Embryo Donation May Be The Answer For You

If you are asking what to do with your extra embryos, embryo donation is a viable, and ethical, option.

Individuals and couples who have turned to IVF to help them have their families are now confronting a confounding question: what do we do with extra embryos?  Embryo donation is becoming the method of choice for many of us, myself included.  Every year when the embryo storage bill arrives, the ethical dilemma comes again.

The Process

Each clinic will have a different protocol to follow for directed embryo donation.  Most require an Embryo Donation Agreement between the donor parent/s and the recipient individual or couple, as well as a clearance for transfer, which includes such details as spousal consent (if one donor parent is not genetically related to the embryo) and which clinic’s cryopreservation equipment will be used.  Once all the pieces are in place, the process goes pretty fast.

To be prepared, it is a good idea to collect all of this information in advance from your fertility clinic.  They will provide you with your own health related information and, if a HIPAA waiver is prepared, the clinic may coordinate directly with the recipient’s clinic to streamline the process.

Embryo Donation Agreements

The requirement of an Embryo Donation Agreement makes good sense for all parties.  Most physicians require that an agreement is reviewed by legal counsel and executed before discussing this as an option with their patients. This agreement spells out the details of the transfer.  These details include: confidentiality and sharing of health information, physical and psychological screening of the donor/s and the recipient/s, custody of the embryos, intention regarding parentage of a child born through the embryo donation, the duration of the agreement timing and legal disclaimers as to the uncertainty of the law around embryo donation.

While the last item may cause alarm for some, it is generally understood that Embryo Donation Agreements are created to define the intention of the parties so that if, at some point in the future, there is a disagreement about the disposition of the embryos, there will be a document that anchors the intention of the parties to the original transfer date.

My Story

My husband and I were recently alerted to the closure of the fertility clinic that helped us have our son through egg donation and surrogacy.  As many gay men who turn to surrogacy know, with a young egg donor, you are likely to have more than one viable embryo.  We kept them in storage until now, but when confronted with the choice of transferring them to another facility or “discarding” them, we asked ourselves if embryo donation would be the best option.

We needed more input.  Our choice, when we had our son, was to remain involved in the lives of our egg donor and our surrogate mother.  We were fortunate enough to find two amazing women who wanted this type of ongoing relationship as well.  We wanted to include our egg donor in this “embryo” conversation because of our relationship.  When we emailed about the idea of embryo donation, she thought it was wonderful.  The thought of “discarding” our remaining embryos just didn’t feel right for any of us.

We agreed that we would try to find either a couple or individual who had been trying to have a child but could not.  Luckily, through our network of friends, we found the perfect person who was looking for a sibling for her son.  The thought of helping someone else have, or grow, their family makes me understand how surrogate mothers must feel.  I am in no way comparing our donation to the journey that is surrogacy, but I do feel that spark of love and hope that a child can bring.  Embryo donation doesn’t have to be a mystery.  It can offer peace of mind to families who find themselves asking what to do with extra embryos.  And you might be surprised whose dream of a family you can help come true.

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One Truth About Adult Guardianship – ‘I’m Petitioning … for the Return of My Life’

When Phyllis Funke hit bottom, the court appointed a guardian to prop her up. The remedy is like prison, she said. But “at least in prison you have rights.”

The last weeks that Phyllis Funke could legally make decisions for herself, she climbed into bed, planning to stay there for a while. It was the end of 2016 and she felt disillusioned with the election and wounded by her brother’s recent move to Texas.

She wasn’t considering suicide, she said. She just needed to go under the covers until she could figure out how to deal with the rest of her life, so totally alone.

adult guardianship

She had credit cards, a car, friends and financial advisers in Maine and New York.

When a caseworker from Adult Protective Services and a city psychiatrist entered her apartment on March 3, 2017, clipping the security chain because she did not answer the door, she was unraveling emotionally and physically, at risk of becoming homeless or worse. She had no idea what price she would pay for the intervention.

