Issues of gender in gamete donation

Sot. Sci. Med. Vol. 36, No. 1, PP. 85-93, 1993 Printed in Great Britain. All rights reserved Copyright 0 ISSUES OF GENDER IN GAM ETE 0277-9536/93 S5.00+ 0.00 1993Pergamon Press Ltd zyxwvutsrq DONATION ERICA HAIMFS Department of Social Policy, The University of Newcastle, Newcastle upon Tyne NE1 7RU, U.K. Abstract-Gamete donation refers to the practice whereby either semen or eggs are donated by a third party to enable infertile individuals or couples to become parents. This paper examines the way in which gender is deployed as a resource for organizing the meanings attached to that practice. The gender aspects of gamete donation are not always immediately apparent since semen and egg donation are often described as being essentially the same. However, a closer examination indicates that behind the claim of equivalence lies a set of unstated assumptions about their difference. These assumptions are tied to ideas about the ways in which men and women are thought to behave more generally in relation to reproduction and the family. This paper draws on two sources of empirical data to reveal how these assumptions are used: first, data from a detailed analysis of the Wamock Report (established by the British Government in 1982 to inquire into and make recommendations on techniques of human fertilization and embryology), which includes a cross-national and historical comparison with other government reports; second, data from a series of in-depth interviews with members of the Warnock Committee. The analysis of the reports suggests that historically semen donation was associated with ‘deviant’ sexuality (masturbation, adultery, illegitimacy) though paradoxically the extant nature of Semen donation was then used to justify the acceptance of egg donation in later reports. This is despite the fact that in these later reports there are clear, albeit implicit, distinctions drawn between the two procedures in terms of donor motivation, the risks of being a donor, and the consequences of donation. These differences were more marked in the interview data. Committee members regarded egg donors as being very altruistic, whereas they frequently raised doubts about the motivations of semen donors. It is suggested in the discussion section of the paper that assumptions about gender and reproduction lead to egg donation being seen in a familial, clinical and asexual context whereas semen donation is seen in an individualistic, unregulated context of dubious sexual connotations. Therefore whilst assisted reproduction provides the chance to challenge gender assumptions, what we find instead is that the everyday reasoning practices of those involved in these policy discussions leads to a reinforcing of such views. Key words-semen donation, egg donation, gender INTRODUCTION Clearly these descriptions of the techniques and uses of gamete donation are not themselves unproblematic nor neutral; they raise many questions which can be subjected to further investigation. I wish to Gamete donation involves the donation of either eggs or semen by a third party to help another individual examine just one aspect in this paper: the way in or couple to have children. Semen donation (otherwhich gender is deployed as a resource for organizing wise known as artificial insemination by donorthe meanings attached to the processes of gamete AID; or donor insemination-DI) has been used donation, even at the same time as the apparent since 1884 [l] though it gained in popularity in both significance of gender can be denied. The starting the United States and Britain in the 1940s. The technique involves the depositing of a quantity of point in this examination is with the not uncommon claim that egg donation is “the female equivalent of donated semen in a woman’s vagina, by means of a zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIH sperm donation” [2] or the “exact counterpart of syringe rather than sexual intercourse. It is used when AID” [3]. In so far as both procedures entail the a male partner is either sterile or has a low sperm giving of genetic material to others so that those count or risks passing on a hereditary disease to any genetically related children. It can also be used by others might have children (itself a deceptively simple description of an enormously complex set of social women wanting a child but wishing to avoid sexual interactions) [4] this might superficially be true. Howintercourse with men. Egg donation was first used successfully in 1984 in ever, a closer, empirically-based examination of the ways in which semen and egg donation are characterAustralia, after the development of in vitro fertilizaized shows that they are in fact regarded very differtion in Britain in the 1970s. The technique involves ently, even by those who on one level assert their the co-ordination of the menstrual cycles of the donor similarity. and the recipient, the hyperovulation of the donor In this paper I shall argue that these differences and then the collection of the eggs using either arise not just from the different physiological tasks surgery, laparoscopy or ultrasound. It is used attributed to sperm and eggs in the fertilization when a woman cannot produce her own eggs for process, nor even from the different processes of fertilization. 85 ERICAHAMIS 86 zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA We were agreed that there is a need to maintain the absolute donation (low-tech, non-invasive, low risk in the case anonymity of the donor Anonymity would give legal of semen donation; high tech, highly invasive, high protection to the donor but it would also have the effect of risk in the case of egg donation), but from assumpminimizing the invasion of the third party into the family tions about the ways in which men and women are [5, P. 251. thought to behave more generally in terms of reproIt was acknowledged that private arrangements might ductive activities. These assumptions then reflect occur (between brothers for example) but this was back onto and become incorporated into, the characseen as falling “outside any general regulation” [6]. In terization of the physiological functions and methods contrast to this the Committee’s position on of donation. The empirical material upon which this analysis is anonymity in