Surrogacy and the Construction of the Maternal-Foetal Relationship: The Feminist Dilemma Examined

The feminist movement remains fundamentally divided over the issue of surrogacy. Within the confines of this article it is argued that the inadequacy of positions on both sides of the debate rests upon their common tendency to deal with the ethical consequences of surrogacy for isolated agents, without sufficient concern for the broader social implications for all pregnant women in society. In order to clarify the issues involved, feminist theorists must consider the implications of surrogacy in a broader social spectrum. Such an analysis will illustrate that the two-person dichotomous model of the maternal-foetal relationship proposed by the surrogacy arrangement has hugely prejudicial effects on the treatment received by non-contract mothers when they interact with agents of certain social institutions whose prior contact with surrogate mothers has made them more susceptible to conceiving the maternal-foetal relationship as fundamentally disconnected. In a climate of increased medical surveillance and intervention in the non-clinical context of pregnancy, the dangers of adopting this dichotomous model are palpable. Given the oppressive physical and psychological effect that this would have upon the liberty of the majority of pregnant women in society, this article argues that the feminist movement must abandon any promotion of the abstracted model of the mother-foetus relationship that is implicit in its arguments in favour of surrogacy.     

An ethnomethodological approach to examine exploitation in the context of capacity,trust and experience of commercial surrogacy in India

The socio-ethical concerns regarding exploitation in commercial surrogacy are premised on asymmetric vulnerability and the commercialization of women’s reproductive capacity to suit individualistic motives. In examining the exploitation argument, this article reviews the social contract theory that describes an individual as an ‘economic man’ with moral and/or political motivations to satisfy individual desires. This study considers the critique by feminists, who argue that patriarchal and medical control prevails in the surrogacy contracts. It also explores the exploitative dynamics amongst actors in the light of Baier’s conceptualization of trust and human relationship, within which both justice and exploitation thrive, and Foucault’s concept of bio-power. Drawing on these concepts, this paper aims to investigate the manifestations of exploitation in commercial surrogacy in the context of trust, power and experiences of actors, using a case study of one clinic in India. The actors’ experiences are evaluated at different stages of the surrogacy process: recruitment, medical procedures, living in the surrogate home, bonding with the child and amongst actors, financial dealings, relinquishment and post-relinquishment.This study applies ethnomethodology to identify phenomena as perceived by the actors in a situation, giving importance to their interpretations of the rules that make collective activity possible. The methods include semi-structured interviews, discussions, participant observation and explanation of the phenomena from the actors’ perspectives. Between August 2009 and April 2010, 13 surrogate mothers (SMs), 4 intended parents (IPs) and 2 medical practitioners (MPs) from one clinic in Western India were interviewed.This study reveals that asymmetries of capacity amongst the MPs, SMs, IPs and surrogate agents (SAs) lead to a network of trust and designation of powers through rules, bringing out the relevance of Baier’s conceptualization of asymmetric vulnerability, trust and potential exploitation in human relationships. The IPs are exploited, especially in monetary terms. The SMs are relatively the most exploited, given their vulnerability. Their remuneration through surrogacy is significant for them, and their acquired knowledge as ex-surrogates is used for their own benefit and for exploiting others. Foucault’s conceptualization of power is hence relevant, since the ex-SMs re-invest the power of their exploitative experience in exploiting others.     

Childhood exposure to emotional abuse and later life stress among Kenyan women: a mediation analysis of cross-sectional data

Background and objective: We explore whether perceived stress among Kenyan mothers is predicted by childhood exposure to emotional abuse – both witnessed among parents and experienced directly. Further, we explore whether this association is mediated by social support, family functioning and polygynous marriage.

Design: We used cross-sectional data from a systematic random sample (n?=?1974) of mothers in semi-rural Kenya.

Methods: Data were collected using validated scales and trained interviewers. Analyses were conducted using bootstrapped structural equation models and fixed-effects linear regression models, controlling for age and household wealth.