“I’ve been bullied, blackmailed and stripped of the things I need to live, including my money,” she said on a recent afternoon. “Everything has been taken away from me. I have no access to my bank accounts. I don’t have the money to pay for the medications that I’m prescribed. I don’t get mail. I can’t choose my own doctors.

In a City like New York, where people are used to looking past their neighbors, how often do you see someone and ask yourself, Is that person O.K.? Should I call someone? Maybe they’re older and not moving well. They look adrift in the produce aisle, or you pass their open apartment door and you can’t see the floor for the clutter. You’re a paramedic and they’re refusing to go to the hospital after a bloody fall. It’s your mother or your uncle, and you’re worried about the bills piling up, or the email scams or the sudden loan to a stranger.

You bandage the wound or you promise to check in tomorrow, or you turn away and get on with your life.

Or you call Adult Protective Services. After all, that person needs some sort of protection, doesn’t she?

New York Times, December 7, 2018 by John Leland

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Chinese Scientist Claims to Use Crispr to Make First Genetically Edited Babies

The researcher, He Jiankui, offered no evidence or data to back up his assertions. If true, some fear Crispr could open the door to “designer babies.”

Ever since scientists created the powerful gene editing technique Crispr, they have braced apprehensively for the day when it would be used to create a genetically altered human being. Many nations banned such work, fearing it could be misused to alter everything from eye color to I.Q.Crispr

Now, the moment they feared may have come. On Monday, a scientist in China announced that he had created the world’s first genetically edited babies, twin girls who were born this month.

The researcher, He Jiankui, said that he had altered a gene in the embryos, before having them implanted in the mother’s womb, with the goal of making the babies resistant to infection with H.I.V. He has not published the research in any journal and did not share any evidence or data that definitively proved he had done it.

But his previous work is known to many experts in the field, who said — many with alarm — that it was entirely possible he had.

“It’s scary,” said Dr. Alexander Marson, a gene editing expert at the University of California in San Francisco.

While the United States and many other countries have made it illegal to deliberately alter the genes of human embryos, it is not against the law to do so in China, but the practice is opposed by many researchers there. A group of 122 Chinese scientists issued a statement calling Dr. He’s actions “crazy” and his claims “a huge blow to the global reputation and development of Chinese science.”

If human embryos can be routinely edited, many scientists, ethicists and policymakers fear a slippery slope to a future in which babies are genetically engineered for traits — like athletic or intellectual prowess — that have nothing to do with preventing devastating medical conditions.

While those possibilities might seem far in the future, a different concern is urgent and immediate: safety. The methods used for gene editing can inadvertently alter other genes in unpredictable ways. Dr. He said that did not happen in this case, but it is a worry that looms over the field.

Dr. He made his announcement on the eve of the Second International Summit on Human Genome Editing in Hong Kong, saying that he had recruited several couples in which the man had H.I.V. and then used in vitro fertilization to create human embryos that were resistant to the virus that causes AIDS. He said he did it by directing Crispr-Cas9 to deliberately disable a gene, known as CCR₅, that is used to make a protein H.I.V. needs to enter cells.

By Gina Kolata, Sui-Lee Wee and Pam Belluck, NYTimes.com – November 26, 2018

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In Scottish schools, students will be required to learn about LGBTI history

Just 18 years ago, it was still illegal in Scotland to “intentionally promote homosexuality” in schools.

Now, the Scottish government will mandate all state schools introduce a curriculum that explains the history of lesbian, gay, bisexual, transgender and intersex (LGBTI) activism. Schools will also educate students on the use of LGBTI terminology and discuss ways to address homophobia.Scottish

“Our education system must support everyone to reach their full potential,” Scottish Deputy First Minister John Swinney said Thursday. “The recommendations I have accepted will not only improve the learning experience of our LGBTI young people, they will also support all learners to celebrate their differences, promote understanding and encourage inclusion.”

The move came after a campaign called Time for Inclusive Education presented a series of suggestions to the Scottish government. According to a 2016 research report on the Scottish LGBTI community published by the group, “90% of LGBT people have experienced homophobia, biphobia or transphobia at school.” The same research found that 27 percent of LGBTI people had attempted suicide — some more than once.

