Other articles on surrogacy can be found at: global surrogacy and surrogacy.

The birth of Sir Elton John’s son on December 25, 2010 was celebrated in the international media. He and his partner, David Furnish, have a civil union and they are a high-profile same-sex couple. When they inquired about adopting a young boy in the Ukraine, they were denied this opportunity because of Elton John’s age (over 60) and his single status; civil unions are not recognized in Ukrainian adoptions and, as such, he could not apply as a married individual. Turning to surrogacy was not a simple matter, even with the infinite financial resources of the couple. This is due to the fact that surrogacy is outlawed on British soil and, as a result, the couple contracted with a California-based surrogate. However, British citizens may purchase surrogate services elsewhere and Elton John and David Furnish are certainly not the first family to be built with “out-sourced” surrogates in another nation.

With Sir Elton John’s successful and highly publicized surrogacy arrangement, the “effect” of star-power and the use of surrogacy on the general population remain to be seen. It is far more financially obtainable as an option today to average people. What has historically been a very expensive option costing $50,000-plus, global surrogacy has become more affordable in recent years largely due to the medical tourism model in India.  An individual or couple may contract for surrogate services for as little as $12,000 plus travel costs. Intermediaries who act like headhunters identify women to carry out this “service” with little oversight and clinics with sophisticated medical services are constructed where surrogates live in dormitories or pregnancy camps. The ethical quagmires related to this business model, now expanding to other nations such as Guatemala, are considerable. While there have been calls for regulation of surrogacy, and some nations like the UK outlaw it, the new global context requires greater consideration especially when one considers the vulnerabilities of deeply impoverished women in developing nations.  

Superstar influence on the social consciousness and how families are built via alternative strategies is relevant. What some have called the “Brangelina Effect” was the beginning of a booming inter-country adoption industry in Ethiopia after Angelina Jolie adopted Zhara in that deeply impoverished nation.  Now, as thousands of people have flocked to Ethiopia in recent years to build their families through adoption, there are grave concerns about corruption and the exploitation of vulnerable women and their children by sophisticated inter-country adoption agencies. The abuses include concerns about child sales and other unethical and illegal practices.

All of this is further complicated by the fact that with the exception of Ethiopia, inter-country adoption is undergoing a significant decline. A practice which affected an estimated 45,000 children in 2004 may have had as much as a 50 percent downturn or more since that time because of a variety of reasons, including implementation of international standards to prevent child sales and theft. However, the demand for healthy babies rages on and it is a billion dollar industry. While the sale of children is prohibited around the world, it happens every day.  And, while surrogacy on a case-by-case basis may be ethical and well-planned, it is hard to believe that such an approach when practiced on a large scale assembly-line style in developing nations will be done so in a fair and just manner.

Much remains to be seen related to this emerging business model and exactly how vulnerable women will be protected. One thing is guaranteed, the activity will be marketed as a win-win “opportunity” for poor women and the individuals and families who seek to build their families in this manner. Oprah Winfrey already weighed-in on global surrogacy, highlighting the practice in India and happy US “customers.” While involvement in global markets is important for marginalized peoples, especially women, one should not underestimate the need for oversight and ethical standards. Without international regulation, I predict dire human rights abuses when the activity is practiced en masse in nations with histories of organized crime and human rights abuses. First on my list of concerns is Guatemala, a nation with notorious problems related to violence against women and human trafficking and it is time for a rapid response to insure the rights of vulnerable women. How that should be done remains to be seen, but one proposal is international private law. Regardless, the time to act is now!