University of Southern California Dissertations and Theses

The global market for wombs: a study of the transnational surrogacy industry in Mexico

(USC Thesis Other)

The global market for wombs: a study of the transnational surrogacy industry in Mexico

PDF

Download a page range

Download transcript

Copy asset link

Request this asset

Transcript (if available)

Content

THE GLOBAL MARKET FOR WOMBS:
A STUDY OF THE TRANSNATIONAL SURROGACY INDUSTRY IN MEXICO

April Hovav

A Dissertation Presented to
the Faculty of the USC Graduate School
UNIVERSITY OF SOUTHERN CALIFORNIA

In Partial Fulfillment of the Requirement for the
DOCTOR OF PHILOSOPHY DEGREE
(SOCIOLOGY)

August 2019

ii

iii
ABSTRACT

Medical tourism for surrogacy is a multi-billion dollar market that is largely unregulated.
An increasing number of intended parents are traveling to other countries to hire women to
gestate and birth children for them.

However, we know little about this industry, the experiences
of the various actors involved, or the processes through which specific sites become hubs for
transnational surrogacy. Rather than focuses on a single surrogacy agency or fertility clinic, my
project takes the entire Mexican surrogacy industry as its object of study to examine how
international networks, fractured regulatory regimes, and local economies converge in the
formation of new transnational industries and how, in turn, women’s bodies are refashioned to
serve global markets.
This dissertation is based on a multi-sited global ethnography that links everyday
practices to global processes. Between 2014 and 2017, I conducted ethnographic research in
Tabasco, Quintana-Roo, and Mexico City, Mexico, with supplementary research in Spain and the
United States. I also conducted 120 in-depth semi-structured interviews with actors in the
Mexican surrogacy industry, including surrogate mothers, intended parents, doctors, government
officials, and surrogacy agency staff. Through observation, interviews, and archival research, I
collected information about the history and organization of the Mexican surrogacy industry, the
key actors, and the everyday processes through which commercial surrogacy is negotiated and
experienced. Drawing on this wide-range of data, my dissertation analyzes the technical, legal,
and social processes that led to the emergence of Mexico as a new site in the global market for
baby making and the effect of this industry on the actors involved.
While surrogacy clients come from every part of the world, only a few places have
become hubs for surrogacy tourism. Drawing on interview data, government documents, and

iv
news reports, the first half of Chapter 1 describes the local and global context in which the state
of Tabasco, Mexico emerged as an international surrogacy destination. Using Mexico as a case
study, I investigate the processes through which certain places become “visible” or legible as
possible surrogacy tourism destinations, and which wombs become “available” as a result of
these global searches. The second half of Chapter 1 focuses on the government of Tabasco’s
2015 decision to heavily restrict surrogacy within the state. I argue that two main factors led to
this regulatory change: 1) the perception that the surrogacy industry in Mexico was started by
and for foreigners, and 2) the high visibility of non-traditional families amongst surrogacy clients
in Mexico. I posit that the Tabascan government’s decision is best understood as part of a larger
trend towards re-entrenchment of national borders.
Chapter 2 analyzes the stigma management strategies of intended parents and surrogates.
I find that Mexican surrogate mothers describe the decision to enter surrogacy, often in defiance
of conservative family members, as an act of agency. Meanwhile, intended parents describe
surrogacy in Mexico as a last resort rather than a choice. While existing literature tends to paint
intended parents as members of a global elite, this chapter attends to how elements of
marginalization, such as marital status, sexual orientation, and age, can drive their engagement
with transnational surrogacy as well.
Chapter 3 focuses on the contentious issue of commercialization. I demonstrate that
treating altruism and commercialism as dichotomous can actually further market interests. I find
that surrogacy agencies draw on this dichotomy to sustain the profitability of the industry in two
key ways: by rendering it morally palatable to consumers and by disciplining surrogates to create
a docile and compliant labor force. Chapter 4 analyzes childbirth practices in the Mexican
surrogacy industry to understand how competing values are negotiated in a transnational context.

v
I find that physicians promote the use of Caesarean sections by stating that the maternal-infant
bonding experience of vaginal birth is contraindicative of the goals of surrogacy. I explore the
implications of this ideology for understanding how gender and kinship ideologies intersect with
notions of risk in medical contexts.
Together, these chapters offer a critique of normative claims about the surrogacy industry
based on abstract, ostensibly universal values by analyzing “ethics-on-the-ground;” that is, the
values that emerge in relation to new technological possibilities in specific historical, religious,
and social contexts.

vi

TABLE OF CONTENTS

ACKNOWLEDGMENTS………………………………………………………………..vii

INTRODUCTION……………………………………………………………………….. 1

CHAPTER 1: CREATING A GLOBAL SURROGACY HUB..………………………...32

CHAPTER 2: MANAGING STIGMA…………………………………………………..64

CHAPTER 3: PRODUCING MORAL PALATABILITY………………………………96

CHAPTER 4: CUTTING OUT THE SURROGATE……………………………………119

CONCLUSION……………………..……………………………………………………137

BIBLIOGRAPHY………………………………………………………………………..147

vii
ACKNOWLEDGMENTS

First and foremost, I would like to thank my advisor, Andrew Lakoff, who has shown in
faith in me since I began working with him seven years ago. My utmost gratitude goes to my
dissertation committee members, Rhacel Parreñas, Sofia Gruskin, and Rene Almeling, whose
comments and suggestions were of inestimable value for my study. My heartfelt appreciation
goes to Katie Hasson for her mentorship and support. My research benefitted greatly from
conversations and feedback from many people, including Jennifer Hook, Mike Messner, Carole
Browner, Emily Mann, Kit Myers, Susan Markens, Liz Ziff, Martine Lappé, Alwyn Lim, Alka
Menon, and Michele Goodwin. My cohort, Chelsea Johnson, Robert Chlala, Carolyn Choi, and
Jennifer Candipan, were a source of inspiration and support throughout the PhD process.
My interest in the topic of surrogacy began while I was a student at Central European
University and I am grateful for the early feedback and encouragement I received from students
and faculty there. I would especially like to thank Judit Sandor, Elissa Helms, and Eva Fodor for
their support. I am indebted to Sofia Charvel who helped me secure contacts in the Mexican
government so that I could research the legislative side of surrogacy. Regina Tames and the team
at GIRE provided valuable insight throughout my research. Amanda Cawley and Aliaksei
Yankouav provided excellent research assistance. Nohemi Cruz Velázquez’s transcription
services were a godsend.
I am lucky to have participated in many workshops during graduate school that shaped
my research and intellectual trajectory. My deepest appreciation goes to Karen-Sue Taussig,
Susan Lindee, and the Biotech Body group of the Social Science Research Council’s Dissertation
Proposal Development Fellowship, who provided carefully considered feedback and valuable
comments. I am grateful for the feedback and advice I received from faculty mentors and fellow

viii
participants at the 2014 California STS Summer Camp, the Harvard STS Summer School, the
Social Science Research Council’s International Dissertation Research Fellowship workshop and
the American Council of Learned Societies/Mellon Foundation Dissertation Completion
Fellowship workshop.
I would like to express my gratitude to my family and friends for their moral support and
warm encouragements. To Jon Boustani, Arielle Winnik, Rachel Zernik, Amy Asheroff,
Jaqueline Cedar, Josh Braver, Meredith Evans, Eddie Hovav, Anat Zeelim, Ron Berger, thank
you for listening to me talk incessantly about my research. While in Mexico, I made new friends
who became like family. My deepest appreciation goes to Esther Zagorin, Julia Hass Nadel, Ale
Lastiri, Doña Lupita, and Rebeca Lepure welcomed me into their homes with open arms. Even
though we had only met a few hours earlier, Esther Zagorin spent hours by my bedside when I
was hospitalized in Mexico City far from friends and family. I do not know what I would have
done without her help and care.
This dissertation would not have been possible without the generosity of the research
participants. Thank you for sharing your stories with me. To the intended parents and surrogate
mothers, thank you letting me be a part of one of the most intimate and trying experiences of
your lives.
Finally, I would like to express my gratitude to the Del Amo Foundation, the Social
Science Research Council, the American Council of Learned Societies, the Mellon Foundation,
and the National Science Foundation for their generous financial support.

INTRODUCTION

When I met Alicia, a single mother of three from Veracruz, she was eight months
pregnant with the child of a gay couple from New Jersey. Like many Mexican women, Alicia
had been hired as a gestational surrogate for a foreign client.
1
In the past 10 years, a multi-billion
dollar global surrogacy industry has emerged in which intended parents hire women in other
countries to gestate and birth children for them. There are no data on the number of children born
annually through surrogacy worldwide but estimates are in the thousands, and by all accounts,
the number is growing. Popular press accounts suggest that in the United States alone
approximately 2,000 children were born through surrogacy in 2013, mostly to foreign clients
(Lewin 2014). This global industry exists in part because many countries have banned surrogacy
–either entirely or for certain groups like same-sex couples—and in part because contracting a
foreign surrogate mother is often cheaper. For example, gestational surrogacy costs upwards of
$100,000 in the United States versus $45,000 in Mexico. While surrogacy clients come from
every part of the world, only a few countries have become hubs for surrogacy tourism, including
the United States, India, Thailand, Ukraine, and, as of recently, Mexico.
The landscape of the transnational surrogacy industry is constantly shifting as surrogacy
destinations shut down due to regulatory changes and others emerge in their place to meet
market demand. The state of Tabasco, Mexico rose to prominence as a global surrogacy
destination, particularly for gay men, after restrictions were placed on surrogacy in India. In

1

Surrogacy comes in two forms. In traditional surrogacy, a surrogate is inseminated with the intended father’s
sperm, fertilizing her own egg, which she then gestates. In gestational surrogacy, the surrogate does not use her own
egg, but rather gestates an embryo made from the intended mother’s egg or a donor egg. Because traditional
surrogacy is now rarely practiced, I use the term surrogacy as a short hand for gestational surrogacy.

2
December 2015, the Congress of Tabasco shook up the industry by passing a bill limiting
surrogacy to Mexican heterosexual couples. Drawing on ethnographic research in Mexico, my
study looks at the creative ways markets respond to changing regulations. Based on interviews
with a range of actors in the Mexican surrogacy industry, my research illuminates the processes
through which different places become “visible” or legible as possible surrogacy tourism
destinations and which wombs become “available” as a result of these global searches.
While studies of surrogacy exist, scholars have primarily focused on the experiences and
motivations of surrogate mothers (Pande 2014; Jacobson 2016; Ragoné 1994; Teman 2010). Few
have looked at the processes through which women’s bodies are leveraged as potential capital on
a global scale. Prior researchers have generally focused on one surrogacy agency or fertility
clinic (Pande 2014; Rudrappa 2015). In contrast, my project takes the entire Mexican surrogacy
industry as its object of study to better understand the emergence of new global markets. I
analyze the surrogacy industry’s history, structure, and systems of knowledge. Using the
Mexican surrogacy industry as a case study, I explore how international networks, fractured
regulatory regimes, and local economies converge in the formation of new transnational
industries and how, in turn, women’s bodies are refashioned to serve global markets.
Existing scholarship on surrogacy has demonstrated the importance of local context to
women’s experiences as surrogate mothers. However, this research is, for the most part,
geographically limited to the United States, India, and Israel. Heeding Elizabeth Roberts and
Nancy Scheper-Hughes’ (2011) call to explore “the historical, economic, political and
institutional characteristics of place that send or draw medical migrants,” my research pays close
attention to the particularities of the Mexican context while also treating the Mexican surrogacy
industry as a case study of a growing global phenomenon of women’s reproductive capacities

3
being marketed and sold to foreign clientele. Accordingly, my dissertation contributes to 1)
research on globalization by highlighting the tensions that arise and ethics that are produced on
the ground as global markets spread to new sites; 2) feminist scholarship on reproduction by
analyzing how social hierarchies of race, class, and global position structure the surrogacy
industry, while also paying attention to the sexuality, age, and marital status of surrogacy clients,
whose engagement with transnational surrogacy is simultaneously shaped by their strong
financial position in the global economy and their marginalized position in relation to
parenthood; and 3) medical and economic sociology by demonstrating how gendered norms
around motherhood, rather than “rational” economic or medical decisions, shape the surrogacy
industry.

Theoretical Framework
My project lies at the intersection of three areas of research: 1) feminist scholarship on
the politics of reproduction; 2) science and technology studies (STS) analyses of global markets
in biotechnologies; and 3) social and ethical debates regarding the commodification of intimate
life. By bringing these literatures together to analyze the surrogacy industry, I am able to
demonstrate the way that reproductive politics, market logics, technology, and bioethics are
intertwined in the production of a transnational baby-making industry.

The Politics of Reproduction
Feminist scholarship has led the way in critically analyzing the politics of reproduction
Feminist scholars have sought to both problematize the naturalness of reproduction, as a
supposedly apolitical arena, and to expose the power dynamics involved in reproduction (Clarke

4
1991; Davis-Floyd 1992; Ginsburg and Rapp 1991, 1995; Mann and Gruskin 1995; Rothman
1989). Feminists working in various fields have “recognized reproduction as systematically
organized, sensitive to change in domestic economics, and therefore always an aspect of the
distribution of power in any society” (Ginsburg and Rapp 1991, 313). Following Rene
Almeling’s definition, reproduction is the “biological and social process of having or not having
children” (2015, 430). Reproduction is inseparable from the social world in which it is given
meaning. Reproduction happens in bodies that have been transformed by chemical injury,
imbued with racial categories, gendered through labor and care relations, and governed by a
constellation of actors including but not limited to legislators, religious authorities, and doctors.
One of the central arguments in this field is that reproduction is stratified. The concept of
“stratified reproduction,” comes from Shellee Colen’s (1995) research on West Indian childcare
workers in New York. Colen writes, “by stratified reproduction I mean that physical and social
reproductive tasks are accomplished differentially according to inequalities that are based on
hierarchies of class, race, ethnicity, gender, place in a global economy, and migration status and
that are structured by social economic, and political forces” (1995, 78). The concept of “stratified
reproduction” has been expanded to describe broad inequalities between those who are
empowered to reproduce and those who have been disempowered by population control policies,
coerced sterilizations, and forced adoption (Briggs 2012; Ginsburg and Rapp 1995; Hartmann
1987; Murphy 2011; Roberts 1997). This concept can be useful for understanding transnational
surrogacy. Not only is reproduction valued or devalued depending on one’s social location, but
the tasks of reproduction are stratified as well. In the surrogacy industry, certain women are
deemed fit for genetic motherhood as egg donors and others as gestational mothers. Meanwhile
social parenthood is determined by procreative intent, which is mediated by access to resources.

5
In transnational surrogacy, both the physical and social roles of reproduction are stratified along
lines of race, class, ethnicity, and place in the global economy (Harrison 2016; Twine 2011).
In an influential essay on reproductive inequality, Dorothy Roberts (2009) argues that the
punitive governance meant to limit the reproduction of poor women and the technological
encouragement of reproducing genetically sound elites are part of the same neoliberal project.
She explains, “both population control programs and genetic selection technologies reinforce
biological explanations for social problems and place reproductive responsibility on women, thus
privatizing remedies for illness and social inequality” (Roberts 2009, 785). Roberts argues that
the biologization of race and of social problems supports neoliberal privatization and is based on
“eugenic thinking.” Roberts defines “eugenic thinking” as “the belief that reproductive strategies
can improve society by reducing the births of socially marginalized people” (2009, 796). Roberts
directly contradicts Nikolas Rose’s (2001) argument that eugenics is a nationalist project of the
past by arguing that eugenics has always been a private as well as national project and that
eugenic thinking still informs the politics of reproduction today.
In a similar vein, Lynn Morgan and Elizabeth Roberts (2012) argue for a theory of
reproductive politics that looks beyond the confines of the law to show how a range of actors and
policies influence reproductive practices. They develop the concept of “reproductive
governance,” to describe “the mechanisms through which different historical configurations of
actors use legislative controls, personal interactions, economic inducements, moral injunctions,
and ethical incitements to control reproductive behaviors and practices” (Morgan and Roberts
2012, 39). Reproductive governance is enacted by a combination of public and private, local,
national, and international actors, sometimes with competing agendas.
Studies of reproductive technologies have been a particularly fruitful area for theorizing

6
the politics of reproduction. Reproductive technologies have a “defamiliarizing impact…
through which many of the most deeply taken-for-granted assumptions about the 'naturalness' of
reproduction are displaced” (Franklin and Ragoné 1998, 5). Because assisted reproductive
technologies enable the fragmentation of procreative acts (i.e., oocyte retrieval, fertilization, and
implantation) and actors (i.e., genetic mothers, gestational mothers, and social parents), debates
around the proper use of reproductive technologies bring cultural assumptions about
reproduction into focus (Markens 2007). Contemporary research in Latin America has shown
that the very need for medical assistance in childbearing is associated with elite status, and thus
“whitens” the subject of biomedical intervention (Braff 2009, 2013: Roberts 2012). This is a
stark contrast to the experiences of indigenous women whose fecundity is problematized by the
paternalistic Mexican medical system (Browner 1986; Smith-Oka 2013; Vega 2018). Mexican
surrogate mothers occupy a unique space vis-à-vis biomedicine, being subjects of technological
intervention for the creation of foreign children. My work builds on a body of literature that
addresses the ways in which subjectivities, kinship, and knowledge are co-constituted through
the use of assisted reproductive technologies (Edwards et al. 1993; Franklin 1997; Rapp 1998,
1999; Roberts 2012; Strathern 1992; Thompson 2005).
The literature of reproductive technologies is part of broader field of scholarship on the
medicalization of women’s bodies and reproduction. Some feminists, such as Nancy Ehrenreich
and Gena Corea, view the medicalization of reproduction, and reproductive technologies in
particular, as part of the “colonization of the womb” by male-centered medical institutions that
exercise control over women's bodies (Corea 1985; Ehrenreich 1993). The medicalization of
reproduction, they argue, has shifted control over the process of procreation from women to
medical institutions, which often maintain the power to override women’s wishes in the

7
supposed best interest of the child. Feminists in this camp argue that reproductive technologies
“finalize the transfer of the control of women’s reproductive power to the male medical
establishment and constitute the finishing stroke in the transformation of women from subject to
object in the birthing process” (Portugese 1998).
More recent scholarship has rejected a simplistic model of women as victims of
medicalization. Instead, scholars explore how cultural ideologies animate reproductive
technologies, produce anxieties, constitute new subjects, and change our understandings of the
body (Franklin 1997; Inhorn 1996; Inhorn and Balen 2002; Rapp 1999; Strathern 1992;
Thompson 2005). For example, in the case of transnational surrogacy, advances in reproductive
technologies, especially the separation of genetic from gestational motherhood and the ability to
freeze and ship embryos internationally, has made the subject position of the Mexican surrogate
mother possible.
Of particular interest for feminists is the relationship between reproductive technologies
and the creation of a fetal subject, separate and sometimes in opposition to, the pregnant woman
(Hartouni 1997, Petchesky 1987, Rapp 1999). In an era of ultrasounds, prenatal diagnoses, and
fetal photography, “the fetus is seen as a discrete and separate entity, outside of, unconnected to,
and by virtue of its ostensible or visual independence, in adversarial relationship with the body
and life upon which it is nevertheless inextricably dependent” (Hartouni 1997, 67). The notion
of a fetal subject that exists separate from the pregnant subject is central to the logic of
surrogacy. The conceptualization of pregnancy as a passive condition in which the fetus grows
thanks to the help of medical practitioners, has paved the way for surrogacy to be an intelligible,
commercialized endeavor. Intended parents can bypass the surrogate mother in receiving
information about their future child. Furthermore, surrogate mothers can separate themselves

8
ontologically from the fetus growing inside of them. This ontological separation is central to
medical metaphors of pregnancy and childbirth.
Conceptualizing the womb as an empty, surplus space, which can be separated from the
self, is essential to the logic of surrogacy (Pande 2014; Ragoné 1994; Teman 2010). In her study
of commercial surrogacy in India, Kalindi Vora (2009) explains that surrogates are taught to
understand their bodies through a Western medical model, which “depends on an acceptance of
the separation of body and self, and the concept of the body as a machine that works in parts, so
that uterus becomes just an empty space which is not being used when a woman is not pregnant”
(272). In this view, the womb is not only imagined as “an empty space in which a guest fetus
will temporarily reside,” but also a “surplus part” (271). This conceptualization of the body
characterizes women’s bodies as both incomplete (without a fetus) and as excess (with an unused
uterus). Many Indian surrogate mothers resist the reduction of their bodies to machines by
emphasizing the importance of their bodily labor and fluids (sweat and blood) in the gestation
and birth process (Pande 2009).
In contrast, Elly Teman (2010) argues that in Israel, a society that hails technological
achievement and places a strong emphasis on genetics, the compartmentalization of the body is
in line with dominant thinking. Most Israeli surrogates conceive of their bodies as configurations
of discrete parts, each with a varying degree of relation to their true self. They divide their
pregnant bodies into three distinct parts: “a personalized nature that carries their emotional bonds
to their own children but remains dormant during surrogacy; an artificial presence that subdues
their personal nature and makes sure that their wombs remain separate, neutral space; and the
intended parents' nature, which they temporarily warm inside their wombs” (54). In this “body
map,” the heart is inseparable from the self, while the womb can be distanced, de-naturalized, so

9
as to gestate but not emotionally bond with the fetus (68). Teman (2010) explains that a
cartographic conceptualization of the body enables surrogates to simultaneously uphold their
identity as loving mothers while and serving as gestational carriers who will relinquish the child
they gestate and birth.
The spatial metaphors surrogates use to describe their bodies stem from their
understanding of the surrogacy process. In India, surrogates are often told that their wombs are
like extra bedrooms that can be rented out for profit (Pande 2014; Vora 2009). This discourse
naturalizes the commercial aspect of surrogacy, which is central to the Indian surrogacy market.
In the Israeli context, where surrogacy is not organized as a for-profit market, surrogates often
liken their wombs to ovens, greenhouses, or incubators. These metaphors describe a warm place
where things grow; they do not describe places where transformation occurs. Thus, the embryo is
perceived as a complete form, taking all of its genetic and biological material from the intended
parents and only warming up and expanding in the surrogate's womb. This analogy, Teman
argues, presents the womb as a space that is “controlled externally” by the “baker,” “gardener,”
or physician (2010, 55). Doing so reinforces a distinction between real and artificial pregnancies,
which itself is essential to maintaining the surrogate's subject position vis-a-vis the future child.
These examples show that surrogacy is experienced and negotiated differently in different
contexts as a function of cultural understandings of the body and motherhood as well as by the
organization of the surrogacy market.
Surrogacy is a complex social, technical, legal and biological process that produces new
subjects and redefines the body and kinship, and as such, surrogacy is an inherently political
project. As Donna Haraway reminds us, “who controls the interpretation of bodily boundaries in
medical hermeneutics is a major feminist issue” (1985, 65). Analyzing the surrogacy industry

10
through the lens of reproductive politics helps to both expose the stakes involved as well as to
destabilize normative assumptions and denaturalize inequalities.

Science, Technology, and Global Markets
In contrast to a deterministic model of technology, STS scholars have argued that
technologies and subjects are co-produced (Jasanoff 2004). Technologies are social objects that
are imbued with meaning within specific cultural, economic, and moral contexts. Recent
advances in biotechnology and the life sciences have made it possible for human tissue and body
parts – including DNA, stem cells, gametes, embryos, and organs – to circulate at national and
global scales. STS scholarship has sought to elucidate the institutional, moral, and legal
frameworks that structure biomedical markets (Almeling 2011; Lakoff 2006; Ong and Collier
2005; Roberts and Scheper-Hughes 2011).
These studies entail a scholarly engagement with what Kaushik Rajan (2006) calls
“biocapital.” The concept of “biocapital” signals a new “biopolitical form of capitalism… in
which the very grammars of the life sciences and of capital are co-constituted; life becomes a
business plan” (283). Through studies of clinical trials, organ transplantation, genomics and stem
cell research, and pharmaceutical development, scholars are formulating novel analytics to
describe the changing relationship between capital, the body, and science in a late-modernity
(Cooper and Waldby 2014; Cohen 2005; Franklin 2005; Lakoff 2005, 2006; Petryna 2009; Rajan
2012).
Scholars in the social studies of medicine, science, and technology have argued that
potentiality, experimentality, and market logics inform both the life sciences and post-Fordist

11
capitalism, working together to produce new forms of labor and value (Cooper and Waldby
2014; Rajan 2006; Thompson 2005). Melinda Cooper and Catherine Waldby (2014) argue that
the life science industries rely on “clinical labor,” which they describe as “the extensive yet
unacknowledged labor force whose service consists in the visceral experience of experimental
drug consumption, hormonal transformation, more or less invasive biomedical procedures,
ejaculation, tissue extraction, and gestation” (7). Oocyte donation, donations for stem cell
research, surrogacy, and participation in clinical trials are rarely at the center of discussions of
labor. In fact, these acts are often discussed through the language of altruism. Cooper and
Waldby argue that not only are they forms of labor, they are also emblematic of precarious labor
conditions in the age of neoliberalism.
Cooper and Waldby (2014) and Charis Thompson (2005) argue that the capitalist mode
of production is insufficient for understanding the way that value operates in clinical labor,
especially in relation to reproduction. Thompson (2005) develops the theory of “the biomedical
mode of reproduction” to analyze the way that value is generated through the use of assisted
reproductive technologies. Embryos and oocytes only hold promissory value in their potential to
become children. Thus, Thompson argues that a commodity in the Marxist sense is an inaccurate
term to describe the oocyte and embryo markets. Waldby and Cooper argue, that “women who
donate their tissues to the stem cell industries contractually engage their bodies with these
experimental systems and promissory economies, giving not so much the surplus products of
reproduction as technical and legal traction on their bodily potentials for regeneration” (2014,
115). Regenerative labor cannot be explained using Marxist analytics of alienation. Instead, they
argue that regenerative labor is “about the transaction of biological potential and the creation of
experimental relations” (107). Like oocyte selling, surrogacy has often been described in terms

12
of alienated labor. Scholars like Thompson, Waldby, and Cooper provide on opening for
developing a new lens through which to analyze the labor conditions of surrogacy. Rather than
understanding clinical labor as either a free choice or a form of exploitation, Cooper and Waldby
(2014) convincingly argue that clinical labor is not uniquely exploitative, but nevertheless based
in ‘unequal exchanges’ that shape society and the labor conditions in the 21
st
century.
Almeling (2011) argues for a gendered perspective on the organization of clinical labor.
In Sex Cells, she argues that the market for gametes in the United States is gendered in a way that
does not reflect biological differences. Rather, markets for eggs and sperm are organized
according to normative gender ideologies. This gendered framing shapes the process and
experience of gamete donation. Egg donors are expected to be motivated by altruism while
sperm donors are treated, and think of themselves, as doing a job, reflecting a breadwinner model
of masculinity (ibid). Framing egg donation as an altruistic endeavor also assuages moral
concerns about compensation causing undue enticement for women to undergo the considerable
physical risks of egg retrieval.
One of the key insights from this literature is that bioethical regimes are part of the
political economy of the life sciences (Cohen 2005; Cooper and Waldby 2014; Petryna 2009;
Scheper-Hughes 2005). Ethics is explicitly constructed as separate from the market, a
determination of right and wrong uncontaminated by crude market forces, even when, in the case
of the liberal ethics of “free choice,” ethical arguments provide the moral justification for market
capitalism. This theoretical and analytical separation is inaccurate. Rather than running contrary
to, or tempering, the forces of marketization, “bioethics as a discourse and practice is internal to
the political economy of the life science” (Cooper and Waldby 2014, 14). Research has
demonstrated how regulations meant to protect patients in clinical trials, gamete vendors, and

13
surrogates, are integral to the configuration of a system that makes outsourced clinical trials and
contracted clinical labor feasible and profitable (Cooper and Waldby 2014; Lakoff 2006; Petryna
2009). For example, limited compensation is justified as an ethical measure to deter individuals
from taking on physical risks for financial reasons, but in doing so, it renders these forms of
labor invisible. Furthermore, standardization processes that have been central to the project of
bioethics, enable the circulation of knowledge, bodies, and capital and thus the creation of global
markets (Lakoff 2006).
Meanwhile, shifting regulations create a continuously changing ethical geography within
which biocapital travels (Petryna 2009; Rajan 2006, 2012). For example, Petryna (2009)
discusses the influx of clinical trials to Poland where medical training and infrastructure
remained strong from the socialist era but where the ailing healthcare system left many citizens
ill and without access to care. Poland had a high number of people with untreated heart disease
and diabetes, the biological characteristics necessary to maximize the data on efficiency for new
medications to treat both illnesses. Meanwhile, Cooper and Waldby (2014) explain that the
Czech Republic has become an international hub for egg donation because of the number of
white women in the Czech Republic for whom the compensation offered is considerably better
than their other options. The Czech oocyte industry is structured by economic inequalities
between Western and Eastern Europe and racial hierarchies resulting in the reification of racial
categories. Like Poland and the Czech Republic, Mexico had the right combination of highly
educated doctors, medical infrastructure, and economic inequality to become a global surrogacy
destination. Like the clinical trial industry and gamete markets, the surrogacy industry depends
on advanced medical technologies and sites with a combination of highly trained medical staff,
permissive regulation, and a population with the right biological profile and unmet financial

14
and/or health needs (Cohen 2005; Petryna 2009).
Lawrence Cohen’s (2005) study of the kidney market in India provides a number of
critical insights that can be applied to the case of transnational surrogacy. Rather than engaging
in the overwrought debate about whether or not organ selling is ethical or exploitative, Cohen
argues, “the iterated opposition of sale and gift in such debates fails to engage their common
bioavailability” (83). “Bioavailabity,” in Cohen’s terms, means to be available “for the selective
disaggregation of one’s cells or tissues and their reincorporation into another body” (83). To
clarify this concept, he describes three technical shifts that enabled a transnational organ
transplant industry. First, techniques for safely extracting, transporting, and grafting tissues
allowed some family members to donate to each other. Second, once technology was developed
to deal with rejection of the organ by tissue typing, the almost dead became bioavailable. In the
process, “new ways of conceiving of these bodies as more or less dead needed to be articulated
and acceded to: thus the emergence of ‘brain death’” (Cohen 2005, 84). Finally, the development
of immunosuppressant drugs led to the emergence of multiple bioavailable populations and the
globalization of transplant operations. Bioavailability as a concept demonstrates how technical
procedures and biomedical innovations create new subjects and relations.
STS scholarship on biocapital provides an alternative to deterministic and teological
theories of technology and of globalization. Scholars in this field demonstrate the complex and
contingent ways that technologies converge with legal and ethical regimes and global capital to
create new markets and in turn, new forms of labor and social relations (Lakoff 2005, 2006;
Rajan 2006; Petryna 2009). Scholars like Cohen, Cooper, and Waldby argue that markets in
bodies, should not be analyzed through the strict binary of exploitation versus agency nor should
they be understood as distinct from the normal workings of contemporary neoliberalism. Instead,

15
clinical labor, including organ selling, clinical trial participation, and commercialized gestation
provide a window onto the changing landscape of contemporary social conditions.

The Commodification of Intimate Life
The examination of intimacy has emerged as a new field of inquiry within the sociology
of sex and gender. Intimacy is a lens for analyzing feminist thought, labor market experiences,
work-family balance, and the politics of the body. Intimacy studies extend the idea that the
personal is political by demonstrating that intimacy is not private, natural, or separate from
market forces, but instead is inextricably related to global political and economic processes like
colonialism and capitalism (Povinelli 2006; Stoler 2002; Wilson 2004). The study of intimacy
incorporates structural analysis with an attention to everyday life and draws on the experiences
of individuals to make claims about global processes.
Referencing Joan Scott’s (1986) famous essay “Gender as a useful category of analysis,”
Ara Wilson (2012) argues that “intimacy is a useful category of transnational analysis” in that it
“facilitates the simultaneous recognition of social patterns in relationships and ideological norms
about relationships” (32). Intimacy, as a category and analytic tool, moves away from the
dichotomies of public/private, global/local, rational/emotional, and money/love to show how
these categories are themselves negotiated in daily practice. The concept of “intimate
economies,” according to Wilson, “provides one model for thinking about global intimacy in
ways that avoid a top-down image of impersonal forces ‘penetrating’ intimate life, understood as
local” (2012, 33). Intimacy as an analytic lens can expose inequalities without resting on staid
moralism, gender essentialism, or modernist dichotomies.