Results: Reported experience of emotional abuse – both directly experienced and observed among household adults – was high in the present population (72.5% and 69%, respectively). Perceived stress among women was significantly higher if they were exposed to more emotional abuse during childhood (p?<?.001). Lower social support, worse family functioning and higher rates of polygynous marriage mediated pathways between emotional abuse exposure during childhood and adult perceived stress.

Conclusion: Future research should investigate whether social integration, identity formation and self-esteem underlie observed dynamics in sub-Saharan Africa. Efforts to promote social integration and support should target children currently experiencing emotional abuse, and may include child-targeted high quality television programing and adult-targeted media and celebrity campaigns.     

Experiences with stigmatization among transgender individuals after transition: A qualitative study in the Netherlands

Abstract

Background: Transgender individuals belong to one of the most stigmatized groups in society. Although the social stigma of transgender individuals has been examined many times, post transition stigma experiences among transgender individuals have received limited research attention. The aim of this study was to examine experiences with stigmatization among Dutch transgender individuals after their transition.

Method: Ten trans women (age: M?=?58.50, SD?=?9.49) and 10 trans men (age: M?=?42.90, SD?=?13.62) participated in face-to-face semistructured interviews. Grounded theory was used to conceptualize and analyze the data. We examined the positive and negative reactions that transgender individuals experienced in the period after their transition. Furthermore, we explored differences between experiences of trans men and trans women. Finally, we examined differences between cisgender men and women regarding their reactions toward transgender individuals.

Results: Participants reported improved psychological well-being since transition. However, they still experienced different forms of stigmatization. Trans women appeared to experience stronger social stigma than trans men. Trans women also experienced lower social status after their transition. They mainly experienced negative responses from cisgender men. Participants emphasized the importance of social and peer support.

Conclusion: The current study findings demonstrate the presence of stigmatization after transition and argue for psychological aftercare. Social and peer support appeared to be important for coping with stigmatization, and improving the social network of transgender individuals is beneficial. Health providers and researchers are recommended to promote the development of constructive coping skills for transgender individuals with interventions especially targeting trans women.     

Families created through surrogacy arrangements: parent-child relationships in the 1st year of life

Findings are presented of a study of families created through surrogacy arrangements. Forty-two surrogacy families were compared with 51 egg-donation families and 80 natural-conception families on standardized interview and questionnaire measures of the psychological well-being of the parents, the quality of parent-child relationships, and infant temperament. The differences that were identified between the surrogacy families and the other family types indicated greater psychological well-being and adaptation to parenthood by mothers and fathers of children born through surrogacy arrangements than by the natural-conception parents.     

Stigma modifies the association between social support and mental health among sexual violence survivors in the Democratic Republic of Congo: implications for practice

Background and Objectives: The aim of this study was to further understanding of the relationship between social support, internalized and perceived stigma, and mental health among women who experienced sexual violence in the eastern Democratic Republic of Congo (DRC).

Methods: Drawing from baseline survey data collected in eastern DRC, researchers conducted a secondary cross-sectional analysis using data from 744 participants. Regression and moderation analyses were conducted to examine associations between social support variables, felt stigma, and depression, anxiety and posttraumatic stress disorder (PTSD).

Results: Emotional support seeking and felt stigma were positively associated with increased symptom severity across all three mental health variables. Stigma modified associations between emotional support seeking and depression (t?=??2.49, p?=?.013), anxiety (t?=??3.08, p?=?.002), and PTSD (t?=??2.94, p?=?.003). Increased frequency of emotional support seeking was associated with higher mental health symptoms of anxiety and PTSD among women experiencing all levels of stigma.

Conclusions: Enhancing understanding of social support and stigma may inform research and intervention among Congolese forced migrant populations across circumstances and geographic locations. Implications for practice and research are discussed.     

Indigenous Healing Practices in Australia

ABSTRACT

Indigenous Australian women are among the most disadvantaged women in the world. Over two centuries of colonization have had a damaging impact on perceptions of their gender roles and status as well as many other consequential oppressions. These experiences have affected the social and emotional wellbeing of Indigenous women of all ages, resulting in socio-economic ghettoization, higher suicide rates, psychological distress, illness, and poverty. Generations of women have experienced the forced removal of their children, resulting in complex forms of historical trauma. Despite this, Indigenous women have also maintained strong leadership roles and have kept families and communities intact. In the last few decades, the Australian Indigenous mental health movement has emerged within the context of a broader self-determination movement, restoring and strengthening women’s traditional therapeutic practices. This article offers an overview of the social and emotional wellbeing of Indigenous women within neocolonial Australia and explores women’s relationship to traditional therapeutic practices. Future directions and key issues for the capacity building of Indigenous women’s healing are explored.     

Mothers of transgender youth experience stigma-by-association

The current research investigated whether mothers of transgender youth experience stigma-by-association. Mturk participants (N = 489) were randomly assigned to read a vignette about a family in which the social identity (transgender, gay/lesbian, cisgender/heterosexual control) and gender (girl, boy) of a child was manipulated, while all other information was held constant. Results revealed stigma targeting mothers as a function of children's social identity (but not gender), such that mothers of transgender girls and boys were viewed substantially more negatively than identical mothers of cisgender/heterosexual youth. Moreover, this stigma was particularly robust among politically conservative participants. In contrast, mothers of gay/lesbian youth did not encounter systematic stigma, though they were sometimes perceived more negatively than mothers of cisgender/heterosexual youth. Results provide novel experimental evidence of stigma-by-association targeting mothers of transgender youth and raise serious concerns about the treatment of parents who seek to affirm their transgender children.     

Social Anxiety and Social Surrogacy in College Roommate Relationships

The social surrogate hypothesis proposes that people with higher social anxiety (HSA) recruit others to accompany them into social situations. We tested this hypothesis with college roommates using both hypothetical (Study 1) and retrospective (Study 2) measures, while assessing roommate's perceptions of recruitment and how social surrogacy might influence liking between roommates. Across two studies, we found that HSA participants were less likely to enter social situations alone (i.e. higher conditional entry); however, HSA was related to recruitment only when participants considered hypothetical scenarios, not when recruitment was assessed globally or retrospectively. There was little evidence that HSA participants' roommates were aware of these behaviours, although there was preliminary evidence that less social anxiety might increase liking when roommates perceived more conditional entry. We also found preliminary evidence that social anxiety may be negatively related to liking when participants were less likely to recruit an alternate surrogate if their roommate was unavailable. Taken together, these preliminary findings emphasize the importance of studying the surrogacy process from an interpersonal/dyadic perspective and using methods that will differentiate between anticipated (which may be assessed by hypothetical scenarios) and enacted recruitment behaviours. Copyright © 2017 European Association of Personality Psychology     

Two questions about surrogacy and exploitation

In this article I will consider two related questions about surrogacy and exploitation: (1) Is surrogacy exploitative? (2) If surrogacy is exploitative, what is the moral force of this exploitation? Briefly stated, I shall argue that whether surrogacy is exploitative depends on whether exploitation must be harmful to the exploited party or whether (as I think) there can be mutually advantageous exploitation. It also depends on some facts about surrogacy about which we have little reliable evidence and on our philosophical view on what counts as a harm to the surrogate. Our answer to the second question will turn in part on the account of exploitation we invoke in answering the first question and in part on the way in which we resolve some other questions about the justification of state interference. I shall suggest, however, that if surrogacy is a form of voluntary and mutually advantageous exploitation, then there is a strong presumption that surrogacy contracts should be permitted and even enforceable, although that presumption may be overridden on other grounds.     