egg donation was as follows: based derives from a study [4] I conducted on the Despite our desire to maintain the anonymity of the donor we recognize that because of the present practicalities of egg work of the Warnock Committee [5], established by donation, particularly the fact that eggs cannot be successthe British Government in 1982 to inquire into and fully stored, it may not always at present be possible to make recommendations on, techniques of human achieve this. An exception to the principle of anonymity fertilization and embryology. These recommenwould occur where the egg was donated by a sister or close dations were the basis of the British Human Fertilizafriend. In such cases particularly careful counselling for all tion and Embryology Act, 1990. In this study I concerned would be necessary, and thought would have to be given as to how and at what stage the child should be told examined both the contents of the Committee’s final about its parentage [5, p. 371. report, comparing it cross-nationally and historically with other reports on this subject, and also, through Two points need to be made here. First, it is signifia series of depth interviews, members’ views on their cant that though in egg donation the potential lack participation in the Committee and the range of of anonymity is not exactly welcomed, it is not techniques under investigation. The interviews in considered to be sufficient reason for banning the particular provide detailed evidence of how gender is practice altogether. This might be thought surprising deployed as part of everyday commensense reasoning given the importance attached by the Committee to to construct ideas about semen and egg donation. zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJ the principle of anonymity as a whole. Second, there is a significant difference in the manner and tone in which this issue is discussed in relation to each SEMEN AND EGG DONATION IN THE WARNOCR REPORT practice: in particular, the association between lack of anonymity and invasiveness which is made in the case My initial reason for being interested in the work of semen donation is absent in the case of egg of the Warnock Committee grew from earlier redonation. Instead of “invasion” of a third party, search on the management of information concerning there is a “sister or close friend” who would be given the genetic origins of children conceived through “careful counselling”. It is also interesting to note gamete donation. The position of the Warnock Comthat though the Committee mentioned the difficulty mittee in this debate is interesting since they went of recruiting semen donors [5, p. 271 the possible against established practice by insisting that such solution of using siblings was not proposed. The children should be told about the circumstances of circumstances surrounding egg donation seem to be their conception, but at the same time confirmed in less need of the protection thought to be afforded elements of that earlier practice by also insisting on by anonymity. anonymity between all parties. Each of these accounts is creating a world in which This anonymity was one of three principles identthe reader is instructed to deploy different criteria for ified by the Committee as central to all the procedures perceiving, and then judging, the different practices. of assisted reproduction. It is important therefore to try to tease out what those A number of the techniques we consider involves a third hitherto unstated criteria might be. It is even more party outside the infertile couple . In all cases, the important to do this when we realise that, despite the question is whether it is better that a third party who helps a couple to overcome their infertility should be known to the (uncommented on) differences in attitude towards couple or that the third party should remain anonymous . . anonymity, the Report states, our general view is that anonymity protects all parties not only from legal complications but also from emotional difficulties. We recommend that as a matter of good practice any third party donating gametes for infertility treatment should be unknown to the couple before, during and after the treatment, and equally the third party should not know the identity of the couple being helped [5, p. 151. However, if the Report is read more closely the principle of anonymity works rather differently in the case of egg donation to that of semen donation. In the discussion in the Report on the principles of good practice for the future use of donor insemination, it was said, In weighing up the arguments for and against egg donation we have concluded that since we have accepted AID and IVF it would be illogical not to accept egg donation, notwithstanding the relatively minor surgical risks to the donor inherent in egg recovery . . It is both logical and consistent that the law should treat egg donation in the same way as AID and that the same principles of practice . . should apply to both [5, p. 361. Thus despite the fact that there are acknowledged differences in procedure and unacknowledged differences in overall perception of the two practices, the Committee thinks of them as being essentially the Issues of gender in gamete donation same and also regards itself as having treated them in essentially the same way [7& Clearly the Committee members were using unstated and perhaps unconscious assumptions about the social context of each procedure which led them to distinguish between the two on the basis of one of their central principles, without being fully aware of the extent to which they were actually doing this. The question then becomes how to render explicit those unstated assumptions so as to make visible the reasoning processes whereby the above account in the Report can be read as consistent. It was for this purpose that I then interviewed the Committee members to try to discover their repertoire of concerns when considering these matters. I shall present some of the material from those interviews in the next section. However, before turning to the interview data, it is worth pointing out that the Wamock Report was not alone in containing this apparent inconsistency, nor in conveying a sense of danger in relation to semen donation/donors which is not then attached to egg donation/donors. This