woman bearing a Black child. The fertility business mirrors the adoption market in catering to the preferences of childless white couples. What is objectionable about both these systems is not so much white people's desire for a particular child as the way these markets are structured solely to fulfill that desire.

RACE AND THE HARM IN SURROGACY

The devaluation of the Black genetic tie helps to explain the harm in surrogacy. Some feminists have denounced contract pregnancy arrangements because they exploit women and commodity women's reproductive capacity. People who hire surrogates are usually wealthier than the women who provide the service. An adopting couple must be fairly well off to afford the costs of a surrogacy arrangement -- typically at least $25,000. Surrogacy is appealing to some low-income women because it pays better than other unskilled employment and because it is one of the few available jobs that do not require leaving home. But what is exploitative about paying a surrogate mother a sum of money she would not be able to obtain at other work? What distinguishes activities poor women are induced to perform for money that are exploitative from those that are not? Economic necessity in general pressures poor women to accept occupations rich women would not tolerate. Wealthy people hire poor, unskilled women, for example, to clean their homes and offices.

The claim that poor women are coerced into entering surrogacy contracts by the promise of large sums of money is meaningless by itself. For instance, would it be more or less exploitative to increase the fee paid to surrogate mothers? It has been argued that unpaid surrogacy may be more coercive than an arm's-length commercial arrangement with a stranger; yet increasing the payment would heighten the pressure on a potential surrogate to press her womb into service for the payer. The woman's decision to enter into the surrogacy arrangement at least shows that she found it preferable to her other options for work. Her decision may be evidence that surrogacy is less exploitative than other services wealthier people could buy from her-services which the law does not prohibit despite their harmful or degrading qualities and the parties' unequal bargaining power.

At bottom, the argument against surrogacy rests on the peculiar nature of childbearing that makes its sale immoral. Legal theorist Margaret Jane Radin and other scholars argue that surrogacy impermissibly alienates a fundamental aspect of one's personhood and treats it as a marketable commodity. In Radin's words, "Market-inalienability might be grounded in a judgment that commodification of women's reproductive capacity is harmful for the identity aspect of their personhood and in a judgment that the closeness of paid surrogacy to baby-selling harms our self-conception too deeply." Philosopher Elizabeth Anderson argues that using surrogates' bodies, rather than respecting them, fails to value women in an appropriate way. Surrogacy treats women as objects rather than as valuable human beings by selling their capacity to bear children for a price. The practice places a specific dollar value on the surrogate's personal traits. Directories display photographs of and vital information (height, hair color, racial origins) about women willing to be hired to gestate a baby. Barbara Katz Rothman notes how the term "product of conception," often used to describe the fertilized egg to be implanted in a surrogate mother, reflects this commodification: "It is an ideology that enables us to see not motherhood, not parenthood, but the creation of a commodity, a baby."

Moreover, pregnancy impresses a surrogate's body into paid service to a degree distinct from other work. Unlike most paid laborers, the surrogate mother cannot separate herself from the service she per-forms. As Kelly Oliver puts it, "Surrogacy is a twenty-four-hour-a-day job which involves every aspect of the surrogate's life... Her body becomes the machinery of production over which the contractor has ultimate control." Commercial surrogacy can be seen as liberating when liberation is measured by the individual's freedom and ability to buy and sell products and labor on the market. But women's wombs and pregnancy are not ordinary products or labor. Like children, organs, or sexual intimacy, women's reproductive capacities should not be bartered in the market.

The relationship between race and reproduction further illuminates this market inalienability. It demonstrates how surrogacy both misvalues and devalues human beings. First, Anderson and Radin argue that surrogacy values women and children in the wrong way. Why do they conclude that paying women for their gestational services will produce this harmful conception of women and their reproductive capacity? It's also possible, as John Robertson suggests, that we could view gestators as "worthy collaborators in a joint reproductive enterprise from which all parties gain, with money being one way that the infertile couple pays its debt or obligation to the surrogate." Anderson's and Radin's sense of the immorality of commercial surrogacy may arise from the features it shares with the American institution of slavery. The experience of surrogate mothers is not equivalent to slavery's horrors, dehumanization, and absolute denial of se determination. Yet our understanding of the evils inherent in marketing human beings stems in part from the reduction of enslaved Blacks to their physical service to whites.