South Asian American Daughter–Father Relationships in the Aftermath of Maternal Loss

ABSTRACT

In this transcendental phenomenological study, we interviewed five South Asian American daughter–father dyads regarding their experiences of coping and resiliency in the aftermath of maternal/spousal loss. Mothers play a crucial role in immigrant families as they serve not only as caregivers, but also as the main people who facilitate the transmission of culture. An untimely death of mothers in immigrant families can lead to confusion of roles within the family subsystems. Three main themes emerged for daughters from the interviews: (a) re-grieving, (b) coping/resiliency, and (c) daughter’s relationship with father following maternal loss. Three themes also emerged from the interviews with the fathers: (a) lack of traditional sources of familial support, (b) coping/resiliency, and (c) relationship with daughter following spousal loss. We utilized dyadic analysis to examine the dynamics of the daughter–father relationship. Overall, in the aftermath of maternal loss, the families experienced significant reorganization in its structure and reassignment of roles. For many of the daughters, cultural norms of patriarchy and traditional gender roles explained their pattern of assuming more responsibility in the household after the death of their mothers. Findings also showed how the intersection of gender, culture, and immigration status contributed to the process of complicated grief following maternal loss and the struggles experienced with reorganization of familial roles, rules, and expectations for South Asian American daughters and their fathers. Results from this study have implications for future research and clinical practice.     

Family Financial Pressure and Maternal and Adolescent Socioemotional Adjustment: Moderating Effects of Kin Social Support in Low Income African American Families

The moderating effect of kinship social support on the association of family financial pressure with socioemotional adjustment was examined in 200 African American mothers and adolescents. Financial pressure was positively associated with mothers’ depressive symptoms and negatively related to mothers’ optimism about the future. Financial pressure was also positively associated with adolescents’ depressive symptoms and problem behavior. Kin social support was negatively linked to mothers’ depressive symptoms and positively associated with optimism. Kin support was negatively related to adolescents’ problem behavior. Kinship support moderated the association of family financial pressure with mothers’ and adolescents’ adjustment. Positive association of financial pressure with mothers’ depression was less apparent for mothers with more compared to less kin social support. Also, negative association of financial pressure with mothers’ optimism was less apparent for mothers with more compared to less kin social support. Positive relation of financial pressure with adolescents’ problem behavior was less apparent for those with more compared to less kin social support. The need to assess the links of kin social support to other domains of family life such as marital relations is discussed.     

Beyond sex differences: Family and occupational roles' impact on women's and men's dreams

The question addressed is: do recent changes in the occupational roles of women, with their indirect influence on men's lives, have an impact on the dreams of women and men? Three groups of parents (N=96) including in equal numbers, mothers at home, wage-earning mothers and fathers, kept a dream diary from which two dreams per dreamer were content analyzed. Assuming continuity between daytime and dream experiences, it was hypothesized that differences in manifest dream content would be a function of single versus dual role enactment, rather than sex. Contrary to predictions, statistical analyses performed on selected dream variables did not yield significant differences between groups for pleasant and unpleasant emotions, friendly interactions and aggression. Dream characters, and the concerns they reflect, were found to vary, though, according to social roles. Commitment to their family was reflected above all in the mothers' at home dreams, while commitment to their profession took precedence in those of the wage-earning mothers. Comparable commitment to work and family was found among the fathers. Findings suggest that as gender differences in waking life decrease, so may differences in dreams.     

Breadwinner Seeks Bottle Warmer: How Women’s Future Aspirations and Expectations Predict Their Current Mate Preferences

Contemporary women in Western cultures are often trying to juggle careers alongside personal and societal expectations for childrearing in an effort to “have it all.” We examine the effects of this balancing act on heterosexual women’s mate selection motivations. Across three Canadian samples (n?=?360), we tested concurrent hypotheses about the desirability of both similar and complementary characteristics in a potential mate. Specifically, women’s aspirations (to prioritize career over family) and their expectations for the roles they will most likely adopt within their future partnerships (primary breadwinner and/or caregiver) were tested as key predictors of mate preferences. Although specific effects varied across samples, a mega-analysis of the combined sample and an internal meta-analysis of effect sizes from the three studies provided support for both complementary and similarity motives (controlling for gender role attitudes). Women’s aspirations to prioritize career (over family) predicted greater similarity in mate preferences, such that they placed less importance on men’s parenting qualities, more importance on their access to financial resources, and preferred a career-oriented over family-oriented exemplar. However, women’s expectations of actually taking on the breadwinner role predicted greater complementarity in mate preferences (greater desirability of parenting qualities and a family-oriented partner; with financial resources rated as less important). Our work expands current understanding of women’s decision-making processes when selecting a mate and has implications for men’s changing traits and roles.