can be seen by reference to other reports, which were attempting a similar task of reviewing, and making recommendations for the regulation of, forms of assisted reproduction. In two of the reports which the Warnock Reports itself cites as its predecessors, the attitude towards semen donation was very negative. This was tied to the perceived circumstances of donation, the consequences of using donated semen and possible motivations of the donors and recipients. The Archbishop of Canterbury’s Commission [8] recommended that semen donation should be criminalized since it involved masturbation by the donor and resulted in an illegitimate child. They agreed that this led to an inevitable secrecy surrounding the use of donor insemination which was itself a further indication of the unacceptability of the practice and its constituent procedures. Such was their concern about masturbation that they discussed a suggestion from elsewhere that to avoid this, semen might be collected from the donor’s wife’s vagina instead. This procedure was further recommended on the grounds that the donor’s wife might then feel that she too was contributing to the donation [8, p. 151. The Commission also expressed doubts about the motivation of both the Semen donor and the female recipient. They wondered, for example, whether semen donors sheltered behind ‘altruistic idealism’ to disguise what was in fact ‘spiritual pride’ in their ability to propagate large numbers of their own children, thus asserting their greater virility [8, p. 271. They also questioned the willingness of the wife of an infertile man to become a mother through, “the seed of a man not her husband”, which they said, “meant the desire for motherhood must be judged to be pathological” [8, p. 251. This is particularly significant since there were debates at the time as to whether use of donor insemination amounted to adultery. 87 The Feversham Committee [9] was similarly negative, expressing similar concerns about masturbation and about the qualities and motivations of the semen donors. Donors, they argued, might be considered irresponsible given their apparent willingness to father children with whom they would have no further contact. The Report said of semen donation in general, it is an activity which might be expectedto attract more than the usual proportion of psychopaths [9, p. 581. Concern was expressed in both reports about the feelings of the infertile husband concerning the use of donated semen and his own infertility. Fletcher [lo], writing in the same period, reported that doctors ‘often’ allowed the infertile husband to operate the actual syringe containing the donated semen so that he could say, “I impregnated my wife” [lo, p. 1251. Though these are but snapshots from two very detailed reports, it is already becoming clear that these discussions about the use of semen donation were implicity gendered. From the above comments it is apparent that male concerns in reproduction were presumed to revolve around ideas of virility, genetic continuity and generally being assertive and in control. Female concerns were presumed to revolve around the need to become a mother which led to a form of pathological assertiveness when otherwise the woman’s role was characterized by passivity. It is important to note, however, that these characteristics were not just a feature of a practice disliked by the two committees and thus deliberately portrayed in a negative light, but were also part of what were seen to be possible solutions to some of the problems identified. For example, the donor’s wife is presumed to be passive in the solution to masturbation and the male is presumed to need to be in control in Fletcher’s solution to the infertile husband’s feelings of inadequacy (itself dependent again on the passivity of the woman being “impregnated”). Finally, the whole context of semen donation is, in these two reports, associated with ideas of inappropriate sexuality: adultery, masturbation and illegitimacy. I shall return to these observations in the final section of the paper. An international review [4] of more recent reports reveals that attitudes now appear to be more positive towards semen donation and donors. The scope of such reports is much wider too since, like the Wamock Committee, most groups were asked to consider the full range of assisted reproduction including egg donation. Prominent amongst these reports are those from the American Fertility Society [1l] and a European Community commissioned report known as the Glover Report [12]. These both take a similar approach to that of the Warnock Report in so far as both deem semen and egg donation to be acceptable [13]. However, with varying degrees of explicitness, the criteria of acceptability differ between the two forms of donation. ERICAHAIMES 88 zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA Once again the question of information about the donor provides a forum for comparison. For example, the American Fertility Society judged each third party conception in the light of its impact on the child’s genetic lineage. It argued that identifying information about the semen donor should only be provided in ‘extreme situations’ but that in the case of egg donation, though anonymity might be desirable the lack of it should not prevent the practice. A lack of hard evidence about the benefits of identifying semen donors was cited as grounds for retaining anonymity in donor insemination, but a lack of hard evidence about the dangers of using known donors in egg donation was cited as grounds for not objecting to that practice. The distinction here was not commented upon. The Glover Report makes an interesting observation on these issues, potential victim of either physical risks or emotional risks resulting from pressure to donate. The possibility that egg donors may have questionable motives or that semen donors be exploitable is not counten- Policies on anonymity represent a social choice about the meaning of donation [12, p. 361. Sweden [14, p. 651. though what is perhaps most interesting is that this is a point raised about semen donation only: they do not reflect on its significance for their own report. Thus, despite their claim that, Egg donation raises the same issues of social attitudes as sperm donation [12,p. 381. they