Two Men and a Surrogate: A Qualitative Study of Surrogacy Relationships in Canada

• Published date: 01 February 2021
• Author: Sophia Fantus
• Date: 01 February 2021
• DOI: http://doi.org/10.1111/fare.12450

S F The University of Texas at Arlington School of Social Work

Two Men and a Surrogate: A Qualitative Study

of Surrogacy Relationships in Canada

Objective: To retrospectively explore how gay

fathers and gestational surrogates in Canada

perceived their relationshipat three distinct time

points: prepregnancy, during pregnancy, and

postbirth.

Background: Canada has witnessed an

increased number of gay men seeking father-

hood through surrogacy. However, there is

limited empirical research on the experiences

and perspectives of surrogacy for gay men, both

in Canada and worldwide.

Method: Qualitative in-depth interviews

(∼60–120 minutes) were conducted with (a)

gestational surrogates implanted with one or

more embryos from a donated egg and gay

fathers’ sperm, (b) gay men who pursued gesta-

tional surrogacy to have a biological child, and

(c) single or partnered gay men and their paired

surrogate. Participants who agreed to partic-

ipate, who were willing to contact their third

party, and whose matched party agreed resulted

in a surrogate triad in which the intended

parents and surrogate all participated. Inter-

views (n=21) were recorded, transcribed, and

analyzed using interpretive phenomenological

analysis.

Results: Findings from the present study

draw attention to the intricacies of surrogacy

The University of Texas at Arlington School of Social

Work, Social Work Complex, Building B, Suite 101H, Box

19129, 211 South Cooper Street, Arlington, TX 76019-0129

(sophia.fantus@uta.edu).

Key Words: gay fathers, gestational surrogacy, heteronor-

mativity, intended parents, same-sex parenthood,surrogacy

relationships.

relationships and demonstrate the variability

of how gay men and surrogates identify and

address their procreativeroles and responsibili-

ties through pregnancy and postbirth.

Conclusion: Participant narratives challenge

heteronormative experiences of pregnancy and

childbirth, extending the two-parent family

paradigm to include families of choice and a

close network of individuals and communities.

Implications: Allied health professionals ought

to provide competent, inclusive care that

actively confronts a priori biases and assump-

tions regarding same-sex parent families and

surrogacy.

C, S,  G R

Advances in reproductive technologies and the

progress of equal rights for sexual minorities

have led to new family planning options for gay

men in Canada. In particular, a growing number

of gay men are electing to pursue biological

paternity through the practice of surrogacy

(Kelly, 2014). Surrogacy is a form of third-party

reproduction in which a woman agrees to bear

a child for another individual or couple. The

woman may either be (a) a genetic surrogate,

supplying her own egg for fertilization, or (b) a

gestational surrogate, in which she is implanted

with an embryo from fertilized donor gametes

(sperm and ovum; Imrie & Jadva, 2014).

Intended parent(s) (known colloquially as IPs)

refers to the individual or couple who, although

they may or may not be genetically related to the

child, plans to be the child’s social and legal par-

ent(s) and raise the child from birth (Greenfeld

246 Family Relations 70 (February 2021): 246–263

DOI:10.1111/fare.12450

Two Men and a Surrogate 247

& Seli, 2011). In Canada, gestational surrogacy,

in which the surrogate does not have a genetic

connection to the offspring, is more commonly

practiced than genetic (traditional) surrogacy

among same-sex IPs (Dar et al., 2015; Grover

et al., 2013). This is perhaps due to fears that a

surrogate’s genetic (as opposed to gestational)

attachment may foster maternal–fetal bonding

and hinder the surrogate to relinquish the child

postbirth (Sanabria, 2013).

In Canada, the Assisted Human Reproduc-

tion Act (AHRA) stipulates that it is a criminal

offense to pay or offer to pay a surrogate, to

pay or offer to pay a person to arrange for the

services of a surrogate, and to advertise payment

for surrogacy or arrangement of surrogacy. It is

illegal also to pay an egg or sperm donor. Altru-

istic surrogacy, however, is legally permissible,

and surrogates are able to seek medical reim-

bursements associated with surrogacy (rather

than nancial compensation). Yet a lack of legal

clarity has created ambiguity in how to discern

legitimate monetary reimbursements between

IPs and surrogates (Busby & Vun, 2010; Fan-

tus, 2020; Nelson, 2016). IPs and surrogates

may seek support through online surrogacy con-

sulting services that, for a fee, will provide refer-

rals to fertility clinics and reproductive lawyers

and answer questions related to legal regulations

of third-party reproduction (Motluk, 2014).

Fertility clinics assist with both medical and psy-

chosocial assessments as well as the fertilization

process but remain unable to assist with contract

negotiations or nancial payment (because even

the facilitation of payment is prohibited under

the AHRA; Havelock, Liu, Levitan, Petropana-

gos, & Kahn, 2016). Across most fertility clin-

ics, support groups primarily target heterosexual

couples experiencing infertility.In turn, informal

supports established through private online com-

munities of surrogates and IPs (mainly through

Facebook) have been an important mechanism

for information sharing and building networks.

Thus, surrogates and IPs in Canada tend to enter

arrangements and proceed through surrogacy

without professional counseling or therapeutic

support to navigate these complex relationships.

S R

Surrogacy typically comprises a formal legal

arrangement based on effective communication;

mutual collaboration; and matched expectations,

interests, and goals between IPs and surrogates

(Braverman, 2013). Research shows that these

surrogacy relationships are a critical facet of

third-party reproduction; surrogates tend to

enter arrangements with hope and anticipation

of developing close, intimate, and enduring

friendships with their IPs (Berend, 2012, 2014).

Although many surrogate relationships proceed

successfully, among some heterosexual couples,

surrogates report fears of concealment that

derive from intended mothers’ embarrassment

or shame with infertility (Bellafante, 2005).

Intended mothers who pursue surrogacy may

project these feelings of jealousy, inadequacy,

and disappointment onto the surrogate (Klein-

peter, 2002; MacCallum, Lycett, Murray, Jadva,

& Golombok, 2003; van den Akker, 2007),

resulting in ineffective communication, dis-

comfort, and detachment (Berkowitz, 2013;

Stacey, 2006). Surrogates want involvement

from the intended mother and yet also want to

limit her desire to control or micromanage the

pregnancy (Jacobson, 2016). These reactions

may inuence IPs’ involvement during preg-

nancy and the continued surrogacy relationship

postbirth.

A qualitative retrospective study conducted

in the United Kingdom among genetic and

gestational surrogates for heterosexual cou-

ples explored surrogacy relationships at three

time periods: before pregnancy, during preg-

nancy, and postbirth/1-year follow-up (Jadva

et al., 2003). Participants reported on their

perceptions of the relationship, the frequency of

contact, and IPs’ involvement in the reproduc-

tive process. Surrogates (n=34; genetic =19;

gestational =15) indicated harmonious surro-

gacy relationships (97%) with their intended

mothers before and during their pregnancy:

83% reported that the intended mother was very

involved in the pregnancy, and 94% of surro-

gates were happy with her level of involvement

(Jadva et al., 2003). Postbirth, the frequency of

contact with the intended mother was mixed:

21% of respondents had no contact at all, 32%

reported contact at least once a month, and 47%

had contact that ranged once a month to once

in the past year; ve surrogates had no further

contact with the family. These ndings show

that relationships between surrogates and IPs are

diverse across arrangements; strategies for com-

munication evolve and shift over the pregnancy,

and postbirth interactions often affect perceived

long-term satisfaction (Berend, 2012).