Scottish ministers adopted all of the recommendations from the campaign’s working group. The Guardian reported there will not be options to opt out of the curriculum, which will be interspersed throughout various subjects.

Swinney said this makes Scotland “the first country in the world to have LGBTI-inclusive education embedded within the curriculum.”

In recent years, Scotland has reckoned with its legacy of discrimination against the LGBTI community.

In a unanimous vote in June, Scottish lawmakers chose to pardon men who were previously charged with participating in homosexual acts. The BBC reported at the time that sexual relations between two men was decriminalized in Scotland in 1981. Some of the acts that were previously considered illegal and for which gay men are now being pardoned included consensual sex in private, or even acts such as kissing in public. In some cases, men perceived as flirting with another man could also have been charged.

Thousands of men were to be pardoned after the law was passed in June. But when it comes to the LGBTI community, there are still divisions within Scottish society, especially among religious leaders.

Washington Post, by Siobhan O’Grady – Nomvemb er 9, 2018

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Trump Administration Eyes Defining Transgender Out of Existence

The Trump administration is considering narrowly defining gender as a biological, immutable condition determined by genitalia at birth, the most drastic move yet in a governmentwide effort to roll back recognition and protections of transgender people under federal civil rights law.

A series of decisions by the Obama administration loosened the legal concept of gender in federal programs, including in education and health care, recognizing gender largely as an individual’s choice and not determined by the sex assigned at birth. The policy prompted fights over bathrooms, dormitories, single-sex programs and other arenas where gender was once seen as a simple concept. Conservatives, especially evangelical Christians, were incensed.trans trump

Now the Department of Health and Human Services is spearheading an effort to establish a legal definition of sex under Title IX, the federal civil rights law that bans gender discrimination in education programs that receive government financial assistance, according to a memo obtained by The New York Times.

The department argued in its memo that key government agencies needed to adopt an explicit and uniform definition of gender as determined “on a biological basis that is clear, grounded in science, objective and administrable.” The agency’s proposed definition would define sex as either male or female, unchangeable, and determined by the genitals that a person is born with, according to a draft reviewed by The Times. Any dispute about one’s sex would have to be clarified using genetic testing.

“Sex means a person’s status as male or female based on immutable biological traits identifiable by or before birth,” the department proposed in the memo, which was drafted and has been circulating since last spring. “The sex listed on a person’s birth certificate, as originally issued, shall constitute definitive proof of a person’s sex unless rebutted by reliable genetic evidence.”

The new definition would essentially eradicate federal recognition of the estimated 1.4 million Americans who have opted to recognize themselves — surgically or otherwise — as a gender other than the one they were born into.

“This takes a position that what the medical community understands about their patients — what people understand about themselves — is irrelevant because the government disagrees,” said Catherine E. Lhamon, who led the Education Department’s Office for Civil Rights in the Obama administration and helped write transgender guidance that is being undone.

The move would be the most significant of a series of maneuvers, large and small, to exclude the population from civil rights protections and roll back the Obama administration’s more fluid recognition of gender identity. The Trump administration has sought to bar transgender people from serving in the military and has legally challenged civil rights protections for the group embedded in the nation’s health care law.

Several agencies have withdrawn Obama-era policies that recognized gender identity in schools, prisons and homeless shelters. The administration even tried to remove questions about gender identity from a 2020 census survey and a national survey of elderly citizens.

By Erica L. Green, Katie Benner and Robert Pear, New York Times, October 21, 2018

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Stigma Against Gay People Can Be Deadly

L.G.B.T. people experience a range of social, economic and medical disparities that jeopardize their long-term health.

I’ve never been sure what to expect when meeting someone who’s just tried to take his own life. But I’ve learned to stop expecting anything.

Sometimes, the person in front of me barely speaks, staring right through me, lost in a deep catatonic depression. Sometimes he or she can’t stop talking, breathlessly describing what happened as if we’re gossiping at brunch after an hour of SoulCycle.LGBTQ

Yesterday, my patient, a 20-something graduate student, swallowed a jumble of unmarked pills, hoping to die, after his father told him never to come home again. Today, he greeted me with a soft smile, his delirium starting to clear, his heart beating normally again.

“Whoops,” he said.

He’d been a happy kid who aimed to please. He once felt so bad for lying about having done his homework before playing video games, he told me, that he’d grounded himself. Sociable but square, he didn’t drink until he was 21, even though he’d gone to a college with a reputation for partying. Deeply religious, he was gay but desperately wanted not to be.

Now his father’s disavowal pushed him over the edge, capping a string of stigmatizing experiences at home, at school and at church. He’d had enough.

For decades, we’ve known that lesbian, gay, bisexual and transgender individuals experience a range of social, economic and health disparities — often the result of a culture and of laws and policies that treat them as lesser human beings. They’re more likely to struggle with poverty and social isolation. They have a higher risk of mental health problems, substance use and smoking. Sexual minorities live, on average, shorter lives than heterosexuals, and L.G.B.T. youth are three times as likely to contemplate suicide, and nearly five times as likely to attempt suicide.

Some of these disparities have interpersonal roots: social exclusion, harassment, internalized homophobia. But often they stem from an explicit denial of rights: same-sex marriage bans, employment discrimination, denial of federal benefits. Discrimination in any form can have serious health consequences: Sexual minorities living in communities with high levels of prejudice die more than a decade earlier than those in less prejudiced communities.

But civil rights advances and growing public acceptance of L.G.B.T. individuals in recent years are among the more transformative social changes in modern American history. And evidence increasingly suggests this shift has measurably improved health care access and health outcomes for L.G.B.T. populations.

The halting, patchwork nature of L.G.B.T. rights expansions across the country has allowed researchers to study the effects on health and well-being by comparing states that expanded rights to those that failed to introduce protections, or actively curtailed them. Since Vermont became the first state to formally recognize same-sex partnerships in 2000, many other states either legalized same-sex marriage, or conversely, passed constitutional amendments banning it — until the landmark 2015 Supreme Court decision in Obergefell v. Hodges required all 50 states to recognize same-sex marriage.

By Dhruv Khullar, M.D., NYTimes.com, October 9, 2018

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44 siblings and counting

A lack of regulation has created enormous genetic families.  Now they are searching for one other.

Kianni Arroyo clasps 8-year-old Sophia’s hands tightly as they spin around, giggling like mad. It’s late afternoon, and there are hot dogs on the grill, bubble wands on the lawn, balls flying through the air.lesbian moms

The midsummer reunion in a suburb west of the city looks like any other, but these family ties can’t be described with standard labels. Instead, Arroyo, a 21-year-old waitress from Orlando, is here to meet “DNA-in-laws,” various “sister-moms” and especially people like Sophia, a cherished ­“donor-sibling.”

Sophia and Arroyo were both conceived with sperm from Donor #2757, a bestseller. Over the years, Donor #2757 sired at least 29 girls and 16 boys, now ages 1 to 21, living in eight states and four countries. Arroyo is on a quest to meet them all, chronicling her journey on Instagram. She has to use an Excel spreadsheet to keep them all straight.

“We have a connection. It’s hard to explain, but it’s there,” said Arroyo, an only child who is both comforted and weirded-out by her ever-expanding family tree.

Thanks to mail-away DNA tests and a proliferation of online registries, people conceived with donated sperm and eggs are increasingly connecting with their genetic relatives, forming a growing community with complex relationships and unique concerns about the U.S. fertility industry. Like Arroyo, many have discovered dozens of donor siblings, with one group approaching 200 members — enormous genetic families without precedent in modern society.

Because most donations are anonymous, the resulting children often find it almost impossible to obtain crucial information. Medical journals have documented cases in which clusters of offspring have found each other while seeking treatment for the same rare genetic disease. The news is full of nightmarish headlines about sperm donors who falsified their educational backgrounds, hid illnesses or turned out to be someone other than expected — such as a fertility clinic doctor.

And while Britain, Norway, China and other countries have passed laws limiting the number of children conceived per donor, the United States relies solely on voluntary guidelines. That has raised fears that the offspring of prolific donors could meet and fall in love without knowing they were closely related, putting their children at risk of genetic disorders.

By Washington Post, September 12, 2018

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More People Now Support Allowing Businesses To Refuse LGBTQ Customers: Survey

Americans are conflicted over whether Christians like Colorado baker Jack Phillips should have the right to refuse service to queer customers.

In handing a narrow victory to a Christian baker who refused to make cakes for a gay wedding, the U.S. Supreme Court decided to punt a bigger question down the road: whether Americans can use religion to justify discrimination against LGBTQ people.

A new survey from the Public Religion Research Institute suggests that for many Americans, the jury is also still out on this issue.

PRRI completed the survey shortly after the Supreme Court’s June decision on Masterpiece Cakeshop v. Colorado Civil Rights Commission. It found that Americans were conflicted over whether Christians with conservative religious beliefs, like Colorado baker Jack Phillips, should have the right to refuse service to queer customers.

The survey of 2,008 adults between June 27 and July 8, 2018, showed evidence of an America still divided over how to treat LGBTQ citizens.

Nearly half of Americans surveyed (46 percent) said that owners of wedding-based businesses, such as caterers, florists and bakers, should be allowed to refuse to serve same-sex couples if doing so violates their religious beliefs. Roughly the same number (48 percent) disagreed, saying that these types of businesses should be required to serve queer couples.   

That’s a slight shift from how Americans felt about the issue last year, PRRI reports. In 2017, only 41 percent of Americans said wedding-based businesses should be allowed to refuse service to LGBTQ people, while a majority of Americans (53 percent) said these businesses should be required to serve gay and lesbian couples.

The Masterpiece Cake Shop Decision – A Narrowly Decided Cautionary Tale

The Masterpiece Cake Shop Decision demonstrated the Supreme Court of the United States threading the religious needle.   

In Masterpiece Cake Shop, while making it a point to explain that no determinations were actually being made on whether people with religious convictions can openly discriminate against gay people, or, more alarmingly, whether gay people deserve protections against such discrimination at all, the Supreme Court went out of their way to emphasize the importance of respect for religion.

 

gay rightsDon’t get me wrong, I have great respect for most religious belief.  My family holds hands and says what we are thankful for before every meal. We acknowledge the need for divine intervention with friends and family who are dealing with health issues.  We have ingrained just such a respect in our son to be tolerant of others, even those who would mock and deride our family just because it has two dads.

 

However, most Americans do not take the time to parse Supreme Court decisions to get to what the Justices are actually saying and, with the Masterpiece Cake Shop Decision, the message most people will hear is that religious beliefs now trump the dignity and equality of the LGBTQ community.

 

I feel the need to explain what I interpreted as the main message of The Masterpiece Cake Shop decision. In the majority decision, Justice Kennedy, the author of almost every positive gay rights decision out of the high court, gave short shrift to a complete analysis of the freedom of speech and free exercise of religion claims which strike to the heart of this decision. He did, however, along with the majority of the court, focus on the treatment that the baker received from the Colorado Civil Rights Commission.

 

masterpiece cake shop decisionJustice Kennedy held that, “When the Colorado Civil Rights Commission considered the case, it did not do so with the religious neutrality that the Constitution requires.  In other words, because of the Commission’s original treatment of the baker’s claim, no matter whether the result of their analysis was correct, the process was tainted from the start and therefore the holdings of all subsequent courts agreeing that the baker violated the rights of the petitioning gay couple, who, as Justice Ginsburg stated in her dissent,  “simply requested a wedding cake: They mentioned no message or anything else distinguishing the cake they wanted to buy from any other wedding cake Phillips (the Respondent) would have sold.”  But because the process was tainted with anti-religious bias, the underlying discrimination was no longer relevant.  

