Huffington Post, March 18, 2013 – Dov Fox and I. Glen Cohen
This week the United Kingdom joined the ranks of countries like Israel and Canada that provide in vitro fertilization (IVF) treatment to citizens under a certain age (42 in the U.K.) who can’t have children without it. That includes gays and lesbians. When it comes to helping people form the families they long for, the United States is woefully behind. The U.S. has among the lowest rates of IVF usage of any developed country in the world, owing in part to boasting the highest cost for the procedure, on average $100,000 per successful pregnancy.
Among the handful of states that require insurers to cover IVF, many carve out exclusions for same-sex couples and people who aren’t married. These singles, gays, and lesbians are sometimes called “dysfertile” as opposed to “infertile” to emphasize their social (rather than just biological) obstacles to reproduction. The U.S. should expand IVF coverage for the infertile and include the dysfertile too.
The U.S. Supreme Court has held that the inability to reproduce qualifies as a health-impairing disability under the Americans with Disabilities Act. The commitment to universal health care that we renewed in President Obama’s health reform act invites us to understand the infertile and dysfertile alike as needing medicine to restore a capacity–for “[r]eproduction and the sexual dynamics surrounding it”–that is, in the words of the Supreme Court, “central to the life process itself.”
It is true that dysfertility fits less comfortably within the medical model. But why should that alone make less worthy the desires of gays and lesbians to have a genetic child? Joe Saul, the protagonist in John Steinbeck’s 1950 play Burning Bright, put it best:
A man can’t scrap his bloodline, can’t snip the thread of his immortality. There’s more than . . . the remembered stories of glory and the forgotten shame of failure. There is a trust imposed to hand my line over to another.
My impulse to create a biological family, to raise “my own” children, to “hand my line over to another” is shared by people single or married, black or white, gay or straight. And the arguments against IVF subsidies fall short.
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