16
The concept of intimate life is rooted in the Marxist separation between productive and
reproductive labor. Reproductive labor is the labor of reproducing workers (through sex, care,
and cooking, etc.) so that the worker’s labor power can be alienated and extracted by capitalists.
Capitalism brought workers out of the home and into factories thus sharpening the gendered
divide between public and private realms. The commercialization of intimate life is seen by
many as an erosion of the home as a safe haven away from the self-interested rationality of
capitalism (Hochschild 2012). As more women moved into paid labor outside the home,
reproductive labor, including the care of children and the elderly, increasingly became monetized
and outsourced primarily to women of color (Ehrenreich and Hochschild 2002; Glenn
Hondagneu-Sotelo 2001; Parreñas 2000). The impact of these global shifts has been the subject
of intense debate.
Commodification is a highly contentious topic within feminist studies of intimacy.
Zelizer (2000) contends that most discussions on the commercialization of intimate life are
shaped by a “hostile worlds” view, which argues, “such a profound contradiction exists between
intimate social relations and monetary transfers that any contact between the two spheres leads to
moral contamination and degradation” (818). From this perspective, intimacy is not only eroded
by payment but intimacy is antithetical to rational, self-interested capitalism. For example, Arlie
Hochschild views the commercialization of intimate life as a sad turn of events in which society
has become depersonalized. “The more we apply market language, habits of emotional
detachment, and focus on ‘the purchase moment’ to our most intimate life,” Hochschild (2012)
argues, “the more fragile it becomes” (225).
Commercial surrogacy is often described as the ultimate form of commodified intimate
life. Hochschild (2012) describes commercial surrogacy as “the ultimate encounter between the

17
market and intimate life... The surrogate’s experience, the parents’ connection to the birth –
every aspect of this service raises difficult questions about hiring others to perform personal
acts” (178). In a similar vein, Anthropologist, Lesley Sharp (2000) argues, “surrogate
motherhood emerges as the quintessential example of the commodification of female bodies and
their reproductive capabilities” (302). She contends that a dualistic separation of the body and
self “facilitates the depersonalization—and, thus, dehumanization—of persons-as-bodies, a
process that ultimately allows for the commodification of the body and its parts” (Sharp 2000,
290). Feminist theorist Carole Pateman (1988) argues that when a woman enters a surrogacy
contract, she alienates “the unique physiological, emotional and creative capacity of her body,
that is to say, of herself as a woman” (207).
In contrast to the “hostile worlds” perspective, Zelizer (2005) offers a theory of
“differentiated ties.” She argues that commerce and intimacy have always co-mingled, and that
the exchange of money is part of the process of conferring intimacy. Rather than the sexual acts
or the exchange of money automatically determining the meaning of the interaction, Zelizer
argues that everyone, from sex workers to married couples, does relational work to define the
nature of intimate relationships. This relational work is often done through specific types of
monetary exchange. Whether money is a labeled as a payment, an entitlement, or a gift makes a
tremendous difference in its legal and social meaning (Zelizer 2005).
Building on Zelizer’s work, numerous scholars have documented the complex and
diverse ways in which markets for intimate labor are organized and relationships negotiated
through monetary exchange (Almeling 2011; Boris and Parreñas 2010; Chin 2012; Parreñas
2011). This literature illuminates the moral and cultural work that goes into normalizing

18
controversial new markets and demonstrates that the boundaries between market and non-market
are not pre-determined, but rather, they are constantly negotiated and morally defined.
Eileen Otis and Rhacel Parreñas (2010) developed the concept of “intimate labor” to
analyze the linkages between paid and unpaid care work, domestic work, and sex work. They
define intimate labor as, “the work of forging, sustaining, nurturing, maintaining, and managing
interpersonal ties, as well as the work of tending to the sexual, bodily, health, hygiene, and care
needs of individuals” (Parreñas, Thai, Silvey 2016, 2). Bringing together care work, domestic
work, and sex work highlights the commonalities between these forms of gendered labor, which
have long been studied separately (Boris and Parreñas 2010; Constable 2009). To address the
increasingly organized, institutionalized, and incorporated nature of intimate labor, Rhacel
Parreñas, Hung Cam Thai, and Rachel Silvey (2016) develop the concept of “intimate
industries.” In a similar vein to Cooper and Waldby’s (2014) argument about clinical labor as a
microcosm of labor conditions in late capitalism, Parreñas, Thai, and Silvey (2016) argue that
intimate industries and intimate laborers, are central to the global economy. Moving beyond the
binaries of public vs. private and exploitation vs. agency, scholars of intimate industries have
analyzed, “the contested, political nature of the making of these markets, as well as the long
history of stratification by race, gender, and nation that are reinforced through intimate labor”
(Ibid, 4; Bernstein 2007; Chin 2013; Constable 2009; Deomampo 2013; Parreñas 2010; Wilson
2004).
Zelizer (2005) argues, “when relationships resemble others that have significantly
different consequences for the parties, people put extra effort into distinguishing the relations,
marking their boundaries, and negotiating agreements on their definitions” (3). Such is the case
with commercial surrogacy, which is seen by many as an exploitative process of baby selling.

19
Empirical research shows that women experience commercial surrogacy differently depending
on the specific context (Jacobson 2016; Pande 2014; Teman 2010). For example, studies of
surrogacy in the United States have continually shown that surrogate mothers do not view
surrogacy as work (Jacobson 2016; Ragoné 1994). Surrogate mothers in the United States
typically emphasize the altruistic nature of surrogacy and describe payments as gifts rather than
wage or compensation. This is in line with local gendered ideologies of motherhood and care
work more generally, as selfless gifts of the heart rather than paid labor (Almeling 2011; England
2005). Amrita Pande (2014) found that Indian surrogate mothers did not consider themselves to
be workers, but they did not emphasize altruistic motivations either. Instead, they emphasized
their motherhood, including their need to care for their own children and their ability to create
life through blood, sweat, and tears. These studies illuminate the contradictions of a gendered
discourse of altruism and selflessness in a highly lucrative industry (Goslinga-Roy 2000; Ragoné
1994; Roberts 1998).
Emerging research on surrogacy in Eastern Europe shows that the altruism narrative is
absent in the Ukrainian and Russian contexts (Weis 2105; Guseva 2017). Eastern European
surrogate mothers are frank about their financial motivations and even haggle over wages.
Christina Weis (2015) found that Russian surrogacy agencies prefer women who view surrogacy
as work. An employee/employer style relationship is seen as preferable to the messiness of an
emotional relationship between intended parents and surrogates. Russian surrogates are seen as
good businesswomen who will follow procedures and endure discomforts to succeed in their job
(Ibid). The trust afforded to business-minded Russian surrogates may be a reflection of Russian
cultural views around motherhood, love, and money, but also suggests that race and global
location influence the perceived trustworthiness of surrogate mothers.

20
Studying the transnational surrogacy industry from the perspective of intimate labor and
intimate industries, puts surrogacy in the context of broader transformations in the global
economy that “produce, enable, promote, and market some relational connections while
disrupting and rearranging other, previously existing social relations” (Parreñas, Thai, and Silvey
2016, 2).

Research Context
The Mexican surrogacy industry exists in a legal grey area. Tabasco, a relatively poor
state on the southern border with Guatemala, was for many years the only Mexican state with
legislation explicitly permitting surrogacy. The 92
nd
Article of the Civil Code of Tabasco, which
was added in 1997, states that the intended parent(s) in a surrogacy contract is (are) the legal
parent(s) of the resulting child(ren). This short and vague article in the civil code does not
specify who can contract a surrogate or under what conditions. Furthermore, there is no oversight
of the industry. There are no accounts of how many women are involved, how many agencies
exist, or how many children have been born through surrogacy (Fulda and Tamés 2017).
Although surrogacy was legalized in Tabasco in 1997, Mexico only became a global
destination for surrogacy in 2013. Prior to 2013, surrogacy was almost entirely unheard of in
Tabasco. The influx of foreign surrogacy clients was precipitated by regulatory changes in India,
previously a major global surrogacy hub. With the announcement of new restrictions in India,
transnational surrogacy brokers began to search for other viable destinations, especially for gay
men and single intended parents who are banned from hiring surrogates in other countries, and
they found Tabasco. In direct contrast with India, where the surrogacy industry began with local
fertility doctors and patients, then grew to serve international clients, foreign medical tourism

21
entrepreneurs built the Mexican surrogacy industry explicitly for foreign clients. Foreign
companies that also operate in Thailand, India, and Ukraine own most of the surrogacy agencies
in Mexico.
In December 2015, the Congress of Tabasco passed new regulations on surrogacy that
limit the practice to heterosexual, Mexican couples with a medically certified diagnosis of
infertility. The regulations also ban surrogacy agencies or lawyers from serving as paid
intermediaries. Contrary to what many expected, the industry did not come to a halt. There was
one month between when the law was passed in congress and when it went into effect. In that
month, intended parents from around the world signed surrogacy contracts with hundreds of
Mexican women. Surrogacy agencies in Mexico have continued to coordinate surrogacy for
couples that signed contracts prior to January 2016. Meanwhile, a number of surrogacy agencies
have teamed up with Mexican gay rights activists to fight the new regulations in court by arguing
that it is unconstitutional to restrict surrogacy to heterosexual couples. Furthermore, a number of
agencies have begun advertising “hybrid programs” in which Mexican women undergo the
majority of the surrogacy process in Mexico, but then travel to California to give birth.
Mexico is a critical site for studying surrogacy tourism because of its colonial history,
racial politics, and position in the global economy. While surrogacy tourism to Mexico is new,
the industry is embedded within the long-standing political economic context of outsourced and
migratory labor, stratified reproduction, and border politics (Fernadez- Kelley 1983; Hondegneu-
Sotelo 2007; Massey, Durand, and Malone 2002; Plankey-Videla 2012). The current backdrop to
this industry is a tense political relationship between the United States and Mexico with anti-
immigration sentiments sparking intense debates over border control. My research pays close
attention to the particularities of the Mexican context while also treating the Mexican surrogacy

22
industry as a case study of a growing global phenomenon of women’s reproductive capacities
being marketed and sold to foreign clientele.
The Mexican surrogacy industry relies on advanced medical technologies, an existing
tourism infrastructure, and selectively porous borders. Women from across the country travel to
fertility clinics in Mexico City, Cancun, and Villahermosa, the capital city of Tabasco, to
participate in surrogacy. Although some surrogates undergo the entire process in Tabasco, most
undergo in vitro fertilization in Cancun or Mexico City and then travel to Villahermosa for their
last two months of pregnancy, as the surrogate must give birth in Tabasco for the state’s
surrogacy law to apply. Meanwhile, because of the desire for “white” babies, egg donors are
often flown in from the United States, South Africa, and Ukraine (Schurr 2016). The global
circulation of bodies and body parts is not only technically complex, it highlights the global,
racial, and gendered politics of borders that undergirds the transnational surrogacy industry.
Race and class shape the Mexican market in many profound ways. In an incisive analysis
of the Mexican surrogacy industry, Carolin Schurr (2016, 241) demonstrated how racialized
access to the surrogacy market, the selection of egg donors, and the division of reproductive
labor in the surrogacy industry reflect and reinforce “(post)-colonial imaginaries of white
desirability.” Through the surrogacy industry, the fecundity of poor Mexican women, which has
been decried by advocates of population control for decades (Braff 2013; Browner 1986; Smith-
Oka 2013), has been marketed and sold to surrogacy clients. “By using the reproductive
capacities of those women whose children are not desired as citizens of the Mexican nation for
gestating the babies of (white) commissioning parents,” the Mexican surrogacy industry
reproduces post-colonial racial hierarchies along with white bodies (Schurr 2016, 258). In this
context, “whiteness not only stands for a certain skin color but rather serves as a surrogate for the

23
economic status, financial affluence, nationality and class belonging in this market” (258).
In Mexico, race “manifests along a flexible social spectrum of skin color, class, power,
and region” and “ascriptions of race in practice are dynamic, contingent, and relational” (Braff
2013, 126, emphasis in original). Race in Mexico is further complicated by the ideology of
mestizaje, a nation-building project of mixture between indigenous and colonial people that
masks inequalities by denying the existence of racial categories (Figueroa 2010, 390). Intended
parents are marked as white by virtue of their participation as consumers (Schurr 2016).
Conversely, Mexican surrogates are marked as non-white, or racialized as others, due to their
position as paid, gestational laborers. The separation of genetics from gestation in gestational
surrogacy creates a racialized division of labor between gamete providers and surrogates while
enabling “whiteness” to be reproduced at discount rates (Schurr 2016).
While attending to the role of race and class inequalities in the Mexican surrogacy
industry, it is important not to reduce Mexican surrogate mothers to “condensed symbols of
oppression, subordination and victimhood” (Mohanty 2003). Accounts of the surrogacy industry
that deny surrogate mothers of their agency are as inaccurate as they are problematic. As,
Parreñas, Thai, and Silvey argue, “the moral denigration and heightened regulation of affective
labor when it is exchanged by women in lower-class settings reinforce the devaluation of
gendered, racialized, and classed labor” (2016, 10). Even with the intersecting systems of
oppression that constrain poor Mexican women’s lives, surrogate mothers are nonetheless
agents. Through their participation in the surrogacy industry, Mexican women are redefining the
value of their reproductive labor.
At the time of my research, Mexico was one of the only places in the world where
foreigners, regardless of marital status, could contract a surrogate. For several years, Mexico was

24
billed as the only “affordable” alternative to the United States for same-sex couples and single
intended parents. Mexico’s surrogacy industry had the exact characteristics that were most
criticized in other markets: a largely foreign clientele of gay and single men who were evading
bans on surrogacy in their home countries by going abroad and/or seeking a “discount”
alternative to the United States by contracting a surrogate in a developing country. Having
witnessed the wave of bans on surrogacy in other countries, surrogacy agencies operating in
Mexico were acutely aware of the need to combat criticism to avoid the same fate. Many of the
surrogacy agencies operating in Mexico were owned and managed by the very same people who
had previously operated agencies in India and Thailand. Surrogacy agency owners sought to
maximize their business opportunities in Mexico, in part by staving off criticism to hinder, or at
least delay, restrictive regulations.
The intended parents, who contracted surrogates in Mexico, were also well aware of the
critiques of transnational surrogacy that had spurred regulatory changes in former “low-cost”
surrogacy hubs and were proactive in countering the narrative that surrogacy is exploitative. The
Mexican surrogacy market, during the time of my research, was a precarious market. Actors in
the Mexican surrogacy industry understood that they have limited opportunities, given the
restrictions on markets in India and Thailand, and sought to protect those opportunities. This
context shapes my research questions as well as the themes and issues that I explore in my
dissertation.

Research Questions
Surrogacy tourism epitomizes the current “global situation” in which states, extra-
national institutions, biomedicine, and capitalism converge in new ways that impact how we live

25
and create life (Franklin and Lock 2003; Tsing 2000). My research addresses the intellectual,
material, and social problem of how we as a global society deal with new technological
possibilities in a world of global circulation whose conduits are shaped by economic and social
inequalities. Rather than make normative claims about the surrogacy industry based on abstract,
ostensibly universal values, this dissertation analyzes "ethics-on-the-ground," that is, the values
that emerge in relation to specific historical and social contexts and in relation to new
technological possibilities (Cohen 1999; Lakoff and Collier 2004). Therefore, I ask the following
research questions:

Producing global markets
What processes are involved in creating and sustaining a new site of medical tourism? What are
technical and social processes that are involved in producing a global market for baby making?
How do different places become "visible" or legible as possible surrogacy tourism destinations
and which wombs become "available" as a result of these global searches? How does the
organization of the Mexican surrogacy industry affect the way actors experience the surrogacy
process?

Negotiating intimate economies and ethics on the ground
How do various actors in the Mexican surrogacy industry legitimize their involvement in an
industry that has been banned in most of the world? How do these actors make sense of their role
in the surrogacy industry and in the global market for babies? How do they negotiate the
commercialization of baby making and reconfiguring of kinship?

26
Methods
To answer these questions, I conducted a “global ethnography” of the Mexican surrogacy
market that examines how “global flows of people, technologies, and political agendas shape
reproduction” (Browner and Sargent 2011, 6; Burawoy 2000). Between 2014 and 2017, I
conducted ethnographic research in Tabasco, Quintana-Roo, and Mexico City, Mexico, with
supplementary research in Spain and the United States. Through observation, interviews,
document analysis, and archival research, I collected information about the history and
organization of the Mexican surrogacy industry: the key actors and the everyday processes
through which commercial surrogacy is negotiated and experienced.

History and Organization of a Commercial Surrogacy Market
Through in-depth interviews with a wide range of actors in Mexico’s surrogacy industry,
I sought to understand how and why Mexico became a global surrogacy destination.
Interviewing various actors, including legislators, agency staff, and intended parents, provided a
picture of how the Mexican surrogacy market emerged: the regulatory environment that enabled
it, the international entrepreneurs that initiated it, and the intended parents that sustained it.
I reconstructed a history of surrogacy laws in Mexico through interviews with legislators
and agency staff. I also searched and analyzed documents from the Tabascan congressional
archives. I conducted in-depth interviews with current and former members of the Congress of
Tabasco, government officials from the Secretary of Health, as well as legal scholars at
Universidad Nacional Autónoma de México, Instituto Technologico Autónomo de México, and
Universidad Juárez Autónoma de Tabasco. I collected government documents and media related
to surrogacy to better understand the legal and public debates about surrogacy in Mexico. I

27
interviewed representatives of several non-governmental organizations that are involved in
research, advocacy, and lobby efforts on the topic of surrogacy. I worked closely with legal
scholars and non-governmental organization (NGO) representatives in Tabasco and Mexico City
to reconstruct the history of surrogacy in Mexico and contextualize it within Mexican
reproductive politics.
I interviewed surrogacy agency staff to learn about the history of commercialized,
transnational surrogacy in Mexico. I interviewed owners of surrogacy agencies in Mexico, many
of whom are based in other countries. Through these interviews, I learned about the history and
organization of the surrogacy industry in Mexico.

Observing the Surrogacy Process
Rather than conducting the ethnography at one site, I used an iterative approach and a
“snowball sampling of sites rather than populations” (Erikson 2011, 28). I observed a variety of
participants in the surrogacy industry as they conducted their daily business. For example, I
shadowed a Mexican surrogacy coordinator who works for an international agency based in
Europe as she visited surrogates to deliver medications, met with a lawyer to discuss contracts,
and spoke with intended parents via Skype. During fieldwork, I conducted observations at,
among other sites, a hospital in Villahermosa where most surrogates undergo Caesarean-
sections, a house for surrogates in Cancun, a fertility clinic in Villahermosa, a congressional
symposium in Mexico City on regulating surrogacy, and conferences in San Francisco and Los
Angeles for intended parents considering surrogacy. I accompanied surrogates to medical
appointments, to meetings with surrogacy agencies and intended parents, and during various day-
to-day activities. I went with intended parents to pediatricians, the civil registry office, meetings

28
with lawyers, and social events with other intended parents. Through observations at a wide
variety of sites and with a range of participants, I collected information about the everyday
negotiations and practices involved in the operation of the transnational surrogacy industry.
In addition to observation, I conducted in-depth, semi-structured interviews with 120
participants, including 45 surrogates, 26 intended parents, 15 surrogacy agency staff members,
15 government officials, and eight doctors. Interviews ranged in length from 30 minutes to five
hours. Of the participants, 117 were interviewed in person at least once and the remaining three
interviews were conducted via Skype. Sixteen participants became key informants and were
interviewed multiple times over a three-year span. Interviews were conducted in Spanish,
English, or Hebrew, depending on the participant’s wishes. All but five of the formal interviews
were audio-recorded and transcribed. The remaining participants asked not to be audio-record.
For those five interviews, I took detailed notes. Many of the formal interviews led to more
informal discussions that are included in my field notes. All translations are my own. Names and
some identifying information have been changed to protect participants’ anonymity.
Surrogates and intended parents were found using snowball sampling through personal
connections and calls for participation on Facebook and Twitter. I specifically sought out the
intended parents who hired the surrogates that I had interviewed and vice versa. Separately,
interviewing each party in a surrogacy arrangement allowed me to compare their narratives and
understandings of the process. I contacted surrogacy agency owners and staff, doctors,
government officials, and staff at NGOs using contact information that I found on the Internet or
through other participants. My fieldwork took place during visits of varying length over the
course of three years. After each visit to the field, I coded the new data, wrote memos, and

29
adjusted my research plan and interview questions to account for emerging themes and to further
investigate unexpected findings

Chapter Overview
Chapter 1 provides an overview of the history of the Mexican surrogacy industry from
1997 when the term surrogacy was first added to the Civil Code of Tabasco to January 2016
when the Congress of Tabasco passed a bill to heavily restrict surrogacy. I describe the origins of
Mexico’s surrogacy industry and its growth as a global surrogacy hub. I then discuss the
conditions under which the Tabasco government decided to prohibit both foreign intended
parents and gay and single men from contracting surrogates. In this chapter, I demonstrate that
two factors contributed to the instability of the surrogacy industry in Tabasco and ultimately the
government’s decision to shut it down: 1) the perception that the surrogacy industry in Mexico
was started by and for foreigners, and 2) the high visibility of non-traditional families amongst
surrogacy clients in Mexico. Chapter 1 highlights the unstable and contingent nature of the
transnational surrogacy market. The Mexican surrogacy industry is an example of the remarkable
creativity of global capital in which global demand finds sites of opportunity, as well as the
limits of global capital and the growing pains of globalization.
Chapter 2 explores the strategies Mexican surrogate mothers and intended parents use to
manage the stigma associated with participating in surrogacy. I find that Mexican surrogate
mothers manage the stigma associated with surrogacy by condemning their condemners and
projecting a social identity as modern subjects in a backwards society while intended parents
emphasize their marginalization, downplay the element of choice, and construct moral
boundaries between themselves and intended parents in India.

30
The literature on surrogacy tends to paint surrogates as victims and intended parents as
elite consumers with agency. However, in managing the stigma around participation in
surrogacy, participants seek to flip the script. Intended parents in the Mexican surrogacy industry
describe themselves as victims of discriminatory surrogacy and adoption policies and poor health
insurance coverage for fertility treatments while surrogate mothers describe themselves as
independent, strong-willed women. Both the surrogate mothers and intended parents in Mexico’s
surrogacy industry, manage the stigma of participating in surrogacy by portraying themselves in
ways that contrast with the dominant narratives about transnational surrogacy.
Chapter 3 focuses on the issue of commercialization, which is a major point of contention
in surrogacy debates in Mexico and globally. Scholars have long debated the relationship
between morality and the market. Some argue that morality tempers market interests while others
argue that the market has its own moral order. Meanwhile, feminist scholars have argued that a
false binary between altruism, family, and intimacy on the one hand, and the cold calculus of the
market on the other, is based on gender ideologies. Norms around motherhood, in particular,
emphasize self-sacrifice, love, and altruism in opposition to self-interested market logics.
Commercial surrogacy blurs the line between family and commerce and is therefore an ideal
setting for studying tensions between altruism and profit. In Chapter 3, I demonstrate that
treating altruism and commercialism as dichotomous can further market interests by preserving
the moral palatability and profitability of the industry while perpetuating power asymmetries
rooted in gender, race, class, and nationality between surrogate mothers and intended parents.
Chapter 4 analyzes childbirth practices in the Mexican surrogacy industry to understand
how competing values are negotiated in a transnational context. Feminist scholars have argued
that childbirth practices reflect broader cultural values and norms. I find that even in the

31
consumer-driven world of surrogacy, physicians are primarily responsible for childbirth
decisions. In the Mexican surrogacy industry, physicians promote the use of Caesarean sections
by stating that the maternal-infant bonding experience of vaginal birth is contraindicative of the
goals of surrogacy. I explore the implications of this ideology for understanding how gender and
kinship ideologies intersect with notions of risk in medical contexts. This chapter contributes to
feminist analyses of medicalization by demonstrating how normative views of motherhood and
family formation inform medical practice and materially impact women’s bodies. Reproductive
technologies have the potential to disrupt deeply ingrained cultural assumptions about family,
kinship, and gender, but as Chapter 4 demonstrates, sometimes those very cultural assumptions
shape the way technologies are deployed.

32

CHAPTER 1: CREATING A GLOBAL SURROGACY HUB

Chapter 1 details Mexico’s emergence as a global surrogacy hub. Originally, I proposed
to study the Mexican surrogacy industry to better understand the processes through which new
routes of medical tourism are established. However, Mexico’s surrogacy industry never fully
stabilized. The industry was plagued by scandals, legal battles, and miscommunications
throughout its short history. The Mexican case highlights the contingent and unstable nature of
the transnational surrogacy market. The Mexican surrogacy industry is an example of both the
remarkable creativity of global capital in which global demand finds sites of opportunity as well
as the growing pains of globalization.
While surrogacy clients come from every part of the world, only a few countries have
become hubs for surrogacy tourism. This chapter explores the local and global context in which
the Mexican surrogacy industry emerged to better understand how certain places become
“visible” or legible as possible surrogacy tourism destinations, and in which wombs become
“available” as a result of these global searches. Using interview data, government documents,
and news reports, Chapter 1 traces the way international networks and biomedical technologies
converge with fractured regulatory regimes and local economies in the formation of new
transnational industries.
Ahiwa Ong and Stephen Collier’s (2005) concept of global assemblages is useful for
analyzing the history of Mexico’s surrogacy industry. The “global assemblage” is a tool for
analyzing global phenomena through the heterogeneous, contingent, and unstable groupings of
actors, regulatory regimes, and technologies that form in specific sites and around specific
problems. Through its attention to instabilities and conflicts, the global assemblage approach

33
“diverges from the standard fare of relativizing cultural analyses, sociological reductions to
structures of power, or political economic analyses of hegemony that have dominated
discussions of globalization” (Collier and Ong 2005, 10). Collier (2006) describes “global
assemblages” as “an alternative to the categories of local and global, which serve to cast the
global as abstraction, and the local in terms of specificity” (400). Using the concept of global
assemblages brings analytic focus to the tensions and instability of the Mexican surrogacy
industry.
In what follows, I describe the contingent relations through which the Mexican surrogacy
industry formed. Through this history, I elucidate several key factors that enabled Tabasco to
emerge as a global surrogacy hub at a specific historical moment. The legalization of surrogacy
in Tabasco set the conditions of possibility for the industry. Meanwhile, the increased cultural
and legal valence of gay parenthood along with the changing surrogacy regulations in former
surrogacy hubs fueled consumer demand. Advances in medical, transportation, and
communication technologies made the industry feasible. The pre-existing infrastructure of
international surrogacy agencies meant that agencies could set up in Mexico quickly. Through
these processes, diverse people were brought into intimate contact for the creation of a child. In
producing a new industry, these legal, technological, and cultural shifts also produced new
subjects, ways of understanding the body and kinship, and moral quandaries to contend with.

The Origins of Tabasco’s Surrogacy Law

The Mexican surrogacy industry is centered in the State of Tabasco, Mexico. Tabasco is a
relatively poor state in Southern Mexico with approximately 2.3 million residents. Prior to
becoming a global hub for surrogacy, Tabasco was not a medical tourism destination. In fact,

34
Tabasco was not an international tourist destination at all. How then did Tabasco become a
global surrogacy hub?
The story of Tabasco’s surrogacy industry begins more than a decade before the first
child was born through gestational surrogacy in the state and a full six years before the first
fertility clinic with in-vitro fertilization capabilities opened in Tabasco. When I began fieldwork
in 2014, very few people outside of the surrogacy industry knew what surrogacy was and many
were shocked to find out that surrogacy was legal in Tabasco. In fact, a number of government
officials confessed that they did not know that surrogacy was legal in Tabasco until foreign
intended parents started requesting birth certificates for children born through surrogacy at the
civil registry office in Villahermosa, the capital city of Tabasco.
In 1997, the Congress of Tabasco ratified a new civil code that included an article with
instructions on how to legally register a child born through surrogacy. Unlike other international
surrogacy hubs like India, Thailand, and the United States, surrogacy was formally legalized in
Tabasco, Mexico long before the practice was popularized. This history begets several questions:
Why was surrogacy legalized in 1997? Why did it take another 15 years for Tabasco to become a
global surrogacy destination? In what follows, I draw on interviews and archival research to
answer these questions and reconstruct the history of Tabasco’s surrogacy industry.
In 1994, Roberto Madrazo Pintado was elected governor of Tabasco. He was known as a
forward-thinking reformer. He studied law at Mexico’s largest and most prestigious university,
Universidad Nacional Autónoma de México (UNAM) and urban planning at the University of
California, Los Angeles. Part of his project to reform Tabasco was to completely re-write the
Civil Code and the Criminal Code of Tabasco. To do so, he enlisted the help of legal scholars at
UNAM and Universidad Juárez Autónoma de Tabasco, the largest university in Tabasco.

35
In 1997, the Congress of Tabasco passed a new civil code, which had been drafted by a
group of legal scholars. Included in the 771-page civil code is an article that essentially legalized
surrogacy in Tabasco. Article 92 of the civil code focuses on the legal duty to recognize children
(deber de reconocer al hijo). This article details the information that should and should not be
included in birth certificates. The article specifically prohibits the terms “illegitimate child,”
“child of unknown father,” or “children created through a method of artificial human
reproduction” from being listed on a birth certificate. The article then explains how birth
certificates for children born through surrogacy should be handled:

En el caso de los hijos nacidos como resultado de la participacion de una madre gestante
sustituta, se presumira la maternidad de la madre contratante que la presenta ya que este hecho
implica su aceptacion. En casos en lo que participe una madre subrogada, debera estarse a lo
ordenado para la adopcion plena.

Se entiende por la madre gestante sustituta, la mujer que lleva el embarazo al termino y
proporciona el componente para la gestacion, mas no el componente genetico. Por el contrario,
la madre subrogada provee ambos: el material genetico y el gestante para la reproduccion. Se
considera madre contratante a la mujer que convega en utilizar los servicios de la madre
gestante sustituta o la madre subrogada, segun sea el caso.

In the case of children born as a result of the participation of a gestational surrogate mother, the
maternity will be presumed to be of the contracting mother since this fact implies its acceptance.
In cases in which a [traditional] surrogate mother participates, there must be an order of full
adoption.

It is meant by gestational surrogate mother, the woman who carries the pregnancy to term and
provides the gestational component, but not the genetic component. In contrast, a [traditional]
surrogate mother provides both: the genetic material and the gestation for reproduction. The
contracting mother is considered the woman who agrees to use the services of the gestational
surrogate mother or the [traditional] surrogate mother, whichever is the case.

The 92
nd
Article of the Civil Code of Tabasco defines two types of surrogacy: gestational and
traditional and provides instructions on how parentage claims should be handled for each type of
surrogacy arrangement.

36
In 1997, very few countries had laws regarding surrogacy. How did an article about
surrogacy end up in the Civil Code of Tabasco long before most jurisdictions around the world
even began to consider the issue of surrogacy? This is a question I asked dozens of people during
my fieldwork, including preeminent legal scholars and lawyers working in the surrogacy
industry. Rather than simply recount what I managed to find out about the origins of this law, I
will walk readers through my research process. I have chosen to present the information in this
way because I believe that the narrative surrounding the origins of Tabasco’s surrogacy law is as
important, if not more important, than its “true” origin, which is impossible to fully verify.
When I arrived in Mexico in 2014, I asked everyone that I spoke to if they knew why an
article regarding surrogacy was included in the Civil Code of Tabasco in 1997. The response I
heard most often was that a local senator’s wife was unable to get pregnant and he asked the
governor to include the clause regarding surrogacy in the civil code as a favor to him. When I
probed for more details, I was told that the origin of the article was a mystery that I would not be
able to solve. For example, I had the following conversation with the most well-known surrogacy
lawyer in Tabasco, Luis:

April: Do you know anything about the history of the law here? Because I’ve been trying
to find out why –

Luis: You won’t find anything, believe me, I’ve been looking for information – when was
this approved, because in order to include this in the civil code, there has to be a petition.
But it’s gone, it’s not out there I mean. People just don’t know.

April: I’ve heard stories. The governor’s wife couldn’t get pregnant…

Luis: It wasn’t the governor. It was a senator.

April: Do you know the senator’s name?

37
Luis: No. No, because this guy was very, very, very careful with his identity. It was
approved to include this into the civil code because of him. But nobody says his name. So
nobody knows.

After speaking with Luis, I met with a group of legal scholars at Universidad Juárez
Autónoma de Tabasco. When I asked about the origin of the law, one professor explained, “The
governor at the time wanted a vanguard civil code, the most modern, as modern as possible”
Another professor added, “And he left us with problems.” When I asked where I could find
information about the impetus to include an article on surrogacy in the civil code, the first
professor replied, “There are no records of the debates, because the discussion really happened
within the commission [the group of legal scholars who wrote the civil code]… but what you
will find is the exposition of motives or the justification for the article because that is the manner
in which you explain the reasoning… that we have.” A third professor, Patricia Mendoza Torres
interjected, “I looked. It is not there!”
Professor Mendoza Torres wrote her Master’s thesis about surrogacy and researched the
origin of Tabasco’s law. She told us that she searched the congressional archives and could not
find much information about the impetus to legalize surrogacy. She also searched the
congressional archives for a recording or notes from the congressional debates regarding the
1997 Civil Code and came up empty handed. This led to a debate amongst the scholars. One
professor said, “I worked in the judiciary, it was recorded… all of the… for examples we sat
today to debate a reform and they always have a recorder and they take photos.” Professor
Mendoza Torres shook her head and replied, “It is not there, not even the stenographic version
exists.”

