Table Of ContentINTERNATIONAL SURROGACY
AS DISRUPTIVE INDUSTRY IN
SOUTHEAST ASIA
MEDICAL ANTHROPOLOGY: HEALTH,
IN EQUALITY, AND SOCIAL JUSTICE
Series editor: Lenore Manderson
Books in the Medical Anthropology series are concerned with social patterns of and
social responses to ill health, disease, and suffering, and how social exclusion and
social justice shape health and healing outcomes. The series is designed to reflect the
diversity of con temporary medical anthropological research and writing, and will
offer scholars a forum to publish work that showcases the theoretical sophistication,
methodological soundness, and ethnographic richness of the field.
Books in the series may include studies on the organ ization and movement of
peoples, technologies, and treatments, how inequalities pattern access to these, and
how individuals, communities, and states respond to vari ous assaults on well- being,
including from illness, disaster, and vio lence.
Jessica Hardin, Faith and the Pursuit of Health: Cardiometabolic Disorders in Samoa
Carina Heckert, Fault Lines of Care: Gender, HIV, and Global Health in Bolivia
Alison Heller, Fistula Politics: Birthing Injuries and the Quest for Continence in Niger
Joel Christian Reed, Landscapes of Activism: Civil Society and HIV and AIDS Care in
Northern Mozambique
Beatriz M. Reyes-F oster, Psychiatric Encounters: Madness and Modernity in Yucatan,
Mexico
Sonja van Wichelen, Legitimating Life: Adoption in the Age of Globalization and
Biotechnology
Lesley Jo Weaver, Sugar and Tension: Diabetes and Gender in Modern India
Andrea Whittaker, International Surrogacy as Disruptive Industry in Southeast Asia
I NTERN ATI O N A L
SU RRO G AC Y
A S D ISRU PTI V E
I N D USTRY I N
SO UTH E A ST A SI A
andrea whittaker
rutgers university press
New Brunswick, Camden, and Newark, New Jersey, and London
Library of Congress Cataloging- in- Publication Data
Names: Whittaker, Andrea (Andrea M.), 1967– author.
Title: International surrogacy as disruptive industry in Southeast Asia /
Andrea Whittaker.
Description: New Brunswick, New Jersey : Rutgers University Press, [2018] |
Series: Medical anthropology | Includes bibliographical references and index.
Identifiers: LCCN 2018011717| ISBN 9780813596846 (cloth) |
ISBN 9780813596839 (pbk.)
Subjects: LCSH: Surrogate motherhood— Social aspects— Thailand. | Surrogate
motherhood— Moral and ethical aspects— Thailand. | Surrogate motherhood—
Cross-c ultural studies.
Classification: LCC HQ759.5 .W485 2018 | DDC 306.874/309593— dc23
LC rec ord available at https:// lccn . loc . gov / 2018011717
A British Cataloging- in- Publication rec ord for this book is available from the British
Library.
Copyright © 2019 by Andrea Whittaker
All rights reserved
No part of this book may be reproduced or utilized in any form or by any means,
electronic or mechanical, or by any information storage and retrieval system, without
written permission from the publisher. Please contact Rutgers University Press,
106 Somerset Street, New Brunswick, NJ 08901. The only exception to this prohibition
is “fair use” as defined by U.S. copyright law.
The paper used in this publication meets the requirements of the American National
Standard for Information Sciences— Permanence of Paper for Printed Library
Materials, ANSI Z39 .4 8 - 1992.
www . rutgersuniversitypress . org
Manufactured in the United States of Amer i ca
For my daughters Claire and Rachel
and those who wish to create families
CONTENTS
Foreword by Lenore Manderson ix
Preface xiii
List of Abbreviations xvii
Notes on Language and Transliteration xix
Introduction 1
1 The Growth of Disruptive Commercial Surrogacy in Asia 27
2 Merit and Money: The Moral Economy of Surrogacy 48
3 The Best of Intentions 67
4 Facilitation 99
5 Digital Umbilical Cords 116
6 Rotten Trade 131
7 Baby Gammy 147
8 New Destinations, New Markets 167
Conclusion: The Future of International Surrogacy 180
Acknowl edgments 195
Notes 197
Bibliography 201
Index 221
vii
FOREWORD
LENORE MANDERSON
Medical Anthropology: Health, Ine quality, and Social Justice is a new series
from Rutgers University Press, designed to capture the diversity of con temporary
medical anthropological research and writing. The beauty of ethnography is its
capacity, through storytelling, to make sense of suffering as a social experience,
and to set it in context. Central to our focus in this series on health and illness,
in equality and social justice, therefore, is the way in which social structures and
ideologies shape the likelihood and impact of infections, injuries, bodily rup-
tures and disease, chronic conditions and disability, treatment and care, social
repair and death.