The quintessential commodification of human beings was the sale of slaves on the auction block to the highest bidder. Slaves were totally and permanently commodified. Slaves bore all of the legal attributes of property: just like a horse, a necklace, or a piece of furniture, they could be "transferred, assigned, inherited, or posted as collateral." In the words of a slave, he was a "flesh and blood commodity, which money could so easily procure in our vaunted land of freedom." Surrogacy's use of women's wombs is reminiscent of Baby Suggs's admonition in Beloved about slavery's objectification of Africans: "And 0 my people they do not love your hands. Those they only use, tie, bind, chop off and leave empty."

Slave women were treated as surrogate mothers in the sense that they lacked any claim to the children whom they bore and whom they delivered to the masters who owned both mother and child. As the contemporary surrogate mother takes the place of an infertile wife, the economic appropriation of slave women's childbearing was the only way for the slave economy to produce and reproduce its laborers. It is the enslavement of Blacks that enables us to imagine the commodification of human beings, and that makes the vision of fungible breeder women so real.

The issue of race illuminates the harm of surrogacy in a second way. The feminist arguments against surrogacy focus on the commodification of women's wombs. Just as critical, however, is the commodification of the genetic tie, based on a variation of its worth. In his discussion of egg donation, John Robertson defends recipients' desire to "receive good genes" from women who "appear to be of good stock." He advocates perfecting the technology of egg donation because it will "enhance the ability to influence the genetic makeup of offspring." "Eugenic considerations are unavoidable," Robertson concludes, "and not inappropriate when one is seeking gametes from an unknown third party." Although this process devalues all women, it devalues Black women in a particular way.

Feminist opponents of surrogacy miss an important aspect of the practice when they criticize it for treating women as fungible commodities. A Black surrogate is not exchangeable for a white one. In one sense, Anderson and Radin are right that marketing babies misdescribes the way that we value people. Surrogacy, however, is so troubling precisely because its commercial essence lays bare how our society actually does value people. We must assess both the liberating and the oppressive potential of surrogacy, not in the abstract realm of reproductive choice, but in the real world that devalues certain human lives with the law's approval.

THE BLACK GESTATIONAL SURROGATE

Gestational surrogacy separates the biological connection between mother and child into two parts -- the gestational tie and the genetic tie. In gestational surrogacy, the hired gestator is implanted with an embryo produced by fertilizing the contracting mother's egg with the contracting father's sperm using IVF. The child therefore inherits the genes of both contracting parents and is genetically unrelated to her birth mother. This type of surrogate is treated even more like an "incubator" or "womb for rent" than paid gestators who contribute an egg to the deal. Gestational surrogacy disconnects the parents' valuable genes from the gestator's exploited reproductive capacity.

Gestational surrogacy allows a radical possibility that is at once very convenient and very dangerous: a Black woman can give birth to a white child. White men need no longer rely on white surrogates to produce their valuable white genetic inheritance. This possibility reverses the traditional presumptions about a mother's biological connection to her children. The law has always understood legal parentage to arise definitively from female but not male, biology. The European-American tradition identifies a child's mother by the biological act of giving birth: at common law, a woman was the legal mother of the child she bore. But Black gestational surrogacy makes it imperative to legitimate the genetic tie between the (white) father and the child, rather than the biological, nongenetic tie between the (Black) birth mother and the child.

In Johnson v. Calvert, a gestational surrogacy dispute, the court legitimated the genetic relationship and denied the gestational one in order to reject a Black woman's bond with the child. The birthmother, Anna Johnson, was a former welfare recipient and a single mother of a three-year-old daughter. The genetic mother, Crispina Calvert, was Filipina, and the father, Mark Calvert, was white. The press, however, paid far more attention to Anna Johnson's race than to that of Crispina Calvert. It also portrayed the baby as white. During her pregnancy, Anna changed her mind about relinquishing the baby and both Anna and the Calverts filed lawsuits to gain parental rights to the child.