38
After my conversation with the law professors, I searched the congressional archives.
There were notes regarding Article 92 of the 1997 Civil Code of Tabasco and there were no
minutes from the congressional meeting for the day that the civil code was ratified. As the
archivist and her assistant searched through binders and boxes for the files, they kept repeating,
“que raro” (how odd). They were surprised that the records were missing. After picking up a
copy of the civil code at a local bookstore, I found that surrogacy was mentioned in a short
exposition of motives at the start of the civil code. The exposition of motives explains that new
legal figures, including the “gestational surrogate mother,” were included to “prevent a series of
conflicts that could arise in case of artificial insemination… and the imminent presence of
scientific methods of procreation.”
I then contacted several people who served in the Congress of Tabasco in 1997 when the
civil code was passed. Several former congressmen were working in state government during my
research and declined my requests for interviews. I managed to interview two former
congressmen who were in office in 1997 when the civil code that legalized surrogacy was
passed. One is currently a religious leader in Tabasco. He told me that he did not read the entire
civil code before voting to pass it and had no idea that there was an article legalizing surrogacy.
If he had known, he contended, he would not have agreed to pass the civil code. The other
former congressman, currently a law professor, said that he knew about the Article 92 but that
most of his colleagues did not. Both explained to me that in Tabasco and Mexican state politics
generally, the bills that come down from the governor are almost always rubber-stamped.
Mexican politics, they explained, is top-heavy in that the governor’s agenda is usually approved
by state congress with little resistance.

39
Through various interviews, I learned that a team of legal scholars at UNAM’s Institute
for Juridical Investigations were involved in writing the 1997 Civil Code of Tabasco. It is
common practice in Mexico for elected officials to work with legal scholars to write legislation. I
was given the names of several scholars who were thought to have been involved in writing the
Civil Code of Tabasco. A few of these scholars denied involvement or declined to be
interviewed. One legal scholar, currently serving as a magistrate in Mexico City, not only agreed
to be interviewed, but also claimed to have drafted the article regarding surrogacy. When I asked
him how the topic of surrogacy came up, he explained that the governor had specifically
requested revisions to family and divorce law. He then said, “We found that one of the main
reasons for divorce was because the wife conceived a child, not through adultery, but through
artificial insemination without the knowledge of her husband.” When he and his team began
looking into this issue they realized that reproductive techologies could lead to a variety of issues
around parentage that had yet to be addressed in Mexican law. Looking at examples from
abroad, he noticed that “there were many conflicts in the United States.” In writing a new civil
code for Tabasco, the magistrate had the opportunity to address the topic legislatively rather than
wait for a case, like the Baby M case in the United States, to go through the court system. He
explained, “usually social phenomena predate the law, so when we had the opportunity to revise
the civil code [we took it].” This magistrate and his collegues at UNAM participated in the
revision of many other state civil and penal codes but each state had different priorities. Since
family and divorce law was not a top priority for some states, the topic of surrogacy did not
come up. In other cases, similar surrogacy laws were suggested by the team at UNAM but were
not approved by the state government.

40
When the magistrate told me that the topic of surrogacy arose from cases in which
women were getting pregnant through artificial insemination without the knowledge of their
husbands, I was skeptical. However, I found an article in a Tabasco newspaper from 1997 that
discusses the state’s new civil code and specifically the issue of wives using artificial
insemination without their husbands’ knowledge. The article states:

En cuanto el Código Civil, expresó que al renovarse se introdujeron
nuevas figuras jurídicas, entre ellas se sumaron dos nuevas causales
de divorcio: por separación de cuerpos por más de un año y el embarazo
por métodos artificiales, sin el consentimiento del cónyuge. (Juan Jose Padilla 1997)

As for the civil code, he [the governor] expressed that the revised version introduces new
juridical figures, amongst them are two new causes for divorce: for physical separation more
than a year and for a pregnancy using artificial methods, without the consent of one’s partner.

Another legal scholar who was involved in writing the 1997 Civil Code of Tabasco
echoed the magistrates sentiments, explaining that Tabasco’s forward thinking governor gave
this group of scholars a rare opportunity to get ahead of technology. At the time, he said, the
main concern with surrogacy was legal parentage. By delineating the parentage laws before
surrogacy was popularized in Mexico, he thought Tabasco could avoid the dilemmas that had
faced courts in the United States. He never imagined that this article in the civil code would lead
intended parents from around the world to seek surrogates in Tabasco. Both lawyers expressed
dismay that surrogacy had become “so commercialized.”
According to the legislators and legal scholars I interviewed, the origin of Tabasco’s
surrogacy law is not nearly as salacious as most people in the state believe. Instead, Article 92,
they argue, is the product of Mexican legal scholars looking abroad in attempt to predict the
complications that would arise from new technologies. It is also a product of a political system in
which legislation is passed without much debate. The entirety of the Civil Code of Tabasco is

41
available for purchase at any bookstore in the state and yet government officials, lawyers,
doctors, as well as laypeople repeatedly told me that they had never heard of surrogacy or did not
know that it was legal in Tabasco until foreign intended parents arrived.

Surrogacy Begins in Tabasco

Article 92 of the Civil Code of Tabasco created a legal basis for the surrogacy industry in
Tabasco. However, it took doctors, laboratories, surrogacy tourism entrepreneurs, and women
willing to be surrogates to make Tabasco a global hub. In this section, I will discuss the
beginnings of surrogacy in Mexico before it became an international hub for surrogacy tourism.
In 2003, a husband and wife team of OB/GYNs from Mexico City opened Reproduction
Center, the first fertility clinic in Tabasco. At the time, they had no idea that surrogacy was legal
in the State of Tabasco. Dr. Beltran, founder of Reproduction Center explained:
We started in 2003, we were the first center for reproduction in the state… I want to be
honest; we did not know that this [surrogacy] existed, this law, this article in the civil
code, until one of our patients who is well-connected to the government and whose
husband is a lawyer told us. We said “Wow, how nice! If it’s legal of course we can do it
for you…” And that’s how we started to do this.

Dr. Beltran became a national leader in surrogacy by chance. In 2007, a woman from Veracruz
approached Dr. Beltran about having a child through surrogacy. After suffering numerous
miscarriages, she found a woman who was willing to be a surrogate for her and needed a doctor
to perform the medical procedures.
At the time, Dr. Beltran knew little about surrogacy. Technically, Dr. Beltran explained,
surrogacy procedures are simple in that they are identical to the in-vitro fertilization procedures
he performs regularly. But legally, socially, and ethically, this was new territory for the clinic.
He reached out to Latin American Network for Assisted Reproduction (REDLARA) but they had

42
no guidelines for surrogacy. He contacted colleagues in the United States but did not find the
contracts used in the U.S. to be particularly useful for the Mexican context. So, with a group of
lawyers in Tabasco, Dr. Beltran designed a short legal document to guide the process. As the
clinic’s surrogacy practice has grown, this legal document has expanded into a much lengthier
contract.
The first gestational surrogacy birth in Tabasco took place in 2008. For the next few
years, Reproduction Center handled only a few surrogacy cases a year. Intended parents were
referred to Reproduction Center through word-of-mouth. One Mexican woman, Marina, who had
a child through surrogacy with the help of Dr. Beltran and his team at Reproduction Center was
particularly instrumental in spreading the word about surrogacy in Tabasco. Marina created a
website, Facebook page, and blog to document and publicize her experience. Her story caught
the attention of National Geographic: Latin America and was featured in an episode of a
documentary series about bio-ethical issues called Mi Decision or My Decision. Each episode of
the series explores a controversial topic, such as euthanasia and abortion, through first-hand
accounts from three or four people. The episode on surrogacy included a well-known
Argentinian reporter who contracted a surrogate in the United States, a Colombian woman
seeking the opportunity to be a surrogate, and Marina. Mi Decision’s surrogacy episode aired in
2010 and brought attention to Reproduction Center and surrogacy in Tabasco. Marina’s story
was also mentioned in a few Mexican newspapers after the episode aired.
The National Geographic television show brought media attention to Tabasco’s surrogacy
law for the first time, but Tabasco did not become an international surrogacy hub for another few
years. Reproduction Center saw an uptick in patient inquiries after the show aired, but they were
still only managing a handful of surrogacy cases a year. During these first few years of surrogacy

43
in Tabasco, intended parents usually arrived at Reproduction Center with a woman who had
agreed to be a surrogate for them. The clinic’s role at the time was limited to the medical aspects
of surrogacy. As the surrogacy industry in Tabasco grew and a number of competing clinics
opened in Villahermosa, the clinic took on more of agency role in surrogacy arrangements.
While Dr. Beltran insists that Reproduction Center is a medical clinic and not a surrogacy
agency, Reproduction Center performs the functions of an agency. Reproduction Center staff
screens potential surrogates, matches intended parents with surrogates, provides counseling
services for intended parents and surrogates, and refers intended parents to surrogacy lawyers.
As Tabasco went from a word-of-mouth surrogacy destination for Latin Americans to an
international surrogacy hub, Reproduction Center’s business practices changed to manage the
growing demand for surrogacy.

Making a Global Surrogacy Destination

The following section outlines how Tabasco went from having one clinic that handled a
handful of surrogacy cases a year to becoming a global hub for surrogacy. Regulatory changes
sparked global demand for a new hub. The pre-existing infrastructure of the transnational
surrogacy industry made it relatively easy for international agencies to set up a new hub. By the
time Mexico became a global hub for surrogacy, international agencies were already adept at
shifting operations amidst changing regulations.
Hugo is an attorney and the Mexico program coordinator for New Generations, a
transnational surrogacy agency. When I interviewed him in June 2014, New Generations’
Mexico Branch had only been open for a few months. However, Hugo was quick to explain that
the agency had been operating internationally for much longer, “our company has worked for

44
seven years, all over the world, providing surrogacy services in India, Cyprus, Georgia, Ukraine,
and Ireland.” Like most of the surrogacy agencies that operate in Mexico, New Generation’s list
of international branches changes frequently in response to changes in the global surrogacy
market.
Surrogacy has been legal in the State of Tabasco since 1997 but it was not until 2013 that
Mexico rose to popularity as a global surrogacy destination. Hugo explained that this was the
direct result of legal changes in India:
People have been doing it in Mexico for a long time. They'd been doing it, how to say it,
like in a more confidential way. It's something not really well known… Now what
happened, after surrogacy was banned from India last year, well, we started with this
project, a big marketing project, to say it this way, so that everyone all over the world
could be aware of Mexico.

In late 2012, the government of India announced that surrogacy visas would only be issued to
heterosexual couples that had been legally married for at least two years (Rajadhyaksha 2013).
International surrogacy agencies set out to find new destinations for intended parents who did not
meet the new requirements for surrogacy in India. Some agencies moved operations to Thailand
and Nepal but both hubs were short lived (Schurr and Militz 2018). In 2014, the Baby Gammy
scandal in which an Australian couple was accused of abandoning their child via surrogacy
because he had Down syndrome led to a complete ban on surrogacy in Thailand. In 2015 the
Nepal earthquake devastated the country and halted the nascent surrogacy industry (Preiss and
Shahi 2016). With these destinations shutting down, Mexico became even more popular. By the
time India’s surrogacy regulations changed, surrogacy had already been legal in Tabasco for over
a decade, but this fact was mostly unknown, even to international surrogacy experts. Thus,
surrogacy agencies like New Generations, created “big marketing projects” to make potential
clients aware of this “new” destination, in turn creating a new global surrogacy hub.

45
The first international surrogacy agency to start working in Mexico was Planet Hospital.
Planet Hospital, the brainchild of American entrepreneur Rudy Rupak, was an international
leader in the medical tourism industry. Planet Hospital had operated a surrogacy agency in India
for several years before opening a Mexico branch in 2013. Rupak began directing surrogacy
clients to Mexico when it was announced that India would be shutting its doors to gay and single
intended parents as well as couples who had been married for less than two years.
Planet Hospital’s surrogacy program in Mexico did not last long. In 2014, less than a year
after beginning operations in Mexico, Rupak came under investigation by the FBI for fraud. A
group of disgruntled intended parents sued Rupak for fraud and the company was forced into
bankruptcy. Rupak was adamant that he did not intend to defraud intended parents, but was
simply bad at managing money. In 2017, Rupak was sentenced to two years in prison for
defrauding clients, bribery, and international wire fraud.
The story of Planet Hospital’s collapse first made headlines in the summer of 2014. The
New York Times published a lengthy article by Tamar Lewin entitled “A Surrogacy Agency
Delivers Heartbreak” on the front page of its New York Edition. Lewin characterized the story of
Planet Hospital as a “cautionary tale about the proliferation of unregulated surrogacy agencies,
their lack of accountability and their ability to prey on vulnerable clients who want a baby so
badly that they do not notice all the red flags” (Lewin 2014). But, rather than deterring intended
parents and stopping Mexico’s surrogacy industry in its track, there was a surge of surrogacy
clients in Mexico after the article came out. While the article focused on the risks of engaging in
the unregulated world of transnational surrogacy, media coverage of Planet Hospital led to
increased awareness of Mexico’s surrogacy industry. Planet Hospital shut down as a result of the
fraud charges, but a plethora of new surrogacy agencies arose in its place, many headed by

46
former Planet Hospital employees. As Lewin explained, “the demand for affordable surrogacy
and the potential profits are such that all the former main players in Planet Hospital — its vice
president, the head of the egg-donor agency it worked with, the woman in charge of the Cancún
surrogate housing, and Ms. Moscarello, the client representative — are starting their own
surrogacy businesses in Mexico” (Ibid). Other entrepreneurs followed suit by opening surrogacy
agencies in Mexico.
Overseas Surrogacy was one such agency to rise from the ashes of Planet Hospital. When
I asked Emily, the U.S. based owner and founder of Overseas Surrogacy how she became
involved with surrogacy in Mexico, she explained:
Well, actually there was a conference that was in Los Angeles, and Planet Hospital was
exhibiting there, and my employee at the time who is actually now an employee again,
she went to go just kind of look at, you know, just the conference in general, and said
"Oh, you know there is a company doing surrogacy in Mexico," and I said "Oh, that
sounds much more manageable than India." Cause at the time we were being kind of
looked at to send our [egg] donors in India, which I wasn't very comfortable with, just
because I wasn't quite happy with the conditions of the surrogates, and how far away it is,
and how difficult it is to kind of have our management on. And so, she came back and
she said "Oh, Mexico," and I said "Well great, but I'm trying to figure out India right
now. Let's table this." So a few months later I reached out Planet Hospital and they
ended up utilizing my egg donors for about three months, and then they, you know,
exploded and everything went crazy for them in a very bad way. So, a lot of those
intended parents had come to me and said, "You know, since you've been doing
surrogacy for so long, you have this experience and background, are you considering
doing Mexico?" And, at that time I really wasn't… I was very content and happy in my
little, you know, donor and surrogate world in the US. But there was definitely a need for
it. And, at the time when I looked into the field there was really no one with any sort of
background or experience in surrogacy in general, in that arena, that seemed, you know,
that they could be trusted with money, or ethics, or anything. So that's when I started
Overseas Surrogacy.

Emily had been running an egg donor and surrogacy agency in the United States for several
years before she began considering expanding her business abroad. She describes her entrée into
the Mexican surrogacy industry in almost altruistic terms. She describes herself as having the
expertise and trustworthiness to help out intended parents who were left without options after

47
Planet Hospital’s collapse. While at first Emily felt that her expertise in surrogacy made her well
suited to running a surrogacy agency in Mexico, she later found the task far more arduous than
she had ever imagined. Operating a transnational surrogacy agency in Mexico was far more
complex and arduous than managing a database of U.S. based egg donors and surrogates.
Surrogacy agencies in Mexico oversee every aspect of the surrogacy process.

The Role of Surrogacy Agencies
In addition to advanced reproductive technologies, the transnational surrogacy industry
depends on reliable and affordable communication and transportation technologies for its
operations. International surrogacy agencies market their services to prospective clients, direct
intended parents to jurisdictions that fit their needs/desires and budget, recruit women to serve as
surrogate mothers, and match surrogate mothers with intended parents. Additionally, along with
the staff at fertility clinics, agencies coordinate the surrogate mother’s medical procedures from
preparation to birth. Surrogacy agencies usually provide a form contract that surrogate mothers
and intended parents sign. Depending on the policies of each agency and the desires of the
intended parents, surrogate mothers and intended parents may communicate directly, but most
communicate only via the agency. A few Mexican surrogacy agencies provide housing for
surrogate mothers, where the surrogates are monitored by agency staff and transported to and
from doctor’s appointments. In other cases, surrogates live in their own homes throughout the
process.
Like all surrogacy agencies, one of Planet Hospital’s primary functions was to recruit
intended parents. Rupak had approximately 150 domain names for his surrogacy business with
websites for companies appearing to specialize in gay surrogacy, Christian surrogacy, Mexican

48
surrogacy and more. I found that it was common practice for surrogacy agencies to have multiple
websites with multiple company names to attract more clients.
Once intended parents decide to work with a specific surrogacy agency, the first step is to
sign a contract with the agency and pay initiation fees. The money intended parents pay
surrogacy agencies is supposedly put in an escrow account and then used to pay for fertility
treatments and surrogate’s fees. One of the issues with Planet Hospital was that the money
intended parents paid was never actually put into an escrow account. Next, the surrogacy agency
matches the intended parents with a surrogate. In most cases, the intended parents also select an
egg donor from a database provided by the agency. Intended parents then travel to Cancun or
Mexico City to deposit sperm. The intended parents sign a contract directly with the surrogate.
This ensures that the she is not considered an employee of the agency. Some contracts between
the intended parents and surrogates in Mexico did not include specifics about payment because
of the misconception that paying a woman to be a surrogate in Mexico was illegal. Other times,
the contracts describe the amount and timing of compensation for time and pregnancy-related
expenses. Each agency uses a slightly different standard contract but certain elements were
standard practice in Mexico. The contracts usually state that the surrogate will undergo no more
than three embryo transfers. If all three transfers are unsuccessful, then the contract between the
surrogate and the intended parent will be voided. The contracts describe the process and cover
the surrogate’s obligations to assist the intended parents in conferring their parentage after the
birth. Once the contracts are signed, the surrogate is prepped for an embryo transfer. Contracts in
Mexico are only enforceable if they are notarized by a notario publico. The services of a notario
publico, which translates to but is not equivalent to functions of a notary public in the United

49
States, are very expensive. Therefore, agencies usually wait until the embryo transfer or until a
pregnancy is confirmed to have the contracts notarized.
Preparing a surrogate for an embryo transfer involves a number of steps. First surrogate
mothers are prescribed birth control to stop ovulation. Next, they undergo hormone injects to
prepare the uterine lining for the embryo transfer. In the case of Planet Hospital surrogate
preparation, embryo transfers, egg retrievals, and sperm deposits were all performed at two
fertility clinics in Cancun. After Planet Hospital shut down some agencies, they continued to
have surrogates prepped at fertility clinics in Cancun while other agencies had surrogates
prepped in Villahermosa and then flown to Cancun or Mexico City for the embryo transfer. This
circulation of surrogates is done for several reasons. First, fertility clinics in Cancun and Mexico
City have a longer history of doing in-vitro fertilization and have more experienced clinicians
and embryologists. The clinics’ success rates are often touted on agency websites. Also, agencies
prefer to have intended parents deposit sperm in Cancun or Mexico City where they can combine
sperm deposit with a vacation. Visiting a fancy clinic in Mexico City or Cancun also gives
intended parents a sense of confidence about the process. Many intended parents are later
shocked when they come to Villahermosa and see a very different side of Mexico.
Meanwhile, the egg donor is prepared for oocyte retrieval. Some egg donors live in
Cancun or Mexico City, two cities with large and diverse populations. In other cases, because of
the demand for “white” babies, egg donors are brought in from other countries like the United
States, Ukraine, and South Africa. For agencies, it is easier to recruit and transport international
egg donors to major cities like Mexico City and Cancun than to Villahermosa. Some surrogacy
agencies have their own egg donation programs within the same organization. In other cases,

50
fertility clinics run egg donor recruitment. There are also independent egg donation agencies that
work with surrogacy agencies.

Building an Industry
While anyone with a laptop can claim to run a surrogacy agency, actually operating an
industry requires staff. Once surrogacy entrepreneurs found Tabasco, they had to assemble an
industry. They needed doctors, lawyers, and on-the ground management. Luis is one of the most
central figures in Mexico’s surrogacy industry but he knew nothing about surrogacy until a
Canadian surrogacy agency owner contacted him. Luis entered the surrogacy industry solely
because he was the only bilingual lawyer in Tabasco that this Canadian surrogacy entrepreneur
could find in a Google search. Luis explained “This guy from Canada called me once and he was
like, “You know what, I’ve been looking for a bilingual lawyer...and I have this company and I
do... something like medical tourism.” Luis was trained as a criminal defense attorney and had
no experience with medical tourism but decided to take on the extra work. At first, Luis helped
this Canadian entrepreneur by reviewing a few surrogacy contracts a month. As the surrogacy
industry in Mexico took off, surrogacy contracts became a bigger part of Luis’s business. By the
time I met Luis in June 2014, he was dedicated full-time to surrogacy law, had hired a staff to
assist him, and was planning to move to a bigger office. By the end of 2014, Luis was operating
his own surrogacy agency while also assisting other agencies with contracts and legal issues.
Luis’s shift from criminal attorney with no knowledge of surrogacy to the face of the surrogacy
industry in Tabasco is emblematic of the contingent nature and transformative effects of the
transnational surrogacy industry.

51
Luis’s story was not an outlier. I heard similar stories from other agency staff in Mexico.
For example, Veronica’s career in the Mexican surrogacy industry began when she responded to
an ad looking for someone who speaks English to work in a hospitality position with tourists.
She knew nothing about surrogacy at the time. Veronica is a petite woman in her 40s with pale
skin and well-coiffed hair. She is perpetually late and always impeccably dressed. She speaks
Spanish, English, and French, has traveled across Europe and the United States. Veronica had
been a full-time homemaker for many years but with her children now teenagers, she decided to
look for work, though it did not appear that her family particularly needed the money. Veronica
was intrigued by the job ad and responded. When Veronica first learned that the position was to
manage the Tabasco operations for an international surrogacy agency, she was apprehensive. She
knew very little about surrogacy but was concerned that it was against her religious beliefs.
Veronica described herself as a devout Catholic. She was offered the position and after some
reflection decided that helping create families, even families for gay men, was a noble cause. She
was also excited about the opportunity to meet intended parents from around the world and to
sharpen her language skills. During the course of my fieldwork in Mexico, Veronica went from a
new and somewhat confused employee of an international surrogacy agency to a sought-after
independent, surrogacy consultant.
After finding on-the-ground staff to manage day-to-day operations, the next step in
building a new surrogacy hub was to recruit women willing to be surrogate mothers. The first
wave of Mexican surrogate mothers was recruited primarily through Facebook. Every surrogate
mother I interviewed in Mexico uses Facebook regularly to keep in touch with friends, read the
news, and look for job opportunities. Facebook and Whatsapp are the primary means of
communication for Mexican surrogate mothers. Most Mexican surrogate mothers have smart

52
phones that they use to log on to Facebook. Surrogacy agencies posted ads recruiting surrogates
on popular Facebook groups. They also asked surrogates to recruit their friends and neighbors.
To this day, there are Facebook groups for surrogacy in Mexico with hundreds of members and
daily posts from people seeking surrogates and women advertising themselves as potential
surrogates.
The quick recruitment of both on-the-ground staff and surrogate mothers was made
possible by advances in communication technologies. The proliferation of smart phones and
Internet access throughout urban areas of Mexico meant that surrogacy agencies were able to
quickly and cheaply recruit surrogate mothers. Applications like Whatsapp, Skype, and Google
Translate enabled intended parents, agency staff, doctors, and surrogate mothers to communicate
regularly despite distance and language barriers.

PART 2: SHUTTING DOWN
The end of Mexico’s reign as a global surrogacy hub was as dramatic, uneven, and
complex as its rise. In December 2015, the Congress of Tabasco passed new regulations limiting
surrogacy to heterosexual Mexican couples. Based on interviews with government officials and
an analysis of local media accounts, I argue that two main factors led to this regulatory change:
1) the perception that the surrogacy industry in Mexico was started exclusively by and for
foreigners and 2) the high visibility of non-traditional families amongst surrogacy clients in
Mexico.
An obscure article added to the Civil Code of Tabasco in 1997 directs the civil registry to
list the intended parents’ names rather than the surrogate mother’s on the birth certificates of
children born through surrogacy. This clause effectively made surrogacy legal in Tabasco. The

53
existence of this article, or even surrogacy itself, was widely unknown in Tabasco until foreign
intended parents started coming to Villahermosa, the state’s capital city. Even most legislators
and government officials in Tabasco were unaware that Article 92 of their state civil code
mentioned surrogacy until advertisements soliciting women to serve as surrogate mothers began
to appear in Tabasco more than a decade later. While technically legal, the Civil Code of
Tabasco did not include any regulations regarding who could hire a surrogate and under what
conditions. The lack of regulation and oversight allowed international agencies to direct gay
men, single men and women, older intended parents, and men with HIV to Tabasco for
surrogacy. Changes in India’s surrogacy laws and the shutdown of surrogacy in Thailand lead to
a lacuna in the global surrogacy market. Given the costs of surrogacy in the United States,
Mexico was an appealing option for many intended parents. This, however, made surrogacy even
more controversial in Tabasco as residents associated surrogacy with older parents, and single
and gay men.
The fact that the practice of surrogacy was relatively unknown until foreigners arrived,
added to the controversy. Surrogacy was minimally practiced for several years by one clinic in
Tabasco before the international boom. There was even a National Geographic episode about
surrogacy that featured a couple that had hired a surrogate in Tabasco. Nonetheless, the practice
of surrogacy and its legality in the state was not widely known or understood in Tabasco by
legislators or the public. For more than 15 years after surrogacy was legalized in Tabasco, only
one local clinic had the facilities to perform in-vitro fertilization for gestational surrogacy. The
clinic’s clients were mostly heterosexual Mexican couples who found their own surrogate. The
practice was small and well managed enough to avoid scandals. Once international agencies set
up shop in Tabasco and started advertising for surrogates, the government began to take notice

54
and become concerned. When surrogates or parents experienced problems with the process, it
became common practice to go to the media, which led to a cycle of scandals around surrogacy.
In response, the Congress of Tabasco passed a bill limiting surrogacy to Mexican heterosexual
couples with a medical diagnosis of infertility and banning agencies from acting as
intermediaries in the surrogacy process. Due to ambiguities regarding implementation of the new
regulations, the new law was insufficient to fully shut down the surrogacy industry. By the end
of 2016, the government of Tabasco took more extreme measures to stop the surrogacy industry
by refusing to issue birth certificates to children born through surrogacy. By the summer of 2017,
Tabasco’s time as a global surrogacy hotspot had come to an end. Surrogacy continues to be
practiced in Mexico to a smaller degree, but to date, no state of Mexico explicitly allows
foreigners to contract surrogate mothers.

Reactions to a Growing Industry
When I arrived in Villahermosa for preliminary fieldwork in the summer of 2014, I found
that very few people there knew about surrogacy. When I would tell people why I was in
Villahermosa, my response was generally met with confusion. My discussions with taxi drivers
in Villahermosa were indicative of the public awareness of surrogacy at the time. Unlike other
cities in Mexico, Villahermosa does not have a well-organized public transportation. Taxis are
one of the primary forms of transportation in Villahermosa. Much like New York City, the
streets of Villahermosa are filled with yellow and white taxicabs. I traveled by taxis several times
a day throughout my time in Villahermosa. During the summer of 2014, almost every

55
conversation I had with a taxi driver started the same way. Upon hearing my accent, the driver
would ask where I am from. The conversation would then usually proceed as follows:
A: “Los Angeles”
TD: “What are you doing in Villahermosa?”
A: “I’m here to do research on surrogacy. I’m getting a doctorate in Sociology.”
TD: “What is surrogacy?”
I would then explain the gestational surrogacy processes including in-vitro fertilization in more
or less detail depending on whether the driver appeared to be following. The most common
reactions were, “Wow, I didn’t know that was possible” and “They do that here in
Villahermosa?!” None of the taxi drivers I encountered in 2014 were aware that surrogacy was
being practiced in their city.
By the time I returned to Villahermosa in the spring of 2015, things had changed
dramatically. By 2015, most of the taxi drivers I spoke to had heard of surrogacy, even if they
did not understand all of the details, and knew that it was a controversial practice happening in
Tabasco. In the seven months between my first and second field visits to Villahermosa,
surrogacy had become a regular topic of discussion in the local Tabasco media.
What surprised me was not just how quickly public awareness of surrogacy grew, but
also how much it became associated with gay parents. In 2015, my daily conversations with taxi
drivers rarely involved questions like, “what is surrogacy?” Instead, after explaining the purpose
of my visit to Villahermosa, I was often asked about my views on gay parenthood. The
association between surrogacy and gay parents was so strong. When I told people that I was in
Villahermosa to research surrogacy, the first response was often “how do you feel about gay men
having children?” Media coverage of surrogacy in Tabasco often focused on gay intended

56
parents. There is no reliable data regarding the actual percentage of gay men amongst the
intended parents who contracted surrogates in Mexico, but some estimate that 70% of the
intended parents in Mexico were gay (Burnett 2017). Regardless of whether or not gay men
actually made up the majority of intended parents, the association between surrogacy and gay
parenthood was strong in Tabasco.
Gay intended parents were conspicuous in Villahermosa. Villahermosa is a city of
approximately 600,000 inhabitants and is known as a hub for Mexico’s oil industry. Tabasco’s
economy relies heavily on the oil industry, as does its capital city. While Tabasco is one of the
poorest states in Mexico, the discovery of oil in 1974 led to a small but noticeable upper class
population. The oil industry also brings in a regular stream of business travelers. Daily flights
between Mexico City and Villahermosa are filled with suited men traveling to and from
meetings. While business travel to Villahermosa is common, it is not a tourist destination. The
lack of tourism, especially international tourism, meant that gay intended parents in
Villahermosa were easy to spot. In fact, I found several of the intended parents that I interviewed
simply by approaching them at the airport or the mall. A man pushing a stroller without a woman
by his side is a rare sight in Villahermosa. When I saw a fair-skinned men wearing shorts and
holding a baby or pushing a stroller in Villahermosa, it was clear that they were surrogacy
parents. Gay intended parents, especially European men, stood out in Villahermosa because of
their attire, skin-color, height, and non-gender normative parenting. The hyper-visibility of
international, gay intended parents in Villahermosa solidified the association between surrogacy
and gay parenthood for residents of the city and made surrogacy an even more controversial
issue.