The brief for this series is broad. The books are concerned with health and
illness, healing practices, and access to care, but the authors illustrate too the
importance of context—of geography, physical condition, ser vice availability,
and income. Health and illness are social facts; the circumstances of the mainte-
nance and loss of health are always and everywhere s haped by structural, global,
and local relations. Society, culture, economy, and po litic al organ ization as much
as ecolo gy shape the variance of illness, disability, and disadvantage. But as med-
ical anthropologists have long illustrated, the relationships of social context and
health status are complex. In addressing t hese questions, the authors in this
series showcase the theoretical sophistication, methodological rigor, and empir-
ical richness of the field, while expanding a map of illness and social and institu-
tional life to illustrate the effects of material conditions and social meanings in
troubling and surprising ways.
The books in the series move across social circumstances, health conditions,
and geography, and their intersections and interactions, to demonstrate how
individuals, communities, and states manage assaults on well- being. The books
reflect medical anthropology as a constantly changing field of scholarship, draw-
ing on research diversely in residential and virtual communities, clinics, and
laboratories, in emergency care and public health settings, with ser vice provid-
ers, individual healers, and house holds, with social bodies, human bodies, and
biologies. While medical anthropology once concentrated on systems of heal-
ing, par tic u lar diseases, and embodied experiences, today the field has expanded
to include environmental disaster and war, science, technology, faith, gender-
based vio lence, and forced migration. Curiosity about the body and its vicissi-
tudes remains a pivot for our work, but our concerns are with the location of
bodies in social life, and with how social structures, temporal imperatives, and
ix
x Foreword
shifting exigencies shape life courses. This dynamic field reflects an ethics of the
discipline to address these pressing issues of our time.
Globalization contributes to and adds to the complexity of influences on
health outcomes; it (re)produces social and economic relations that institution-
alize poverty, unequal conditions of everyday life and work, and environments
in which diseases increase or subside. Globalization patterns the movement and
relations of peoples, technologies and knowledge, programs and treatments; it
shapes differences in health experience and outcomes across space; it informs
and amplifies inequalities at the individual and country levels. Global forces and
local inequalities compound and constantly load on individuals to affect their
physical and mental health, and their h ouse holds and communities. At the same
time, as the subtitle of this series indicates, we are concerned with questions of
social exclusion and inclusion, social justice and repair, again both globally and
locally. The books challenge readers to reflect not only on sickness and suffering,
deficit and despair, but also on re sis tance and restitution—on how people
respond to injustices and evade the fault lines that might seem to predetermine
life outcomes. While not all of the books take this direction, the aim is to widen
the frame within which we conceptualize embodiment and suffering.
In International Surrogacy as Disruptive Industry in Southeast Asia, Andrea Whit-
taker brings together the concerns of embodiment and suffering as illustrated
through the outsourcing of reproduction. Assisted reproductive technology, in
vitro fertilization, and gamete donation have expanded rapidly during the past
few de cades, with increasing propensity for reproductive medical procedures to
take place across borders. The increasing affordability of international transport,
the transmission of bio-i nformation through the internet, and the movement of
expertise globally allow people to pursue family making, increasingly, when and
where it suits them. Thus people side- step national laws, biomedical constraints,
and prohibitive charges and pursue secrecy and efficiency as they manipulate
their desire for biologically related families. But even the most sensitively timed
assisted reproductive technology (ART) procedures, the best doctors, and the
most sophisticated clinics do not cover all eventualities. For a growing number
of individuals and couples, for whom biological parenting remains the grail, the
answer is surrogacy.
Surrogate pregnancy is not new, but it was once largely a private arrangement,
framed by affective (often kinship) ties between gestational and intending social
mothers. But the desire to establish or continue a biological f amily, social con ve-
nience, and its way around medical difficulties in conception and pregnancy
to term have led surrogacy to become an increasingly common reproductive
option. The institutions, procedures, and drugs now available in support of
advanced reproductive technology have increased the success of the implanta-
tion of an embryo (or two or more) into the womb of another w oman as surro-
