Taiwan Eyes Surrogacy Market

On the heels of a presidential election, commercial surrogacy looms on the horizon here in Taiwan. A hot topic in the Western media, with celebrity couples seemingly popping up with a newly purchased baby every week on social media, Taiwan is ready to jump on the surrogacy bandwagon. Announced in December, the Ministry of Health and Welfare is poised to present draft amendments to the current Assisted Reproduction Act, anticipated by the end of 2024. These proposed changes are geared towards enhancing access to assisted reproduction and making all forms of surrogacy legal in the country.

During our recent presidential elections, surrogacy was a hot topic. During election debates, Taiwan People's Party (TPP) presidential candidate Ko Wen-je made legalizing surrogacy a key pillar of his policy platform, highlighting the growing importance commercial surrogacy in the country.

Some women’s rights groups in Taiwan, have raised concerns that disadvantaged women might be exploited as surrogate mothers, or that legalizing the practice might reinforce the pressures on women to have children. The main concerns regarding surrogacy include: adequate protection of the surrogate mothers, as they face health risks from pregnancy; ethical considerations about using surrogates as a treatment tool for infertile couples; and the legal status of the child.

The Assisted Reproduction Act in Taiwan currently prohibits all forms of surrogacy. Despite efforts to amend the laws, as recently as 2017, such attempts have faced opposition from women's and children's rights groups, leading to unsuccessful outcomes. “A woman's body is not a commodity or a tool. We oppose rich people exploiting poor women and buying them as surrogate mothers," said Huang Sue-ying, chairperson of the advocacy group Taiwan Women's Link.

However, Taiwan emerged as a new and potentially explosive market for surrogacy after it became Asia’s first country to legalize same-sex marriage in 2019. This small island nation was bombarded by commercial surrogacy agencies who promised to help couples purchase wombs in exchange for a child of their own. And the potential for making money hand over fist is sure to overturn any ethical or moral opposition to female exploitation.

The initial valuation of global fertility services was approximately $21 billion in 2018, as the market research firm Data Bridge estimated. The industry is projected to experience significant growth in the next few years, reaching an estimated worth of $41 billion by 2026.

American surrogacy agencies have flooded into Taiwan after the legalization of same-sex marriage four years ago. While commercial surrogacy is still illegal here, the agencies work around this by arranging IVF and surrogacy in the relatively unregulated United States. The average cost of purchasing a child? Around 140,000USD, which is nearly ten times the average national salary in Taiwan. It’s big bucks to sell children.

The grotesquely named Men Having Babies, a New York-based misogynist group that claims to "help gay men become fathers through surrogacy", hosted a conference in Taiwan for prospective buyers of female wombs this year. They will host their next event here in 2025, and every two years after that, spreading information on their agencies, clinics, law firms, and other surrogacy providers.

What’s the problem with surrogacy?

Not being discussed in any of the news reports are the negatives associated with surrogacy. Paid surrogacy is illegal in much of Asia, but one should be aware that many surrogacy operators offer back-channel surrogacy with alternative arrangements for couples who come to Asian countries. After having been forbidden in neighboring Thailand (nicknamed the “Womb of Asia” in 2015), after a series of horrific high-profile cases, with Cambodia following suit soon after. In the scandal in Thailand in 2011, fifteen Vietnamese women were discovered being forcibly kept in an apartment in Bangkok, seven of them pregnant. It was a baby-making farm.

Unfortunately, as of 2023, Thailand has been in the process of amending its surrogacy laws to permit foreigners to engage in surrogacy arrangements with Thai women. The proposed revisions also include the commercial exportation of women's eggs. This initiative comes after Thailand imposed restrictions on the surrogacy industry, prompted by concerns raised when David Farnell, an Australian convicted pedophile, was granted custody of a child born through a Thai surrogacy clinic. In what might be the ultimate in outsourcing, Western couples are increasingly traveling to unregulated India to have their baby delivered by a surrogate mother.

Despite the bans, would-be parents are drawn by Asia's lower costs, as compared to wealthier countries. Who would want to pay a woman a higher price for her time and physical labor, when you could get it so much cheaper in Asia? Surrogacy exploits women, particularly those from economically disadvantaged backgrounds, who may be driven to become surrogates due to financial need. Taiwanese women won’t be the ones selling their bodies to make babies for the wealthy, that task will instead fall to the same women who come here and do the dirty work no one else wants to do. The domestic help, the factory workers, and the migrants from Southeast Asia that face discrimination and are easily exploitable…and expendable.

Pregnancies involving surrogacy are inherently categorized as high-risk due to the elevated likelihood of health complications for both the surrogate mother and the baby. In fact, all surrogate pregnancies are medically classified as “high-risk” due to the use of hormones involved, and even egg donation confers risks of developing endometriosis, infertility, or the fatal condition of ovarian hyperstimulation syndrome (OHSS). This increased risk is particularly associated with the practice of implanting multiple embryos, a common strategy to enhance the chances of a successful pregnancy. Surrogate mothers undergoing this procedure face various health hazards, including ovarian torsion, reproductive cancers, stroke, premature menopause, placental abruption, and, in extreme but not unheard of cases, death. The necessity for a Cesarean section (C-section) is also more probable in pregnancies with multiple gestations, introducing a range of associated risks.

Research conducted on surrogacy in developing countries revealed instances where women underwent C-sections purely for the convenience of the "commissioning parents” aka the paying customers. This raises ethical concerns regarding the medical procedures chosen for the sake of timing rather than the well-being of the surrogate mother.

Furthermore, infants born through surrogacy, often referred to as "surrogacy babies," confront their own set of health risks, such as low birth weight, prematurity, and the possibility of miscarriage. A study discussed in an article on the ethics of surrogacy in The Journal of Medical Ethics highlights that a significant proportion of infant mortality can be attributed to complications arising from prematurity, with infertility treatments being a contributing factor.

The emotional and psychological impact of surrogacy on the surrogate is a concern. Some worry about the potential long-term effects on the surrogate's mental health, especially if she forms a strong emotional attachment to the child. The truth is, this practice and the justifications surrounding its regulation bear striking resemblance to prostitution. The debates often revolve around women's "freedom" to lease their wombs, altruistic intentions, and the undeniable desire of those who commission surrogacy to fulfill their dream of starting a family. However, what remains obscure is the darker side: the prevalence of poverty, human trafficking, the exploitation of impoverished nations for surrogacy tourism, the dehumanization involved, and the myriad risks to the emotional and physical well-being of all parties involved.

The Problem with Adoption

In some East Asian cultures, like Taiwan, there is a  strong emphasis on biological lineage and carrying on the family name. Taiwanese on average simply don’t like to adopt children. Laws were changed to promote domestic adoptions in Taiwan, with little effect. There is a notable disparity between the number of children awaiting adoption and available adoptive parents, with the former outnumbering the latter by two- or three-fold. Even in cases where there is a willingness to adopt, prospective adoptive parents in Taiwan frequently have specific criteria for the children they are open to adopting, such as a young age, good health, and a family background with an unblemished history. This means many children are growing up without loving homes, while couples seek commercial surrogacy at sky-high prices.

But it’s not a human right to have a child. This is a narrative we hear time and time again on the topic of surrogacy. It is born of the notion that an individualistic desire for a child translates to a necessity for a child and therefore a right to a child. Couple this delusion with the lie that women, usually economically disadvantaged and marginalized women, are little more than sexual and reproductive resources to be used and exploited and you have a justification for surrogacy.