construct a different framework of discussion for each: a framework in which they perpetuate the emerging trend of discussing semen donation in terms of the wisdom of identifying donors, and in which they discuss egg donation in terms of the wisdom of using related donors. The Glover Report takes an unusual line by advocating an experiment to identify semen donors to the ‘child’ when 18. Their position on egg donors is that either unknown egg donors should be used or that there should be openness about the use of related egg donors. There was no mention of including unknown egg donors in the experiment of giving ‘children’ access to donors’ names. This difference in the policy on anonymity between semen and egg donors should be seen against the broader background of concerns expressed by the Glover Committee about each practice. Again the question of donor motivation is raised in relation to semen donation. For example, they acknowledge that semen donors may be altruistic but they also say, perhaps some men do donate semen for money. But there may be something more subtle about this. Men may have other reasons for being willing to donate, but the payment gives them a ‘reason’ which damps down further selfscrutiny about their motives [12, p. 341. It is not clear what is being referred to here but it does suggest that some motivations for being a semen donor are not easily examined even by the donors themselves, possibly for reason of guilt, shame or embarrassment. In contrast to this, the fears expressed about egg donation posit the donor as a anced One final report should be considered here, to show that even when it is argued in explicit terms that semen and egg donation should be treated differently the arguments for doing so do not lie wholly within the grounds of physiological or even collection procedure differences. The report from Sweden [14] on fertilization outside the body states, Egg donation does not occur in Sweden.. Egg donation is a complicated method of fertilization which goes completely against the natural process of life. We cannot disregard that the method can involve risks of physical and mental strain for the pregnant woman and the developing child egg donation is ethically indefensible. In the Committee’s view egg donation should be prohibited in This statement can be compared with two other related policies in Sweden: the first allows semen donation but provides access to identifying information about donors to the ‘children’ conceived [ 151; the second prohibits the use of semen donation coupled with zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQP in vitro fertilization [14]. When the statement on egg donation is compared to the first policy the reader is invited to view semen donation as a simpler but also more natural procedure, despite the fact that semen donation raises a series of highly complex issues which the policy on access to information acknowledges and despite the fact that natural processes too can be very complicated. The additional argument about the strains for the pregnant woman and developing child is untenable since the same might be said to apply to semen donation. Had this point been made about the egg donor and referred back to the procedures of donation it would carry more weight, but here it simply raises more questions. In a comparison between the policy on egg donation and the policy rejecting the combination of IVF and donor insemination we find that in the latter the case simply rests on setting limits on “how far to go regarding manipulations to remedy childlessness” [14] and makes no reference to other standards of practice, such as those set by ‘nature’. It would be foolish to press the interpretation too far of what is again essentially a snapshot but this last example does at least raise further questions about the grounds on which semen and egg donation are compared: in particular why is nature invoked as an important reference point for evaluating egg donation but not for semen donation? This review of the attitudes displayed in major reports towards semen and egg donation shows that there has been a change over time towards semen donation which appears to have led to its greater acceptability. This in turn has been used to establish the acceptability, in most countries, of egg donation. However, differences still emerge in attitude towards Issues of gender in gamete donation the two forms of donation even in reports which characterize them as being essentially the same. This has been shown to be the case with reference to the debate on the management of information about genetic origins, which has been structured along different lines for each type of donation. In semen donation, the debate is whether to identify donors and although there are moves towards establishing the case for identification, the overall preference so far is not to identify them. In egg donation the debate is tied to the use of known related donors and although this could be seen as essentially the same question as whether to identify semen donors, the phrasing and development of the argument provides a different picture which leads to a different conclusion: that the balance lies in favour of allowing known donors if the alternative is to lose the practice altogether [16]. What is even more significant is that there is little cross over between the two discussions: using relatives as donors is very rarely discussed in the field of donor insemination and explicit debates about access to donor identifying information is hardly ever discussed in the field of egg donation. We have also seen that the differences between the egg and Semen donation are raised in other areas too, particularly in the question of the motivation of donors and the risks that donors are thought to incur through their participation in these procedures. It is possible, therefore, to begin to identify different criteria in the evaluation of semen and egg donation and I have begun, very tentatively to suggest how these criteria are derived. However, the picture so far is very fragmented: that there are questions to be asked has been established but the nature of those questions requires further explication. The data from interviews I conducted with the members of the Wamock Committee provide the opportunity to investigate these questions further. By using the technique of in-depth, face-to-face interviews I explored the members’ views on semen and egg donation, in order to gain further insight into the apparent contradictions identified here. SEMEN AND EGG DONATION IN THE WARNOCK COMMITI-EE INTERVIEWS The interviews with committee members covered a number of topics relevant to the wider research I was conducting, but in this section I shall just present data on gamete donation: how members regarded each process individually and how they compared the two [17]. In discussing donor insemination with committee members, three positions seemed to emerge: those who saw little problem with it (perhaps 4 members); those who expressed fairly strong reservations (perhaps 9 members) and one person who was against it on religious grounds. This range of views had not been evident in the Report [ 181. 