Judge Richard N. Parslow, Jr., framed the critical issue as determining the baby's "natural mother." Johnson's attorney relied on the historical presumption that the woman who gives birth to a child is the child's natural, and legal, mother. All states except Arkansas and Nevada apply an irrebuttable presumption of legal parenthood in favor of the birth mother. Yet Judge Parslow held that Johnson had no standing to sue for custody or visitation rights, and granted the Calverts sole custody of the baby. His reasoning centered on genetics. Judge Parslow described the Calverts as "desperate and longing for their own genetic product." He noted the need for genetically related children and compared gestation to a foster parents' temporary care for a child who is not genetically hers. (Robertson has similarly argued that the gestational surrogate is a "trustee" for the embryo and should be kept to "her promise to honor the genetic bond.")

Judge Parstow also equated a child's identity with her genetic composition: "We know more and more about traits now, how you walk, talk, and everything else, all sorts of things that develop out of your genes." On appeal, the California court of appeals also saw genetics as "a powerful factor in human relationships," writing, "The fact that another person is, literally, developed from a part of oneself can furnish the basis for a profound psychological bond. Heredity can provide a basis of connection between two individuals for the duration of their lives." The California Supreme Court affirmed this view, reducing the legal significance of gestation to mere evidence of the determinative genetic connection between mother and child.

The California courts reduced legal motherhood to the contribution of an egg to the procreative process. But the law need not place such primacy on genetic relatedness. There is little doubt, for example, that a court would not consider a woman who donated her eggs to an infertile couple to be the legal mother, despite her genetic connection to the child. By relying on the genetic tie to determine legal parenthood, the courts in the Johnson case ensured that a Black woman would not be the "natural mother" of a white child.

In Europe, different circumstances have also produced controversy concerning a Black woman bearing a white child. Black women in England and Italy have been implanted with a white woman's eggs in order to bear a child of their own. It was reported that the British woman used a white woman's eggs because of the shortage of Black women who donate their eggs to infertile couples. She resorted to eggs of a different race only after waiting four years for a Black donor. In her mind, the egg donor's race was not determinative: because the father was of mixed racial heritage, the child would be of mixed race as well -- regardless of the egg donor's race. As the clinic director noted, "a you are going to do by having a white woman's egg is have a slightly paler shade of coffee colour rather than a darker shade of coffee colour."

In Italy, an African woman's choice of a white woman's egg was far more momentous. Because her husband, whose sperm fertilized the egg, was white, her baby was also white. The second woman deliberately selected the donor's race because she believed that "the child would have a better future if it were white." Unlike gestational surrogacy, egg donation and marriage to the father gave this woman a solid legal claim to the white child she bore. Yet the shock of a Black woman giving birth to her own white child was great enough to make international news and to send experts pondering about the ethics of such "designer babies." A wide spectrum of commentators condemned even the British woman's selection of a white egg donor. Conservative British politician Jill Knight maintained that choosing a child's ethnic identity was "plain and unvarnished genetic engineering." The chairman of the British Medical Association's ethics committee called for Parliament to debate the issue. And a spokesman for the Catholic media center stated that "the Catholic Church would be opposed to such interference with the natural processes."

It is regrettable that the woman in Italy refused to give birth to a Black child. Seduced by the misleading allure of the new reproduction, she unfortunately sought a technological solution to the problem of racism. On the other hand, the furor over her racial selection of eggs overlooked the fact that most white couples also choose to have a white child when they select the race of a sperm or egg donor or surrogate mother. Race is the sperm donor characteristic most likely to be matched to recipient specifications, and virtually all sperm banks are willing to meet this request. It was most hypocritical for white ethicists and politicians to lash out at this Black woman for picking the most popular type of donor eggs.