 

Because the Colorado Civil Rights Commission “showed hostility” toward the baker and his beliefs, that in and of itself, “cast doubt on the fairness and impartiality of the Commission’s adjudication of the … claim.”  Even if the Commission was right in their determination that impermissible discrimination existed, they weren’t adequately respectful to religion.  Thus the message that religion is more important than discrimination may be misinterpreted.

 

I have been searching for a meaning behind this seemingly incorrect finding.  Many of the greatest LGBT legal minds have attempted to make the distinctions in this decision that would stave off its potential future anti-gay wake of behavior and court reaction to that behavior.  This quote is a bit long but captures the proverbial threaded needle. Mary Bonauto, the civil rights director of GLAD and who argued the Obergefell marriage case before the Supreme Court in 2015 said:

“… this limited ruling provides no basis for this Bakeshop or other entities covered by anti-discrimination laws to refuse goods and services in the name of free speech or religion.

The Court was mindful of how far adrift we could go if every individual could apply his or her religious beliefs to every commercial transaction.  The Court contrasted permission for a clergy person to refuse to marry a couple as an exercise of religious belief, on the one hand, with the unacceptable “community-wide stigma” that would befall gay people if there was a general constitutional right to refuse to provide goods and services.”

I fear that this distinction will not be made by those who are less invested in understanding how these cases actually affect the lives of LGBTQ individuals, couples and families. My concern is for the families out there who now are questioning the legal certainty of their families, or whether their families will receive equal treatment in courts of less gay friendly jurisdictions.  We are, after all, a portable nation and our families are everywhere. 

 

While this decision does not actually give license to shop owners to deny gay people services, it is important to note that employment discrimination based on sexual orientation is still legal in 28 states.

 

At the risk of sounding like a lawyer, full disclosure – I am a lawyer, this case should serve as a wake up call that nothing can be taken for granted.  If you have put off doing your estate planning, do it now.  If you are a religious person, please pray that Justices Kennedy, Breyer and Ginsburg live long and healthy lives because these decisions can turn on a dime once right wing conservatives attain an indisputable majority on the court.  If you have questioned about whether you should get a second or step parent adoption, do it now. If you have legal questions about your immigration status, or that of your partner or spouse, find out about it now.

 

While my sincere hope is that more cases like this, with better fact patterns, will ultimately force the court to answer the questions that we all thought would be addressed in the Masterpiece cake Shop decision, namely whether religious “free speech” trumps anti-discrimination protection for LGBTQ people, until that time, we cannot sit idly by while others find solace and fortitude in their own anti-gay beliefs, whether religiously held or not.  

 

Anthony M. Brown, Time For Families – June 5, 2018

Doctor refuses to treat 6-day-old baby because her parents are lesbians

When Jami and Krista Contreras became parents, their beautiful child was everything to them. But when they took the baby to a local pediatrician, the doctor made sure they knew the lesbian couple was nothing to her.

Even worse? The couple lives in Michigan where it’s perfectly legal to discriminate against LGBTQ people.

The couple met with Dr. Vesna Roi before the birth of their daughter, Bay Windsor. But it wasn’t until the girl was 6 days old and they were waiting at the practice for her first checkup that they learned of the pediatrician’s decision.

“‘Is our doctor coming in?’,” Krista told ABC-7 the couple asked when a different doctor entered the waiting room. “She said ‘No. I’m going to be your doctor; your doctor prayed on it and decided she won’t see you all today’.”

“I was completely dumbfounded,” Krista Contreras told the Detroit Free Press. “We just looked at each other and said, ‘Did we hear that correctly?’”

“We spoke to other people and they would say well they can’t do that… that’s not legal and we looked into it and it was legal,” Jami told the station.

The couple said Roi later wrote them a handwritten letter saying that “after much prayer,” she felt she could not “develop the personal patient-doctor relationships” that she usually builds with patients.

While the incident happened in 2015, the Contreras are telling their story to highlight the need for federal nondiscrimination protections for the LGBTQ community as part of a new national campaign called Beyond I Do.

The campaign highlights states that continue to allow discrimination in employment, housing, credit, public accommodations, and social services.

LGBTQNation.com, by Bill Browning – April 25, 2018

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