57
Changes to Tabasco’s Surrogacy Law
In December 2015, the Congress of Tabasco voted to pass a new law on surrogacy. The
law, which went into effect a month later in January 2016, included a number of restrictions on
the practice of surrogacy in Tabasco. The law allows only married, Mexican heterosexual
couples to contract a surrogate. It also includes age limits for both intended mothers and
surrogates, but notably not for intended fathers. Intended mothers must be between the ages of
25 and 40 and have medical certification that they are unable to carry a pregnancy or have
medical contraindications to pregnancy. To serve as a surrogate mother, women must be between
the ages of 25 and 35, have not been pregnant in the past year, and have the permission of their
spouse. The law requires that fertility clinics receive certification by the Secretary of Health
before engaging in surrogacy. In addition to listing a variety of criteria that must be met for a
surrogacy contract to be valid in the State of Tabasco, the law also includes a list of things that
would render a surrogacy contract null. Number four on the list of factors that would render a
surrogacy contract null is “Intervention by agencies, offices, or third parties.”
The most controversial part of Tabasco’s new law on surrogacy was the restrictions
placed on the use of surrogacy by gay couples. By the time the law passed, the tide of public
opinion regarding gay marriage was shifting across Mexico. Mexico City legalized gay marriage
in 2009, but there was a patchwork of laws and regulations in other states. There was some
congressional support for a bill to reform the Civil Code of Tabasco to recognize same-sex
marriages. But, according to local activists, there was a lack of motivation on the part of
legislators to move the bill forward. In February 2015, for the first time in Tabasco’s history, the
state civil registry office registered a same-sex marriage. Even though the bill to amend the Civil
Code had not passed, a gay couple from Tabasco filed a writ of protection arguing that their right

58
to marry was guaranteed by the Mexican constitution and they won. This was one of many
similar amparos, or writs of protection, that were filed across Mexico in 2015. Applying the
principles of jurisprudence, in June 2015, the Mexican Supreme Court found same-sex marriage
bans to be unconstitutional. This did not immediately invalidate state laws like the U.S. Supreme
Court decision did, but it was a major victory for gay rights in Mexico. Major breakthroughs for
gay rights came about at the same time that Tabasco was implementing restrictions on a
surrogacy industry that had largely served gay men. A number of surrogacy agencies teamed up
with Mexican gay rights activists to fight Tabasco’s new regulations in court by arguing that it is
unconstitutional to restrict surrogacy to heterosexual couples. These cases are still progressing
their way through the Mexican court system.
Contrary to what many expected, the surrogacy industry did not immediately come to a
halt when the new law was passed. There was one month between when the law was passed by
the Congress of Tabasco (December 2015) and when it went into effect (January 2016). In that
month, intended parents from around the world signed surrogacy contracts with Mexican
women. Surrogacy agencies in Mexico continued to coordinate surrogacy for intended parents
that signed contracts prior to January 2016 and well into 2017. A number of surrogacy agency
staff admitted to backdating contracts for intended parents so that they could take advantage of
surrogacy in Mexico before it shut down. I asked Veronica and Yolanda, two women working
for surrogacy agencies, if they were concerned about violating the new law by continuing their
work as intermediaries. They responded that they were not worried because the law did not
include any penalties for working as an intermediary. As far as they were concerned, the law had
no teeth with regards to the regulations against the use of intermediaries. Also, as veterans of the
surrogacy industry, they were now in high demand and could command higher wages from

59
international surrogacy agencies trying to complete a high volume of surrogacy arrangements
quickly.
In December of 2016, Tabasco’s new surrogacy regulations made headlines again when
the civil registry office stopped issuing birth certificates to children born through surrogacy to
international parents. As far as the government was concerned, all surrogacy arrangements
started before the law went into effect in January 2016 should have been completed by
November. Tabasco’s government did not issue specific guidelines regarding surrogacy
arrangements that had already begun when the new regulations were enacted. Surrogacy
agencies and attorneys in Tabasco told intended parents, and me, that any contracts signed before
January 2016 would not be subject to the new regulations. In December 2016, the government of
Tabasco argued that only pregnancies already underway when the new law went into effect,
should be governed by the old rules. As far as the government of Tabasco was concerned,
intended parents who did not meet the criteria for eligibility under the new regulations, but went
ahead with an embryo transfer after the law went into effect, were violating the law. In February
2017, Tabasco’s controversial decision to stop issuing birth certificates to children born through
surrogacy became national and international news. As a result, intended parents “stranded” in
Tabasco turned to the media, both in Mexico and in their home countries, to put public pressure
on the government.
Surrogacy agencies had been arguing since December 2015 that restricting surrogacy to
Mexican nationals was discriminatory, especially against non-citizen residents of Mexico.
However, this contention did not gain much traction until the case of the stranded intended
parents brought renewed attention to Tabasco’s surrogacy regulations. The intended parents who
turned to the media in order to put pressure on the government to issue birth certificates for their

60
children, were all men. Some were same-sex couples and some single. This drew the attention of
progressive media outlets in Mexico and renewed discussions over whether the new regulations
were discriminatory. For the next few months, surrogacy became a topic of major public debate
across Mexico. The government of Tabasco appointed Juan José Peralta Fócil, the coordinator
for legal issues for the State of Tabasco, as the official spokesperson for matters pertaining to
surrogacy. Peralta Fócil was interviewed numerous times by media outlets, including one of
Mexico’s most popular news shows. In interviews, Peralta Fócil described transnational
surrogacy as a form of human trafficking in which both surrogates and children born to
surrogacy were often victimized. In one instance, a TV show host compared Peralta Fócil’s
characterization of foreign intended parents as lawless, child-traffickers who were exploiting
Mexican women to Trump’s anti-immigrant rhetoric.
At that point, I had already developed close relationships with some government officials
in Tabasco. I had been working with one high-ranking official in the Secretary of Health since
June 2014 when I arrived in Villahermosa for preliminary research. She had shared all of her
department’s research on surrogacy with me, introduced me to top-level administrators at
Universidad Juarez Autónoma de Tabasco, helped me find an apartment, and regularly met me
for lunch. When news broke out about the suspension of birth certificates, I reached out to her.
We had plans to meet for lunch, but then she texted me to say that she was no longer authorized
to speak with me and that all inquiries regarding surrogacy should be directed to Juan José
Peralta Fócil. This demonstrates the extent of the controversy surrounding Tabasco’s decision to
suspend birth certificates.
I had interviewed Juan José Peralta Fócil in November 2016 regarding the impetus to
change Tabasco’s surrogacy laws. At the time, I specifically asked him whether contracts signed

61
before January 2015 would be valid under the old regulations even if pregnancy were delayed for
some reason. He responded, “What is the legal reference? The contract… The contract is our
reference, ‘hey, 5 months passed in preparation and it was not achieved,’ the contract is ...
because everything that is being done here is covered by a contract… put 15 months into the
process, but the contract is the reference.” When I interviewed him again in March 2017, Peralta
Fócil took a different position on the matter. He stated, “the transition should have expired on
October 16, nine months, considering someone who signed a contract on January 13, one day
before the reform.” When I asked about cases in which an embryo transfer was not successful on
the first round, he responded, “We cannot have deliveries of 10, 11, 12, 13, 14 months because it
is impossible. So every child that born after November fall under the new law, it’s common
sense.” As we continued to discuss the matter, he explained that embryo transfers performed
after the new law went into effect, were subject to the new regulations even if the contract was
signed earlier: “Because the process is going to be carried out under the authorization of the new
law and which means that the clinic has to notify the Secretary of Health. Because, if not,
imagine you would have a never ending story.”
It was clear from my conversations with Peralta Fócil that he felt that denying
international intended parents birth certificates was the only way to shut down the surrogacy
industry in Tabasco. To some extent, he was right. News of the stranded intended parents spread
and, in cases where a surrogate was not yet pregnant, many intended parents withdrew from the
process and sought out options elsewhere. Surrogacy, however, continues on a smaller scale
throughout Mexico.
The decision of the Tabasco government to pass new regulations that would effectively
shut down the surrogacy industry, demonstrates the limits of global capital. The fact that citizens

62
of one country where surrogacy is banned can use surrogacy services in other countries, is an
example of the porousness of borders in late capitalism. However, the Tabascan government’s
decision to ban international intended parents is indicative of a re-entrenchment of borders and
the reassertion of state power. The dispute in 2017 over birth certificates for surrogacy children
born after the ban was an attempt by the Tabascan government to take control over a situation.
They felt that international surrogacy agencies and intended parents were taking advantage of the
supposed “lawlessness” of Mexico to continue surrogacy despite the ban.

Conclusion
The history of the Mexican surrogacy industry is an example of an unstable and
contingent assemblage of actors, technologies, and regulatory regimes coming together to form a
new site in the global market for wombs. This chapter demonstrates multiple technological
advances and new ways of conceiving of the body, along with cultural and regulatory shifts
made Tabasco “visible” as a surrogacy destination and Mexican woman “legible” as potential
surrogates. Advances in medical, communication, and transportation technologies enabled a
transnational surrogacy industry to develop and set the stage for the Mexican iteration. In-vitro
fertilization technology made the separation of egg and womb possible, which meant that
surrogate mothers were no longer selected for phenotype and genetics but rather for their
gestational labor. This technology fueled the development of transnational and transracial
surrogacy. Advances in embryo freezing have also enabled the transnational surrogacy industry
to grow, enabling the surrogacy process to start without the intended parents, egg donor, or

63
surrogate being in the same country. Communication technologies have also increased the ease
with which international agencies can move to new sites. Through Facebook, agencies advertise
new surrogacy destinations to intended parents and recruit local surrogate mothers.
There were also legal and cultural shifts that brought global attention to Tabasco. India
changed its laws on surrogacy at around the same time that gay parenthood gained increased
legal and cultural valence in Europe and the United States. The Civil Code of Tabasco created
the conditions of possibility for the state to emerge as a global surrogacy hub. However, it was
not until India’s change of surrogacy laws resulting in the lacuna in the surrogacy market in that
Mexico became visible on a global scale. An unstable and contingent grouping of actors,
technologies, regulations, and cultural shifts came together to produce the Mexican surrogacy
industry and in turn produce new ways of conceiving of the body, new understandings of
kinship, and new moral and ethical debates for the people of Tabasco.

64

CHAPTER 2: MANAGING STIGMA

Chapter 2 explores the narratives Mexican surrogate mothers and intended parents use to
manage the stigma associated with participating in surrogacy. I find that Mexican surrogate
mothers manage stigma by condemning their condemners and projecting a social identity as
modern subjects in a backwards society while intended parents emphasize their marginalization,
downplay the element of choice, and construct moral boundaries between surrogacy in Mexico
and surrogacy in India.
In preserving their self-concept, Mexican surrogate mothers rely on and reproduce
modernist binaries in which the Global North is associated with progress and the Global South
with backwardness. This takes the form of dismissing criticisms of surrogacy as the product of
ignorance about genetics and biology, sheep-like religiosity, and close-mindedness regarding gay
parenthood. Mexican surrogates appeal to individualist notions of agency, genetic
understandings of kinship, and liberal discourses that equate the acceptance of gay parenthood
with modernity. Furthermore, Mexican surrogate mothers describe themselves, and fellow
surrogates as strong-willed, independent, and open-minded. They also code the genetic models
of kinship that undergird gestational surrogacy as modern and scientific and describe those who
oppose surrogacy as old-fashioned, religious, and ignorant. Dominant narratives about
transnational surrogacy, in both popular media and academic literature, often portray surrogates
in the Global South as victims. However, Mexican surrogate mothers describe the decision to
become surrogates, often in defiance of conservative family members and societal taboos, as an
act of agency.

65
While the literature on transnational assisted reproduction generally portrays intended
parents as monolithic members of a global elite, intended parents in Mexico emphasize how
elements of marginalization drive their engagement with transnational surrogacy. In Mexico,
surrogacy clients are often gay men, older couples, or single intended parents who cannot afford
the cost of surrogacy in the United States and have been banned from participating in surrogacy
in other jurisdictions. These same intended parents often face barriers to adoption as well.
Intended parents describe surrogacy in Mexico as a last resort rather than a choice due to a lack
of alternative affordable surrogacy options, especially for same-sex couples or single intended
parents. Intended parents in Mexico also construct moral boundaries between themselves and
intended parents who contract surrogates in India, where they argue exploitation is more rampant
due to high levels of poverty.
The literature on surrogacy tends to paint surrogates as victims and intended parents as
elite consumers with agency (Harrison 2016; Twine 2011). However, in managing the stigma
around participation in surrogacy, these scripts are somewhat flipped. Intended parents in the
Mexican surrogacy industry describe themselves as victims of discriminatory surrogacy and
adoption policies and poor health insurance coverage for fertility treatments, while surrogate
mothers describe themselves as independent, strong-willed women. Both the surrogate mothers
and intended parents in Mexico’s surrogacy industry manage the stigma of participating in
surrogacy by portraying themselves in ways that contrast with dominant narratives about
transnational surrogacy.

66
The Stigma of Surrogacy
Surrogacy is a highly controversial practice and women who serve as surrogate mothers
often face social stigma. Following Goffman’s definition, stigma stems from undesirable
attributes that are “incongruous with our stereotype of what a given individual should be” (1963,
3). In the case of surrogacy, bearing a child and relinquishing it to someone else is incongruous
with our stereotypes of how a mother should act. Commercial surrogacy violates social norms
regarding the pricelessness of children and the sanctity of maternal-child bonds.
Like other stigmatized groups, surrogate mothers engage in identity work, which David
Snow and Leon Anderson (1987) define as the “range of activities individuals engage in to
create, present, and sustain personal identities that are congruent with and supportive of the self-
concept” (1348). Surrogate mothers deploy different stigma management strategies depending on
the context. In her work on commercial surrogacy in India, Amrita Pande (2010) found that
surrogate mothers in India used a variety of strategies to manage stigma. For one, Indian
surrogates “downplayed the element of choice in their decision to become surrogates” (Ibid,
299). Indian surrogate mothers also managed stigma by creating symbolic boundaries and
morally distancing themselves from sex workers and women who give their children up for
adoption. The identity work surrogates engage in is a means of resisting both the stigma and
subordination associated with surrogacy in India. At the same time, Pande (2010) argues, Indian
surrogates’ stigma management strategies are embedded in and reproduce gender norms by
reinforcing the image of women as “selfless dutiful mothers” (303).
In managing stigma, surrogate mothers in the United States also reproduce norms around
proper motherhood. For example, Helene Ragoné (1994) found that both surrogate mothers and
intended parents downplayed the commercial aspects in favor of a narrative of maternal altruism

67
that more readily fits with social norms. Heather Jacobson (2016) found that surrogates in the
United States generally resist labeling surrogacy as work. Instead, they insist on locating
surrogacy within the feminine sphere of family and home. Even while engaging in a process that
disrupts the concept of motherhood, U.S. surrogates reinforce gendered tropes around selfless
motherhood and maternal altruism. These narrative strategies can be understood as a form of
stigma management in which surrogates attempt to resist the spoiled identity of a “bad mother”
who would sell her child.
There is very little research on intended parents’ experiences with stigma. There is a
range of psychological and sociological research on the stigma of infertility, but intended parents
in Mexico are not necessarily infertile (in the medical sense of the term). Most intended parents
in my study are gay men for whom the path to surrogacy is very different from that of infertile
heterosexual couples. The stigma associated with becoming a parent through surrogacy depends
on who is contracting a surrogate, where, and why. Transnational surrogacy arrangements in
which gay men or single intended fathers from the Global North contract poorer women in the
Global South may be the most stigmatized form of surrogacy. These are also the most common
arrangements in the Mexican surrogacy industry.
Like academic literature, media coverage of transnational surrogacy often focuses on the
issue of exploitation. Media representations both shape and reflect public perceptions and
therefore provide insight regarding the type of stigma intended parents face. Markens (2012)
found that media coverage of surrogacy in India focused on the exploitation of women while
coverage of surrogacy within the U.S. was framed more favorably. Rafeal Ventura, Xosé Ramón
Rodríguez-Polo, and Carles Roca-Cuberes (2018) found that media coverage of surrogacy in
Spain leads viewers to associate surrogacy with wealthy gay men who carelessly exploit poor

68
women in India for their own ends. They note that the media portrayal of gay men as the face of
surrogacy is not representative of reality. One study found that 80% of Spanish intended parents
are heterosexual (Leon 2015). Ventura et al. (2018) argue that the media focus on India, as
opposed to Canada, Ukraine, or the United States where surrogacy is also legal and practiced,
might skew viewers’ perceptions of surrogacy. They conclude that the media coverage of
surrogacy in Spain frames surrogacy as an exploitative process practiced primarily by gay men.
This study is particularly relevant to my research as Spanish gay men make up a large portion of
intended parents that I interviewed.
In the following section of this chapter, I analyze the strategies that Mexican surrogate
mothers employ to manage the stigma associated with surrogacy. In the second half of the
chapter, I explore how intended parents, especially gay and single men coming from countries
where surrogacy is morally condemned, manage the stigma associated with surrogacy.

Surrogates’ Stigma Management Strategies

“People are ignorant:” Kinship, religion, and the modern subject

In interviews, surrogate mothers generally described the opposition to surrogacy in
Mexico as the result of close-mindedness and ignorance about the medical process of surrogacy.
Many surrogates felt the need to dispel what they viewed as misconceptions about the surrogacy
process. One of the main points of contention was whether or not the child they were carrying
was theirs. Surrogates ended up educating family members about in-vitro fertilization and
therefore promoting a genetic conceptualization of kinship.

69
Celia is a 29-year-old woman from Tabasco. She has a 9-year-old son and is separated
from her son’s father. When we met, she was preparing to be a surrogate for a second time. Two
years earlier she bore a child for a gay couple from England. She later helped a single father
from Spain care for his children (born to a different surrogate mother in Mexico) while he was in
Tabasco waiting for paperwork to take the children to Spain. Celia first decided to become a
surrogate after suffering a miscarriage. The experience caused her to think about how difficult it
must be for people who want children but are unable to bear them. In explaining her decision to
become a surrogate she said, “I saw it as a way to heal myself, to heal from my wound from that
baby.”
Celia’s family was supportive of her decision to be a surrogate and supported her
throughout the process. However, she faced criticism from others. Celia, like most surrogates,
described her critics as ignorant:
You know what the problem is, it’s that people are ignorant; people say a lot of things
because they don’t understand. And yeah, I have a neighbor, I hadn’t seen her in years,
and not long ago I bumped into her, she asked, “are you pregnant?” I told her “yes… but
it’s not mine.” She said, “but how?” So I explained and she said, “tell me though, I heard
that they say that it’s insemination but still it’s yours, it’s your blood.” I told her “no” and
I explained the process… how they [the surrogacy agency staff] explained it to me, it’s
not how I thought about it, but the reality is that it is not yours, it’s a different egg, it’s a
different… it’s a process. And then people are left like, “oh.” And you give them a little
understanding of the subject. But the people that are ignorant and stubborn, you won’t get
them out of there.

In describing the criticism that she faced, Celia focuses on what she considers a general
ignorance about the medical aspects of the surrogacy process. In educating her neighbor, Celia
repeats what she has been told by the surrogacy agency, which she admits, is not how she had
previously thought about kinship. Becoming a surrogate therefore entails a process of re-
education about kinship, one in which kinship is based on genetics and can be separated from
gestation through medical techniques. Even though Celia has trouble explaining the details of the

70
surrogacy process to her neighbor (and to me in retelling her conversation), she distinguishes
herself from the ignorant masses. She describes herself as unlike others in her willingness to
learn about the surrogacy process and adjust her views on kinship. She credits the surrogacy
agency with bringing her out of ignorance, which she defines as the belief that the woman who
gestates a child is always the mother.
For surrogate mothers, distinguishing gestation from motherhood is essential to stigma
management. Persuading critics that the child they are carrying is not theirs is first and foremost
about defending their moral character. Giving away their own child would make them bad
mothers, as Celia explained:

And I’ll tell you, a lot of people say to me, “ay, you are selling your child, you sold your
child, you are a bad mother.” I tell them, “no I’m not selling anything if it’s not mine.”
“But you gave birth from your blood.” “Yes, but genetically it’s not mine.” They don’t
have my genes and in fact I think they do a DNA test… I say, “it’s not mine,” but I tell
you, there are people who are simply close-minded.

Celia’s description of the conversations she has had with critics is typical of the situations
Mexican surrogates described to me in interviews. For Mexican surrogates, defining the child
they are carrying as “not theirs” is crucial to managing stigma. Selling or giving away one’s
child marks one as a “bad mother.” If the child is not theirs, it is not theirs to sell or give away.
Surrogates dismiss critiques of surrogacy and of themselves as the result of ignorance about
kinship, biology, and technology.
Marta, a 33-year-old surrogate and mother of one, faced criticism from her family for
being a surrogate. She described the main problem as their ignorance about her connection to the
child:
Unfortunately here in Tabasco the people judge, if someone does this [surrogacy]… they
point you out, they judge. At the moment I’m going through a terrible situation with my

71
family. At first, when they found out that I was going to do this, I entered a controversy.
[They asked] why are you going to do this – that is part of you? No it’s not part of me.
They are not my kids. I mean, it would be ignorant [to think that they are]… I am like an
incubator really, I mean they did a [embryo] transfer and I am going to give birth but they
are not my blood. They are not mine.

Like Marta, many surrogates described themselves as incubators. For feminist critics of
surrogacy, the reduction of women to incubators, objects whose sole purpose is to sustain the life
growing inside them, is one of the most pernicious aspects of surrogacy. However, for Mexican
surrogate mothers, describing themselves as incubators serves as a way to manage stigma.
Describing themselves as “incubators” distances surrogates from the child that they are carrying
and therefore from the role of mother. Mexican surrogate mothers fight against the spoiled
identity of “bad mother” by rejecting the designation of mother altogether, minimizing their role
in the child’s life, and promoting a genetic model of kinship.
Vanessa, a 27-year-old surrogate from Villahermosa, also described herself as “nothing
more than an incubator.” In describing the criticism she faces as a surrogate, Vanessa brought up
a number of themes that were present in other interviews as well: ignorance, disputes about
kinship, moral judgments around payments, and the role of religion. Like Marta and Celia,
Vanessa faced criticism from people who believed that she was selling her own child. She
countered that criticism by referring to herself as an incubator rather than the mother. Unlike
Marta however, Vanessa said the criticisms did not bother her:
The people who are going to criticize you, like my mother says, they will always criticize
you, they will always judge you, that it is a sin, because many people bring in religion…
“why do they pay,” “it’s that you’re selling your child,” “it’s your child, it’s not their
child.” But, well, to me I see it as, I feel that I was nothing more than an incubator
practically, I don’t feel that it’s my… that it’s my blood

In my case, they said to me, “It’s that this is a sin”…“how are you going to give away
your child or you’re going to sell.” Because that is the first thing they say. Not for all the
money in the world would I do that…

72

But this doesn’t make me uncomfortable, not what the people say. My mother says, “they
criticize you, they will always criticize you, don’t let listen to them.” Sometimes when
people say things like that, I say, “it is my life.” I, with my life, do what I want. Always,
without fail, someone will criticize you and they something like, “why are you going to
give away your child, the doctors are cheating you, they are telling you lies.” You
understand? But well, if you study a little bit you see that things are different from what
they are saying.

Vanessa contends that religion plays a role in the way people in Mexico perceive surrogacy.
Selling or giving away one’s child does not just make one a bad mother. It is perceived as a sin.
Mexican surrogates do not push back against the idea that it is sinful to sell or give away one’s
child. Rather, they insist that they are not the mother of the child they are gestating and therefore,
it is not their child to give away. Vanessa insists that she would not give up her own child for “all
the money in the world.” In doing so, she is presenting herself as a good mother who treats her
children as priceless.
Vanessa’s reaction to the criticism she faces was typical of the surrogates that I
interviewed in Mexico. She does not seek to hide her identity as a surrogate. Rather, she
manages the stigma of being a surrogate by dismissing her critics, and by extension their
criticisms, as ignorant and judgmental. This is a strategy Sykes and Matza’s (1957) refer to as
“condemnation of the condemners.” Meanwhile, she presents herself as an independent woman,
who understands genetic kinship, leaves religion out of her decisions, and does not cave to social
pressure. Mexican surrogates manage the stigma attached to being a surrogate by presenting their
critics as ignorant, close-minded and overly religious, and themselves by contrast as proper,
modern subjects. In doing so, Mexican surrogates reproduce binaries of modernity in which
Mexicans are backward and unmodern.

73

“I’m not one of those who is at the church all the time:” Religiosity and objections to surrogacy
When discussing why surrogacy is stigmatized in Mexico, surrogates often mentioned the
role of religion in Mexican society. For example, I asked Patricia if she thought surrogacy was
generally accepted in Mexico and she said “no.” When I asked why she thought that was the
case, she responded, “More than anything it’s because of religion. Right? Because of religion. I
bumped into two women from my son’s school. The two women are of a different religion and
are very attached to the church and all of that, so like they would have seen this as very bad.”
Patricia sees religion as the primary reason that surrogacy is stigmatized in Mexico. She
describes the type of women who would see surrogacy as “very bad” as women who are very
attached to the church and presumably derive their views from church leaders or religious
doctrine. In contrast, Patricia describes herself as, “Catholic but I’m not one of those who is at
the church all the time.” The implication of her statement is that unlike the women from her
son’s school, Patricia’s life and worldview are not dictated by religion. When asked about
religion, most surrogates responded similarly to Patricia, describing themselves as Catholic but
not dedicated churchgoers. Others described themselves as “believers” but not adherents of any
particular religion. Presenting themselves in this manner can be seen as a form of identity work.
Patricia, like other Mexican surrogate mothers, is managing the stigma of being a surrogate by
presenting herself as a modern, more secular and independent minded subject than the average
Mexican person.
Mexican surrogate mothers often dismiss critics of surrogacy as overly religious.
Attributing criticisms of surrogacy to religiosity is a way of deflecting from the moral concerns

74
raised by surrogacy. It is also a way for surrogates to protect their self-concept amidst harsh
critique. Some surrogates faced intense criticism from their families, especially their mothers.
For example, Francisca, a 26-year-old mother of two from a small town outside of Villahermosa,
told me, “My mom is pretty Catholic and she said to me that I shouldn’t do it [surrogacy]
because it’s going to stay on my conscience and that God is going to punish me and stuff like
that.” Francisca did not seem upset by her mother’s statements. Instead, her tone was dismissive
as if she was recalling the ramblings of a person whose views were not worth engaging with.
A few other surrogates recalled facing similarly harsh critiques of their moral character
from family members. For example, Paulina’s family was initially opposed to her becoming a
surrogate. The 34-year-old three-time surrogate explained, “my mom is very religious and
thought that these babies are being brought [into the world] to steal their organs or sell them, to
do all these things to them. So they did not want [me to be a surrogate], they said that it’s a thing
of the devil.” Both Francisca and Paulina begin their statements by explaining that their mothers
are religious. In doing so, they are attributing all of their mothers’ statements to their religiosity.
While Mexican women are generally portrayed as religious, surrogate mothers’ describe overly
religious people as ignorant and close-minded. By contrast, surrogate mothers describe
themselves as independent thinkers who seek out information rather than following public
opinion.
Like Francisca and Paulina, many Mexican surrogates faced the strongest resistance from
religious family members. Religious family members who oppose surrogacy, were often
described as Christian, which in the context of Tabasco, indicates participation in the growing
evangelical movement. At other times, they were described as being “attached to the church” or
simply “very religious.” For example, Teresa faced resistance from her sister. During our

75
discussion Teresa explained, “My sister, she knows [that I’m a surrogate], but well she is a
Christian and she told me that, because she is crazy, that it was my baby, that how had I thought
there would be other people’s baby in my stomach, which was something impossible.” When
Teresa’s sister challenges her regarding the surrogacy process and the idea that pregnancy does
not automatically confer kinship, Teresa dismisses her sister’s concerns by calling her “crazy.”
Teresa implies that her sister is ignorant for believing it impossible that “there would be other
people’s baby” in her stomach. Teresa describes her sister first as a Christian, thereby presenting
her sister’s concerns as a product of her religiosity. Therefore, Teresa is equating religious
objections to surrogacy with ignorance about science (i.e. the process through which having
“other people’s baby” in her stomach becomes possible). This framing of naysayers as both
ignorant and overly religious was present in many surrogates’ narratives.
Mexican surrogates often described educating those they perceived as ignorant. At first,
Juanita, a 23-year-old surrogate from Tabasco faced a lot of criticism from her mother, but over
time, she persuaded her mother that surrogacy was a morally sound practice:
It never seemed right to my mom, since she’s Christian it never seemed right to her. She
said this is foolishness that I will end up dead for having another baby, so it never seemed
right to her… Then time passed and I explained it to her, I told her or she would call me
and I would tell her if I felt bad or not and thank God everything went well. And she told
me, “well how good that you are helping parents that can’t [have a baby on their own].”
So she came to understand after like 7 months or something like that.

Juanita attributes her mother’s apprehensiveness about surrogacy to her being Christian. The
implication is that her mother’s concerns are based entirely on her religious beliefs rather than on
facts. Juanita presents her mother’s initial concerns as baselessness by highlighting the fact that
that with time and a proper explanation, her mother “came to understand” and agree with her
decision to become a surrogate.

76

“We are a little stronger:” Stigma for helping gay parents & open-minded surrogates

In addition to religious mandates against the use of reproductive technologies and the
controversies that arise from conflicting views on kinship, surrogacy is particularly controversial
in Mexico because of its association with gay parenthood. At the time of this study, gay parents
made up a large and highly visible portion of the intended parents who contracted Mexican
surrogates. Many surrogates connected the stigma around surrogacy to debates about gay
parenthood. For example, Valentina, a 23-year old surrogate from Quintana-Roo, contended,
“Mexico is still very much ruled by this concept of holiness and they cover up all of this
[homosexuality]. They still don’t accept homosexuality here and a lot of the intended parents are
homosexuals.” Valentina described herself as not having a religion. She associated religiosity
with close-mindedness regarding LGBT rights and particularly the rights of gay couples to marry
and have children. Rather than being concerned about the stigma associated with being a
surrogate for a gay couple, Valentina, like many other surrogates, talked about it like a badge of
honor. Mexican surrogate mothers describe the stigma around gay parenthood, and surrogacy
more generally, as a product of religiosity and ignorance and an indication of Mexico’s
“backwardness.” By contrast, Valentina present herself as a knowledgeable, secular, modern
subject through her acceptance of gay parenthood.
Celia, introduced earlier, had a lot to say about the stigma of being a surrogate in Mexico.
She did not describe the criticism she faced as hurtful. Instead, she talked about how much
courage she felt in dispelling myths about surrogacy and gay parents. She said:

77
When people talk and criticize and say stuff with knowing how it is ... it gives me
courage, it gives me a lot of courage because I say, they do not know. Not long ago, a
neighbor sent me a message on WhatsApp, she sent me a video of a girl who according to
this had suffered because her dad was gay and that it was not right for gay couples to
have children or adopt children. I was like, “but why did you send this to me?” So,
because I was a surrogate for a gay couple and now I’m doing it a second time, [she said]
“it’s that this kid is going to suffer.” I said, “He [the future baby] will not suffer and they
[the children she birthed for a gay couple] don’t suffer.” The girl from the video actually
suffered but if you look at the video you’ll notice the difference, because here [in the
video] the mom got pregnant by the father of the girl knowing that he was gay so that she
could keep the child. It’s something distinct. Here [in surrogacy] it is a couple that is
looking for a child because it is wanted and loved. Another person said, “Oh you don’t
know, in the news they say that some of them adopt and then violate the baby.”…

So, I tell you there are the things that people don’t see well and they mostly criticize just
to criticize without paying attention to the pain or the suffering underneath, whether
you’re gay, or heterosexual, or whatever you are, we’re all humans and we all have the
same feelings and the same desire to have a family…

They criticize me…a woman, a neighbor, said, “Ay! They're going to sell the boy, they're
going to sell the organs!” Let's be realistic. Now I know how much the process costs
more or less. I will not spend more than a million pesos to pay for a baby [for organs].
Even if I sell the organs I will not recover half of that.

It is clear from Celia’s statements that she has faced a lot of criticism from people in her
community. During the course of our interview, she recounted five different interactions in
which a neighbor criticized her for being a surrogate. In each interaction the neighbor focused on
a different issue including, kinship, organ selling, baby selling, and gay parenthood. Her
response in every situation was to dismiss her critics as ignorant. This strategy of “condemning
the condemners” is a way for Celia to preserve her self-concept (Sykes and Matza 1957). The
allegations that she is selling her own child to be violated or sold for organs, are incredibly harsh
indictments of her character. Through their allegations, Celia’s neighbors are labeling her as a
“bad mother,” a “baby-seller,” and a “sex trafficker.” These are undoubtedly “spoiled identities”
(Goffman 1963).

78
One way to rehabilitate a “spoiled identity” is to engage in boundary work, to distinguish
oneself from those who are morally inferior and thus regain the moral high ground (Lamont
2000). This type of boundary work usually entails distinguishing oneself from an even more
stigmatized group. The boundary work Celia and other surrogates are performing is not between
themselves and an even more stigmatized group, but between themselves and the average
Mexican, who they describe as ignorant, close-minded, and backwards.
In addition to dismissing critics as ignorant, Mexican surrogate mothers manage stigma
by presenting themselves as independent, modern women. When explaining how they became
involved in surrogacy, Mexican surrogate mothers generally described themselves in agentive
terms. They often talked about their decision to become surrogates, despite their family’s
concerns and the negative public opinion of surrogacy, as an act of agency. The decision to
become a surrogate was described as an extension of their independent, adventurous nature and
their open-mindedness.
Surrogates’ self-descriptions as independent and open-minded came out most discussing
the reactions of their family and friends. For example, Samantha described her mother’s reaction
to her decision to become a surrogate: “My mom still says that I am crazy. Yes, my mom says,
‘How dare you let go of your daughter?’ [I say] ‘Mom, she is not my daughter!’ We explained it
to her but their generation grew up with different ideas.” Samantha then describes how her
mother’s attitude shifted a bit after Alma was born: “Now she asks me, ‘How is Alma?’ I told
her, ‘They [the intended parents] sent me some photos and she looks very nice, and is growing.’
My mom knows that we helped a family and that just because they are gay, they are not bad
people. [She knows] that they are going to care for her and are going to love her.” For Samantha,
being a surrogate gave her an opportunity to challenge her mother’s views about gay parents.

79
Samantha is one of the surrogates that I spent the most time with in Tabasco. We met in 2014,
during my first days of fieldwork, and have spoken regularly either in person or via Whatsapp.
Samantha is an inquisitive and entrepreneurial woman. We often discussed her small business
ideas and she asked me with great curiosity about my travels, education, and what life is like in
other countries. In these conversations, she consistently presented herself as an independent and
adventurous woman. She saw surrogacy as an opportunity to not only continue her education and
finance her small business, but also an opportunity to experience something unusual and meet
people from other walks of life.
Miranda, a 27-year-old surrogate from Puebla, had a similar attitude. I met Miranda
when she was living at a house for surrogate mothers in Cancun. Miranda had just begun the
process and was not yet pregnant when I interviewed her. I asked if her family and friends knew
that she had signed up to be a surrogate. She told me that only her husband, her daughter, and her
sister knew. Her sister, she explained, was very upset when she found out that she had signed up
to be a surrogate:

When I told this to my sister she burst into tears… She told me, “How are you going to
do that, you can’t do that, what is the matter with you?” And I already explained to her,
“it is nothing bad, relax, it is not what it sounds like…you have to think differently and
open up your mind a little bit. But no, nothing but what your social circle tells you. They
say it’s bad, so then it’s bad. Why do you listen their words? You need to open your mind
to more possibilities”… We [surrogates] have, I believe, a slightly more open mentality
and we are a little stronger.