Gestational surrogacy invokes the possibility that white middle-class couples will use Black women to gestate their babies. Since contracting couples need not be concerned about the gestator's genetic qualities (most important, her race), they may favor hiring the most economically vulnerable women in order to secure the lowest price for their services. Black gestators would be doubly disadvantaged in any custody dispute: besides being less able to afford a court battle, they are unlikely to win custody of the white child they bear, as the Johnson case demonstrates. Writer Katha Pollitt speculates that this legal advantage might have been the Calverts' motive choosing a Black gestational surrogate in the first place. "Black women have, after all, always raised white children without acquiring any rights to them," Pollitt notes. "Now they can breed them, too."

Some writers had already predicted a caste of breeders, composed of women of color whose primary function would be to gestate the embryos of more valuable white women. These breeders, whose own genetic progeny would be considered worthless, might be sterilized. The vision of Black women's wombs in the service of white men conjures up images from slavery. Slave women were similarly compelled to breed children who would be owned by their masters and to breast-feed their masters' white infants, while neglecting their own children. In fact, Anna Johnson's lawyer likened the arrangement Johnson made with the Calverts to "a slave contract."

Some white feminists present these images of Black women's degradation in order to enhance the potential horror of reproductive technologies' oppression of women. But a strictly gender-focused analysis falls to confront the racism that makes these images a real possibility. In Gena Corea's futuristic scenario, for example, white women are equally exploited as compulsory egg donors in the reproductive brothel. Corea does not question whether white middle-class women might collude in their husbands' use of Black women's bodies to produce their own white, genetically related children.

MAGNIFYING RACIAL INEQUITIES

So far I have argued that use of new reproductive technologies reflects an already existing racial caste system. High-tech means of procreation may also magnify racial inequities by enhancing the power of privileged whites and contributing to the devaluation of Blacks. With only 40,000 babies in the United States conceived through IVF since 1981, the racial disparity in its use will hardly alter the demographic composition of the country. Rather, the harm occurs at the ideological level -- the message it sends about the relative value of Blacks and whites in America. But this is not an imaginary harm: ideology has a real effect on social policy and consequently on the material conditions of people's lives. By strengthening the ideology that white people deserve to procreate while Black people do not, the new reproduction may worsen racial inequality.

We should not dismiss the possibility of more tangible harms, however. The ability to select or improve the genetic features of one's off-spring carries material as well as symbolic advantages. Modern genetic technologies allow parents who can afford them to secure the health and physical abilities of their children. Without government subsidies, this could produce a society where only the poor bear children with genetic disorders. Concentrating the power of genetic enhancement in the hands of an already privileged class would exacerbate differences in the status and welfare of social groups.

While birth control has been the tool for imposing negative eugenics, the new reproduction is the instrument for achieving positive eugenics -- increasing the number of births from superior parents. According to Noel Keane, the doctor who assisted in the first public surrogacy arrangement explained his participation in terms of eugenics: "I performed the insemination because there are enough unwanted children and children of poor genetic background in the world."

The March 1934 issue of Scientific American reported that each year between 1,000 and 3,000 American women requested sperm for artificial insemination, a procedure used by women with sterile husbands since the mid-nineteenth century. Noting that the women usually wanted the most biologically fit donors, the article extolled the eugenic potential of this reproductive technology: "Some 10,000 to20,000 babies [could] be born every year from selected sources, while less than 500 babies per year are now being born to the men of real talent in our country. What will be the eugenic effect on the race, if this same tendency grows?"

The eugenic possibilities of artificial insemination were explored most notably by Hermann J. Muller, a zoologist who won the Nobel Prize in 1946 for his discovery that radiation causes gene mutations. Muller believed that mankind should take control of the evolutionary process in order to transform society for the better. In his 1935 classic, Out of the Night: A Biologist's View of the Future, Muller estimated that artificial insemination could enable 50,000 children to inherit the genes of a single "transcendently estimable man" and the majority of the population to possess the innate qualities of such mere as Lenin, Newton, Pasteur, Beethoven, and Marx. Unlike most eugenicists, Muller rejected the notion that socio lower classes or less advanced races had genetically inferior intelligence, attributing differences among groups to their environment. In fact, Muller condemned social inequalities for hindering eugenic progress; he advocated a classless society with equal opportunity for education and welfare that would reveal the population's true genetic variation.

Muller revived his vision of improving mankind's genetic quality through artificial insemination in a paper presented at a 1959 University of Chicago conference celebrating the hundred-year anniversary of Darwin's 0rigin of Species. In 1971, four years after Muller's death, a right-wing millionaire named Robert K. Graham realized Muller's fantasy by establishing the Hermann J. Muller Repository for Germinal Choice. (Muller had disavowed the repository prior to his death because of his concern about biased solicitations.) Graham originally stocked the bank with sperm donated exclusively by Nobel Laureates, including William Shockley, but later began accepting donations from other scientists.

Singapore provides a contemporary example of a positive eugenics program. The Singapore government responded to the country's falling birthrate by investing in the rapid development of new reproductive technologies, including the world's first egg bank and micro-insemination sperm transplant (MIST), a technique used to increase a man's sperm count. Fueled by concern over Singapore's growing Malay and Indian populations, the program aims at increasing the fertility of the educated elite, particularly those of Chinese ancestry. The tax laws as well as employment and social security benefits provide added incentives for the affluent to have more children. The state-run Social Development Unit helps female university graduates find suitable husbands. Singapore's policy has succeeded in boosting fertility 3.5 percent over the past decade.

WHAT SHOULD WE DO?

What does it mean that we live in a country in which white women disproportionately undergo expensive technologies to enable them to bear children, while Black women disproportionately undergo surgery that prevents them from being able to bear any? Surely this contradiction must play a critical part in current deliberations about the morality of these technologies. What exactly does race mean for our understanding of the new reproduction?

Let us consider three possible responses for social policy. First, we might acknowledge that race influences the use of reproductive technologies, but decide this does not justify interfering with individuals' liberty to use them. Second, we could work to ensure greater access to these technologies by providing public assistance or including them in insurance plans. Finally, we might determine that these technologies are harmful and that their use should therefore be discouraged.

The Liberal Response: Setting Aside Social Justice

One response to this racial disparity is to note that it stems from the economic and social structure, not from individuals' use of reproductive technologies. Protection of individual's procreative liberty should prohibit government intervention in the choice to use IVF and other high-tech services, as long as that choice itself does not harm anyone. Because protecting individual liberty from state intrusion is so central to liberal philosophy, I call this the liberal response. Currently, there is little government supervision of reproduction-assisting technologies, and many proponents fear legal regulation of these new means of reproduction. in their view, financial and social barriers to IVF are unfortunate but inappropriate reasons to interfere with those fortunate enough to have access to this technology. Nor, according to the liberal response, does the right to use these technologies entail any government obligation to provide access to them. Just as current constitutional jurisprudence recognizes no right to public funding of abortions or other reproductive health services, there is no constitutional right to government subsidies for high-tech fertility treatment. Some prominent liberal thinkers, such as John Pawls and Ronald Dworkin, have addressed economic inequality in their accounts of political liberalism. But most, including a majority of U.S. Supreme Court justices, set aside such concerns. Furthermore, if for cultural reasons Blacks choose not to use these technologies, this is no reason to deny them to people who have different cultural values.

Perhaps we should not question infertile couples' motives for wanting genetically related children. After all, people who have children the old-fashioned way may also practice this type of genetic selection when they choose a mate. It would be hypocritical to condemn people who resort to new reproductive technologies for having the same desires for their children as more conventional parents, whose decisions are not so scrutinized. The desire to share genetic traits with our children may not reflect the eugenic notion that these particular traits are inferior to others; rather, as Barbara Berg notes, "these characteristics may simply symbolize to the parents the child's connection to past generations and the ability to extend that lineage forward into the future." Several people have responded to my concerns about race by explaining to me, "White couples want white children not because of any belief in racial superiority, but because they want children who are like them."

Moreover, the danger of government scrutiny of people's motives for their reproductive decisions may override concerns about racism. This danger leads some commentators who oppose the practice of using abortion as a sex-selection technique to nevertheless oppose its legal prohibition. As Tabitha Powledge put it, "To forbid women to use prenatal diagnostic techniques as a way of picking the sexes of their babies is to begin to delineate acceptable and unacceptable reasons to have an abortion.... I hate these technologies, but I do not want to see them legally regulated because, quite simply, I do not want to provide an opening wedge for legal regulation of reproduction in general." It would similarly be unwise to permit the government to question individuals' reasons for deciding to use reproduction-assisting technologies.

The Distributive Solution

We need not question individuals' reasons in order to question the societal impact of a practice. My purpose is not to judge individuals' motivations, but to scrutinize the legal and political context which helps to both create and give meaning to individuals' motivations. Another approach to procreative liberty places more importance on reproduction's social context than does the liberal focus on the fulfillment of individual desires. Procreative liberty cannot be separated from concerns about equality. In fact, the very meaning of reproductive liberty is inextricably intertwined with issues of social justice. Policies governing reproduction not only affect an individual's personal identity they also shape the way we value each other and interpret social problems. The social harm that stems from confining the new reproduction largely in the hands of wealthy white couples might be a reason to demand equalized access to these technologies.

This view also recognizes the social constraints on individuals' ability to make reproductive decisions. The concept of the already autonomous individual who acts freely without government intrusion is a fallacy that privileges decisionmaking by the most wealthy and powerful members of society. It ignores the communities and social systems that both help and hinder an individual in determining her reproductive life.

Obviously, the unequal distribution of wealth in our society prevents the less well off from buying countless goods and services that wealthy people can afford. But there may be a reason why we should be especially concerned about this result when it applies to reproduction. The same reasons that lead liberals to protect the rights of privileged individuals to use expensive reproductive technologies counsel in favor of paying closer attention to reproduction's social consequences.

Reproduction is special. Government policy concerning reproduction has tremendous power to affect the status of entire groups of people. This is why the Supreme Court in Skinner v. Oklahoma declared the right to bear children to be "one of the basic civil rights of Man." This is why in their Planned Parenthood v. Casey opinion, Supreme Court Justices O'Connor, Kennedy, and Souter stressed the importance that the right to an abortion had for women's equal social status. It is precisely the connection between reproduction and human dignity that makes a system of procreative liberty that privileges the wealthy and powerful particularly disturbing.

Because procreative liberty is such an important right, so central to personal identity, to dignity, and to the meaning of one's life," its infringement by forces other than the state should also be addressed. Why must we adopt the baseline of existing inequalities? Why should the deepening of these inequalities not weigh heavily in balancing the benefits and harms of assisted reproduction? Procreative liberty's importance to human dignity is a compelling reason to guarantee the equal distribution of procreative resources in society. Moreover, addressing the power of unequal access to these resources to entrench unjust social hierarchies is no less important than allowing wealthy individuals alone to fulfill expensive procreative choices. We might therefore address the racial disparity in the use of reproductive technologies by ensuring through public spending that their use is not concentrated among affluent white people. Government subsidies, such as Medicaid, and legislation mandating health insurance coverage of fertility services would allow more diverse and widespread enjoyment of the new reproduction.

Should We Discourage the New Reproduction?

If these technologies are in some ways positively harmful, will expanding the distribution of fertility services solve the problem? Will distributing more of the technologies be enough to redress the racist social arrangements that make these technologies dangerous? Political philosopher Iris Marion Young criticizes liberal theories of distributional justice for ignoring the institutional context that inhibits people from determining their actions and that helps to guide distributive patterns. This distributive approach restricts the meaning of social justice to the morally proper allocation of material goods among society's members. Although the more equalized distribution of resources would alleviate many social problems, it alone cannot eliminate oppressive social structures. My racial critique of the new reproduction is more unsettling than its exposure of the maldistribution of technologies. It also challenges the importance that we place on genetics and genetic ties. Eradicating the harmful aspects of new reproductive technologies, then, may require deterring people from using them.

But can we limit individuals' access to these technologies without critically trampling on individual freedom from unwarranted government intrusion? After all, government has perpetrated much injustice on the theory that individual interests must be sacrificed for the public good. This was the rationale justifying the eugenic sterilization laws enacted earlier in this century. According to eugenicists, the law could restrict the reproductive liberty of the unfit in the interest of improving the genetic quality of the nation.

Even for liberals, individuals' freedom to use reproductive technologies is not absolute. Most liberals would place some limit on their use, perhaps by identifying the legitimate reasons for procreation. John Robertson, for example, concedes that the state may prevent parents from cloning offspring or using genetic screening to intentionally diminish the health of their children (intentionally bearing a deaf child, for example). He justifies this restriction by arguing that these uses of reproduction-assisting technologies do not further the core value of procreation of producing "normal, healthy children" for rearing. If such a core view of reproduction can limit individuals' personal procreative decisions, then why not consider a view that takes into account the new reproduction's role in social arrangements of wealth and power? If the harm to an individual child or even to a core notion of procreation can justify barring parents from using the technique of their choice, then why not the new reproduction's potential for worsening group inequality? The magnitude of harm that can result from the unequal use of these technologies, an inequality rooted partly in racism, justifies government regulation.

Some have concluded that the harms caused by certain reproduction-assisting practices even justify their prohibition. In 1985 for example, the United Kingdom passed the Surrogacy Arrangements Act banning commercial contract pregnancy arrangements and imposing fines and/or imprisonment on the brokers who negotiate these agreements. The authors of the act reasoned that "[e]ven in compelling medical circumstances the dangers of exploitation of one human being by another appears [sic] to the majority of us far to outweigh the potential benefits, in almost every case." Some Marxist and radical feminists agree that paid pregnancy contracts should be criminalized to prevent their exploitation and commodification of women and children. Surrogacy contracts are void and unenforceable in five states in this country; three others prohibit commercial surrogacy.

On the other hand, the government need not depart at all from the liberal noninterference model of rights in order to discourage or refuse to support practices that contribute to social injustice. Even the negative view of liberty that protects procreative choice from government intrusion leaves the state free to decide not to lend assistance to the fertility business or its clients. Indeed, liberals who argue that the state must facilitate the use of these technologies, by enforcing paid pregnancy contracts for instance, contradict their own precepts.

We should therefore question a system that channels millions of dollars into the fertility business, rather than spending similar amounts on programs that would provide more extensive benefits to infertile people. New York Times reporter Trip Gabriel describes the "$350 million-a-year" fertility business as "a virtually free-market branch of medicine ... largely exempt from government regulation and from the downward pressure on costs that insurance companies exert." The fact that new reproductive technologies facilitate procreative decisions is not reason enough to exempt them from government supervision; obstetrics and abortion services are subject to regulation. Taking these social justice concerns more seriously would justify government efforts to reallocate resources away from expensive reproductive technologies toward activities that would benefit a wider range of people.

Indeed, we can no longer avoid these concerns about the social costs and benefits of IVF. Such calculations are now part of the debate surrounding the advisability of state laws requiring insurance companies to include the cost of fertility treatment in their coverage. One as yet unsuccessful couple reported that "insurance has paid for everything at about $100,000 a year (three years now)." Covering the costs of expensive high-tech procedures means raising the price of insurance for everyone. The Massachusetts Association of Health Maintenance Organizations says its members pay $40 million more in premiums to cover infertility treatment for 2,000 couples. The federal Office of Technology Assessment estimates that it would cost $25 million to extend coverage for IVF under the plan that insures the nation's 3 million civilian employees of the federal government. Moreover, providing insurance for expensive fertility treatments but not adoption (which can also cost thousands of dollars) ironically makes these technologies the only alternative some people can afford.