89 Of those who saw little problem with donor insemination most were aware of the objections contained in the evidence submitted to the Committee. One member said, There was probably more hostility I think to AID than to almost everything else, if you put it on the scales and weighed it [19]. Even so, Iris view was that he had not much hesitation in accepting it; though he had concerns about its delivery he had no concerns about “the thing in principle”. Another saw “no great moral problem”; a third said she had no concerns and found it difficult to explain the concerns expressed by others. It was a very reasonable way for infertile couples to be treated . . it seemed to work very well, produced very few problems afterwards. A second group was far less certain about donor insemination and, in common with some members of the first group, gave the strong impression that it was simply the fact that it had already existed for at least 40 years that its continuance could even be contemplated: We were very very much less sure that AID was a suitable treatment. In fact our attitude to that was ‘it exists, we can’t do away with it, we ought to regulate it and make it better than it is now, but . in an ideal world maybe we wouldn’t have it, but we’ve got it so we can’t do anything about it’. Another view was “it’s here to stay and you’ve got to get on with it”; yet another said “AID has been going on since time immemorial” and another, I think quite a few of us took a fairly robust view and said, ‘well it’s happened and let’s try and make it happen properly’, but not try and get that genie back in the bottle. Along with the length of its period of practice members also cited the fact that that period had itself seen fairly radical changes in opinion on donor insemination; to a certain extent they felt they were the ones who could finally bring it out into the open and achieve a better quality of service. Even if the force of history worked in favour of accepting donor insemination, some members still felt quite unsure about it: EH: Could you say a bit about . . . what you felt uncertain of? 06: I think that it’s the sort of ‘yuk’ feeling about it, which I think is probably historical as much as anything. I don’t know, I think it’s an instinctive dislike rather than being able to identify it. Other members were concerned about the degree of intrusion in a marital relationship and the problems for the husband. In other words, the members of the Committee shared the concerns put to them in the evidence, but nonetheless chose to accept it as a treatment. One member explained this in the following way: here we get into a very difficult area because I can’t say yes and no in abstract. My position on these things is that I can see theoretical objections to that process, AID, but not 90 zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA ERICAHAIMES theoretical objections which would counter effectively the arguments in favour. In other words, it’s an argument on balance. However, it is very noticeable that not one member put a positive case forward for semen donation during the interviews. Therefore the arguments stated in the Report in favour of its use could not be added to, nor could they even be restated in the interviews. Members were particularly disturbed by the selection and characteristics of donors in the United Kingdom and preferred the French system of encouraging older, married men, who were already fathers, to donate. That much is referred to in the Report, but lying behind their uncertainties about the U.K. system was the figure of the Leicestershire (sometimes known as the Nottinghamshire) postman: an individual who had been brought to their attention for selling his own frozen semen, direct from his refrigerator to local hospitals. Reference to the figure acted as a symbol of all their fears about donor selection, from lack of screening, possible suspect motivations, the inducement of cash and generally the ‘hole in the comer’ attitude to donor insemination. One member said there was a general question in people’s minds about why anyone would want to volunteer as a donor and that there were versions of good and bad motivations for donating. The desire to perpetuate one’s genes was a bad motivation, . . the thought was perhaps that if there was somebody who simply liked the idea of the world being full of these (children) whom he would never know, he would be a slightly cranky sort of person and secondly if there was someone who thought he could make a quick buck he was also not particularly reputable . . . the motivation that seemed most satisfactory is that people thought they were partly doing some good, partly doing what was asked of him and, you though why this was a bad thing was never clear know, not particularly keen, necessarily, to have all these children. Another member had slightly mixed views on the idea of donor motivation, saying that she did not agree with the view that says a man who offers to donate must be “pretty kinky” but followed this immediately with: Alright, they are odd in some way perhaps, but perhaps they’re not . . and anyway how serious a concern was this because, I can’t see that that sort of bit is going to be handed on to their children. Therefore, a high degree of anxiety about donor insemination was expressed but often without any specific focus. The Committee had to move beyond the difficulties of donor insemination to consider a new form of donation: that of eggs, which was made possible through the development of in vitro fertilization. In the interviews I asked members first for their views on the IVF procedure, then on egg donation. Few concerns were expressed about IVF and it was not something that anyone wanted to discuss at length. When I raised the question of egg donation I was interested in several aspects: their general views on it and then whether they drew any distinction between the donation of ova and that of semen (here I used the device of asking their opinion of the Swedish proposal to ban egg donation, as a means of encouraging members to be more expansive in their replies). A recurrent theme in the interviews was that egg donation was the same in principle to semen donation, but different in terms of collection. This was not necessarily a first response though: I think some people sort of gulped and said, ‘oh yes’ and then ‘what am I worried about? Am I worried about it?’ and then they decided they weren’t, that really it was no different. Another described egg donation as “just the sort of l%p side” of semen donation. However, there is a question of what the phrases “same in principle” and “the equivalent” said, actually mean since one member I regard it as the exact equivalent of sperm donation. The difference is that it’s more stressful for the woman to donate eggs than it is for the man to donate sperm. Not many members could actually follow through to explain exactly on which grounds semen and egg donation were the same and on which grounds they were different, nor did they explore the implications these differences had for the argument that ‘in principle’, they were the same. Two members who attempted this both opined that there might be a case for drawing psychobiological distinctions. One speculated that since semen is ‘exited’ from the body for donor insemination and ova extracted for egg donation, one view may be is that he is not therefore woman is to an egg. attached as a but he himself did not really regard this as a valid distinction, particularly as the egg is ‘exited’ every month anyway. Curiously that monthly occurrence confirmed for another speaker that there was “biological asymmetry” between semen and eggs, because women had to think about their eggs on this monthly cycle, whereas semen is treated “much more casually”. However, he argued that this did not constitute a strong enough distinction to regard the two as essentially different in terms of donation, though the subject merited much more discussion, in his view. On the whole though, members thought little about the distinction made by the Swedes in banning egg donation. Their responses included “if donation is to be allowed for a man it should be allowed for a woman”; “rather woolly thinking”; “it sounds as though the politicians are really off their clogs”; “another of those generalizations”; “a bit illogical. I think one gift is the same as another gift”. Yet many were worried about the problems of egg collection even though they did not regard these as Issues of gender in gamete donation sufficient to stop its practice. In the Report the problems associated with the actual collection of eggs tend to be mentioned simply as part of the explanation of the technique. For the individual members, however, they were more prominent. The issue of informed and free consent of the donor taxed some members. One argued that it should be taken very seriously particularly as he regarded the “medical business” as being “highly sexist” and likely to presume consent. In his view a woman should not be asked to donate eggs when lying on her back, about to have a hysterectomy. Another also said he was not at all happy about consent since some women were in a very weak position to say ‘no’ since the people asking for the eggs may be the same people providing the original treatment. He regarded this as different from semen donation since the donor there is not under the same obligation. However, the first member here felt fairly positive towards egg donation if that opportunistic element were removed. That positive attitude prevailed over members’ other concerns, such as the risks of superovulation, the risks of anaesthetics while eggs were being removed, and of the need for counselling to ensure informed consent was given. The overall view was, on the whole they assumed that the woman would he doing it because it was no trouble to her in the circumstances and that it would be thought to be good for somebody else. Another member, acknowledging the concerns about egg donation suggested nonetheless another view: There are a lot of women about who have a feeling of altruism as well. I mean they may need to be sugared by a bit of money as well, but, nevertheless they may feel altruistic and say, ‘I don’t mind giving an egg so that somebody else may have a child’. This view was confirmed by another member who suggested there was a “lot of donative feeling about” and that some women will “very joyfully” donate eggs. From these interviews it is apparent that there are differences in attitude to egg and semen donation, over and beyond the technicalities of donation. These differences are found in the way the donation is couched within other social practices and assumptions. For example, members made no mention of egg donors as possibly being odd unlike their view of semen donors; there was little mention in semen donation of sibling donation; there was less mention of exploitative practices in semen donation; there was more mention of the generosity of the donor in egg donation than in semen donation. Therefore, holding the view that egg and semen donation are ‘the same’ means that since semen donation is acceptable, egg donation must be as well. However, once the acceptability of egg donation has been established, it becomes clear, on closer questioning, that there are actually very different attitudes held about the two: egg donation is generally seen in a positive light and semen donation in a rather negative light. It is 91 perhaps worth speculating what the attitude towards semen donation might have been if egg donation had been developed first. DISCUSSION It is clear from both the reports and the interviews that despite claims about the essential similarity between semen and egg donation they are in fact sharply distinguished from each other. These distinctions work on several levels but are particularly prominent in two areas: the procedures of donation and the motives ascribed to donors. Semen donation is presented in the reports and in the interview data as a simple, well-established procedure which nonetheless raises concerns in a number of areas to do with forms of inappropriate sexuality, such as masturbation, adultery and illegitimacy [20]. These associations remain strong despite the fact that as a procedure it actually circumvents the need for sexual intercourse whilst duplicating the essential reproductive process of intercourse, the transmission of semen. Egg donation, on the other hand, is presented as a new and complex procedure, which completely overthrows the procedures of reproduction from sexual intercourse, but is firmly located in a clinical setting and is essentially asexual. The motives of semen donors are seen as questionable, possibly because of the association with ‘deviant’ sexuality but also because of the fear that they will be too active: by donating too frequently, by wanting to father too many children and by invading the families their donated semen helped to create. Egg donors on the other hand are portrayed as more passive, being subject not just to the clinical procedures of the collection (itself a more passive word than ‘donation’) but also, potentially, being a victim of the demands of relatives and exploitation by clinicians. Thus, the egg donor apparently runs the risk of physical damage through her participation in the practice which serves only to enhance the view that her motives must be altruistic whilst the semen donor runs the risk of social damage, since there is little physical risk attached to his participation but some possibility of ‘illicit’ pleasure. In a sense it is the very simplicity of semen donation which has been interpreted as the source of its danger. The image held by the Warnock Committee, and others, is of the semen donor as a stranger with strange motivations: unknown, unregulated and undesirable. Hence the fears that he might be invasive. Conversely, it is the complexity of egg donation which appears to be the source of reassurance about this practice. The egg donor is known to at least the clinician and possibly the recipient: she is familiar in person and familial in motivation. Both the clinical and familial context of egg donation appear to provide a sense of regulation and control. Hence the view that anonymity is less important. ERICAHAIMFS 92 zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA However, the reassurance which is derived from the connection between egg donation and family matters rests on a very particular type of family which appears to inform such discussions. It is a family which is assumed to be heterosexual, patriarchal and nuclear. The family has to be heterosexual for the woman to woman donation of an egg to be seen as completely asexual, in a way that the man to woman donation of semen apparently cannot be seen as asexual; it has to be patriarchal for the involvement of a female third party not to be seen as so invasive or so significant a threat to the socio-political stability of the family as a semen donor is apparently regarded; it has to be nuclear since the boundaries are seen as less threatened in egg donation than in semen donation by an individual claiming genetic ownership of the ‘child’ and thus displacing the social parent. This threat is regarded as reduced in egg donation for several reasons: first, the claim of the genetic mother is balanced by the claim of the carrying mother; second, if the donor is a sister any claim she could make would be from within the boundaries of the nuclear family of origin; third, since the donor could be from within the family the implication is that such disputes are less likely to occur anyway [21]. In semen donation, however, it might be feared that the boundaries are more easily breached since the social father has a less obvious counter claim to that of the genetic father. Finally, a view which accepts egg donation more easily than semen donation would also have to have a version of the family in which the notion of motherhood rests at the centre. Accordingly, egg donation would be consistent with maternal and hence familial values, whereas semen donation would have no such obvious moral corollary [22]. Identifying the links between ideas about gamete donation and ideas about the family exposes the broader set of assumptions surrounding gender relationships and reproduction. There is an irony in this observation, however, since the very fact of egg donation provides the possibility of at least loosening the ties between women, sexuality, the family and reproduction, and semen donation provides the opportunity for re-thinking the male role in reproduction. It has been argued by O’Brien that, prior to assisted reproduction, the male role has been one of separation [22, p. 511: the separation, that is of the man and the semen during intercourse and then between the man and the child resulting from that intercourse. The female role has, however, been one of integration, by the very fact of being the locus of fertilization and gestation, as well as usually being the main source of nurture. Semen donation might be thought, initially, to reflect and indeed exacerbate that process and sense of separation, particularly if the dominant view, apparent in this paper, is accepted. Equally, however, semen donation might allow, through the elicitation of the views of the donors themselves, a reappraisal of male involvement and motivation in reproduction [23]. Egg donation, on the other hand, disrupts the picture of integration and suggests a move is possible towards greater separation. Whilst O’Brien acknowledges that for men separation is a form of ‘forced’ freedom [22, p. 521 it could be argued that for women it would be a potential source of true freedom: freedom for example from assumptions about the equivalence of the ability to reproduce with the desire (or even need) to reproduce. What we find instead is that ways of talking about the two forms of gamete donation, both independently and in comparision with each other, seek to return each to that earlier framework of separation for the male role and integration for the female role. In providing at least some empirical data to show how this return is effected, this paper has attempted to display the nature of the assumptions on which this is based. There are many other sources of empirical data, researchable by social scientists, which will extend our ability to question these assumptions even further. Papers such as this demonstrate that though the analysis of reproduction in terms of gender is not new, it is still necessary. In showing how practices such as egg and semen donation are gendered we have shown how even the most fundamental of biological processes are socially defined and constructed. Acknowledgemenfs--I should like to thank Jane Keithley, Peter Selman, Margaret Stacey, Robin Williams and two anonymous referees for their assistance with this paper. REFERENCES Snowden R. and Mitchell G. D. The Arlificial Family, p. 13. Allen and Unwin, London, 1981. Downie S. Baby Making, p. 13. Bodley Head, London, 1988. Cusine D. J. New Reproductive Techniques, p. 129. Dartmouth, Aldershot, 1990. See Haimes E. Family connections. University of Newcastle Upon Tyne doctoral thesis, 1990, for a more detailed discussion of these interactions. of Health and Social Security. Report of the 5. Department Committee of Inquiry into Human F&tili.&ionand EmbrvoloPv. (‘The Warnock Report’), Cmnd 9314. Her Majesty’s_Stationery Office, London; 1984. to 6. Elsewhere I have disputed the need for anonymity provide legal protection since other provisions in the Warnock Report covered this very adequately. See for example, Haimes E. Recreating the family? In The New Reproductive Technologies (Edited by McNeil M. er al.). Macmillan, London, 1990. 7. I have suggested elsewhere (see Refs [4] and [6] above) that the conflation of semen and egg donation in the Warnock Report was part of a process whereby these procedures were differentiated from other procedures such as surrogacy according to a familistic ideology: ‘families-by-donation’ were seen as supporting this ideology whereas surrogacy was seen as challenging it. Artifical Human Insemination: the report of a Commis8. zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLK sion appointed by His Grace the Archbishop of Canterbury. Society for the Propagation of Christian Knowledge, 1948. Issues of gender in gamete donation 93 9. Home Office and Scottish Home Department. zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGF Report of 17. Out of a potential 17 interviews, (16 members plus the Departmental Committee on Human Artificial Insem secretary) I was able to conduct 14 interviews and I ination (‘The Feversham Report’), Cmnd. 1105. Her corresponded with a 15th person. The interviews were Majesty’s Stationery Office, London, 1960. conducted in May and June 1988. 10. Fletcher J. M orals and M edicine. Victor Gollancz, 18. Within the limits of this paper one can only speculate London, 1955. on why this range of views was not evident in the 11. American Fertility Society. Ethical considerations of the Report. Perhaps it was clear to members that a pragnew reproductive technologies. Fertility Sterility matic approach would be taken towards most issues and Suppl. 1, 46, 3, 1986. that therefore explicit disagreements would need to be 12. Glover J. Fertilify and the Family Report on the reserved for other, perhaps more pressing issues (such as reproductive technologies to the European Commission surrogacy and embryology), for which there were dis(‘The Glover Report’). Fourth Estate, London, senting minority reports. That this question should even 1989. arise is a testament to the necessity of conducting these 13. Neither report is exceptional in this respect; Walters interviews rather than treating the Report and the views reports that 12 out of 15 international reports take a of the Committee members, as one and the same thing. similar stance: “Egg donation in conjunction with clini19. Each quotation is a verbatim extract from the tape cal IVF seems closely analogous to semen donation in recorded interviews which were all fully transcribed. connection with artificial insemination by donor. 20. This association has been extended by the risks now Perhaps in part for this reason 12 of the 15 extended attached to semen donation of being infected with the Committee statements found egg donation to be ethiHIV virus. cally acceptable without qualification”. Walters L. 21. Though the question of sibling egg donors has been Ethics and the New Reproductive Technologies. Hastfiercely debated in the United Kingdom, both sides of ings Center Report, Special Suppl. 17, 5, 1987. the debate rest on the same set of assumptions about the 14. Statens Offentliga Utredningar, Sweden, Barn genom ‘normal family’ which differs little from the image of the befruktning utanfor kroppen, p. 5, 1985. family presented here: heterosexual, patriarchal and IS. Statens Offentliga Utredningar, Sweden. Children connuclear. See for example, Craft I. et al. Voluntary ceived by artificial insemination, 1983. Licensing and IVF/ET. The L.uncet 16/5, p. 1148, 1987; 16. The current situation in Great Britain is less clear since and Editorial The Luncet 16/5, p. 1126, 1987. the highly influential Interim Licensing Authority now 22. O’Brien, for example, says a Hegelian analysis sees the recommends that, “egg donors should remain anonyfamily as ‘the sole source and appropriate realm of mous and for this reason donation for clinical purposes female ethical being. Female morality, like women from any known person including close relatives should themselves, remains particular, and relates only to the be avoided”: The Fifth Report of the Interim Licensing individuals in the family, concentrating on biological Authority for Human In Vitro Fertilization and Embrylife’. O’Brien M. The Poliiics of Reproduction, p. 26. ology, p. 47, London, U.K., 1990. It is expected that this Routledge and Kegan Paul, London, 1981. issue will be considered under the code of practice to be 23. See, for example, Daniels K. Artificial insemination published by the Human Fertilization and Embryology using donor-semen and the issue of secrecy: the views of Authority, which was established by the Human Fertildonors and recipient couples. Sot. Sci. M ed. 27, ization and Embryology Act, 1990. 377- 383, 1988.