Miranda describes her sister as a close-minded person who should learn to think for
herself rather than simply follow popular opinion. In contrast, Miranda describes herself as an
independent thinker who is open-minded and willing to try new things. Miranda does not
describe herself or other surrogates as desperate. Rather, she describes herself and other

80
surrogates as stronger and more open-minded than other women. When we met, Miranda had not
yet told her parents that she had signed up to be a surrogate, but felt that her father would be
accepting of her decision. She explained: “My dad is open-minded. He always told me, ‘your
decisions are your decisions and you will be responsible. You will forge your own path and be
who you want to be.’” Miranda’s contrasting descriptions of her father and her sister demonstrate
that she equates an acceptance of surrogacy with open-mindedness and independent thinking.
Like Miranda, many surrogates described themselves as open-minded and considered
those opposed to surrogacy to be close-minded and old-fashioned. For example, Ana’s sister was
also opposed to her decision to become a surrogate, especially for a gay couple. During a
conversation about her sister’s reaction, Ana described her sister as “more closed minded on all
of this, as much about the gay couples as the lesbian couples.” Ana is implying that she and the
other surrogates who work with gay couples, are open-minded. The association between
surrogacy and gay parenthood in Mexico adds to the stigma faced by surrogates, but it also
contributes to surrogates’ self-perception as open-minded, modern women. Mexican surrogate
mothers manage stigma by condemning their condemners as old-fashioned and close-minded in
their inability to accept modern families.

“I am living my life. I don’t care about anyone else’s opinion.”

Whether or not they attempted to educate and convince naysayers, most surrogates were
adamant that the decision was theirs alone. For example, when I asked Karina who knew about
her participation in surrogacy, she said, “My mom knows and my daughter knows. They are the
first people and the last people that I have to give explanations to, and they agree, from there on
out I am not interested in anybody else knowing it.” Karina’s attitude that her decision was no

81
one’s business but her own and that she did not owe anyone other than her daughter and mother
an explanation, which was fairly common amongst surrogates. Some surrogates decided
unilaterally, while others sought out the advice and support of one or two family members.
Like Karina, many chose not to disclose their participation in surrogacy to their broader
social circles. This was easier for surrogates who lived in agency-sponsored housing than for
surrogates who lived at home during the process. But, even those who lived in their own homes
sometimes chose not to discuss their participation in surrogacy. For example, Katia, who lived at
her home in Tabasco during the surrogacy process, said, “The only ones who know [that I am a
surrogate] are my husband and my mother. No one knows, no one.” I asked her why she chose
not to tell her friends and neighbors. She explained, “It’s not important what people think, I do it
because I want to, but then there are negative views on this, I don’t like when people walk
around saying things.” Jimena, a 26-year-old surrogate from Tabasco, made a similar remark.
She also had not told many people about becoming a surrogate. For Jimena, it was not a
conscious decision as much as the result of her general attitude. She explained, “I hardly speak to
anyone. And maybe they never dared to ask me because they always say I am bitter because I do
not speak to anyone. But, I am living my life. I don’t care about anyone else’s opinion.”
Telling only a select group of trusted individuals about a potentially discrediting aspect of
one’s identity is a classic strategy of stigma management. While this information control
technique helps surrogates avoid stigma, Karina and Jimena insist that they also avoid telling
people because others’ opinions do not matter to them. The “I don’t care what others think”
attitude that surrogates project is a way of rehabilitating their “spoiled identities” by flipping the
script. They present the stigma against surrogacy not as a burden, but as the result of ignorance
and close-mindedness that they, as independent thinkers, have not succumbed to. Mexican

82
surrogates could appeal to their poverty, a lack of alternative employment options, or their
motherhood to counter criticism about their involvement in surrogacy. Instead, they focus on
their personal traits, such as independence, adventurousness, and open-mindedness to explain
why they chose to become surrogates and to manage the stigma associated with this decision.
This was the case even when disapproval came from a spouse. One of the concerns about
transnational surrogacy in low-income countries is that greedy husbands or family members will
force young women into surrogacy. I did not find this to be the case in Mexico. I found it was
more common for surrogates’ husbands to be apprehensive about surrogacy and for surrogates to
convince their husbands than the other way around. For example, when I asked Marla, a 28-
year-old surrogate, what her husband thought about her being a surrogate, she said, “At first he
didn’t want me to … then later he accepted it, or conceded, because I told him that with him or
without him I was going to do it.”
Marla’s attitude was common amongst the surrogates that I met. Many were adamant that
becoming a surrogate was their decision alone. For example, Maria’s husband disapproved of her
decision to become a surrogate. He was particularly worried about what his conservative family
would think. He asked Maria not to tell his family about her decision to become a surrogate:

My husband asked me to block my Facebook from his family and not tell to them
anything about this out of respect for him and because his family is pretty close-minded.
Then he told me “imagine what they would say if I gave you permission for something
like that.” And, then I told him “ok, we will come to an agreement, but I don’t want your
permission.”

Maria’s husband thinks that her role as a surrogate would reflect poorly on him because his
family would assume that he gave her permission. She agreed not to tell his family but clearly
stated that she does not need or want his approval.

83
Sofia, a 35-year-old surrogate, had a similar attitude in discussing surrogacy with her
boyfriend. Sofia signed up to be a surrogate while she was separated from her boyfriend. When
they got back together, she had already begun the surrogacy process. Her boyfriend disapproved
but that did not faze her. She explained, “When I entered this process we didn’t live together…
when we got back together I was already in the [surrogacy] process. Then he didn’t want me to
do it, and I said to him ‘Well if you don’t think [I should do this], go. I had my plans without you
and if you don’t want them fine.’” Sofia gave her boyfriend a choice: respect my decision to be a
surrogate or leave. These statements are a stark contrast to the dominant image of surrogate
mothers, and women in the Global South more generally, as weak, docile, and compliant
(Deomampo 2016, Mohanty 1988). Mexican surrogate mothers present themselves in ways that
sharply contrast with prominent portrayals of surrogates as victims.

Intended Parents’ Stigma Management Strategies

While Mexican surrogate mothers countered negative images of surrogates by describing
themselves as modern, and agentive subjects surrounded by ignorant peers, intended parents used
very different strategies to manage the stigma associated with contracting a surrogate. Intended
parents emphasized their marginalization, in terms of access to reproductive technologies and
adoption, and downplayed the element of choice. Both groups engaged in boundary work to
morally distinguish themselves from morally inferior others. Surrogate mothers used a strategy
of “condemned the condemners” through a narrative of Mexican backwardness (Sykes and
Matza 1957). Meanwhile, intended parents constructed symbolic boundaries between surrogacy
in Mexico and surrogacy in India, positioning the latter as morally reprehensible and the former
as morally acceptable.

84

“Our only option:” Intended parents downplay choice

Unlike Mexican surrogate mothers, intended parents downplayed the element of choice
and focused on their marginalization to manage the stigma associated with contracting a
surrogate mother in Mexico. I found that intended parents generally used less agentive language
than surrogates. They talked about surrogacy in Mexico as a last resort, rather than a choice or a
privilege. Most of the intended parents I interviewed, were gay men. Some were in relationships
and others were electing to become single fathers. Of the three heterosexual couples I
interviewed, two couples were older than the typical reproductive age (late 50s – early 60s).
Marginalization, in terms of age, relationship status, and sexuality, is an important part of most
intended parents’ experiences with surrogacy in Mexico.
Only one couple I interviewed, fit the normative heterosexual two-parent, middle class
family model: Amir and Joanna. Before meeting Amir, Joanna experienced an ectopic pregnancy
and had her ovaries and fallopian tube removed. She was told that it would be dangerous for her
to carry a pregnancy. When they decided to have children, Joanna was open to adoption but
Amir wanted to try surrogacy so he could have a genetically related child. Even though Amir and
Joanna are well off, they did not feel that they could afford the cost of surrogacy with an egg
donation in the United States. When I interviewed them, their son, born through surrogacy in
Mexico, was six months old. When I asked them how they decided on Mexico, they framed it as
their only option. Amir said, “We started looking at surrogacy. We were married a year and we
looked at India – India you have to be married two years so we started looking elsewhere.
Thailand was shutting down. Nepal, I don’t know.”

85
Amir and Joanna eventually found out about a surrogacy agency operating in Mexico.
They were amongst the first wave of international intended parents in Mexico. The surrogacy
agency they used had only recently opened and there was very little information available at the
time about surrogacy in Mexico. Amir explained his concerns, “We couldn’t get a reference. We
couldn’t talk to anybody that had had kids in Mexico. But that was our only option, and we
looked at the costs and the risk and we said this is the right decision... We looked at the U.S. as
well.” Joanna then jumped in to explain why they decided against surrogacy in the U.S. “With an
egg donor and surrogacy, both of those combined, it was going to be like over 200,000 dollars.”
Amir’s comment that Mexico was the “only option” is representative of the language
intended parents used when describing their decision to pursue surrogacy in Mexico. This
language contrasts with the portrayal of intended parents as consumers in the global surrogacy
marketplace. Even the most privileged of intended parents I met in Mexico, were there because
contracting a surrogate in the United States, the gold standard of surrogacy, felt out of their reach
financially.
During the interview, Amir and Joanna discussed the lack of health insurance coverage
for the medical costs of surrogacy. Amir explained that it was not the surrogate’s fee or the
agency fees that made surrogacy in the U.S. prohibitively expensive. The issue was the medical
costs:
That’s the problem: insurance – our moral compass is defined by insurance companies.
And they define the baby being born out of the womb. And they won’t cover inside of a
womb of another woman… Yeah, you’re paying healthcare out of pocket at that point…
The healthcare and the insurance and laws need to get on the same page. Seems like the
healthcare is way more progressive than our insurance.”

To Amir, the lack of health insurance coverage for surrogacy is a moral issue. If Joanna were
pregnant, the costs of prenatal visits and labor would be covered by their health insurance.

86
Insurance companies are generally unwilling to cover medical costs for surrogates. Therefore,
intended parents pay out of pocket for the typical costs of pregnancy and labor in addition to the
costs of in-vitro-fertilization and egg retrieval.
Amir and Joanna were clearly concerned about the stigma associated with transnational
surrogacy. They, in part, agreed to be interviewed in order to “set the record straight” about
surrogacy. After their son was born in Tabasco, Amir and Joanna faced some difficulties in
bringing him to California. The civil registry office in Villahermosa was slow and opaque in
responding to their requests for a birth certificate for their son. After several weeks they became
worried. They decided to reach out to their congressman and media outlets in California about
the issues they were facing in bringing their son home from Mexico. Their decision to go to the
media may have expedited the process of bringing their son to the United States, but it also led to
an unexpected barrage of criticism from commenters. The way they described it to me, Amir and
Joanna did not know how controversial transnational surrogacy was until they became the face of
surrogacy in Mexico. By participating in research, like mine, and sharing their story more
widely, they felt they could counter some of the stigma around surrogacy. About a year after I
first interviewed them, Amir and Joanna reached out to tell me about a documentary film they
were planning to produce about surrogacy. The goal, they explained, was to share their story as
well as the stories of other intended parents to demonstrate the “positive, human aspects of
surrogacy.”

Emphasizing Marginalization
Most intended parents I interviewed, are in a more marginalized position in relation to
parenthood than Amir and Joanna because of their age, marital status, and/or sexuality. For these

87
intended parents, marginalization was a large part of their surrogacy narrative. Gay and single
intended parents, in particular, faced barriers in their pursuit of parenthood such as
discriminatory adoption and surrogacy laws. These experiences of marginalization shaped their
path to surrogacy in Mexico while serving as a means of managing the stigma associated with
contracting a surrogate in a poor country.
Juan is a gay man from Spain who became a single father through surrogacy in Mexico.
He began looking into becoming a father five years before his son was born. At first, he planned
to adopt a child but soon found adoption to be impossible as a single man. He explained that
while adoption by single men was technically legal in Spain, he knew it was unlikely that he
would be approved. He also explained that the adoption process was expensive and complex
with administrative fees for initiating the process reaching 30,000 Euros. After paying the fee,
applicants undergo psychological evaluations and then must obtain a certificate of suitability
from a social worker. He felt it was unlikely that a social worker would give a single man a
certificate of suitability. He was so determined to be a father that he decided to go back to school
and get a degree in social work. He was convinced that the only way he would be approved for
adoption is if he was a social worker. Before finishing the adoption process though, he saw a
flyer promoting an event about surrogacy.
Once Juan decided on surrogacy, he considered the United States, India, and Mexico. He
explained that although India was presented as an option during the talk he attended, there were
already some concerns that India would stop allowing same-sex couples and single men to
contract surrogates. The United States was beyond his reach financially. Not only was the cost of
surrogacy in the U.S. prohibitive, he was particularly worried about accruing hospital bills if the
baby was born prematurely or with a medical emergency. He told me about a Spanish couple he

88
knew that had traveled to the United States for surrogacy and had to sell their house in order to
pay the hospital bills from their child’s stay in the neonatal intensive care unit. At that point, he
decided that surrogacy in Mexico was his best chance of becoming a father.
While there is a clear consumer aspect to Juan’s story, he, like Amir and Joanna, chose
between different market options based on an analysis of risks, costs, and benefits. He frames his
narrative as a search for options amidst obstacles, rather than as a story of empowerment. While
he, and the other intended parents I interviewed, were grateful that the option of surrogacy in
Mexico existed for them, their narratives focused more on the lack of what they considered
viable alternative options.
Pedro is a Spanish single father of twins born through surrogacy in Mexico. He also
discussed the difficulties of becoming a single father and the other options he considered before
turning to surrogacy in Mexico. Pedro explained how he first learned about surrogacy:
My dream is to be a single father. I did something crazy in Spain that is illegal. I was
talking to some women over the Internet because in my work I have a lot of free time. I
am a doorman for a building so I spend a lot of hours sitting. I was on the Internet and I
looked for an announcements page. I posted “gestational surrogate” and “womb for rent”
and a lot of women in Spain were in agreement to be a surrogate. But… I couldn’t buy
eggs, everything was very sloppy. The wrong way to do things. And, what happens is that
you meet people who want to cheat, do business, and such. So, okay I was telling all of
this to an Italian guy that lives in Barcelona and had a one-year-old daughter. He said,
“Pablo stop with this foolishness, I know that you don’t have money, and it’s impossible
for you to do it [surrogacy] in the United States but look, I did it in Mexico. I will give
you three names of three different agencies and then you can go with the one you like
most.”

Pedro first considered finding a surrogate in Spain, even though he knew it was illegal.
He recalled finding numerous Spanish women who were open to being surrogates. But, if he had
pursued that option, it would have been a traditional surrogacy arrangement in which the
surrogate is implanted with intended father’s sperm and uses her own eggs. He would have
worked directly with the surrogate as no doctor or lawyer would get involved in an illegal

89
surrogacy arrangement. Also, given the prohibition on surrogacy in Spain, it would have been
extremely difficult for him to claim sole parenthood of the child. This is what Pedro describes as
a “sloppy process” and his friend called “foolishness.” Pedro ended up having a hard time
bringing his children back to Spain from Mexico and lamented having to leave his job and family
for so long. He wished that he could have gone through the surrogacy process in Spain. But,
given the legal standing of surrogacy, he decided it was not worth the risk to proceed
clandestinely in Spain.
Pedro is not as wealthy as most of the other intended parents that I met in Spain. Also, as
a single man, he relies on a single income. Pedro is from a rural part of Spain and works as the
superintendent and doorman for a building in the nearest city. For him, surrogacy in the United
States was completely out of reach financially. This was a common theme in parents’ narratives.
The United States is held as the gold standard for surrogacy, where the industry is most
established but also the most expensive. All of the intended parents I interviewed, lamented that
they were unable to contract a surrogate in their home country. Intended parents from countries
where surrogacy is illegal or unrecognized, like Spain and France, said that if it were legal in
their home country, they would not have contracted a surrogate in Mexico, even if it were less
expensive in Mexico. These statements, which intended parents made unprompted, serve to
mitigate the stigma associated with transnational surrogacy. Intended parents downplayed their
own agency in the surrogacy process. Intended parents in Mexico see themselves as the victims
of discriminatory surrogacy and adoption laws as opposed to the drivers of a global industry.
Jorge and his partner, Rafael, had a more direct path to surrogacy. They reached out to a
Spanish NGO for LGBT families to obtain information about surrogacy. Through the

90
organization, they learned about various hubs for transnational surrogacy, including Ukraine and
Mexico. Jorge and Rafael explained their process for deciding where to pursue surrogacy:
Jorge: They talked about Ukraine.

Rafael: But we didn’t see that as feasible…

Jorge: Yes, because we couldn’t tell the truth. In Ukraine, surrogacy is not legal for
singles or for homosexuals. They said it was the most feasible because it’s in Europe and
close by and because the results [success rates] are, well, very effective. But, as a second
option, they told us about Mexico and right away we loved the idea because not only do
we like Mexico a lot, we had already been to Mexico.

Rafael: Yes, and over everything … what made us decide [on Mexico]… the language is
fundamental, no? We already knew that it is a long process. We were going to need time,
to be there in Mexico for a good amount of time, or in whichever place we do it.

While the NGO presented Mexico as a second choice after Ukraine, Jorge and Rafael
were pleased with the idea of contracting a surrogate in Mexico because of the common
language and their personal connections to Mexico. Jorge had lived in Mexico for several years
and they had both vacationed in Mexico. Knowing that surrogacy is a long and complex process
and that they might need to stay in the surrogate’s country for a while, they figured it was best to
go somewhere where they could at least speak the language, even if it was farther and the
surrogacy industry was less established.
Even though Jorge and Rafael were pleased with the idea of surrogacy in Mexico, they,
like other intended parents, described it as their only option. Jorge and Rafael’s narrative is one
of consumer choice that is constrained by discriminatory policies. Intended parents describe their
journey to surrogacy in Mexico as a process of making morally sound decisions amongst very
limited options. For some parents, like Jorge and Rafael, this meant not participating in a
surrogacy process where they would have to lie about their marital status and sexuality, like they

91
would have in Ukraine. Others described the decision to pursue surrogacy in Mexico as morally
superior to other surrogacy destinations, especially India.

Moral Boundaries with Surrogacy in India
Another stigma management strategy intended parents deployed was to create symbolic
boundaries between surrogacy in Mexico and surrogacy in India, the most well-known
destination for “budget” surrogacy. Although regulations in India limiting surrogacy to married
heterosexual couples were instituted before most of the intended parents had begun the surrogacy
process, many intended parents nonetheless described India as an option they had rejected due to
moral concerns. Surrogacy in India was not actually a viable option for most of the intended
parents I interviewed, but it served an important role in their moral narratives around surrogacy
in Mexico.
Antoine and Julien are a gay couple from France. Over the course of my three years of
fieldwork, Louis and Martin had three children through surrogacy in Mexico: twins followed by
another child a year later. I first interviewed them a couple weeks after their twins were born.
During the interview, Antoine and Julien explained how they came to surrogacy in Mexico:
Antoine: Ok. So, as soon as I met Julien, I told him I wanted to be a father… it's very
important for me. And Julien was very skeptical about that. He said “How? We're gay”
Well, gay doesn't mean sterile, so there must be a way; we just need to find a way. And
so I inspected all of the existing processes like co-parenting, trying with a lesbian couple
or even a heterosexual woman, or surrogacy.

Julien: ...or the adoption.

Antoine: Or the adoption. With the gay situation in France adoption has been too
complicated, there's much more money involved as well, and many complications all the
times. So we decided to stop. When we started to talk about [children] gay marriage
didn't exist in France. So that was part of it. At the beginning I thought that it would be
great to have a mother involved for our child. And we start like this. So we found a
lesbian couple, and we decided to try to make a child all together. At the end we saw a lot

92
of issues arriving, just kind of different points of view on how to raise child, about social
environment, it got too complicated. And we then said, “it's already complicated to be
parents, and to have kids, so then to have somebody else in the process…”

Julien: ...to take care of, it would have been a nightmare.

Antoine: So Julien said, “I prefer to pay to be free with my kids.” And I said “Ok. Let's
go do some research.” And I start to have a look. So we knew about Canada, USA, some
of the countries in Asia, in Ukraine. But we saw that there are many changes in the Asian
countries, and we didn't want to do that process... I mean, taking advantage of poor
people. Like horrible stories in India. Like he [an Indian surrogate’s husband] asked his
wife to do babies for strangers. I said, “We can't tell this story to our child, I can't
imagine, because we don't want to lie.” So we looked around Canada-USA and randomly
I found Mexico. Totally randomly.

Antoine and Julien researched a number of options including adoption and co-parenting
with a lesbian couple before deciding that surrogacy was their best option. Many gay couples and
single intended parents described adoption as even most costly and difficult than surrogacy. Even
where it is technically legal for gay couples to adopt children, gay parents often face
discrimination by adoption agencies and can face longer wait times and increased scrutiny of
their personal lives. Likewise, co-parenting comes with its own set of legal and social
difficulties. Once Antoine and Julien decided that surrogacy was their best option for having
children, they researched surrogacy destinations. Surrogacy is illegal and highly controversial in
their home country of France. Thus, any surrogate arrangement would involve a woman in
another country.
Like Antoine and Julien, many intended parents described surrogacy in Mexico as
morally preferable to surrogacy in India, which they viewed as a poorer country where
surrogates are more likely to be exploited. Some described surrogacy in India as an unacceptable
option because they had seen reports of surrogates being abused. This can be understood as a
form of boundary work meant to symbolically separate surrogacy in Mexico from the morally

93
tainted realm of surrogacy in India. Surrogacy in India has received an abundance of media and
scholarly attention and has been decried as an abusive industry in which wealthy intended
parents exploit poor Indian women. The intended parents I interviewed, actively differentiated
themselves from the intended parents who contracted surrogates in India. As I will discuss in
Chapter 3, they did so in part by describing Mexican surrogate mothers as economically stable
and motivated by motherly altruism.
For example, Manuel described the process he and his partner went through in deciding
where to pursue surrogacy:
So about two years ago we started the search for options. We have the option of the
United States, which is the most secure, the most well-known, the most reliable, and the
most expensive. It’s also not very accessible, especially for Europeans. So we began to
search and switched to looking at more economical options like India, Thailand, we even
saw some places in Russia.

Manuel describes surrogacy in the United States as the best option, but an option that is out of
reach for him. His attention then turned to more affordable surrogacy destinations. Manuel does
not describe surrogacy in affordable destinations as a better value, but rather as the only options
available to him because of the high cost of surrogacy in the United States and the illegality of
surrogacy in Spain. When deciding between these “affordable places,” Manuel describes the
decision as morally driven. He explained,

India appeared to us quite denigrating, it seems very third world, right? India, Thailand,
for me it generated a moral doubt. To go to a third world country where people live on
the streets and pay money to a lady that well, it doesn’t fit. Also it coincided with the year
that they closed the border to homosexuals, singles and such, so we completely discarded
[the option of India] despite the price, which was like nothing. It was I think like 20
thousand euros for the whole process.

While surrogacy in India was no longer available to gay couples by the time Manuel and his
partner began the process, he makes a point of telling me that he was uncomfortable with hiring a

94
surrogate in India. He describes India as a “third world country where people live on the street.”
In doing, so he is implying that Mexico is not as impoverished and therefore, the surrogacy
industry in Mexico is less morally problematic. He explained that even though surrogacy in India
would have cost him only 20 thousand euros, less than half of what they paid in Mexico, he
disregarded the option of contracting a surrogate in India.
Manuel acknowledged that India’s laws changed the same year that he was researching
surrogacy but insists that he would not have pursued surrogacy in India anyway. Manuel’s
narrative serves to morally distinguish surrogacy in Mexico from the “denigrating” surrogacy
industry in India. He is also morally distinguishing himself from the types of intended parents
who are willing to pay a lady “in a third world country where people live on the streets.”
Manuel’s statement is a form of boundary work that serves to rehabilitate a spoiled identity, in
this case the identity of a person who exploits poor women. He, like most other intended parents
I interviewed, was well aware of the critiques of surrogacy as a process in which rich couples
exploit poor women. He sought to distance himself from that stereotype by stating that he is
neither rich (otherwise he would have gone to the U.S.) nor willing to exploit poor women (in
which case he would have gone to India). By constructing Mexico as a middle ground where the
non-wealthy can participate in surrogacy without exploiting poor women, intended parents in
Mexico are constructing themselves as marginalized yet morally superior would-be parents.

Conclusion

Intended parents employ multiple strategies to manage the stigma of engaging in
transnational surrogacy. In narrating their experiences with surrogacy in Mexico, they downplay
the element of choice, focus on their marginalization in relation to parenthood, and morally

95
distance themselves from surrogacy in India. These strategies serve to counter dominant
narratives about intended parents as callous consumers in a global marketplace for surrogacy.
Even though intended parents are driving the global demand for surrogacy, when describing their
individual experiences, intended parents downplay their power and agency in the surrogacy
process.
Meanwhile, Mexican surrogate mothers face immense structural constraints on their
agency. They are poor mothers in a country with high levels of income inequality and
unemployment. Many are single mothers who had children at a young age and have few
opportunities for economic advancement. Yet, despite these structural constraints, Mexican
surrogate mothers consistently portray themselves as agents. They manage the stigma associated
with being a surrogate mother in Mexico not by emphasizing their poverty and lack of alternative
options but by rejecting the narrative of victimhood. Mexican surrogates flip the script by
portraying themselves as open-minded, strong-willed, independent women. Participating in
surrogacy becomes a part of their narrative of survival rather than of third-world victimhood.
Surrogates’ stigma management strategies disrupt dominant narratives about “third-world
women” while simultaneously reproducing narratives about Mexican “backwardness.”

96
CHAPTER 3: PRODUCING MORAL PALATABILITY

In 1992, Sharon Anleu identified the core criticism of surrogacy as “the economic issue
of whether a woman should be paid for this service” (31). Many legislators and bioethicists
express concern that surrogacy payments may be a form of undue enticement. However, Anleu
(1992) argued that the moral distinction between altruistic and commercial surrogacy rests on
deeply held gender norms about the proper division between love and money. More than 25
years later, the issue of payment remains central to moral and legal debates regarding surrogacy.
Over the past decade, surrogacy has expanded into a multi-million-dollar transnational
industry in which intended parents hire women in other countries to gestate and birth children for
them. The expansion of the surrogacy market into countries such as India, Thailand, and Mexico,
where there is a significant socioeconomic gap between intended parents and surrogates, has
exacerbated moral concerns about paying women to gestate, birth, and relinquish children
(Markens 2012; Rudrappa and Collins 2015). Building on Anleu’s (1992) critique of the moral
distinction between altruistic and commercial surrogacy, I use empirical evidence to demonstrate
that the distinction is not only gendered, but also reflects and reinforces power asymmetries
between intended parents and surrogate mothers that are shaped by gender, race, class, and
nationality. This chapter demonstrates how notions of maternal altruism not only structure the
organization of reproductive markets, but actually enable the market to exist by simultaneously
producing moral palatability and profitability.
Surrogacy agencies, for-profit companies that arrange surrogacy programs for their
clients, go to great lengths to present surrogacy as morally palatable to participants and the
public (Rudrappa and Collins 2015). These efforts have not always been successful, as evidenced
by the recent wave of restrictions on transnational surrogacy. I examine the international

97
Mexican surrogacy market that emerged largely in response to these restrictions; it is especially
useful for an examination of how market actors work to make surrogacy both morally palatable
and profitable.
Since 2012, there have been major shifts in the global marketplace for surrogacy. First,
India restricted access to married heterosexual couples (Schurr and Militz 2018). Then Thailand
and Nepal, two of the largest transnational surrogacy destinations, banned commercial surrogacy
(Schurr and Militz 2018). Mexico’s surrogacy market emerged as a direct result of these shifts in
the global surrogacy marketplace. The Mexican surrogacy industry was established by
international surrogacy agencies to meet market demand for “low-cost” surrogacy options,
especially for same-sex couples and single intended parents. In light of increased regulation and
volatility, how do market actors in this controversial industry preserve the seemingly
incompatible goals of moral palatability and profitability?
A close examination of actors’ experiences in the market reveals the important role of
gender, race, and class, in shaping a rhetoric of altruism that allows surrogacy agencies to
preserve moral palatability and profitability simultaneously. I find that surrogacy agencies draw
on a perceived altruism/ commercialism dichotomy—which I define as a framing of altruism as
contradictory to and in tension with profit, market logics, and commodification— to facilitate
market exchanges in two key ways: by rendering it morally palatable to consumers, and in
disciplining surrogates to create a docile and compliant labor force. Together these mechanisms
render the industry profitable. Taking up Fourcade’s (2007, 1028) call to theorize the ways
“different types of class, gender, and racial relations are not only expressed in but constituted by
and reproduced through market/nonmarket and commodity/noncommodity boundaries,” I argue
that actors in the Mexican surrogacy industry draw boundaries between altruism and

98
commercialism in ways that both reflect and reinforce power asymmetries based in gender, race,
class, and nationality between surrogates and intended parents

Morals And Markets
The relationship between markets, morals, and society is a long-standing topic of
sociological inquiry. There are three principal approaches to analyzing this relationship. The pro-
market approach espoused argues that markets, operating through supply and demand, are the
best way for all goods to be distributed in a society (Becker and Elias 2007; Landes and Posner
1978).
A second approach argues that money contaminates social relationships, and therefore
certain goods and services, especially those related to intimate life, should not be bought, sold, or
priced by the market (Dickenson 2008; Walzer 1983). From this perspective, which Zelizer
(2005) called the “hostile worlds view,” profit-driven markets lead people to see each other as
means rather than ends (Hochschild 2003). In contrast, voluntary or altruistic giving is
considered a less exploitative way of distributing certain goods and services. In bioethical
debates on blood and organ donation, Healy (2010, 21) found that whether an exchange is
deemed morally acceptable “rests overwhelmingly on the moment of individual choice, the
decision to give or sell, and its moral implications are measured in terms of the amount of
autonomy possessed by the donor.” The underlying assumption is that money creates an undue
enticement, degrading the seller’s autonomy and leading to an exploitative exchange. This focus,
Healy (2010) argued, misses the organizational and social processes that occur outside of the
“moment of individual choice” (21). From a “hostile worlds” perspective, altruism is not only
morally superior but yields superior goods and services (Zelizer 2005). Titmuss (1970, 158), for

99
example, argued that a for-profit blood exchange would entice “skid row” suppliers and lead to
an unsafe blood supply. More recently, Heyes (2005) argued that increasing nurses’ pay would
lead to an influx of profit-driven rather than altruistic nurses and, thus, result in inferior care for
patients.
The third approach, proposed by Zelizer (2005), advocates for studying commodification
as a dynamic social process shaped by organizational practices and participants’ social location.
Building on her work, economic sociologists have documented the complex and diverse ways
that markets are organized and relationships are negotiated through monetary exchange. A
“hostile worlds view” assumes that intimate relationships can be separated from money and
market logics, but empirical research demonstrates otherwise. In the exchange of organs and
blood (Healy 2010), reproductive material (Almeling 2011), and sex and care work (Boris and
Parreñas 2010), monetary exchanges are imbued with social and moral meaning as a way of
signifying certain relationships.
Feminist scholars argue that gender norms influence the creation of boundaries between
markets and intimate life by positioning the self-interested, public world of men against the
altruistic, private world of family and women (Nelson and England 2002). For example, in her
study of the U.S. market for eggs and sperm, Almeling (2011) found that fertility clinics de-
emphasize the commodification of eggs by using the term “donation” and appealing to a
gendered discourse of motherly altruism. Men were not expected to define the sale of their
reproductive material as an altruistic act.
Surrogacy markets present a challenge to these perceived boundaries. Commercial
surrogacy violates numerous social norms, including the separation of intimate family life from
the market, the non-commodification of children, and the sanctity of maternal-child bonds

100
(Jacobson 2016; Smietana 2017). The discomfort with surrogacy is not just with the
commodification of human life, but also with women profiting financially from the use of their
reproductive capacities (Anleu 1992). Gestating and birthing a child for profit is seen as an
affront to proper motherhood (Jacobson 2016). Accordingly, commercial surrogacy is an
important case for studying the negotiation of tensions between altruism and profit. How do
surrogacy agencies, intended parents, and surrogates manage these tensions so as to render the
industry both morally palatable and profitable?

The Mexican Surrogacy Industry
The Mexican surrogacy market developed as a result of increased scrutiny and regulation
of other transnational surrogacy hubs, including India and Thailand. Although surrogacy had
been legal in Tabasco, Mexico since 1997, Mexico did not become a global destination for
surrogacy until 2013. With the announcement in 2012 of increased restrictions on surrogacy in
India, transnational surrogacy brokers began to search for other options—especially for gay men
and single individuals who are banned from hiring surrogates in many other countries. Market
demand for Mexican surrogates grew even more when Thailand banned commercial surrogacy
(Schurr 2016). This particular history makes Mexico’s surrogacy industry a useful case for
understanding how market actors attempt to maintain the moral palatability of a precarious and
controversial market.
At the time of this research, Mexico was one of the only places in the world where
foreigners, regardless of marital status, could contract a surrogate. For several years, Mexico was
billed as the only “affordable” alternative to the United States for same-sex couples and single
intended parents. Mexico’s surrogacy industry had the exact characteristics that were most

101
criticized in other markets: a largely foreign clientele of gay and single men who were evading
bans on surrogacy in their home countries by going abroad and/or seeking a “discount”
alternative to the United States by contracting a surrogate in a developing country.
Having witnessed the wave of bans on surrogacy in other countries, surrogacy agencies
operating in Mexico were acutely aware of the need to combat criticism to avoid the same fate.
Many of the surrogacy agencies operating in Mexico, were owned and managed by the very
same people who had previously operated agencies in India and Thailand. Surrogacy agency
owners sought to maximize their business opportunities in Mexico, in part by staving off
criticism to hinder, or at least delay, restrictive regulations. The intended parents, who contracted
surrogates in Mexico, were also well aware of the critiques of transnational surrogacy that had
spurred regulatory changes in former “low-cost” surrogacy hubs and were proactive in
countering the narrative that surrogacy is exploitative.
The Mexican surrogacy market, at the time of this research, was a precarious market.
Actors in the Mexican surrogacy industry understood that they have limited opportunities, given
the restrictions on markets in India and Thailand, and sought to protect those opportunities. This
precarity makes the tensions between morality and market especially clear, and helps illustrate
how actors manage these tensions in order to produce moral palatability. My analysis is
especially useful because data was collected when the Mexican market was still open to single,
same-sex, and international intended parents.