A study recently reported in the New England Journal of Medicine calculated the real cost of IVF at approximately $67,000 to $14,000 per successful delivery. For older couples with more complicated conditions, the cost rose to $800,000. Unlike the $8,000 cost per IVF cycle, these figures refer to the costs involved in the birth of at least one live baby as a result of IVF, including the cost of treatment, delivery, and neonatal intensive care. (The high incidence of risky multiple births with IVF dramatically boosts hospital charges.) The authors concluded that the debate about insurance coverage must take into account these economic implications of IVF, as well as ethical and social judgments about resource allocation. Yes, insurance coverage increases access to these technologies to some degree. But can we justify devoting such exorbitant sums to a risky, nontherapeutic procedure with an 80 percent failure rate when so many basic health needs go unmet?

Research designed to reduce infertility, programs that facilitate adoption, and the general provision of basic human needs are examples of expenditures that would help a far broader range of people than IVF. The federal government has done little to combat the epidemic spread of chlamydia, an STD that affects millions of people and contributes to especially high infertility rates among young Black women. It must be remembered that most high-tech interventions such as IVF do not cure infertility, the couples who use them remain biologically unable to bear a child without technological assistance. The medical establishment has much more to gain from developing expensive technological interventions that foster a dependent clientele than from research directed at the causes and prevention of infertility. The IVF clinic at New York Hospital-Cornell Medical Center, for example, generates a $2 million annual surplus for the Cornell Medical College that enables its physicians to earn up to $1 million a year. This kind of profit creates a strong incentive to push infertile couples toward repeated attempts at a high-tech solution, despite abysmal success rates that only drop with each try.

Black women in particular would be better served by a focus on the improvement of basic conditions that lead to infertility, such as occupational and environmental hazards, diseases, and complications following childbirth or abortion. Increasing access to preventive health care and treatment for STDs would yield a far bigger payoff than increasing access to expensive fertility treatment. Yet the relative modesty of financial rewards, combined with disinterest in increasing Black birthrates, steers medical ventures off this more promising course. Indeed, as we saw in Chapter 3, more resources are directed toward developing long-term contraceptives for poor women of color in the United States and abroad that may lead to an even higher incidence of infertility-causing STDs and other health problems.

The concentration of effort on the new reproduction diverts attention from the interests of poorer Black women in another, more subtle way. Although the "biological clock" metaphor is grossly exaggerated, one reason for infertility among white, educated, high-income women is their postponement of childbearing in order to pursue a career. The cause of these women's infertility is not biological; rather, it is a workplace that makes it virtually impossible for women to combine employment and child-rearing. These women can avoid this social problem by seeking expensive fertility treatment after achieving some status in the office. In other words, they can afford to bypass the structural unfairness to mothers through technological intervention. Similarly, many affluent white women gained entry to the male-dominated workplace by assigning female domestic tasks to low-paid dark-skinned nannies. These luxuries, which most Black women cannot afford, take the place of widespread reforms that would increase all women's employment options. Relying on expensive interventions to resolve the tension between child-raising and work destroys the possibility of unity in women's struggle for fundamental change in the sexual division of labor.

This reliance on high-tech intervention rather than improving basic health and workplace conditions hurts not only Black women but all women and, ultimately, all of our society. We would all benefit from a health policy that redirected the billions of dollars currently spent on fertility treatment toward eradicating the causes of infertility. We would all benefit from a view of family that valued loving relationships, however created, rather than genes traded on the market. We would all benefit from a work world that appreciated mothers' care for children. Once again, America's unwillingness to attend to the needs of Black citizens stymies the potential for widespread change that would enrich everyone's life.

* * *

There is no question that the way we view the freedom to create children technologically, as well as "naturally," is shaped by race. Racial injustice infects the use of new reproductive technologies no less than it infects the use of birth control. While too much fertility is seen as a Black woman's problem that must be curbed through welfare policy, too little fertility is seen as a white woman's problem to be cured through high-tech interventions. The new reproduction is designed for the creation of white babies.

We must address the contribution that this disparity makes to racial injustice in America. Staunch civil libertarians object that intervening might unfairly limit the choices of wealthy white people. I, too, am wary of state interference in reproductive decisionmaking; after all, Black women are the most vulnerable to such government abuse. But our vision of procreative liberty must include the eradication of group oppression, and not just a concern for protecting the reproductive choices of the most privileged. It is to that reconception of reproductive liberty that I now turn.


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