Lack of Information

Western mainstream media and organizations claiming to support human rights advocate for the censorship of those who acknowledge women’s sex-based oppression. Similarly, there is little to no information being provided to the public in Taiwan showing the negatives of commercial surrogacy. This coincides with the push for the acceptance of gender identity ideology in Taiwan, which was greatly influenced, like surrogacy, by Western ideology and thinking. In 2021, the Taipei High Administrative Court issued a ruling allowing a trans-identified male calling himself “Xiao E (小E)” to change his legal sex to female without sex reassignment surgery — the first ruling of its kind. Until then, individuals could not change their sex on an ID card unless they provided medical certificates confirming a diagnosis of gender dysphoria and proof of a sex change operation. The Chinese language news outlets that covered this case (UDN News, ET Daily, Apply Daily, LTN Liberty Times) all did so with no comment on how these changes would impact women in Taiwan. Across the board, they printed copy and paste statements from groups representing trans activist interests and offered no counter opinion or discussion of potential harm to women and girls. The two English-language news outlets to discuss the case — Focus Taiwan and Taipei Times — provided the barest of details and also failed to discuss the negative impacts on women.

What the media fails to do, time and time again, is show how these issues affect women negatively. The media conceptualizes surrogacy as some sort of empowerment of women in the forms of self-reliance, self-confidence, and the social and economic movement out of poverty. However, this empowerment framework appropriates feminist language to the extent that the ‘Third World’ woman (typically from Southeast Asia) has to align herself with Western market systems in order to demonstrate her “agency”. The concept of “choice” is not free from exploitation, and the systems put in place for surrogacy do not at all prioritize the women that surrogacy supposedly “empowers”. A surrogacy contract will appear financially attractive to poor women with the payment being marginal compared to the time invested in the service. The formal language of the contracts in addition to cultural barriers often discourage these Asian women from reporting exploitation or seeking help, which, in turn, restricts the surrogate mother’s understanding of what they have signed and any information on regulations that could have protected them

Taiwan continues to be influenced by Western trends, from gender ideology to the commercialization of women’s wombs for profit. The DPP, the political party of both the former and incoming presidents, has said that the surrogacy act should be amended to allow single women and female same-sex couples to receive assisted reproduction so that they do not have to risk going abroad and spending a lot of money on procedures. While I am also resolutely in favor of same-sex parenting, I am angry that Taiwan is currently leading the way in destigmatizing a deeply unethical practice. Rather, they promote the idea that one must use their wealth to rent women’s wombs, whilst child welfare authorities are struggling to find foster or adoptive parents for those many children in care. There is no tabloid fawning over those unwanted babies in Taiwan, or anywhere else in the world.

Follow the Money

Public opinion on surrogacy in Taiwan has been divided, and discussions on the topic have involved ethical, legal, and cultural considerations. But in the end, I believe that Taiwan will allow commercial surrogacy into the country. Why? Because it will bring in a lot of money. It’s as simple as that. There is simply too much money to be made from it. Already commercial surrogacy agencies in Taiwan take huge sums of money to place couples with foreign surrogates. And when there is money to be made from women’s bodies, the sharks will circle.

Advocates of the surrogacy industry, encompassing both profit-driven medical professionals and affluent infertile couples capable of purchasing a child, contend that women receive generous compensation for their "services" and are therefore not subjected to exploitation. They assert that it is within a woman's right to utilize her body as a workplace, akin to a vending machine. This narrative closely mirrors the arguments put forth by supporters of prostitution, emphasizing personal choice. However, I maintain the perspective that all forms of surrogacy involve exploitation. These women are reduced to mere vessels, their essential human needs often overlooked in favor of prioritizing the desires of the "commissioners" who claim ownership of the developing baby.

Despite the availability of children who need homes, surrogacy will be the primary choice for the wealthy on this island nation. Unfortunately, the ethical fix for delayed pregnancy, not wanting stretch marks, for same-sex couples, or even for infertility, is not to exploit women. No one has the “right” to have their own biological child, and certainly, no one has the right to use a woman’s body for their personal benefit.

To quote feminist writer Rachel Klein; “Pared down to cold hard facts, surrogacy is the commissioning/buying/renting of a woman into whose womb an embryo is inserted and who thus becomes a ‘breeder’ for a third party.” While many people have strong emotional desires to have children, there is no “right” to have a child genetically related to you. The moral claim for surrogacy is an illusion.

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