Producing Moral Palatability And Profitability

102
Surrogacy agencies draw on an altruism/commercialism dichotomy that is shaped by
gender norms, along with race and class, to facilitate the surrogacy market by rendering it both
morally palatable and profitable. My data demonstrate that surrogacy agencies and intended
parents distinguish good surrogates from morally suspect surrogates on the basis of their
motivations. In turn, surrogates’ motivations become a barometer for the moral acceptability of
the entire industry. Surrogacy agencies draw on a narrative of altruism that is shaped by gender,
race, and class to produce moral palatability by countering fears that surrogates are exploited or
will exploit intended parents. Meanwhile, the agencies’ enforcement of an altruistic orientation
serves to discipline surrogates into a docile and compliant labor force.
Intended parents attempt to preserve their moral self-concept while participating in the
precarious Mexican surrogacy market by insisting that their surrogate is not poor and therefore is
not driven to surrogacy by financial need. In response, surrogacy agencies manage intended
parents' fears through their selection of surrogates. The selection process reflects a dichotomous
view of altruism and commercialism in which altruistic motivations are deemed morally superior
and more appropriate for the feminine project of surrogacy than commercialism. After surrogates
are selected, agencies continue to draw on an altruism/commercialism dichotomy by promoting a
narrative of surrogacy as an altruistic endeavor in which the goals of intended parents are
paramount. I demonstrate that gender and class, which in the Mexican context is closely
intertwined with race and nationality, shape this altruism/commercialism dichotomy. These
processes both reflect and reinforce power asymmetries in the surrogacy industry that are based
in gender, race, class, and nationality.
The relationship between intended parents and surrogates is shaped by power
asymmetries that are rooted in gender, race, class, and nationality. Intended parents are generally

103
of higher socioeconomic standing than Mexican surrogates. The majority of intended parents I
interviewed are white, professional class gay men from relatively high-income countries such as
France, Israel, Spain, and the United States, mirroring findings from other studies (Fulda and
Tamés 2017; Schurr 2016; Schurr and Militz 2018). Meanwhile, Mexican surrogates are
generally working-class mestiza women with young children and few employment options.
While my data speaks most directly to the way economic inequalities between intended parents
and surrogates shape perceptions of moral palatability, as Schurr (2016) demonstrates, class is
intimately entangled with race and nationality in the Mexican surrogacy industry.

Countering Exploitation Narratives
Intended parents are aware of the narrative that surrogacy is exploitative and take
measures to counter or separate themselves from this narrative. Almost every intended parent I
interviewed raised the issue of exploitation unprompted. Intended parents attempted to counter
the exploitation narrative by stating that their surrogate was economically stable and therefore
was not compelled to be a surrogate by financial need. When I asked intended parents what they
looked for in a surrogate, one of the most common answers was economic stability. To some
extent, economic stability was a stand in for health and hygienic living conditions, but it was also
a way for intended parents to preserve their moral self-concept by indicating that the process was
not exploitative. For example, when I asked Manuel, a Spanish intended parent,
what he and his partner looked for in a surrogate, he responded, “We wanted a person who was
financially stable … Not a person that is begging, but a person who lives in a house, hygienic
and clean, a person who … of course, none of them live in a house like this [referring to the
home he was renting while in Mexico], right? But … at least they should have a stable life.”

104
Manuel acknowledged that none of the surrogates in Mexico were living in a home as expensive
as his, but was adamant about selecting a surrogate who was not poor. He stated, “In the media
they treat this issue as … the exploitation of women … the poor versus the rich, right? But, for
example, I consider that my process is a voluntary process.” By “my process” he is referring to
the surrogacy arrangement, which he believes is unlike the exploitation of poor women by the
wealthy that he sees in media portrayals of surrogacy.
Later, Manuel implied that surrogacy in India is exploitative because of the level of
poverty: “To go to India, which is a third-world country where people live on the street and pay
money to a lady [to be a surrogate], it just doesn’t fit.” Manuel differentiated exploitative from
non-exploitative surrogacy by the poverty of the surrogate, which speaks to her degree of
voluntary participation. By using India as an example of morally unpalatable surrogacy, Manuel
was arguing that Mexican surrogates are not as impoverished as Indian surrogates and therefore
are capable of voluntarily choosing to be surrogates. More broadly, Manuel’s words illustrate
that the discussion of moral palatability is shaped by economic location.
Manuel’s comments resonate with Healy’s (2010) assertion that most discussions of
exploitation focus on a singular decision moment and an individual’s autonomy in that moment.
From this perspective, voluntary exchanges, based on autonomous choice, are not exploitative.
According to Manuel, economic stability allows women to autonomously choose surrogacy such
that the exchange is voluntary and not exploitative. Conversely, poor women are burdened by
financial needs that limit their ability to make autonomous decisions. Hiring a poor surrogate is
thus seen as automatically exploitative.
This normative view disadvantages Mexican surrogates, who must conceal their financial
needs from intended parents and agencies in order to be deemed morally acceptable surrogates.

105
Surrogates cannot request additional money from intended parents without risking upsetting
intended parents’ moral self-concept and desire to see the exchange as non-exploitative.
Mexico’s place in the global economy allows Mexican surrogacy to be a more “affordable”
option for intended parents from high-income countries, but this also means that the specter of
exploitation looms large.

Selecting “Proper” Surrogates
While intended parents are concerned with being seen as exploiting financially needy
surrogates, surrogacy agencies are concerned that monetarily motivated surrogates might exploit
intended parents. Surrogacy agencies draw on a dichotomous view of altruism and
commercialism to establish a hierarchy—shaped simultaneously by gender, race, class, and
nationality—between properly feminine, altruistic surrogates and exploitable and exploitative
profit-driven women. Surrogates with purely monetary motivations could be forced into
surrogacy by economic necessity or may exploit intended parents for more money. Both
scenarios are morally problematic. Therefore, surrogacy agencies either reject or reorient
prospective surrogates who express monetary motivations. Meanwhile, this
altruism/commercialism dichotomy increases the profitability of surrogacy by discouraging
surrogates from negotiating their wages lest they be deemed unfit for surrogacy.
Surrogacy agencies are for-profit entities that hire paid employees to recruit surrogates
and coordinate surrogacy programs. Part of their job, as they see it, is to decide if a woman
would be an appropriate surrogate. This is determined in large part by the woman’s motivation
for becoming a surrogate. In interviews with agency staff, I was repeatedly told that women who
are interested in being surrogates only for financial reasons would not be accepted. Agency staff

106
occasionally acknowledged that poor women were more likely to be interested in surrogacy, but
they insisted that money should not be a surrogate’s primary motivation.
Surrogacy agencies view prospective surrogates who are motivated primarily by money
as untrustworthy. For example, I asked Laura, the Mexican-American manager of the Mexico
branch of an international surrogacy agency, how the agency recruits surrogates. She explained:
You know, we have to make sure that it's a surrogate that can think on her own, someone
who … says, “Ok, I want to do this,” and not doing it because, you know, “I really need
the money.” … Yes, there is that factor, there is always that factor, but not the main
factor, you know. We don't want this to be the only thing that's driving her … There are
surrogates that look at all the agencies to see which one financially benefits them most
and … [the surrogates say,] “These agencies pay me this, you know, can you do the
same?” And [if] we always change [the payment], then we are going to get surrogates
that are going to want to manipulate us or manipulate the parents … We don't want at the
very end to say, “Oh no, we have a problem because the surrogate doesn't want to give
the baby, or wants money … to give up the baby.” You know, we want to avoid that, and
to do that we need to make sure that she is not just driven by the money.

Laura stated that money is always a motivating factor for Mexican surrogates, but she did
not want money to be “the main factor.” She was critical of women who compare payment
across agencies or try to negotiate their wages. Even though comparing wages is common
practice in other forms of employment, Laura saw this as a prime indicator that a woman’s
motivations were misguided. This reflects a gendered “hostile worlds view,” in which self-
interested market logics should be separated from reproductive labor. Laura’s statement also
demonstrates that tensions between altruism and commercialism are shaped by class. Laura
feared that women who seek to profit financially by being surrogates would blackmail intended
parents for more money. The leap from comparing wages to blackmail demonstrates the extent to
which financially motivated surrogates are perceived as immoral and untrustworthy women.
Additionally, by contrasting a woman who “can think on her own” from a woman who really
needs the money, Laura is implying that financial need is at odds with voluntary choice and

107
therefore morally suspect. By rejecting prospective surrogates who compare and negotiate
wages and keeping surrogates’ wages low, Laura is both producing moral palatability and
profitability.
Similarly, Edgar, a Tabascan agency owner, discussed the importance of using the
“correct filters” to select appropriate, trustworthy surrogates. He described other agencies as
being less careful in their selection of surrogates and therefore more susceptible to blackmail:
"[Agencies] need surrogates fast. They need as many as possible to be available, so they just
promote money, money, money and they forget the human part, and obviously it turns into a
completely economic idea, and then, [the surrogates] say, ‘I have the power, I have the baby, I
want more money.’" Like Laura, Edgar sees it as his job to weed out monetarily motivated
surrogates who might blackmail intended parents. According to Edgar, when surrogacy becomes
“completely economic,” it loses the “human part.” Even though he runs a for-profit surrogacy
business, Edgar described economics as separate from and a threat to the human aspect of
surrogacy.
Surrogates have immense power once a pregnancy is confirmed, as the industry’s sole
“product” is physically contained within the surrogate’s body. This power is a source of fear for
surrogacy agencies and intended parents. In Edgar’s view, women who are financially motivated
may act inhumanely and exercise this power to demand more money. Because of surrogates’
embodied control over the means of reproduction, surrogacy has the potential to disrupt the
power asymmetries between surrogates and intended parents. By contrasting commodification
with humanity, Edgar is attempting to produce a compliant and docile labor force of surrogates
who will not seek higher wages or disrupt the pre-existing power dynamic.

108
Despite his concerns about the suitability of monetarily motivated surrogates, Edgar
considered it foolish to think that Mexican women are signing up to be surrogates out of love or
altruism. In explaining his own selection process for surrogates, he said, “It is important that it’s
not all for the money, but it would be dumb to say, ‘They do it out of love.’ No, there are none. It
is foolish to tell you that—[there are women who] do it out of pure altruism—excuse me but no.”
Although he claimed that none of the Mexican surrogates “do it out of pure altruism,” it is okay
“as long as they understand the need of the parents, that is, they can empathize with it, and this
does not become a commodity product.”
According to Edgar, treating surrogacy as a commodity exchange indicates that a
surrogate is not sufficiently empathetic to intended parents’ plight. This reflects a view of
economic transactions as incompatible with empathy and care. Mexican surrogates who seek to
benefit financially from the process and take steps to ensure fair wages, such as negotiating fees,
are thus deemed immoral. Monetary motivations are seen as a threat to both the moral
palatability and profitability of the industry. Next, I demonstrate how agencies counter
surrogates’ monetary motivations through a narrative of altruism that privileges the “needs” of
intended parents, and in turn, exacerbates existing power asymmetries between intended parents
and surrogates.

Promoting an Altruistic Orientation
After the selection process, agencies continue to promote an altruistic orientation to
surrogacy, which entails elevating intended parents’ goals over surrogates’. This is not to say
that Mexican surrogates are not truly altruistic, but rather that the perceived
altruism/commercialism dichotomy enables agencies to promote an altruistic orientation as a

109
form of discipline that serves market interests. This altruistic orientation protects agencies and
intended parents from accusations of exploitation while curbing surrogates’ negotiating power,
thereby simultaneously producing moral palatability and profitability. This orientation both
reflects and reinforces power asymmetries, shaped by gender, race, and class.
Each of the 45 surrogates I interviewed discussed both monetary and altruistic
motivations, but there was variation as to which motive predominated and initially drew them
into surrogacy. Carla, whose story is representative of most surrogates I interviewed, was
initially drawn to surrogacy by financial need but came to see it in altruistic terms, likely at the
suggestion of agency staff.
Carla is a single mother living in a poor neighborhood of Villahermosa, where surrogacy
has become popular among women of reproductive age. Her debts had been piling up when a
neighbor came to recruit her. Carla told me she was initially drawn to surrogacy because of the
money, but after meeting with the surrogacy agency she “realized” that surrogacy is about much
more than money. Although Carla had children unexpectedly at a young age, she, like most
Mexican surrogates, considers her children her greatest treasure and expressed a desire to help
others become parents. While surrogates expressed both monetary and altruistic motivations,
surrogacy agencies present these motivations as dichotomous.
Many of the surrogates I interviewed described entering into surrogacy for monetary
reasons but then “realizing” or “learning” to view it as an altruistic act after discussions with
agency staff. They also discussed motherhood as their greatest achievement and expressed
sympathy for those who had not experienced the joy of parenthood. This expression of maternal
altruism meshes well with views of feminine docility that privileged elites project onto working-
class “Third World Women” (Mohanty 1988; Salzinger 2003). The language of “helping parents

110
realize their dreams” is so ubiquitous that it is possible that surrogates are simply repeating what
they have been told to say or strategically using this narrative to gain the trust of agencies and
intended parents. Whether or not surrogates truly believe that surrogacy is more of an altruistic
endeavor than an economic one, agencies often enforce an altruistic framing that privileges
intended parents’ plight over surrogates’ goals. This framing exacerbates the existing power
imbalances, based in gender, race, class, and nationality, between intended parents and
surrogates.
During interviews, agency staff repeatedly told me that a good surrogate understands that
surrogacy is about creating families, not making money. For example, Katrina, a woman
working at the Mexican branch of a surrogacy company, stated that surrogates should view
surrogacy as “a voluntary contribution to help a couple create a family, not as a job.” This
statement situates surrogacy in the altruistic sphere of family and motherhood, rather than in the
self-interested world of the market. In a similar vein, Armando, manager of the Mexico branch of
another international surrogacy agency, explained, “In the end what we want to do is to create
families, we’re not encouraging people to make themselves rich by renting their wombs.” In
Armando’s statement, much like in public debates on surrogacy, the figure of the pure, morally
righteous surrogate who creates a child out of “maternal love” and a desire to help others is
juxtaposed with a money-hungry surrogate who “prostitutes her maternity” (Cannell 1990, 683).
Both Katrina and Armando contended that surrogates should be focused on fulfilling intended
parents’ goal of having a child rather than on their own monetary goals. The language they used
implies that these two goals are in conflict.
To promote an altruistic orientation, surrogacy agency staff often recount the difficulties
intended parents have gone through in their quest to have children, appealing to notions of

111
maternal altruism. For example, Selena, a surrogate, explained during a conversation with two
other surrogates: "There are times when we [the surrogacy coordinator and other surrogates] talk
about the intended parents’ history and all that they have suffered … I think that is when we feel
the most obligated and the most like we are helping someone who really wants and yearns for a
baby." For Selena, a focus on intended parents’ plight leads to a sense of obligation and a more
altruistic orientation.
While surrogates often express pride in helping others become parents, an altruistic
orientation can also be a way of disciplining surrogates and creating a compliant labor force. In a
study of egg donation, Curtis (2010, 93) found that “altruistic motivations, in which the needs of
others are placed ahead of their own, renders many donors less able to express their concerns and
less alert to possible risks than a more ‘selfish’ orientation might foster.” In the case of Mexican
surrogacy, I find that an altruistic orientation hinders surrogates’ ability to negotiate their wages,
thus rendering Mexican surrogacy more affordable for intended parents and profitable for
agencies. Next, I demonstrate how this process serves to discipline surrogates while making the
exchange appear morally palatable to intended parents.

Managing Tensions
The moral palatability of surrogacy is tethered to perceptions of surrogates’ motivations.
Intended parents are concerned with presenting surrogacy as non-exploitative to preserve their
moral self-concept, while agencies present themselves as astute selectors of trustworthy (i.e., not
motivated primarily by money) surrogates. The following story, which is representative of
agency mediations I either witnessed or heard about during fieldwork, demonstrates how
surrogacy agency staff deploy the rhetoric of altruism to render surrogacy moral palatable to

112
intended parents while disciplining surrogates and maintaining the profitability of the industry by
stunting surrogates’ wages.
Javier and Ruben are a couple from Spain who contracted Marla, a Mexican woman, to
serve as a surrogate for them. Carlos, a Mexican attorney and surrogacy agency owner,
introduced Javier and Ruben to Marla, wrote their surrogacy contract, and agreed to manage the
surrogacy process and distribute payments to Marla. However, Carlos disappeared soon after
Javier, Ruben, and other intended parents paid him. Veronica, an independent surrogacy
coordinator, stepped in to help the intended parents Carlos had abandoned, including Javier and
Ruben.
When I met Veronica, she was preparing for a meeting between Javier, Ruben, and Marla
to discuss a disagreement about Marla’s pay. Prior to Carlos’s disappearance, a doctor implanted
two of the couple’s embryos in Marla’s uterus. Marla was paid 1,500 MXN, about U.S.$85 at the
time, for the embryo transfer. The embryo transfer was unsuccessful, and Marla did not become
pregnant. Marla began preparations for a second embryo transfer, which was scheduled to take
place a few days after this meeting, and asked Javier and Ruben when she would receive her next
payment. Javier and Ruben did not want to pay Marla for undergoing a second embryo transfer.
Furthermore, Javier and Ruben found Marla’s requests for additional money distasteful.
Veronica set up a Skype meeting with Ruben, Javier, and Marla to resolve the dispute
and invited me to observe. Everyone consented to be audio-recorded. Veronica described the
situation as typical of the issues she deals with as a surrogacy coordinator. Marla was late to the
meeting, so Veronica discussed the issue with Javier and Ruben first. Javier and Ruben
complained that Marla only seemed interested in surrogacy for the money. They found her
requests for additional payment, and her text messages generally, cold and off-putting. Veronica

113
explained to Javier and Ruben, “Look, all of them, all, all, all of the surrogates I have now and
have worked with are doing it for the money. So, I don’t want you to be offended because she’s
requesting her compensation. They’re all like that. Marla lives in a very difficult situation … her
house is very poor, I’m not taking her side but she’s a good lady.” Javier and Ruben seemed very
upset by this information. Veronica continued, “Her level of education is very low, so I am just
asking for your patience. You are right that her messages and emails are usually cold, but inside
of it all, I think that she is a good person, because she is cooperative, she has a good soul.”
Veronica explained that the contract Javier and Ruben signed did not stipulate what to do in the
case of a second embryo transfer. She noted that Javier and Ruben had been paying Marla extra
money for “family support” above what was required by their contract. Veronica suggested that
instead of paying Marla another 1,000 MXN in family support, they should tell Marla that this
1,000 MXN is payment for undergoing a second embryo transfer. This way, Marla would be
appeased but the couple would not have to spend more money. Although still visibly upset,
Javier and Ruben agreed to Veronica’s plan.
A few minutes after the call with Javier and Ruben ended, Marla arrived at Veronica’s
office. Veronica pulled out a copy of Marla’s contract and read it out loud while Marla looked
over it. This led to a disagreement about whether Marla should be paid for undergoing a second
embryo transfer, and whether the payments for embryo transfers were included in the total sum
of 198,000 MXN. Veronica began to write out numbers on a napkin. Marla then pulled out a
napkin from her purse with numbers and calculations written on it. To resolve the dispute,
Veronica suggested they call a woman who worked at Carlos’s now-defunct agency and was
there when Marla signed the contract. Veronica called Carlos’s former employee and confirmed
that the embryo transfer payment was part of the total sum and not extra.

114
Veronica then told Marla that Javier and Ruben had decided to pay her 1,000 MXN for
the second embryo transfer because they wanted to make sure she was well taken care of.
Veronica emphasized that in doing so, Javier and Ruben were going above and beyond the terms
of the contract. Veronica then reminded Marla that the family support payments and cell phone
she received from Javier and Ruben were also beyond the terms of the contract. Veronica also
reminded Marla of all that Javier and Ruben had gone through in their quest to have a child,
including being scammed by Carlos. After they came to agreement on the contract, Veronica
gave Marla tips on how to seem less cold in her text messages to Javier and Ruben. She
suggested opening with a question such as “How are you?” before getting into details, ending
conversations with “thank you,” and using exclamation marks to express excitement. Most
importantly, Veronica told Marla that discussions of payment should go through the agency so as
not to give Javier and Ruben a “bad impression.”
This story demonstrates how surrogates are disadvantaged when their interests conflict with
those of intended parents and agencies. As a surrogacy coordinator, part of Veronica’s job is to
manage the relationship between intended parents and surrogates. Veronica must explain Marla’s
“cold text messages” in a way that presents Marla as sympathetic, without disrupting Javier and
Ruben’s perception of the surrogacy process as mutually beneficial and morally sound. Javier
and Ruben were upset to hear that Marla is poor. This indicates they were unaware of her
financial circumstances when they originally signed the contract and reflects their discomfort
with hiring a poor woman to be a surrogate for them. Veronica’s response that Marla has a “good
soul” is an attempt to simultaneously assuage Javier and Ruben’s guilt and convince them that,
despite her poverty, Marla chose to be a surrogate for “the right reasons,” i.e., to help others, not
to get rich. Javier and Ruben’s discomfort with Marla’s poverty reflects a breach of what

115
Smietana (2017, 8) called the “normative expectation of free agency and self-determination”
through which a surrogate’s financial situation becomes a proxy for determining whether the
arrangement is exploitative. Because Marla is poor, she is perceived to lack the agency to freely
choose to be a surrogate, and her poverty is taken as an indication that she might not be
trustworthy. This is reflected in Veronica’s response that Marla has a “good soul,” which implies
that Marla’s moral character is in question. The discovery that Marla is poor brings into question
her suitability as a surrogate and the morality of the whole exchange.
Veronica’s solution to stop Marla’s family support payments and re-label that money as
payment for a second embryo transfer is an example of the creativity needed to keep tensions at
bay in an industry that blurs the lines between market and nonmarket relationships. Veronica
waited until after she and Marla had confirmed that Marla was not entitled to payment for a
second embryo transfer to tell her that Javier and Ruben had decided, as an act of generosity
above and beyond the contract terms, to pay her for the second transfer. This gave Marla the
impression that Javier and Ruben had taken her request seriously and were acting generously. By
reminding Marla that family support money was not in the contract, Veronica laid the
groundwork for Javier and Ruben to discontinue those payments without drawing a direct
connection to the embryo transfer payment. Urging Marla to be “nice” in her messages to Javier
and Ruben re-positions her as properly feminine, docile, and deferential rather than as a market-
driven actor.
The meeting repaired Marla’s relationship with Javier and Ruben, but Marla did not
actually receive more money, which was her goal. Veronica’s intervention helped mollify all
parties but constitutes a missed financial opportunity for Marla. Not only was Marla told she
would be paid extra when in fact an existing payment was just re-labeled, she was discouraged

116
from bringing up money again for fear it would reflect poorly on her and threaten the continued
viability of the surrogacy arrangement. Marla’s “cold” and direct requests for money threatened
to commodify the exchange in ways that would compromise the moral integrity of the process.
Veronica could have simply told Javier and Ruben to pay Marla for the second embryo transfer,
but that would have further disrupted the balance of power in the surrogacy relationship. Javier
and Ruben are Veronica’s clients, and therefore her primary goal is to appease them. Doing so
requires maintaining a moral framework of surrogacy as neither exploitative nor the
commodification of children. This framework hinges on perceptions of surrogate motivations
that are shaped by gender, race, class, and nationality.
This is a concrete example of how surrogates are discouraged from seeing surrogacy as
work and are taught to view it as an altruistic act. This helps justify relatively lower wages, while
creating “pliable and reliable” reproductive workers (Curtis 2010, 88). Women who do not
comply are deemed improper surrogates by agencies and intended parents. The rhetoric of
altruism is used to discipline surrogates into quietly accepting the terms of the arrangement. As
Curtis (2010, 88) argued in the case of egg donation, “donors who are free to be selfishly
motivated may be more likely to be demanding of their doctors, may have higher expectations
for patient care, and may require more from recipients.” The rhetoric of altruism in surrogacy
both reinforces essential notions of femininity and limits the monetary compensation women
receive for their labor. It also perpetuates power asymmetries, rooted in gender, race, class, and
nationality, between Mexican surrogates and international intended parents.

Conclusion

117
Actors engaged in surrogacy draw on moral frameworks of altruism to legitimate the
surrogacy market and defend against accusations of exploitation and baby selling. As Rudrappa
and Collins (2015) argued, a moral framework that counteracts narratives of exploitation is
constitutive of the surrogacy industry because it enables the market to persist. To recruit clients
and prevent legislators from outlawing surrogacy, international surrogacy agencies must actively
negate criticism of transnational surrogacy as exploitative.
My research builds on these insights to demonstrate how actors in the Mexican surrogacy
industry draw on an altruism/commercialism dichotomy that is shaped by gender, race, and class
to preserve both the moral palatability and the profitability of surrogacy. My data demonstrate
the prevalence of a rhetorical dichotomy between trustworthy, altruistic surrogates and morally
suspect, financially motivated surrogates that is shaped by gender norms, as well as race, class,
and nationality. This false dichotomy allows surrogacy agencies to keep surrogate wages low by
creating a docile and compliant labor force while maintaining the appearance of a morally sound
exchange, which in turn perpetuates power asymmetries between Mexican surrogates and
international intended parents.
The moral suspicion with which surrogates’ demands for remuneration are met reflects a
gendered “hostile worlds view” and class bias. Selfish motivations are considered incompatible
with the feminine project of surrogacy, and profiting off a child is seen as an affront to proper
motherhood and womanhood. But “squeamishness about money is a luxury” only affordable to
those who are not burdened by financial need (Nelson 1999, 49). When surrogates’ motivations
are the primary measure of the morality of surrogacy, poor surrogates are automatically morally
suspect. The attention on surrogates’ motivations and the circumstances under which women

118
choose to be surrogates also deflects attention from other aspects of the surrogacy process that
may be more or less exploitative.
Debates about surrogacy, both academic and legislative, often focus on whether women
should be paid to act as surrogates. These debates are often premised on the idea that commercial
surrogacy is inherently more exploitative than altruistic surrogacy. But, as this chapter
demonstrates, the very dichotomy between altruism and commercialism can be exploited to
produce compliant surrogates and sustain the industry. The rhetoric of altruism as a feminine
virtue enables surrogacy agencies to cultivate a docile workforce that cannot advocate for their
own financial gain. This has important implications for our understanding of reproductive labor
and gender inequality more broadly. As Raymond (1993, 58) argued in her discussion of
surrogacy, “The altruistic pedestal on which women are placed is only one more way of
glorifying women's inequality.” The designation of altruism as a feminine virtue dichotomous
with self-interest fuels gender inequality by facilitating the devaluation of reproductive labor
(Raymond 1993). This chapter builds on Raymond’s assertion with an intersectional analysis of
who profits from the idealization of motherly altruism.

119

CHAPTER 4: CUTTING OUT THE SURROGATE

Feminist scholars in sociology and anthropology have demonstrated that childbirth
practices reflect broader cultural values, are shaped by institutional processes and structural
constraints, and are experienced differently by women depending on their social location within
a society (i.e., race, class, immigration status). Scholars have found that whether medicalized and
technologically mediated childbirth is considered preferable or coercive depends on a woman’s
level of agency, which is shaped by her place with social hierarchies, and the meanings attached
to medical care in her specific historical and cultural context (Nelson 1983; Roberts 2012; Vega
2018). Whether medicine is understood as a consumer good or a public service shapes how
childbirth is practiced and the values that are attached to those practices. Transnational,
commercial surrogacy is an interesting case for studying how these dynamics shape experiences
and values attached to childbirth since the “consumers” of medicine are the intended parents
rather than woman giving birth (i.e., the surrogate). Furthermore, the consumers/intended parents
and the surrogates often come from different countries with distinct understandings of childbirth
and of medical care. How do these dynamics play out in the consumer-driven context of
transnational, commercial surrogacy where the woman gestating the fetus and giving birth is
neither the consumer nor the “mother”? What cultural values shape childbirth practices in the
Mexican surrogacy industry? For Mexican surrogate mothers, how does their social location
within Mexican society shape their experiences of childbirth?
In this chapter, I analyze childbirth practices in the Mexican surrogacy industry. Mexican
surrogate mothers usually deliver via Caesarean section (C-section), even in instances where
there is no medical indication for a Caesarean birth. I find that the high rate of C-section births

120
does not necessarily reflect the desires of surrogate mothers or of intended parents. Instead, the
C-section rates for Mexican surrogates reflect physicians’ normative views of gender and
motherhood. I demonstrate that high C-section rates in the Mexican surrogacy industry are
driven by physicians, who believe that C-sections are preferable to vaginal births for surrogates
because of the bond created between mother and child during vaginal birth. In this chapter, I
explore the implications of this ideology for our understanding of how gender and kinship
ideologies interest with notions of risk to inform medical practice.

Feminist Analyses of Childbirth Practices
Childbirth practices shed light on cultural values, ideologies of gender and motherhood,
and social inequalities. In her path-breaking book about cultural and medical constructions of
women’s bodies, Emily Martin (1987) argues that childbirth practices in the U.S. are based in
Western metaphors of the body as a machine. Martin demonstrates that an ontological separation
between the body and the self dominates both medical and lay imagery about women’s
reproductive processes from menstruation to menopause. This imagery positions women as
passive objects that are subjected to bodily processes rather than agents in the childbirth process.
In obstetrical literature, the uterus with its involuntary contractions, rather than woman, does
most of labor of childbirth, while in popular parlance, physical sensations of birth are described
as happening to women rather than being acts a woman engages in (“the contractions came on,”
“she went through labor,” “the doctor delivered the baby”). In the machine metaphor, doctors are
like mechanics or technicians who fix the woman’s body using tools like forceps and procedures
like C-sections.

121
Feminist scholars have examined the impact of a medical model of reproduction on
women’s bodies and identities. For example, Davis- Floyd (1992) describes childbirth in the
United States as “right of passage” in which women are indoctrinated into
America's patriarchal and technocratic culture. Davis-Floyd argues that American birthing
practices are shaped by the value U.S. culture places on science and medical expertise, which are
coded masculine and contrasted with nature and women’s embodied knowledge. She also argues
that many common childbirth practices in U.S. hospitals are technocratic rituals that serve little
practical purpose. More recently, Theresa Morris (2013) argued that the high rate of C-sections
in the U.S. is driven by institutional factors, rather than by physician or patient preference. Even
though the health outcomes for both mother and child are worse with C-sections than with
vaginal birth, C-sections are performed in order to minimize legal risks to hospitals. While
Morris’s argument focuses on the institutional factors that shape doctors’ clinical practice, her
book also demonstrates how a culture of risk management and litigiousness in the United States
shapes childbirth practices.
The meanings attached to childbirth practices, and medicalized and technologically
mediated childbirth in particular, vary greatly depending on the social context. In her
ethnographic study of in-vitro fertilization in Ecuador, Elizabeth Roberts (2012) found that C-
sections were highly correlated with race and class. None of her white or upper class mestizo
informants knew anyone of their generation who had a “normal birth” aside from their domestic
servants. Vaginal birth is seen as animalistic and degrading and therefore C-section scars become
a mark of upper-class whiteness (Roberts 2012). In Ecuador, white women are seen as having
weaker constitutions than indigenous or Afro-Ecuadorian women. Thus, the need for medical
intervention is continuous with the schema of white women’s reproductive dysfunction (Roberts

122
2012). In this context, a C-section scar is seen as a bodily marker of one’s belonging in the
private system of care and is associated with private healthcare and the resources to be cared for
during recovery from a C-section. Similarly, Maust Good (2002) found that having a C-section
in Mexico mark a woman as whiter because C-sections entail a long recovery period during
which one relies on resources, familial or economic, to which not all Mexican women have
access.
More recently, the association between C-sections and wealth has begun to shift as poorer
women in Mexico are subjected to the routinized and overcrowded public health system and the
most elite Mexican women are able to access a transnational network of “natural birthing
experts” (Vega 2018). Scholars of reproduction in Mexico have demonstrated that the state
privileges biomedical forms of knowledge and imposes this form of knowledge on low-income
women by making hospital births a condition of subsistence programs (Browner 1986; Smith-
Oka 2013). The relationship between medical authorities and pregnant women is highly
stratified, as is the Mexican healthcare system. While poor women are treated as disobedient
vectors of risk and must give birth in overcrowded public hospitals under strict medical control,
wealthy women are seen as consumers who can make demands on clinicians.
In her research at the maternity ward of a public hospital in Puebla, Smith-Oka (2012a,
2012b, 2015) found that hospital staff confounded social risk and biological risk in their
treatment of poor Mexican women. Poor Mexican women were considered unmodern subjects
who could not properly comprehend and manage the risks of childbirth. Poor women were
perceived as non-compliant patients who did not fully understand the risks involved in childbirth
and thus had to be treated forcefully or threatened into compliance. Smith-Oka (2012b) found
that a combination of overcrowding, overwork, and negative stereotypes about poor women led

123
to an increased reliance on C-sections. Laboring women who were perceived as insufficiently
compliant with doctors’ orders or who were otherwise deemed troublesome would be sent to
have a C-section, where labor can be fully controlled by medical staff. In Latin America, a
woman’s birthing method is a marker of her claims to, or ability to supersede, citizenship,
whether it be a C-section or a natural birth that marks her as above the masses who rely on the
public healthcare system. What then happens when poor Mexican women are brought into the
world of private medical care as gestational surrogates? What ideologies animate medical
practices in this context?

