Introduction

1. The issue

Transnational reproductive travel (sometimes packaged with holiday time in tourist destinations) is a largely unfettered multibillion-dollar global industry that flourishes, in part, by capitalizing on differences in legal regimes, wages and standards of living, and cultural and ethical norms. Indeed, as Scott Carney explains with respect to the commercialization of human eggs for third-party reproduction, “internationalization has made oversight laughable. … [R]egulators are dogs with no teeth” (Carney 2011, 117). While professional organizations can introduce guidelines and nation-states can introduce laws, the fact is that patients can (and do) travel to places where there are no (or very few) restrictions on what reproductive goods (i.e., gametes) and services (i.e., gestational services) can be purchased. Not all transnational reproductive travel, however, is to avoid legal or other prohibitions. Other reasons for such travel are to reduce costs, to access better-quality care, to access medical resources otherwise not available in one’s home country, to reduce wait times, or to avoid legal or professional prohibitions on access by particular demographic or social groups (Crozier and Baylis 2010).

In recent years, transnational reproductive travel has come to involve the cross-border movement of gametes or embryos, as well as persons. Consider, for example, complex reproductive projects involving the cross-border movement of reproductive materials, reproductive laborers (i.e., women who provide eggs for third-party reproduction and women who provide gestational services), and intended parents. One such scenario might involve the shipment of gametes or embryos to a foreign clinic in a country where a gestational carrier resides, to which the intended parent(s) will later travel in order to pick up the child(ren). While this is not yet a common occurrence, it is not an unfamiliar narrative, especially among those who are unable to adopt or arrange a contract pregnancy in their home countries. Consider, for example, the well-publicized case of Yo-nathan Gher and his partner, Omer. This gay Israeli couple contracted with an Indian woman to bear and birth a child for them, using the egg of another Indian woman whom they selected from an online database (Gentleman 2008).

As this and similar cases illustrate, at the heart of the global reproductive travel industry are women who sell their reproductive materials and/or labor. Typically, these women have no or limited options to earn the money they need to live and pay their bills. In low- or middle-income countries, they are generally poor women, and sometimes poor immigrant women. In middle-and high-income countries, the egg providers are generally young college students who need money to pay school fees or debts; the gestational carriers are women of lower socioeconomic status.

This special issue of IJFAB makes a unique contribution, from an explicitly feminist perspective, to the ethical debates surrounding transnational reproductive travel. The original call for papers invited reflections on vulnerability, exploitation, coercion, commodification, and inequity in anticipation that such reflections would be relevant to the following sorts of questions, some of which are tackled by the contributors to this special issue:

• • Does transnational reproductive travel increase or cloud our understanding of vulnerability?

• • Does transnational reproductive travel benefit women in low- and middle-income countries by increasing employment opportunities, or does it further subjugate women who are at increased risk of exploitation and coercion?

• • Should women be paid for their eggs? If so, what is a fair price? Should women be compensated for their reproductive labor? If so, what is a fair wage?

• • What rules should govern the import and export of reproductive materials, whether for reproductive or research use?

• • When the motivation for transnational reproductive travel is to avoid domestic legal or professional ethical constraints, should health-care providers help to facilitate transnational travel with a view to promoting access to safe and effective interventions, or should they actively discourage such travel?

• • How should national self-sufficiency, as a strategy to reduce transnational reproductive travel by individual and couples, be evaluated?

2. The articles

Some of the articles in this special issue speak to the work of other authors, while some...