     

Ethical Issues in Gestational Surrogacy

The introduction of contraceptive technologies hasresulted in the separation of sex and procreation. Theintroduction of new reproductive technologies (mainlyIVF and embryo transfer) has led not only to theseparation of procreation and sex, but also to there-definition of the terms mother and family.For the purpose of this essay, I will distinguishbetween:1. the genetic mother – the donor of the egg;2. the gestational mother – she who bears and gives birth to the baby;3. the social mother – the woman who raises the child.This essay will deal only with the form of gestationalsurrogacy in which the genetic parents intend to bethe social parents, and the surrogate mother has nogenetic relationship to the child she bears anddelivers. I will raise questions regarding medicalethical aspects of surrogacy and the obligation(s) ofthe physician(s) to the parties involved. I will arguethat the gestational surrogate is “a womb to rent,”that there is great similarity between gestationalcommercial surrogacy and organ transplant marketing.Furthermore, despite claims to freedom of choice andfree marketing, I will claim that gestationalsurrogacy is a form of prostitution and slavery,exploitation of the poor and needy by those who arebetter off. The right to be a parent, although notconstitutional, is intuitive and deeply rooted.However, the issue remains whether this rightoverrules all other rights, and at what price to theparties involved. I will finally raise the followingprovocative question to society: In the interim periodbetween today's limited technology and tomorrow'sextra-corporeal gestation technology (ectogenesis),should utilizing females in PVS (persistent vehetativestate) for gestational surrogacy be sociallyacceptable/permissible – provided they have leftpermission in writing?     

Infant feeding and internalized stigma: The role of guilt and shame

Globally the rates of breastfeeding duration are extremely low and postnatal mental health issues are common. As a result, it is important to examine the emotions that underlie these matters. Across two studies (one correlational study N = 160 and one experimental study N = 118), we examined participants’ experiences of shame and guilt when feeding their baby, and the relationship between these emotions with breastfeeding behaviors and internalized stigma. We also examined the psychosocial factors that predict internalized stigma, and whether shame and guilt mediate these relationships. We focused on three factors that have been shown to be associated with internalized stigma in other domains: self-esteem and social support (Study 1), as well as self-efficacy (Study 2). Multiple regression revealed that experienced guilt uniquely predicted a shorter duration of exclusive breastfeeding (Study 1). Higher self-efficacy (Study 2), self-esteem, and perceived social support (Study 1) predicted lower internalized stigma of feeding choice. We found that shame was a mediator for the self-esteem and internalized stigma relationship (Study 1), while guilt was a mediator for the self-efficacy and internalized stigma relationship (Study 2). Our findings highlight the importance of experienced shame and guilt in mothers’ infant feeding experiences. The current results can inform future research and the design of interventions to improve breastfeeding rates and reduce feelings of stigma.     

Acculturation in Women with Mental Retardation and Its Impact on Genetic Counseling

The provision of genetic counseling to women with mild mental retardation poses many challenges, some directly related to their developmental and cognitive disabilities. Traditional genetic counseling models, in which decision-making is largely based on the understanding of factual information, are particularly affected by the intellectual limitations which characterize this population. Equally important, however, are these women's attitudes, perceptions, and behaviors related to their involuntary inclusion into a highly stigmatized social group. Common themes among these women which surface in the genetic counseling setting include the denial of mental retardation, a hierarchical perception of their own and others' disabilities, and a strong motivation to conceive and parent a child. Such attitudes and behaviors may be symptomatic of acculturation, as these women struggle to take on accepted social roles while rejecting the stigma of intellectual disability. In contrast to factual information, the counselee's ability to discuss emotions and perceptions is not necessarily hampered by her intellectual limitations. A focus on the recognition and discussion of psychosocial issues provides a more meaningful approach than traditional genetic counseling models for facilitating informed reproductive decisions among women with mental retardation.