Caesarean Sections as Kinship Technologies

One might assume that in the consumer driven world of medical tourism clients, the
preferences of intended parents would hold the most weight in medical decisions. However, this
is not the case when it comes to childbirth in the Mexican surrogacy industry. The majority of
surrogate mothers I interviewed gave birth via Caesarean section but neither surrogate mothers
nor intended parents expressed a strong preference for Caesarean sections. When asked about
their childbirth preferences, most surrogate mothers expressed a preference for a vaginal birth,
while most intended parents expressed no particular preference. Although some intended parents
and most surrogates stated a childbirth preference when asked, I found that both parties generally
deferred to, and rarely questioned, the expertise of physicians.
While it may seem preferable for physicians to make medical decisions, as numerous
scholars have shown, medical practice is not “neutral.” Rather, physicians’ views and practices
are shaped to cultural values and norms (Floyd-Davis 1992; Martin 1987). I argue that this is
evident in physicians’ stance that vaginal birth creates bonds surrogate mothers and the child

124
they carry, which they use to justify the high rate of Caesarean sections among surrogates. This
ideology is rooted in normative views of gender and kinship and reinforces the notion that
maternal-fetal bonding is natural and inevitable. This narrative also constructs women as
irrational and driven by hormones and presumes that bonding between surrogate mothers and the
child they gestate is detrimental to the surrogacy process.

Surrogates as Risky Patients, Doctors as Risk Managers
In the Mexican surrogacy industry, doctors are the primary actors responsible for driving
up the rate of Cesarean sections amongst Mexican surrogate mothers. Most doctors I interviewed
stated that Cesarean sections are preferable for surrogacy births because Caesarean sections
bypass the bonding experience of vaginal birth. Doctors asserted that vaginal birth would
produce an emotional connection between the surrogate mothers and the baby and that such a
connection should be avoided for the sake of the surrogates’ wellbeing. For example, when I
asked Dr. Contreras about how he decides if a surrogate will have a vaginal birth or a Cesarean
section, he replied, “It should be determined by obstetric conditions or if there are risks or no
risks for the mother, however it is currently being promulgated that in surrogate patients it is
done by Cesarean section.” He explained, “Subjecting them [surrogates] to labor can foment,
from the psychological and emotional point of view, the strengthening of the affective ties of the
mother to the baby. For that reason, it is recommended that the patients that are from surrogacy
obtain a Cesarean section.” Dr. Contreras is one of only a handful of obstetricians in Tabasco
working on surrogacy cases. He has been the attending physician for more surrogacy births in
Mexico than any other doctor. Thus, his perception of the costs and benefits of C-sections had a
direct impact on the experiences of many Mexican surrogates.

125
Doctors involved in the surrogacy industry asserted that the experience of vaginal birth
might produce such a strong emotional connection that it would cloud the surrogates’ judgment
and make it more difficult for her to subsequently relinquish the child. For example, Dr.
Mendoza, an OB/GYN working at a fertility clinic in Cancun, explained,
The [surrogacy] babies are born only through Cesarean sections. The Cesarean avoids the
emotional bond between mother and child. It avoids certain complications… the
surrogates are very conscious of the fact that it’s not their baby and it’s rare that they get
attached to the pregnancy, but because of that risk especially during labor, all are done
via C-section. There are clearly many links that are established during a normal birth. Not
just for the mothers but for the baby too. We try to avoid that whole situation so we do
Cesareans. ”

The implication here is that getting “attached to the pregnancy” is both problematic and
potentially out of a surrogate’s control if she goes through vaginal labor. Dr. Mendoza describes
the emotional attachment between surrogate and child as a risk that can only be controlled
through technological intervention. Her statement implies that Mexican surrogate mothers are
unreliable and unable to manage their emotions. Dr. Mendoza’s statement positions women as
closer to nature, irrational, and emotional while presenting medicine and technology as forces of
reason and control that can and should, be harnessed to manage risks.
Some surrogacy agency staff also promoted the idea that vaginal birth creates a more
intense bond between surrogate and child, and should thus be avoided. Hugo is the manager of
the Mexico branch of an international surrogacy agency. When I asked him about childbirth
practices, he responded:
Normally we have C-sections. Let's say 95% of the time there is a C-section… it allows
you to sketch out the date, and prepare the intended parents, it's to some extent safer for
the surrogate mother, and most of our intended parents prefer it. And the surrogate
mothers, too. Because at the end we also need to see that the surrogate mother is not
creating a bond with the child.

126
Hugo presents C-sections as the preferred childbirth method for everyone involved in a
surrogacy arrangement. His explanation for why C-sections are preferable mirrors the ideology
espoused by physicians in the Mexican surrogacy industry. Hugo acknowledges that C-sections
serve the interests of the agency by allowing them to plan ahead but concludes that preventing
surrogate-child bonding is their primary concern.
This reasoning is passed on to some intended parents as well. For example, Manuel, an
intended father from Spain, explained that the agency he and his partner hired to coordinate their
surrogacy arrangement stated up front that all surrogates in their program deliver via Cesarean
section. Manuel said, “From the first moment they told us that for surrogacy they have Cesareans
because in a natural birth the passage of the baby through the uterus releases a series of
hormones that bond the mother to the baby forever. Therefore, there is a physical reaction that is
avoided with the Cesarean.” Rather than locating “natural” and “ever-lasting” bonding as
occurring during the nine months of gestation, Manuel is taught that intense bonding occurs
during vaginal labor and can thus be avoided with the use of technology. This narrative may
assuage Manuel’s concerns about any difficulty the surrogate may have in relinquishing the baby
and portrays medicine and technology as a powerful force for controlling nature and women.
The social and medical context of childbirth in Mexico adds a level of complexity to the
situation. As scholars like Carole Browner and Vania Smith-Oka have shown, poor women in
Mexico are considered risky reproducers and medical authority has been used as a way to control
the reproductive lives of poor Mexican women. Another obstetrician involved in the Mexican
surrogacy industry, Dr. Valdez, acknowledged that the socio-economic profile of Mexican
surrogates factored into his medical decisions. Dr. Valdez has his own fertility clinic in Tabasco
that mostly serves upper class patients along with some surrogates. He also works at the

127
maternity ward of a public hospital. When I asked him about the high rate of C-sections for
surrogate mothers, he explained,
The cultural aspect is very important. I know that with a woman who takes adequate
prenatal care of her own initiative… I will follow [medical guidelines] to the letter.
Sometimes the women who rent their wombs it is not so easy for them to follow such
indications or understand the gravity of the situation. Sometimes, for that reason we
abuse a bit the need to do C-sections to give a better result in terms of the baby.

Dr. Valdez contrasts surrogate mothers with proper mothers who engage in adequate prenatal
care of their own volition and have the education to “understand the gravity of the situation.”
Much like in the hospital Smith-Oka observed, poor women are seen as incapable of
understanding the “gravity” of childbirth and therefore are in need of more intensive medical
intervention. The women who serve as surrogates in Mexico are generally young, poor urban
women. They come from similar socio-economic backgrounds to the women Smith-Oka
observed in a public hospital in Puebla. Dr. Valdez’s comments echo Smith-Oka’s findings. Dr.
Valdez’s statement presumes that his medical knowledge is more valid than a laboring woman’s
embodied or experiential knowledge, especially if that woman is poor. Although all surrogate
mothers have given birth before, they are deemed incapable of making childbirth decisions
because they lack the type of knowledge that is privileged in this space. Dr. Valdez’s statement
also posits the wellbeing of the baby as separate from and more important than the wellbeing of
the surrogate.

C-sections as a physical and economic burden
While physicians and some agency staff describe Caesarean sections as the preferable
childbirth method for all parties involved in the surrogacy arrangement, I found that surrogate
mothers did not share that view. When asked about their childbirth preferences, most Mexican

128
surrogates said they preferred to have a vaginal birth. The most common reason given was that
the recovery from a Caesarean section is much more difficult, painful, and lengthy than the
recovery from vaginal birth. I discussed the topic of childbirth with four first-time surrogates in
Cancun. When I asked the women if they had a preference between delivering vaginally or via
C-section, Selena, a single mother of one born vaginally, responded, “I would love to have a
natural [vaginal] birth because we know that the recovery is more immediate, because it doesn’t
hurt as much, because it’s much easier to have a vaginal birth after you’ve already had a child.
Therefore, I feel that a vaginal birth is better for me, but if they say it’ll be a C-section, I don’t
have a problem.” The other surrogates in the room agreed that short-term pain of vaginal
childbirth is preferable to long-term pain of recovery from a C-section.
Another surrogate, Teresa, a mother of one born via C-section added: “The pain of the C-
section, I suffered it for my child, because it is my child, but I didn’t suffer for free. It’s an
intense recovery and a painful experience.” The women then discussed their concerns about the
logistics of recovering from a C-section. Selena wondered who would take care of her daughter
while she recovered and Teresa was concerned about flying home to Quintana-Roo days after a
C-section. Many of the surrogates I interviewed, worried about who would take care of them and
their children during the recovery and how long they would have to wait before going back to
work. Most surrogacy contracts included some financial support for the post-Caesarean recovery
period, but surrogates questioned if these funds would be sufficient to cover lost wages,
childcare, and properly compensate them for the pain they would endure from the C-section.
Some surrogates described the C-section as the worst aspect of the surrogacy process. For
example, I asked Blanca what the hardest part about being a surrogate was and she said, “[The
hardest part was] the recovery. I was scared, I wanted a normal birth… but they told me that I

129
cannot.” Surrogates like Blanca who had not previously experienced a C-section were especially
fearful. In addition to being worried about the recovery time, some surrogates expressed fear
over underdoing a major surgery. Fabiana had two children through vaginal delivery before
signing up to be a surrogate. She was nervous about potentially having a C-section: “[the issue of
childbirth] is very important to me, because I’ve never had an operation like this on my womb,
then I will stay marked, scarred.” For surrogates, C-sections are associated with more physical
pain, logistical complications, and economic burdens than vaginal birth.
Surrogates were also concerned about the impact of a C-section on their reproductive
futures. Many surrogates expressed a desire to go through the surrogacy process a second time
and understood that undergoing a C-section would delay their plans. Surrogates who had C-
sections were required by doctors and agencies to wait longer than those who had vaginal births
before entering the surrogacy program again. Too many C-sections could disqualify a woman
from serving as a surrogate. Given the high rate of C-sections in Mexico generally, many
surrogates had already had C-sections with their own children before entering into a surrogacy
arrangement and knew that another C-section would put them at the limit set by doctors and
agencies. This concern is well founded. Agency staff and physicians place a lot of emphasis on
the number of C-sections a potential surrogate has had. Yolanda, a surrogacy coordinator in
Tabasco, explained:

We ask that women have no more than two C-sections [before becoming a surrogate]. So
that I don’t waste their time I always ask the same things first… how many C-sections
have you had? The other day I interviewed a woman who told me that she had one C-
section, I said okay, but I investigated… I have to investigate. I found that she had had 4-
she would be going for her 5
th
. I was like, what is this, this isn’t a joke, you are putting
my job at risk but more importantly you’re putting your life at risk.

130
There were also a few cases where surrogates were considering having more of their own
children and felt that another C-section could delay their reproductive plans. For example, Nadia
signed up to be a surrogate so that she could pay for a tubal ligation reversal. She had two
children from a previous marriage and then had her tubes tied, a service offered for free by her
health insurance. When she got remarried to a man with no children she began looking into tubal
ligation reversal and found that her insurance would not cover it. She decided to sign up for
surrogacy after learning that she could earn $10,000. When I met Nadia, she was 4 months
pregnant. When asked about her childbirth preferences Nadia explained, “I prefer a natural birth
because the recovery is faster and then I don’t have to wait as long to get pregnant again.” At 32,
she was worried that she was running out of time to have children with her second husband.
The high rate of Caesarean sections limits the number of times a woman can serve as a
surrogate, therefore reducing the number of experienced, veteran surrogates in Mexico. Studies
of surrogacy in the United States have shown that women who serve as a surrogate multiple
times are highly sought after and can command higher compensation for their services (Jacobson
2016). When a woman goes from first-time surrogate to repeat surrogate, her status changes to
that of a trusted, skilled laborer with experience. Caesarean sections limit Mexican surrogates’
opportunities to become repeat surrogates and therefore contribute to their position as
“disposable labor” (Wright 2006).
The few surrogates who expressed a preference for C-sections drew on the same ideology
that physicians espoused regarding vaginal birth and emotional attachment. For example, Sonia
explained,
They say that when you have a normal birth the connection between the baby and mother
is stronger. For example, I read that many people say that they love their child more than
they had through normal birth, than when you have it through C-section. Better through
C-section because there is a connection… so to break that, a million times the C-section.

131

Sonia prefers to have a C-section because she believes that a delivery via C-section will lead to
less bonding between her and the baby she is carrying. Sonia is not clear about where she
specifically read or heard that “the connection between the baby and mother is stronger” in
vaginal births but her statement makes clear that this information is not based on her embodied
experience or information passed directly to her from another woman. The “they” in Sonia’s
statement is an unembodied authority. While Sonia stated a personal preference for a C-section,
she noted that C-sections are not ideal for every surrogate. Sonia explained that she had
discussed the issue with a fellow surrogate and had encouraged the woman to have a C-section.
Sonia later saw how difficult the recovery was for her friend and regretted having advised her to
have a C-section:
She decided on a C-section but she had never had a C-section before therefore the pain of
the C-section was abysmal for her… she suffered, the recovery was ugly, she couldn’t
walk or anything. I felt responsible for telling her that it was better to have a C-section.

While Sonia shares the beliefs of physicians that vaginal labor creates maternal-child bonds that
are detrimental to the surrogacy process. She, unlike the doctors, weighs the “risk” of bonding
against the pain and suffering that C-sections entail for surrogates.

“It is the surrogate’s choice:” Intended parents’ views on childbirth

Intended parents’ views on childbirth were less consistent than surrogate mothers’ views.
Most intended parents presumed that surrogates, in conjunction with doctors, make childbirth
decisions. For example, Antoine and Julien, a young gay French couple, were told that their
surrogate, Luisa, was given the choice of having a C-section or vaginal birth and had chosen a C-
section. When I asked them why Luisa had a C-section, Antoine replied, “Well, it's the Luisa's, it
is the surrogate's choice. We are very natural. But it's her choice.” His partner, Julien then added,

132
“here in Mexico they do a lot of Caesareans, more than the normal...” The C-section rate in
France is less than half of the rate of C-sections in Mexico (20.8% of births versus 46.8% of
births, OECD 2017). Antoine and Julien presumed that Luisa’s decision was shaped by the
prevalence of C-sections in Mexico.
Antoine and Julien were under the impression that their surrogate, Luisa, had a say in
childbirth decisions and had chosen to have a C-section. However, the director of the surrogacy
agency that they worked with, Hugo, (quoted above) told me that 95% of the surrogacy births
coordinated by his agency are C-sections. My interviews with surrogate mothers do not lead me
to believe that 95% of surrogates are requesting to delivery via C-section since more surrogate
mothers expressed fears over a C-section than a preference for one. Hugo’s statement contradicts
Antoine and Julien’s understanding of the process.
Antoine and Julien had very little contact with Luisa. They explained that the surrogacy
agency discouraged contact and they did not question the method. After the birth of their twins,
Antoine and Julien gave their contact information to Luisa, in case she wanted to keep in touch,
but at the time of the interview they had not heard from her. It is possible that the agency lied to
Antoine and Julien about the Luisa’s wishes or the agency’s policy on C-sections. Even if the
agency had asked Luisa about her preference, she would likely have had a C-section because she
was carrying twins. The high rate of multiples in surrogacy is part of the reason for high C-
section rates. However, Hugo’s statement that “95% of the time there are C-sections” indicates
that Luisa was likely to have a C-section regardless of whether or not she was carrying multiples.
It also indicates that decisions about childbirth are made prior to any medical indications.
Luisa went into labor earlier than expected and remained in the hospital for 24 hours until
Antoine and Julien arrived from Paris. When Antoine and Julien were told that Luisa had gone

133
into labor early, they were distraught over the possibility of missing the birth. The doctor assured
them that he would wait for their arrival to perform the C-section. While most of the intended
parents did not directly state a preference for a C-section, the importance intended parents attach
to attending the birth may motivate agencies and doctors to schedule C-sections.
Erik and his partner Anders, a Swedish-Norwegian gay couple, were similarly confused
about how and by whom birthing decisions were made. Like many of the intended parents I
interviewed, the method of childbirth was not something they had thought much about. Unlike
Antoine and Julien, Erik and Anders developed a close relationship with their surrogate, Yazmin.
Erik arrived in Mexico two months before the birth of their son and shared an apartment with
Yazmin. Anders joined a week before the birth. At the time of the interview, Erik and Anders’s
son was a few weeks old and the three of them were still sharing an apartment with Yazmin
while they waited for the baby’s birth certificate to be issued so they could return home to
Norway. Despite spending two months living together, Erik and Yazmin never discussed
whether Yazmin would have a Caesarean section or a vaginal birth. When I asked Erik if he and
Anders had discussed a birth plan with the surrogacy agency or with Yazmin, he responded,
No, we didn't... Well we had a tiny discussion. When we were at the hospital, and the
doctor asked, and she looked at me, sort of, “What do you want?” And I said, “I don't
want to discuss this. This is up to you. I don't want to say anything about what I think
would be the best or what I would like … It is going to be your decision completely. So
whatever you choose I'll back you up.” And I'm not sure if she liked that or not, but she
really wanted to do a natural birth. I knew she wanted to do that, so I said “Ok, you know
what, I don't want to say anything.” So I wanted this decision to be hers. So when the
doctor said you have to do the Caesarean she was like, “Uhmm, too bad.” And in a way,
that was the only sort of discussion we had.

Erik stated that whether or not to have a C-section should be Yazmin’s decision, but when the
doctor came in with a decision, the discussion ended. Neither Erik nor Yazmin questioned the
doctor’s authority regarding childbirth.

134
Before choosing to contract with a surrogate in Mexico, Erik and Anders had considered
contracting a surrogate in Thailand and met with agencies there. Our discussion of Caesarean
sections reminded Anders of a conversation they had with an agency in Thailand and he chimed
in,
Anders: I'm just thinking of the question about Caesareans. When we were in Thailand all
the agencies actually said that it was the normal procedure to have a Caesarean. I
remember quite clearly them telling us that.

April: Did they say why?

Anders: I don't remember any specific, but generally like it's a safer, easier, process,
standardized...

Erik: Maybe, maybe - and it's just my thought on that topic, - they can sort of schedule,
the Caesarean, then they have sort of control over everything…I'm not sure, but that's sort
of how it was here, in our case. At first it was going to be the 23 of July, then they said
15th to Yazmin. And they said, ok, maybe it's going to be the 10th. And then they said
“You know what, you've got to come before the 10
th
,” so we were [scheduled for] the 6th
of July. He [the doctor] said, “Well, I don't want to take the chance, so let's do it on the
6th.” Cause I think it was him [the doctor]... who wanted the control, who wants to be in
charge.

Like Antoine and Julien, Erik and Anders felt that the surrogate should choose whether to
have a vaginal or Caesarean birth. However, a surrogate’s choice was deemed secondary to the
physician’s opinion. Intended parents generally deferred to the perceived expertise of doctors
and of the surrogacy agency staff. The high rate of C-sections in the Mexican surrogacy industry
indicates that the medical authority of physicians is valued above the embodied knowledge of
surrogate mothers. It may be that most of the intended parents I interviewed, did not think much
about the birth process nor state a strong preference because they are men. Erik and Anders
suspect that surrogates are subjected to Caesarean sections either for the benefit of intended
parents or doctors. But, Erik and Anders do not see it as their place to intervene even though as
clients they could have potentially advocated on Yazmin’s behalf.

135

Conclusion
Many people, including intended parents, are concerned about the ethics of surrogacy. As
scholars have demonstrated this concern tends to be focused on the exchange of money in
surrogacy arrangements (Anleu 1992; Hovav 2019). There is far more attention, scholarly and
popular, on the issue of payment than on any other aspect of the surrogacy process. However,
there are many aspects of surrogacy, beyond financial compensation, that can make the
arrangement more or less ethical. Caesarean sections are an example of an issue that is important
to surrogate mothers but is rarely discussed in legal or ethical debates about surrogacy. The
medical aspects of surrogacy, such as the quantity of hormones, the number of embryos
transferred, or the rate of Caesarean sections receives less scrutiny than the monetary aspects of
surrogacy. This may because of the perceived authority of medical practitioners. The
presumption is that doctors perform Caesarean sections for sound medical reasons and that their
judgment is not open to debate. However, doctors in Mexico base their medical decisions
regarding childbirth on normative views of kinship and gender that permeate discussions of
surrogacy, rather than on “neutral” medical indications. The near ubiquitous use of Caesarean
sections in Mexican surrogacy belies stereotypes about poor Mexican women as risky subjects,
contributes to the “disposability” of their labor, and reinforces a hierarchy in which the perceived
interests of intended parents and children are above that of surrogate mothers.
Approximately half of all births in Mexico are Caesarean sections. The fact that C-
sections are already common in Mexico makes the specific logic used in the case of surrogacy
especially interesting. The idea that C-sections are preferable in surrogacy cases to avoid the
bonding experience of vaginal birth in surrogacy cases is not simply a Mexican belief or an

136
excuse doctors use to justify the more convenient and costly C-section. This practice should be
recognized as an extension of the cultural logic that permeates discussions of surrogacy. In a
pointed analysis of psychological research on surrogate mothers, Elly Teman (2012)
demonstrates that “the cultural assumption that ‘normal’ women do not voluntarily become
pregnant with the premeditated intention of relinquishing the child for money, together with the
assumption that ‘normal’ women ‘naturally’ bond with the children they bear,” frames the way
research on surrogacy is conducted. From popular culture depictions of surrogacy to feminist
critiques of the practice, gestational bonding is a common topic of concern. In this chapter, I
demonstrate that cultural assumptions about “normal” maternal-child bonding also shape medical
practice. The justification doctors give for the high rate of C-sections in the Mexican surrogacy
industry reinforces the notion that maternal-fetal bonding is natural and inevitable. This implies
that pregnant women who do not bond with the fetus inside them are “unnatural” and
“abnormal.” Mexican surrogate mothers rarely express concerns over their ability to relinquish
the child they bear for others. Nonetheless, doctors feel the need to take extra precautions by
subjecting surrogates to C-sections. Doctors involved in the Mexican surrogacy industry focus
on the “emotional risk” of maternal-child bonding over the physical, economic, and reproductive
risks that surrogates bear by undergoing C-sections. This constructs surrogates as irrational
women who are driven by hormones and cannot be trusted to follow through on their contractual
commitments. Reproductive technologies have the potential to disrupt deeply ingrained cultural
assumptions about family, kinship, and gender, but as this chapter demonstrates, sometimes
those very cultural assumptions shape the way technologies are deployed.

137
CONCLUSION

Surrogacy tourism epitomizes the current global situation in which states, extra-national
institutions, biomedicine, and capitalism converge in new ways that impact how we live and
create life. In this study, I investigate the processes involved in creating and sustaining a new site
for surrogacy tourism, from recruiting clients and surrogates to managing moral concerns. I
analyze how the organization, history, and specific demographics of the Mexican surrogacy
industry affect the way actors experience the surrogacy process. This study contributes to a
number of areas of sociological research including studies of globalization, morals and markets,
medical sociology, reproductive politics, and kinship and family formation.
This study contributes to theoretical debates about the nature and impact of globalization.
The history of the Mexican surrogacy industry provides an alternative to dominant narratives of
globalization in which global capital spreads unimpeded across the globe. The story of the
Mexican surrogacy industry demonstrates the growing pains of globalization. The government of
Tabasco ultimately curtailed global capital, in the form of transnational surrogacy agencies, by
passing restrictions on surrogacy in the state. The flow of money to Tabasco was not enough to
convince locals and government officials that transnational, commercial surrogacy was a morally
acceptable endeavor. The government’s decision to limit access to surrogacy to Mexican
nationals is an example of the re-entrenchment of borders that we are witnessing globally in the
2010s. Multinational companies, transnational trade agreements, and the cosmopolitan elite have
become targets of nationalist unrest around the world. The rhetoric government officials in
Tabasco used to describe the foreign intended parents that were contracting surrogates in Mexico
mirrors the nationalist rhetoric used by anti-immigrant, anti-globalist factions.

138
My study further contributes to research on globalization by demonstrating how global
markets take different forms in different contexts. In some ways, the history of Mexico’s
surrogacy industry was markedly different from the histories of other global surrogacy hubs.
Prior to the Mexican case, the transnational surrogacy industry mostly took root in jurisdictions
with no regulations on surrogacy. Academics and social critics often lament that legislation trails
behind innovations in science and technology. In Tabasco, legislators tried to stay ahead of
technological innovations by regulating gestational surrogacy before it was even being practiced
in Mexico. However, they only focused on what they considered the most pertinent issue raised
by surrogacy: legal parentage. Whether or not staying ahead of technology was the true impetus
behind the addition of Article 92 to the Civil Code of Tabasco, the very mention of surrogacy in
a Civil Code was vanguard in 1997. This history shows us is that staying ahead of technology is
not the neat solution many perceive it to be. Tabasco’s history is a prime example of the
unintended consequences of legislation.
The Mexican surrogacy industry is also distinct from other major hubs for surrogacy
because the industry was started from the outside in. The two biggest global hubs for surrogacy,
the United States and India, began as domestic markets and then expanded to attract foreign
intended parents. In the United States and India, local intended parents make up a large portion
of the clientele. The Mexican surrogacy industry, by contrast, operated primarily by and for
foreigners. Furthermore, the industry was based in Tabasco rather than in a preexisting hub for
medical tourism. This dramatically impacted the way the industry was perceived and the legal
and social debates that ensued. The practice of surrogacy was almost entirely unknown to
residents of Tabasco prior to the sudden, and highly visible, appearance of foreign intended
parents in Villahermosa. The pace at which the surrogacy industry grew in Tabasco and the high

139
visibility of foreign, non-traditional parents led to confusion, misunderstandings, and general
weariness about the surrogacy industry. At the same time, many of the international surrogacy
agencies operating in Mexico used a franchise model that did not account for the social, cultural,
and technical differences between Mexico and other surrogacy hubs. This led to even more
misunderstandings, which often played out as scandals in the media. The cycle of scandals led to
a moral panic around surrogacy. In many ways, this is the same cycle that other surrogacy hubs
went through. India, Thailand, and Nepal were all global hubs until public opinion turned against
surrogacy after a series of scandals drew media attention to the industry.
My study demonstrates the impact that transnational industries can have on local
politics and economies. The transnational surrogacy industry brought debates about gay
parenthood to the front and center of political and social discourse in Tabasco. In speaking with
gay activists in Tabasco, I learned that gay parenthood was not a major topic of discussion in the
community prior to the surrogacy boom. LGBT activists in Tabasco were far more concerned
with sex education, especially HIV prevention, than with parenthood. The sudden influx of
foreign gay parents to Tabasco changed the conversation. When the government of Tabasco
announced that same-sex couples and single people would no longer be allowed to contract
surrogates, the LGBT community found themselves with a lot of new “supporters.” Surrogacy
agency staff, doctors, and surrogate mothers began posting about LGBT rights on Facebook and
changing their profile photos to include the rainbow pride flag. These new supporters were vocal
about the issue of surrogacy rather than issues that most concerned local LGBT activists, such as
sex education and HIV prevention.
The specific context in which Tabasco became a global surrogacy hub and the high
visibility non-traditional intended parents, shaped the way Mexican surrogate mothers

140
experienced surrogacy. Mexican surrogate mothers narrated their experiences and managed the
stigma associated with being a surrogate mother in ways that reflect the specific circumstances of
the Mexican surrogacy industry. Most intended parents in Mexico were foreigners and/or non-
traditional families, such as single men and gay couples. As the 2015 regulations demonstrate,
this was a major point of contention for those who opposed surrogacy. The government of
Tabasco did not ban surrogacy entirely, but banned foreign, gay, and single intended parents.
Mexican surrogate mothers flipped the script and chose to wear the most controversial aspect of
the Mexican surrogacy industry as a badge of honor. Mexican surrogate mothers argued that
being a surrogate for foreign gay couples meant that they were more worldly and open-minded
than their peers. This is a very different stigma management strategy than researchers have found
surrogate mothers using in other contexts. Rather than appealing to their motherhood and the
need to provide for their own children or their lack of alternative employment options as
surrogates in India and the United States have done to justify their participation in surrogacy,
Mexican surrogate mothers describe their decision to be a surrogate as a reflection of their
independent, strong-willed and open-minded nature. Participating in surrogacy becomes a part of
their narrative of survival rather than of third-world victimhood. Surrogates’ stigma management
strategies disrupt dominant narratives about docile “third-world women” while simultaneously
reproducing narratives about Mexican “backwardness.”
My findings regarding the stigma management strategies of Mexican surrogate mothers
contribute to several areas of sociological inquiry. Firstly, they elucidate the way global
industries take different forms in different contexts. These findings also demonstrate how new
global markets result in the creation of new subject positions. Being a surrogate mother becomes
a new way for Mexican women to define themselves as liberal, modern subjects. My findings

141
can also contribute to postcolonial and queer of color critiques of mainstream gay activism.
Postcolonial and queer of color scholars have argued that gay rights, or the lack there of, have
been used as a way to morally condemn societies in the global south as backwards in much of the
same way as women’s rights were used to justify neocolonialist interventions in the global south
by the “progressive” global north (Muñoz 1999; Puar 2007). The international gay rights
movements has focused on individual rights, including gay marriage, rather than on social justice
and welfare measures that are often more pertinent to local communities. In particular, the use of
surrogacy by gay intended parents has been criticized as an example of homonormativity in
which gay men use their financial resources in an attempt to mimic heteronormative two-parent,
genetic family (Duggan 2002; Smietana, Thompson and Twine 2018). In dismissing their critics,
Mexican surrogate mothers often rely on tropes of third-world backwardness.
Intended parents in Mexico also managed stigma in ways that reflect the unique
demographics of the Mexican surrogacy industry. In narrating their experiences with surrogacy
in Mexico, intended parents downplay the element of choice, focus on their marginalization in
relation to parenthood, and morally distance themselves from surrogacy in India. These strategies
serve to counter dominant narratives about intended parents as callous consumers in a global
marketplace for surrogacy. Even though intended parents are driving the global demand for
surrogacy, when describing their individual experiences, intended parents downplay their power
and agency in the surrogacy process. This strategy shifts the narrative from one in which
intended parents are agents to a self-perception of victimhood.
Reproduction scholars have analyzed the race, class, and postcolonial politics that
undergird the surrogacy industry but they have paid far less attention to sexuality, age, and
marital status. The sexuality, marital status, and age of intended parents were central to the

142
formation, structure, and history of the surrogacy in Mexico. Taking sexuality, marital status, and
age into account complicates conceptions of stratified reproduction in surrogacy. My study
elucidates the stratification within the category of intended parents. In many ways intended
parents, even gay and single men, are in a position of power over surrogate mothers because of
their financial status and mobility. However, gay and single intended parents are marginalized in
relation to parenthood. Their marginalization in relation to parenthood shapes how they
experience surrogacy as well as how they manage the stigma associated with hiring a surrogate
in a foreign country.
The stigma associated with surrogacy is rooted in debates about the proper division of
love and money. In 1992, Sharon Anleu identified the core criticism of surrogacy as “the
economic issue of whether a woman should be paid for this service” (31). Many legislators and
bioethicists express concern that surrogacy payments may be a form of undue enticement.
However, Anleu (1992) argued that the moral distinction between altruistic and commercial
surrogacy rests on deeply held gender norms about the proper division between love and money.
More than 25 years later, the issue of payment remains central to moral and legal debates
regarding surrogacy. Building on Anleu’s (1992) critique of the moral distinction between
altruistic and commercial surrogacy, I use empirical evidence to demonstrate that the distinction
is not only gendered, but also reflects and reinforces power asymmetries between intended
parents and surrogate mothers that are shaped by gender, race, class, and nationality. My
dissertation contributes to the morals and markets literature by demonstrating how notions of
maternal altruism not only structure the organization of reproductive markets, but actually enable
the market to exist by simultaneously producing moral palatability and profitability.

