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145 5 Physician Racism and the Commodification of Intimacy I first met Dr. Singh in early 2010 at Origins Gynecology Clinic in south Mumbai. Dr. Singh had started the clinic’s IVF unit three years earlier and had built a small but growing global surrogacy program. Our fifth meeting, on a cool monsoon day in August, occurred at a new clinic she had started in the northern suburbs of the city that specialized in transnational surrogacy. Eden Hill Medical Center, a quaternary care hospital offering advanced levels of specialized care as well as medical tourism services to international patients, hosted the clinic. Dr. Singh explained that her new clinic’s surrogacy program occupied much of her time. She spoke with passion about the challenges of starting her own clinic, and eventually our conversation turned to her management of the relationships between surrogates and commissioning parents. Dr. Singh believed that one of her key responsibilities was to mediate the vast geographical and social distance between surrogates and clients (commissioning parents)—parties who may never meet but nevertheless are engaged in making a baby together. I knew that she discouraged parents and surrogates from meeting, and when I asked her to explain this, she replied: It depends on the parent actually. Some of them want to meet. But actually I feel that until the baby is out, it’s better for the surrogates not to meet the clients, because you’re giving that little chance for emotional blackmail. . . . There was this whole blackmail issue [at another clinic] where the surrogate demanded some ten lakhs [around U.S.$21,000] before the cesarean. That makes me think: Why should you even give her the chance to ask? Once you see white skin and you see that they have money, it’s all [claps hands]—the whole battle is lost. Dr. Singh made explicit the relationship between the business transaction built into surrogacy and the actors’ skin color and socioeconomic 146 | Physician Racism and the Commodification of Intimacy backgrounds when she said that once the surrogates “see white skin and that they have money,” the battle against blackmail is lost. By making whiteness synonymous with commissioning clients, she recognized that surrogate and client are racialized figures. Surrogates became, by definition, nonwhite. By emphasizing what she viewed as immutable difference between surrogates and commissioning parents, Dr. Singh simultaneously highlighted the alterity of surrogates. Her statements illustrate the ways in which Indian doctors racialize the actors involved in surrogacy to justify discouraging contact between clients and surrogates. Parents and surrogates shared Dr. Singh’s sense that doctors have a central role in coordinating surrogate-client relationships at the heart of gestational surrogacy, though many commissioning parents and some surrogates told me they wished they could meet one another. This chapter therefore provides an in-depth examination of the key role that doctors play as a necessary part of illuminating the relationship between surrogates and intended parents. Thus, this chapter unfolds two interrelated analyses: first, I explore the ways in which doctors organize and facilitate surrogates’ relationships with intended parents. Second, I examine how this influences the ways in which surrogates themselves understand and negotiate these relationships. Ultimately I argue that Indian doctors racialize surrogates—whose caste and class backgrounds are distinct from those of the doctors—in ways that justify their unequal position in surrogacy arrangements. I contend that these forms of racialization powerfully shape how surrogates view and experience their relationships with commissioning clients and the fetuses they bear. Central to this chapter is the context in which surrogates and intended parents rarely, if ever, meet in person. This contrasts with the conditions that hold in previous studies of gestational surrogacy, in which parties expected some level of mutual engagement and often had a shared cultural background or at least nationality (Teman 2010; Ragoné 1994). In the United States, most surrogacy agencies encourage the intended parents to meet with their surrogate several times prior to birth, although most contact is limited to e-mail and the telephone due to the sheer geographical distance between them (Ragoné 1994). Israeli surrogacy relationships, on the other hand, rarely involve a distance of Physician Racism and the Commodification of Intimacy | 147 more than two hours’ travel time, and the parties typically have frequent meetings as well as regular contact by phone or e-mail (Teman 2010). In India, Amrita Pande’s (2014c) case study of commercial surrogacy examined how Indian surrogates constructed kinship ties with the intended parents, even...


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