• reproductive medicine
• feminism

Ectogenesis has been proclaimed as a way to increase equality and freedom for women. Giulia Cavaliere,1 however, convincingly argues that these claims often ignore social context and consequently fail to recognise that ectogenesis may not benefit women or it may only benefit a small subset of already privileged women. Cavaliere claims that focusing on ectogenesis ‘distracts from the most urgent and pressing needs of certain women and it locates the problem in women’s biological capacities rather than in current societal structures and arrangements’ (page 17).

In this short commentary, I will contextualise her argument within the broader cultural milieu to highlight the pattern of reproductive technologies being presented as the panacea for women’s inequality. The claim that a specific reproductive technology, such as ectogenesis, will augment women’s rights is not an isolated one, but rather is a common theme for reproductive technologies geared towards women.

For instance, egg freezing, like ectogenesis, has been described as an agent of social change that will enhance women’s rights and reduce social inequalities. Recent media attention has portrayed egg freezing as a liberating force for professional (read: white, straight and educated) women, allowing them to ‘delay’ childbearing while they focus on their education and career. Egg freezing has been labelled as ‘reproductive affirmative action’2 because it extends women’s reproductive years, so they can, like men, focus on their professional lives during their 20s and 30s (often both prime career-building and prime childbearing years). Big tech companies like Facebook and Apple cover the cost of egg freezing as a way of ‘empowering’ and supporting women in their workforce.

Some feminist scholars, however, see egg freezing as an ‘empty benefit’3 that depicts companies as ‘female friendly’ without making any substantive changes to their androcentric culture and policies (eg, offering on-site doggy daycare, but not on-site childcare4). Furthermore, egg freezing without relevant cultural changes may exacerbate sex and gender discrimination by, for example, penalising women who choose to have children in their 20s and 30s instead of undergoing egg freezing. Similarly, Cavaliere cautions that ectogenesis may ‘undermin[e] women who find meaning and self-fulfilment in gestation and childbirth’ (page 11–12).

That there may be negative repercussions for women who reject these reproductive technologies illuminate that these technologies are not value neutral, but rather correspond with and reinforce certain values (eg, career advancement is important, parents should be genetically related to their children). Assisted reproductive technologies may perpetuate dominant cultural norms about who counts as a ‘good’ mother, especially since they are mainly used by affluent, heterosexual, white women and ‘deviant’ women, such as lesbians, have experienced discrimination by both physicians and insurance companies.5 As Cavaliere points out, ectogenesis may become another tool for controlling the reproduction of ‘substandard gestators’ (ie, ‘women of colour, members of ethnic minorities, and disabled and poor women’ (page 12)). Taking an intersectional approach reveals how these reproductive technologies uphold problematic power structures surrounding race, sexual orientation and so on, underscoring that these technologies on their own will not benefit all, or even most, women.

So why are reproductive technologies like egg freezing and ectogenesis portrayed as a boon for women? One reason is that these technologies can, and in some cases already do, help some women—and these are the stories we tend to hear about. As in the case of egg freezing, the media often sympathetically reports how new technologies enable (privileged) women to achieve heteronormative motherhood,6 while marginalising or neglecting information on how these technologies impact less privileged women.7

Outside of egg freezing and ectogenesis, there have been reproductive advancements that were indeed game changers for women, such as the birth control pill which enabled women to better control their fertility and without their partners’ knowledge or involvement. Although the advent of the pill was a significant milestone for women’s rights, it was not the sole cause in changing gender dynamics. There were other social (eg, Women’s Movement, Civil Rights Movement) and legal changes (eg, in the USA there was the Equal Pay Act, the Pregnancy Discrimination Act and Title IX) around the same time that buttressed women’s growing freedom and equality.

A second reason these technologies are portrayed as a boon is that making systemic social changes often take time—we are not able to ‘fix’ the issues women are facing right now—and can be challenging—it is difficult to get various stakeholders to agree to meaningful policy changes. In contrast, technological approaches that target individual women’s bodies are promoted as relatively quick (aligning with our ‘instant gratification’ culture), more legitimate (prioritising ‘objective’ science over ‘subjective’ social policy) and autonomy-enhancing (adhering with our individualistic mentality).

But technomedical approaches generally do not solve social problems because they do not address the root of the issue, which is social in nature, not medical. Egg freezing is supposed to empower women to focus on their professional lives, yet empirical research shows that the reason most women are ‘delaying’ childbearing is not because of their career, but because they lack a partner.8 Egg freezing is not going to address the shortage of ‘suitable’ partners for professional women. Likewise, ectogenesis is not going to resolve women’s inequality because its root cause is not pregnancy; it is a systemic social structure of oppression. ‘Freeing’ women from pregnancy is unlikely to radically upend deeply entrenched gender norms regarding responsibility for traditional private realm activities (eg, childbearing and childrearing), and even less likely to alter dominant arrangements in the public realm (eg, workplace).

In sum, medicine can heal many hurts, but medicine is not the best tool to ‘cure’ oppressive power systems. While ectogenesis may be beneficial for certain groups of individuals (eg, cisgender women who do not want to or cannot experience pregnancy, transgender women, single men and gay couples), we should be careful not to co-opt it as an agent of social change.