143
Through a close examination of actors’ experiences in the Mexican surrogacy market, my
study elucidates the important role of gender, race, and class, in shaping a rhetoric of altruism
that allows surrogacy agencies to preserve moral palatability and profitability simultaneously. I
find that surrogacy agencies draw on a perceived altruism/ commercialism dichotomy—which I
define as a framing of altruism as contradictory to and in tension with profit, market logics, and
commodification— to facilitate market exchanges in two key ways: by rendering it morally
palatable to consumers, and in disciplining surrogates to create a docile and compliant labor
force. Together these mechanisms render the industry profitable. Furthermore, I argue that actors
in the Mexican surrogacy industry draw boundaries between altruism and commercialism in
ways that both reflect and reinforce power asymmetries based in gender, race, class, and
nationality between surrogates and intended parents.
Debates about surrogacy, both academic and legislative, often focus on whether women
should be paid to act as surrogates. These debates are often premised on the idea that commercial
surrogacy is inherently more exploitative than altruistic surrogacy. But, as my research
demonstrates, the very dichotomy between altruism and commercialism can be exploited to
produce compliant surrogates and sustain the industry. The rhetoric of altruism as a feminine
virtue enables surrogacy agencies to cultivate a docile workforce that cannot advocate for their
own financial gain. This has important implications for our understanding of reproductive labor
and gender inequality more broadly. The designation of altruism as a feminine virtue
dichotomous with self-interest fuels gender inequality by facilitating the devaluation of
reproductive labor.
Debates about whether or not women should be paid to serve as surrogates deflect
attention from other aspects of the surrogacy process that may be more or less exploitative. There

144
is far more attention, scholarly and popular, on the issue of payment than on any other aspect of
the surrogacy process. However, there are many aspects of surrogacy, beyond compensation, that
can make the arrangement more or less ethical. My dissertation contributes to research on
reproduction and bioethics by shifting the focus from payment to other aspects of the surrogacy
process that have received less scrutiny.
The overuse of Caesarean sections is an example of an issue that is important to surrogate
mothers but is rarely discussed in legal or ethical debates about surrogacy. The medical aspects
of surrogacy, such as the amount hormones, the number of embryos transferred, and the rate of
C-sections receive far less scrutiny than the monetary aspects of surrogacy. This may be because
of the perceived authority of medical practitioners. The presumption is that doctors perform C-
sections for sound medical reasons and that their judgment is not open to debate. However,
doctors in Mexico base their medical decisions regarding childbirth on normative views of
kinship and gender, rather than on supposedly “neutral” medical indications. The near ubiquitous
use of C-sections in Mexican surrogacy belies stereotypes about poor Mexican women as risky
subjects, contributes to the disposability of their labor, and reinforces a hierarchy in which the
perceived interests of intended parents supersede the interests of surrogate mothers.
This study contributes to literature on childbirth, the medicalization of reproduction, and
reproductive technologies by demonstrating how folk ideas about kinship and women’s bodies
become biologized and routinized in medical practice. The high rate of C-sections in the
Mexican surrogacy industry is driven primarily by physicians. Doctors argue the C-sections are
preferable for surrogates because they bypass the bonding experience of vaginal birth. This
practice is as an extension of two prominent cultural assumptions: 1) “that ‘normal’ women do
not voluntarily become pregnant with the premeditated intention of relinquishing the child for

145
money,” and 2) “that ‘normal’ women ‘naturally’ bond with the children they bear” (Teman
2014). From popular culture depictions of surrogacy to feminist critiques of the practice,
gestational bonding is major topic of concern. Research, however, has found that surrogate
mothers very rarely contest the parentage of intended parents (Jacobson 2016, Teman 2010).
In this dissertation, I demonstrate how cultural assumptions about “normal” maternal-
child bonding shape medical practice. The justification doctors give for the high-rate of C-
sections in the Mexican surrogacy industry reinforces the notion that maternal-fetal bonding is
natural and inevitable. This implies that pregnant women who do not bond with the fetus are
“unnatural” and “abnormal.” Mexican surrogate mothers rarely express concerns over their
ability to relinquish the child they bear for others. Nonetheless, doctors feel the need to take extra
precautions by subjecting surrogates to C-sections. Doctors involved in the Mexican surrogacy
industry focus on the “emotional risk” of maternal-child bonding over the physical, economic,
and reproductive risks that surrogates bear by undergoing C-sections. Doing so, constructs
surrogates as irrational women who are driven by hormones and cannot be trusted to follow
through on their contractual commitments.
Transnational, commercial surrogacy is a practice that disrupts that many deeply
ingrained cultural assumptions about family, kinship, and gender. The transnational surrogacy
industry is also an example of global capital at work and of the commodification of intimate
labor. Surrogacy involves many of the key issues that most concern sociologists from
medicalization and reproductive politics to globalization and family formation. My dissertation
contributes to these various areas of sociological inquiry and highlights their interconnections.
In addition to my theoretical contributions to sociology, my study contributes to debates
about the feasibility of regulating the surrogacy industry. Surrogacy is a complex issue and there

146
is no consensus on how to regulate it. Reproductive tourism is fraught with tensions. Global
economic inequalities delineate the sellers and buyers of reproductive services, while local
regulations limit the technologies available to intended parents, often on the basis of nationality,
marital status, and sexuality. Unlike organ donation, which is subject to international regulation,
surrogacy is not governed at the international level. This demonstrates the lack of international
consensus around the ethics of surrogacy as well as how kinship should be conferred. In depth
qualitative social science research is necessary for understanding the social and political impact
of these global flows of bodies, money, and technology.

147

BIBLIOGRAPHY

Almeling, Rene. 2007. Sex cells. Berkeley, CA: University of California Press.

________. 2015. Reproduction. Annual Review of Sociology 41: 423-442.

Anleu, Sharon. 1992. Surrogacy: For love but not for money? Gender & Society 6(1): 30-48.

Bernstein, Elizabeth. 2007. Intimacy, authenticity, and the commerce of sex. Chicago, IL:
University of Chicago Press.

Becker, Gary and Julio Jorge Elias. 2007. Introducing incentives in the market for live
and cadaveric organ donations. Journal of Economic Perspectives 21(3): 3-24.

Boris, Eileen, and Rhacel Parreñas, eds. 2010. Intimate labors: Cultures, technologies,
and the politics of care. Stanford, CA: Stanford University Press.

Braff, Lara. 2009. Assisted reproduction and population politics: Creating “modern” families in
Mexico City. Anthropology News 50(2): 5-6.

______. 2013. Somos muchos (We are so many). Medical Anthropology Quarterly 27(1):121
138.

Briggs, Laura. 2012. Somebody’s children: The politics of transracial and transnational adoption.
Durham, NC: Duke University Press.

Browner, Carole. 1986. The politics of reproduction in a Mexican Village. Signs 11(4): 710 -
724.
Browner, Carole, and Carolyn Sargent, eds. 2011. Reproduction, globalization, and the state:
New theoretical and ethnographic perspectives. Durham, NC: Duke University Press.

Burawoy, Michael, ed. 2000. Global ethnography: Forces, connections, and imaginations in a
postmodern world. Berkeley, CA: University of California Press.

Cannell, Fenella. 1990. Concepts of Parenthood: The Warnock report, the Gillick debate, and
modern myths. American Ethnologist 17: 667-686.

Chin, Christine. 2013. Cosmopolitan sex workers: women and migration in a global city. Oxford,
UK: Oxford University Press.

Clarke, Adele. 1991. Disciplining reproduction: Modernity, American life sciences, and “the
problem of sex.” Berkeley, CA: University of California Press.

148
Cohen, Lawrence. 1999. Where it hurts: Indian material for an ethics of organ transplantation.
Daedalus 128(4): 135-165.

________. (2005). Operability, bioavailability, and exception. In A. Ong & S. Collier (Eds.),
Global assemblages: Technology, politics, and ethics as anthropological problems (pp.
79–90). Malden, MA: Blackwell Publishing.

Colen, Shelle. 1995. “Like a mother to them”: Stratified reproduction and West Indian childcare
workers and employers in New York. In F. Ginsburg & R. Rapp (Eds.), Conceiving the
new world order: The global politics of reproduction (pp. 78-102). Berkeley, CA:
University of California Press.

Collier, Stephen. 2006. Global assemblages. Theory, Culture, and Society 23(2-3): 399-401.

Collier, Stephen and Ahiwa Ong. 2005. Global assemblages, anthropological problems’ In A.
Ong & S. Collier (Eds.), Global assemblages: Technology, politics, and ethics as
anthropological problems (pp. 3–21). Malden, MA: Blackwell Publishing.

Collier, Stephen and Andrew Lakoff. 2005. On regimes of living. In A. Ong & S. Collier (Eds.),
Global assemblages: Technology, politics, and ethics as anthropological problems (pp.
22-39). Malden, MA: Blackwell Publishing.

Constable, Nicole. 2009 The commodification of intimacy: Marriage, sex, and reproductive
labor. Annual Review of Anthropology 38: 49-64.

Corea, Gena. 1985. The Mother Machine: Reproductive Technologies from Artificial
Insemination to Artificial Wombs. New York, NY: Harper Collins.

Cooper, Melinda, and Catherine Waldby. 2014. Clinical labor: Tissue donors and research
subjects in the global bioeconomy. Durham, NC: Duke University Press.

Curtis, Anna. 2010. Giving ‘til it hurts: Egg donation and the costs of altruism. Feminist
Formations 22(2): 80-100.

Davis-Floyd, Robbie. 1992. Birth as an American Rite of Passage. Berkeley: University of
California Press.

Deomampo, Daisy. 2013. Gendered geographies of reproductive tourism. Gender & Society 27
(4): 514- 537.

_______. 2016. Transnational reproduction: Race, kinship, and commercial surrogacy
in India. NYU Press.

Dickenson, Donna. 2007. Property in the body: Feminist perspectives. Cambridge, UK:
Cambridge University Press.

149
________. 2008. Body Shopping: The economy fuelled by flesh and blood. Oxford, UK:
Oneworld Publications

Duggan, Lisa. 2002. The New Homonormativity: Sexual Politics of Neoliberalism. Durham, NC:
Duke University Press.

Edwards, Jeanette, Sarah Franklin, Eric Hirsch, Frances Price, and Marilyn Strathern, eds. 1993.
Technologies of procreation: Kinship in the age of assisted conception. 2
nd
ed.
Manchester: Manchester University Press.

Ehrenreich, Nancy. The Colonization of the Womb. Duke Law Journal 43: 492-587.

Ehrenreich, Barbara and Arlie Hochschild. 2003. Global woman: Nannies, maids, and sex
workers in the new economy. Henry Holt & Company.

England, Paula. 2005. Emerging theories of care work. Annual Review of Sociology, 31(38): 381-
399.

Erikson, Susan. 2011. Global ethnography: Problems of theory and method. In Reproduction,
globalization, and the state: New theoretical and ethnographic perspectives, edited by
Carole Browner and Carolyn Sargent. Durham, NC: Duke University Press.

Fernández-Kelly, María Patricia.1983. For we are sold, I and my people: Women and industry
in Mexico's frontier. Albany, NY: State University of New York Press.

Figueroa, Mónica. 2010. Distributed intensities: Whiteness, mestizaje and the logics of Mexican
racism. Ethnicities 10(3): 387-401.

Franklin, Sarah. 1997. Embodied progress: A cultural account of assisted conception.
London, UK: Routledge.

___________. 2005. Stems Cells R US: Emergent life forms and the global biological In A.
Ong & S. Collier (Eds.), Global assemblages: Technology, politics, and ethics as
anthropological problems (pp. 59–78). Malden, MA: Blackwell Publishing.

Franklin, Sarah and Margaret Lock (Eds). 2003. Remaking life and death: Towards an
anthropology of the biosciences. Santa Fe: School of American Research Press.

Franklin, Sarah and Helena Ragoné. (Eds.). 1998. Reproducing reproduction: Kinship, power,
and technological innovation. Philadelphia, PA: University of Pennsylvania Press.

Fulda, Isabel and Regina Tamés. 2017. Surrogacy in Mexico. In Babies for sale:
Transnational surrogacy, human rights and the politics of reproduction, edited by
Miranda Davies. London, UK: Zed Press.

Ginsburg, Faye. & Rapp, Rayna. 1991.The politics of reproduction. Annual Review of

150
Anthropology 20: 311-343.

Ginsburg, Faye. & Rapp, Rayna. (Eds.). 1995. Conceiving the new world order: The global
politics of reproduction. Berkeley, CA: University of California Press.

Glenn, Evelyn Nakano. 1992. From servitude to service work: Historical continuities in the
racial division of reproductive labor. Signs 18(1): 1-43.

Goffman, Erving. Stigma: Notes on the management of spoiled identity. London, UK: Penguin.

Goslinga-Roy, Gillian. 2000. Body boundaries, fiction of the female self: An ethnographic
perspective on power, feminism, and the reproductive technologies. Feminist
Studies 26(1): 113-140.

Guseva, Alya. 2017. “(Just) what the doctor ordered: Moral framing of commercial gestational
surrogacy in five surrogacy-friendly countries.” Paper presented at Annual Meeting,
Eastern Sociological Society, Philadelphia.

Harrison, Laura. 2016. Brown bodies, white babies: The politics of cross-racial surrogacy.
New York, NY: NYU Press.

Hartmann, Betsy. 1989. Reproductive rights and wrongs: The global politics of population
control and contraceptive choice. New York: Harper & Row.

Hartouni, Valerie. 1997. Cultural conceptions: On reproductive technologies and the
remaking of life. Minneapolis, MN: University of Minnesota Press.

Heyes, Anthony. 2005. The economics of vocation or ‘why is a badly paid nurse a good
nurse’? Journal of Health Economics 24(3): 561-569.

Healy, Keiran. 2010. Last best gifts: Altruism and the market for human blood and
organs. Chicago, IL: University of Chicago Press.

Heredia-Pi, Ileana et al. 2014. “Obstetric care and method of delivery in Mexico: Results from
the 2012 National Health and Nutrition Survey” PloS One 9(8): e104166.

Hochschild, Arlie. 2003. The commercialization of intimate life: Notes from home and
work. Berkeley, CA: University of California Press.

Hondagneu-Sotelo, Pierette. 2001. Domestica: Immigrant workers cleaning and caring in the
shadows of affluence. Berkeley, CA: University of California Press.

Hovav, April. 2019. Producing Moral Palatability in the Mexican Surrogacy Market.
Gender & Society 33(2): 273-295.

151
Inhorn, Marcia. 1996. Infertility and Patriarchy: The Cultural Politics of Gender and Family
Life in Egypt. Philadelphia, PA: University of Pennsylvania Press.

Inhorn, Marcia. and F. van Balen (Eds). 2002. Infertility around the globe: New thinking on
childlessness, gender, and reproductive technologies. Berkeley, CA: University of
California Press.

Jacobson, Heather. 2016. Labor of love: Gestational surrogacy and the work of making
babies. New Brunswick, NJ: Rutgers University Press.

Jasanoff, Sheila. 2004. States of knowledge: The co-production of science and the social
order. New York: Routledge.

Jordan, Brigitte. 1993. Birth in four cultures: A crosscultural investigation of childbirth in
Yucatan, Holland, Sweden, and the United States. Fourth edition, revised and expanded
by Robbie Floyd-Davis. Prospect Heights, Illinois: Waveland Press.

Lakoff, Andrew and Stephen J. Collier. 2004. Ethics and the anthropology of modern reason.
Anthropological Theory 4(4): 419-434.

Lakoff, Andrew. 2005. Diagnostic liquidity: Mental Illness and the global trade in DNA. Theory
and Society 34: 63-92.

_______. 2006. Pharmaceutical reason: Knowledge and value in global psychiatry. Cambridge
University Press.

Lamont, Michèle. 2000. The dignity of working men: Morality and the boundaries of race, class,
and immigration. Harvard University Press.

Landes, Elizabeth and Posner, Richard. 1978. The economics of the baby shortage. The
Journal of Legal Studies 7(2):323-348.

León, Pablo. (2015, January 24). Papá, mama y la tía Samantha [Dad, mom, and aunt Samantha]
El País. Retrieved from https://cat.elpais.com/cat/2015/01/24/espana/1422116335_
391939.html

Lewin, Tamar. (2014, July 5) Coming to U.S. for baby, and womb to carry it. The New York
Times. Retrieved from http://www.nytimes.com/2014/07/06/us/foreign-couples-heading-to
america-for-surrogate-pregnancies.html

Mann, Jonathan, and Sofia Gruskin. 1995. Women’s health and human rights: Genesis of the
health and human rights movement. Health and Human Rights 1(4): 309-312.

Massey, Douglas, Durand, Jorge, & Malone, Nolan. 2002. Beyond smoke and mirrors: Mexican
immigration in an era of economic integration. New York, NY: Russell Sage Foundation.

152
Markens, Susan. 2007. Surrogate motherhood and the politics of reproduction. Berkeley, CA:
University of California Press.

________. 2012. The global reproductive health market: U.S. media framings
of public discourses about transnational surrogacy. Social Science & Medicine 74: 1745-
1753.

Martin, Emily. 1987. The woman in the body: A cultural analysis of reproduction. Boston:
Beacon Press.

Martin, Lauren Jade. 2009. Reproductive tourism in the age of globalization. Globalizations 6
(2): 249 - 263.

Maust, Marcia Good. 2000. Making bodies: Cesarean narratives in Merida, Yucatan (Doctoral
dissertation, University of Florida).

Mohanty, Chandra. 1988. Under Western eyes: Feminist scholarship and colonial discourses.
Feminist Review 30: 61-88.

________. 2003. Feminism without borders: Decolonizing theory, practicing solidarity.
Durham, NC: Duke University Press.

Morgan, Lynn and Elizabeth Roberts. 2012. Reproductive governance in Latin America.
Anthropology & Medicine 19(2): 241-254.

Morris, Theresa. 2013. Cut it out: The C-section epidemic in America. New York, NY:
New York University Press.

Muñoz, José Esteban. 1999. Disidentifications: Queers of color and the performance of politics.
Minneapolis, MN: University of Minnesota Press.

Murphy Michelle. 2011. Distributed reproduction. In M. Casper. & P. Currah (Eds.), Corpus: an
interdisciplinary reader on bodies and knowledge, (pp. 21-38). New York, NY: Palgrave
Macmillan.

Nelson, Margaret. 1983. Working-class women, middle-class women, and models of
childbirth. Social Problems 30(3): 284-297.

Nelson, Julia. 1999. Of markets and martyrs: Is it OK to pay well for care? Feminist
Economics 5(3): 43-59.

Nelson, Julie and Paula England. 2002. Feminist philosophies of love and work. Hypatia 17(2):
1-18.

OECD. 2017. “Caesarean sections” in Health at a Glance 2017: OECD Indicators. Paris, France:
OECD Publishing.

153

Ong, Ahiwa and Stephen Collier (Eds.). 2005. Global assemblages: Technology, politics, and
ethics as Anthropological problems. Malden, MA: Blackwell Publishing.

Pande, Amrita. 2009. "“It may be her eggs but it’s my blood”: Surrogates and everyday forms of
kinship in India." Qualitative Sociology, 32(4), 379-397.

________. 2010. "At least I am not sleeping with anyone": Resisting the stigma of commercial
surrogacy in India. Feminist Studies 36(2), 292-312.

______. 2014. Wombs in labor: Transnational commercial surrogacy in India. New York, NY:
Columbia University Press.

Parreñas, Rhacel. 2000. Migrant Filipina domestic workers and the international division of
reproductive labor. Gender & Society 14(4): 560-580.

_______. 2011. Illicit flirtations: Labor, migration, and sex trafficking in Tokyo. Palo
Alto, CA: Stanford University Press.

Parreñas, Rhacel Salazar, Hung Cam Thai, and Rachel Silvey. 2016. Introduction: Intimate
Industries: Restructuring (Im) Material Labor in Asia. Positions 24 (11): 1-15.

Pateman, Carol. 1998. The sexual contract. Stanford, CA: Stanford University.

Petchesky, Rosalind Pollack. 1987. Fetal images: The power of visual culture in the politics of
reproduction. Feminist Studies 13(2): 263-292.

Petryna, Adriana. 2009. When experiments travel: Clinical trials and the global search for
human subjects. Princeton, NJ: Princeton University Press.

Plankey-Videla, Nancy. 2012. We are in this dance together: Gender, power, and globalization
at a Mexican garment firm. New Brunswick, NJ: Rutgers University Press.

Portugese, Jacqueline. 1998. Fertility policy in Israel: The politics of religion, gender, and
nation. London, UK: Praeger Publishing.

Povinelli, Elizabeth. 2006. Empire of love: Toward a theory of intimacy, geonology, and
carnality. Durham, NC: Duke University Press

Puar, Jasbir. 2017. Terrorist assemblages: Homonationalism in queer times. Durham, NC: Duke
University Press.

Rajan, Kaushik. 2006 Biocapital: The constitution of postgenomic life. Durham, NC: Duke
University Press.

_______. (Ed). 2012. Lively capital: Biotechnologies, ethics, and governance in global
markets. Durham, NC: Duke University Press.

154

Ragoné, Helene. 1994. Surrogate motherhood: Conception in the heart. Boulder, CO: Westview
Press.

Rapp, Rayna. 1998. Refusing prenatal diagnosis: The meanings of bioscience in a multicultural
world. Science, Technology & Human Values, 23(1), 45-70.

______. 1999. Testing women, Testing the fetus: The social impact of amniocentesis in
America. New York, NY: Routledge.

Raymond, Janice. 1993. Women as wombs: Reproductive technologies and the battle for
women’s freedom. San Francisco, CA: Spinifex Press.

Roberts, Dorothy. 1997. Killing the Black body: Race, reproduction, and the meaning of liberty.
New York, NY: Pantheon Books.

_______. 2009. Race, gender, and genetic technologies: a new reproductive dystopia? Signs,
34(4): 783-804.

Roberts, Elizabeth. & Scheper-Hughes, Nancy. 2011. Introduction: Medical migrations. Body &
Society, 17 (2-3): 1-30.

Roberts, Elizabeth. 1998. Examining surrogacy discourses: Between feminine power and
exploitation. In N. Scheper-Hughes, & C.F. Sargent. (Eds.) Small wars: The cultural
politics of childhood, (pp. 93-110). Berkeley, CA: University of California Press.

_______. 2012. God's laboratory: Assisted reproduction in the Andes. Berkeley, CA:
University of California Press.

Rose, Nikolas. 2001. The politics of life itself. Theory, Culture, and Society 18(6), 1-30.

Rothman, Barbara Katz. 1989. Recreating motherhood: Ideology and technology in a
patriarchal society. New York: Norton.

Rudrappa, Sharmila. 2010. Making India the “mother destination”: Outsourcing labor to Indian
surrogates. Research in the Sociology of Work, 20, 253-285.

_______. 2015. Discounted life: The price of global surrogacy in India. New York, NY: New
York University Press.

Rudrappa, Sharmila and Caitlyn Collins. 2015. Altruistic agencies and compassionate
consumers: Moral framing of transnational surrogacy. Gender & Society 29(6): 937-
959.

Salzinger, Leslie. 2003. Genders in production: Making workers in Mexico's global factories.
Berkeley, CA: University of California Press.

155

Scott, Joan. 1986. Gender as a useful category of analysis. American Historical Review 91(5):
1053-1075.

Schurr, Carolin. 2016. From biopolitics to bioeconomies. The ART of (re-)producing white
futures in Mexico’s surrogacy market. Environment and Planning D: Society and Space
35(2): 241-262.

Schurr, Carolin and Elisabeth Militz. 2018. The affective economy of transnational surrogacy.
Environment and Planning A: Economy and Space 23: 717-733.
Sharp, Leslie. 2000. The commodification of the body and its parts. Annual Review of
Anthropology 29(1), 287-328.

Sykes, Gresham and David Matza. 1957. Techniques of neutralization: A theory of
delinquency. American Sociological Review 22(6): 664-670.

Smietana, Marcin. 2017. Affective de-commodifying, economic de-kinning: Surrogates’ and gay
fathers’ narratives in U.S. surrogacy. Sociological Research Online 22(2): 5.

Smietana, Marcin, Charis Thompson, and France Winddance Twine. 2018. "Making and
breaking families–reading queer reproductions, stratified reproduction and reproductive
justice together." Reproductive Biomedicine & Society Online 7: 112.

Smith-Oka, Vania. 2012a. “They don’t know anything”: How medical authority constructs
perceptions of reproductive risk among low-income mothers in Mexico. In Risk,
Reproduction, and Narratives of Experience, (pp. 103-121) edited by Lauren Fordyce and
Aminata Maraësa. Nashville, TN: Vanderbilt University Press.
_____.2012b. Bodies of risk: Constructing motherhood in a Mexican public hospital. Social
Science & Medicine 75:2275-82.
_____.2013. Shaping the motherhood of indigenous Mexico. Nashville, TN: Vanderbilt
University Press.
_____.2015. "Microaggressions and the reproduction of social inequalities in medical
encounters in Mexico." Social Science & Medicine 143:9-16.
Snow, David, and Leon Anderson. 1987. Identity work among the homeless: The verbal
construction and avowal of personal identities. American Journal of Sociology 92(6):
1336-1371.

Strathern, Marilyn. 1992. Reproducing the future: Anthropology, kinship, and the new
reproductive technologies. Manchester, UK: Manchester University Press.

Stoler, Ann. 2002. Carnal knowledge and imperial power: Race and the intimate in colonial
rule. University of California Press.

156
Teman, Elly. 2008. The social construction of surrogacy research: An anthropological critique of
the psychosocial scholarship on surrogate motherhood. Social Science & Medicine 67(7):
1104-1112.

_______. 2010. Birthing a mother: The surrogate body and the pregnant self. Berkeley, CA:
University of California Press.

Thompson, Charis. 2005. Making parents: The ontological choreography of reproductive
technologies. Cambridge, MA: MIT Press.

Titmuss, Richard. 1970. The gift relationship: From human blood to social policy. Middlesex,
UK: Penguin Books.

Tsing, Anna. 2000. The global situation. Cultural Anthropology 15(3): 327-360
Twine, France Winddance. 2011. Outsourcing the womb: Race, class, and gestational
surrogacy in the global market. New York, NY: Routledge.

Vega, Rosalynn. 2018. No alternative: Childbirth, citizenship, and indigenous culture in Mexico.
University of Texas Press.

Ventura, Rafael, Xosé Ramón Rodríguez-Polo, and Carles Roca-Cuberes. 2018. “Wealthy gay
couples buying babies produced in India by poor womb-women”: Audience
interpretations of transnational surrogacy in TV news. Journal of Homosexuality 1-26.

Vora, Kalindi. 2009. Indian transnational surrogacy and the commodification of vital energy.
Subjectivity 28(1): 266-278.

Walzer, Michael. 1983. Spheres of justice. New York: Basic Books.

Weis, Christina. Workers or mothers? The business of surrogacy in Russia. December 15, 2015,
https://www.opendemocracy.net/beyondslavery/christina-weis/workers-or-mothers
business-of-surrogacy-in-russia

Wilson, Ara. 2004. Intimate economies of Bangkok: Tomboys, tycoons, and Avon ladies in the
global city. Berkeley, CA: University of California Press.

_______. 2011. Foreign bodies and national scales: Medical tourism in Thailand. Body &
Society 7(2-3), 121-137.

________. 2012. Intimacy: A useful category of transnational analysis. In The global and the
intimate: Feminism in our time Edited by Geraldine Pratt and Victoria Rosner

Wright, Melissa. 2006. Disposable Women and Other Myths of Global Capitalism. New York,
NY: Routledge.
Zelizer, Viviana. 2000. The purchase of intimacy. Law & Social Inquiry 25(3): 817-848.

157
________. 2005. The purchase of intimacy. Princeton, NJ: Princeton University
Press.

Abstract (if available)

Abstract Medical tourism for surrogacy is a multi-billion dollar market that is largely unregulated. An increasing number of intended parents are traveling to other countries to hire women to gestate and birth children for them. However, we know little about this industry, the experiences of the various actors involved, or the processes through which specific sites become hubs for transnational surrogacy. Rather than focuses on a single surrogacy agency or fertility clinic, my project takes the entire Mexican surrogacy industry as its object of study to examine how international networks, fractured regulatory regimes, and local economies converge in the formation of new transnational industries and how, in turn, women’s bodies are refashioned to serve global markets. ❧ This dissertation is based on a multi-sited global ethnography that links everyday practices to global processes. Between 2014 and 2017, I conducted ethnographic research in Tabasco, Quintana-Roo, and Mexico City, Mexico, with supplementary research in Spain and the United States. I also conducted 120 in-depth semi-structured interviews with actors in the Mexican surrogacy industry, including surrogate mothers, intended parents, doctors, government officials, and surrogacy agency staff. Through observation, interviews, and archival research, I collected information about the history and organization of the Mexican surrogacy industry, the key actors, and the everyday processes through which commercial surrogacy is negotiated and experienced. Drawing on this wide-range of data, my dissertation analyzes the technical, legal, and social processes that led to the emergence of Mexico as a new site in the global market for baby making and the effect of this industry on the actors involved. ❧ While surrogacy clients come from every part of the world, only a few places have become hubs for surrogacy tourism. Drawing on interview data, government documents, and news reports, the first half of Chapter 1 describes the local and global context in which the state of Tabasco, Mexico emerged as an international surrogacy destination. Using Mexico as a case study, I investigate the processes through which certain places become “visible” or legible as possible surrogacy tourism destinations, and which wombs become “available” as a result of these global searches. The second half of Chapter 1 focuses on the government of Tabasco’s 2015 decision to heavily restrict surrogacy within the state. I argue that two main factors led to this regulatory change: 1) the perception that the surrogacy industry in Mexico was started by and for foreigners, and 2) the high visibility of non-traditional families amongst surrogacy clients in Mexico. I posit that the Tabascan government’s decision is best understood as part of a larger trend towards re-entrenchment of national borders. ❧ Chapter 2 analyzes the stigma management strategies of intended parents and surrogates. I find that Mexican surrogate mothers describe the decision to enter surrogacy, often in defiance of conservative family members, as an act of agency. Meanwhile, intended parents describe surrogacy in Mexico as a last resort rather than a choice. While existing literature tends to paint intended parents as members of a global elite, this chapter attends to how elements of marginalization, such as marital status, sexual orientation, and age, can drive their engagement with transnational surrogacy as well. Chapter 3 focuses on the contentious issue of commercialization. I demonstrate that treating altruism and commercialism as dichotomous can actually further market interests. I find that surrogacy agencies draw on this dichotomy to sustain the profitability of the industry in two key ways: by rendering it morally palatable to consumers and by disciplining surrogates to create a docile and compliant labor force. ❧ Chapter 4 analyzes childbirth practices in the Mexican surrogacy industry to understand how competing values are negotiated in a transnational context. I find that physicians promote the use of Caesarean sections by stating that the maternal-infant bonding experience of vaginal birth is contraindicative of the goals of surrogacy. I explore the implications of this ideology for understanding how gender and kinship ideologies intersect with notions of risk in medical contexts. Together, these chapters offer a critique of normative claims about the surrogacy industry based on abstract, ostensibly universal values by analyzing “ethics-on-the-ground

Linked assets

University of Southern California Dissertations and Theses

Conceptually similar

PDF

Inequalities of care: the practices and morals of transnational caregiving

PDF

Selling virtue: how human rights NGOs and their donors work together to create a better world ... for themselves

PDF

Making global citizens: South Korean student and labor mobilities in the Global Age

PDF

In visible families: gay fatherhood and the politics of family change

PDF

How to be a social media influencer: the work process of the entrepreneurial labor force

PDF

Deciding modalities of global health governance: What facilitates or hinders public-private partnerships?

PDF

Competitions in two-sided markets

PDF

Finding home: the migration and incorporation of undocumented, unparented Latino youth in the US

PDF

Transnational motherhood and fatherhood: gendered challenges and coping

PDF

Inequality regimes in sexual labor

PDF

Rights projects in a globalized world

PDF

Examining global financial regulatory reform in the G20 and the FSB

PDF

The pop show: racial performance and transformation in global arts industries

PDF

Grassroots market-making: the production, policing and politics of value in Los Angeles’ transforming cannabis industry

PDF

Essays on price determinants in the Los Angeles housing market

PDF

Studies on the creation of regulations in nascent drone industry

PDF

Developing countries in the digital era: state and business interactions for industrial upgrading

PDF

Rationality and the primacy of the occurrent

PDF

Making the realm, transforming the people: foreign subjects in seventh- through ninth-century Japan

PDF

The formation and representations of a new trend of labor migration: a case study on Taiwanese working holiday makers in Australia

Asset Metadata

Creator Hovav, April (author)

Core Title The global market for wombs: a study of the transnational surrogacy industry in Mexico

School College of Letters, Arts and Sciences

Degree Doctor of Philosophy

Degree Program Sociology

Publication Date 07/29/2021

Defense Date 06/03/2019

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag altruism,gender,Globalization,Markets,Mexico,Motherhood,OAI-PMH Harvest,reproductive technologies,surrogacy

Format application/pdf (imt)

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Lakoff, Andrew (committee chair), Almeling, Rene (committee member), Gruskin, Sofia (committee member), Parreñas, Rhacel (committee member)

Creator Email April.Hovav@gmail.com,Apriljoh@usc.edu

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c89-201568

Unique identifier UC11663197

Identifier etd-HovavApril-7690.pdf (filename),usctheses-c89-201568 (legacy record id)

Legacy Identifier etd-HovavApril-7690.pdf

Dmrecord 201568

Document Type Dissertation

Format application/pdf (imt)

Rights Hovav, April

Type texts

Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the a...

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA