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America's Hidden Surrogacy, Tom Isern, Dave Thompson and Matt Olien

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Conversations On Health Care
Valerie Bauman

Segments In Today's Show:

Super Sperm Donors - America's Underground Surrogacy Movement: Author Explains Her Journey. The family planning revolution has a new chapter and journalist Valerie Bauman is both documenting it and participating in it. She and others pursuing alternatives say they're frustrated with fertility clinics because of the cost, what they call the discriminatory nature of the system and the lack of insurance coverage. Bauman explains how she met her sperm donor and why others like her say it makes sense for them. Hosts Mark Masselli and Margaret Flinter interview Bauman about her upcoming book "Inconceivable: Super Sperm Donors, Off-the-Grid Insemination, and Unconventional Family Planning.

Harvest Public Media - PFAS - Applying organic waste like manure to farmland has been going on for centuries. And biosolids follow the same logic -- they're a type of treated sewage from wastewater plants that make a nutrient-rich fertilizer. But a group of toxic "forever chemicals" known as PFAS are slipping through the cracks and could be inadvertently contaminating millions of acres of farmland. As Harvest Public Media contributor Teresa Homsi explains, few states are regularly testing for PFAS in their biosolids.

Tom Isern - The Pilots of Our Race - In "The Pilots of Our Race," Tom Isern explores the legacy of the speculators who founded the anticipation town of Hoskins in McIntosh County in the 1880s, highlighting their complex identities as acquisitive capitalists and emblematic Americans destined for historical remembrance. Seth D. McNeal, one of Hoskins' founders, embodies this spirit through his patriotic poetry, capturing the transformative claim of settlers on the land and their envisioned enduring legacy, despite the problematic aspects of their narratives and the eventual fading of their immediate achievements.

News Director Dave Thompson talks about his newsletter and reviews the news

Matt Olien reviews the movie "One Life."

Conversations on Health Care Interview Highlights:

Personal Journey: Valerie Bauman shares her personal journey toward becoming a single mother by choice during the pandemic, highlighting her exploration beyond sperm banks to find a donor, emphasizing the desire for her child to have potential contact with the donor and half-siblings.

  1. Freelance Sperm Donation: Bauman uncovers the "wild west" of freelance sperm donation through online platforms, discussing the risks and the potential to find decent donors outside the sperm bank system, offering a more personalized and potentially ethical approach to donor conception.
  2. Regulatory Gray Areas: She discusses the regulatory complexities and gray areas in sperm donation, including an FDA enforcement action against a donor, illustrating the challenges in navigating the legal landscape of assisted reproduction.
  3. Cost and Discrimination: Bauman touches on the financial barriers and discrimination within the fertility industry, noting the high costs of procedures and the biases against single women and LGBTQ+ individuals, which limits access to family planning resources.
  4. Ethical and Legal Considerations: The interview delves into ethical considerations surrounding donor anonymity and the lack of legal or regulatory requirements for disclosing genetic or health information by donors in the freelance sperm donation world, raising questions about the responsibilities and protections for all parties involved.

Conversations On Healthcare Transcript

Conversations In Health Care Transcript

Mark Masselli

Your book is described as both a memoir and a piece of investigative reporting. I'm wondering if you could just share with our audience what you'd like about your own story.

Valerie Bauman

It was the first summer of the pandemic, 2020, and I was 38 years old, and I realized that I was running out of time. My biological clock was ticking and it wasn't a good time to meet somebody. And, you know, realistically, even if you meet somebody at 38, it may take a few years before you settle down and have kids.

So I decided to take the plunge and try and become a single mother by choice. And I started looking at the sperm banks, but I didn't feel served by the sperm banks. I wanted to give my kid more answers than they could find on a sperm bank website.

I wanted the possibility of meeting the donor potentially before age 18, or at least being able to maintain contact about any medical issues that could have genetic connections that were relevant to my kid. The possibility of meeting other half-siblings, you know, became possible when I stumbled across this world that I've dubbed the world of freelance sperm, where men offer to donate sperm through websites, Facebook groups, and dating-like apps. It's kind of a wild west.

There's a lot of undesirable options out there. There's a lot of creepy men doing it for the wrong reasons. But if you're patient and you take the time, you may be able to find, as I did, a very decent, wonderful person who was willing to donate sperm, who's willing to connect me with my kid's siblings, and provide more information than I would ever get from a sperm bank website.

My personal donor also is done donating after creating 10 families. If you go through a sperm bank, you can wind up with 50 to 100 families and many, many, many siblings that the children can never maintain meaningful relationships with because it's just so beyond anything a typical family structure would create. So it's not a path for everyone.

It's a path that I chose, and I don't condemn nor condone it. I do tell my own story and that of others and advise people to approach it with caution and responsibility and a lot of thoughts. So I would hope that the story would elevate the perspective of donor-conceived people because children never ask to be born.

And when you meet adult children who are born from anonymous sperm donors who have been created in a climate of deceit and secrecy, there's a lot of heartbreak there. And I think that the industry can do better.

Margaret Flinter

Well, Valerie, you say that this underground or perhaps nontraditional community of sperm donors and recipients is circumventing traditional fertility avenues. Is there anything illegal about doing this, anything that's considered unethical about doing this, or this is just a choice that people have organized on their own? Is there a central organizing group, I guess, or is it people just putting themselves out there?

Valerie Bauman

Well, it's interesting. It's a real gray area. The FDA did have one enforcement action that it brought against a donor over 10 years ago.

And he was a donor who created his own website. He advertised his sperm, had created many, many families. And the FDA ended up cracking down on him.

But when his own lawyers challenged it, what really it came down to was the government is loathed to tell people that there's a limit on their ability to procreate. Because he was doing it in this donation context, they basically said he should be going through a very complex FDA-approved process, which costs $6,000 plus, where if you want to donate your sperm as a known donor, you should be tested for multiple diseases, freeze the sperm, quarantine it for six months, thaw the sperm at that time, retest the sperm, retest the donor, and all of this at great expense to the prospective parents. And he was circumventing that because it's an absurd, insurmountable cost. And the only way to get around that under FDA law is through this very vague definition of sexual partners, essentially.

And so a lot of more liberal fertility clinics will consider somebody who is a former sexual partner, somebody who's had sperm of a donor in their body before. So if you've done one home insemination, perhaps even at a time of the month when you're not going to get pregnant, that would fit the criteria. You could get around the $6,000 plus requirements and then have in-clinic treatment.

But the FDA declined to better define sexually intimate partners. And so unfortunately, the vast majority of clinics in this country conflate sexually intimate partners with romantic partners who will play a role as a parent rather than a donor. So there's a lot of gray areas.

And this particular donor had his operation shut down. But as far as my research, I've not been able to find any other incidences of cracking down on because, again, it's a slippery slope. When you tell somebody they can only have children in this certain way or with this many people, it brings into major questions of bioethics.

And people much smarter than me have been debating that and still haven't found answers.

Mark Masselli

You've written about the cost involved in what you call often discriminatory world of sperm banks and fertility clinics. How much money does this cost and where did you find discrimination?

Valerie Bauman

The cost varies because there's a number of different procedures, different medication protocols. But sperm on average costs around $1,000 to $1,200 plus say $250 to ship it to your clinic. IVF cycles can cost between $1,800 and $2,600.

When you add on some of the medications, it can get upwards of like $30,000 potentially. So there's huge obstacles financially. You're just going to be cutting out a huge portion of society.

I mean, the Federal Reserve had a study I think in the past year or two that found 50% of Americans can't afford a $400 emergency expense. If that's your circumstance, you're not going to be able to have a child if you need assistance. So the cost is just a recurring obstacle.

Then again, I've also interviewed women who were lesbians who when they talked to their doctor and said, my wife and I want to have children, the doctor wouldn't provide any information. They wouldn't talk to them about sperm banks. They wouldn't share the information because of homophobia and bias.

I for a time went to a clinic that had a slogan along the lines of creating families one couple at a time. As a single woman, it feels a little bit like I'm an outsider. I understand traditionally most families are going to be created by heterosexual couples.

However, every time I went into that clinic, they would ask me, where's your husband? When is your husband showing up? It just never registered.

So as a single woman, I felt like I wasn't being served in the same way as a traditional heteronormative family would be served.

Margaret Flinter

I'm curious what you and the community of people that you've spoken with have found in terms of religious objections.

Valerie Bauman

That's an interesting question. Truthfully, it's not one that comes up very often in the world of freelance sperm because people don't find their way to a Facebook page to find a sperm donor because that was plan A. These people have gone through grief that their family planning didn't go the way they expected, that they won't be able to reproduce with the partner that they love, that they will have to turn somewhere else.

Usually, by the time I'm interacting with them in that setting, they've made peace that they're going to be breaking some cultural and yes, religious taboos. I think at this point, people are already making their peace and accepting that people aren't going to be comfortable with what they're doing. But the biological imperative to have a child, to create life, to further your family name, there's something so powerful.

It's not unique to humans. This is the essence of being a living creature. We have a drive to procreate.

Yes, as humans, there are people who don't want to have children. But I feel like there's something unifying in all the voices I hear from that religion isn't going to stand in the way of their decision to move forward. Getting into the nitty-gritty of the specific religious obstacles hasn't really come up for me for that reason.

Mark Masselli

You're both an author and a journalist. Are you planning to write as a journalist on this as well in other venues?

Valerie Bauman

Well, initially, I think I wanted to write the book and not become a part of it. I think as a journalist, it gets very uncomfortable making yourself part of the story. But going forward, I think there's a lot of room in the space to continue reporting on and writing about these issues.

There is so much happening. Obviously, the Alabama Supreme Court ruling is raising all kinds of questions, the reversal of Roe v. Wade.

A woman's right to choose isn't just about the choice to not be a mom. It's a choice to be a mom, too. We should have rights and access to our own reproductive decisions that too often a physician or a sperm bank can throw up obstacles, whether they be financial or judgmental.

I also think that there's a lot of room to discuss the evolving nature of the American family. The traditional family structure is fantastic. I would have loved to have been able to give my child a father.

It didn't work out that way. And more often, you're seeing LGBTQ plus families, single women, and others establishing unique, dynamic families. I'm very fortunate that my donor has created a private Facebook page where I and other parents can connect.

And so the siblings meet each other. That's an extended network of family. My kid will grow up and have other siblings that say, yeah, I share this with my half-brother or my half-sister.

And there are other families that are reflected back in my world that look just like mine. And what does that mean? And I think being more open and welcoming to other kinds of families is always going to be a positive thing.

I'm really curious to see where that goes and what stories there are there.

Mark Masselli

Anything you've picked up internationally that's going on in terms of best practices or things that are troublesome?

Valerie Bauman

Well, I think there's a lot internationally going on. I mean, I know of one sperm donor who was banned from New Zealand and Canada, and I think Australia, because he was very open. And when he was trying to enter those countries, he's an American, saying he was just there to donate.

Australia has made really interesting strides limiting the number of children who can be created by one individual donor at a bank. It varies from state to state in Australia, and but a lot of them limit to five to 10 children per donor. And they actually require, which is not required in the U.S., tracking. So the parents who have donor-conceived children by a sperm bank must report back every birth. That is not a requirement in the U.S. Banks in the U.S. don't have any limits by law on how many children can be produced by one donor. The Society for Reproductive Medicine, I believe it is, suggests limiting 25 per 800,000 population area, which if you think about it, with the size of the U.S., that could create so many children. But you have this tension, what you're seeing in Australia with the limits they're creating, there's a huge shortage of sperm donors. And so there's this kind of ethical versus financial tension. And I'm really interested to see how that's going to play out in the U.S. and abroad.

Margaret Flinter

Well, Valerie, you've raised so many interesting questions. We're so glad to have a chance to talk with you. But one of them is that we understand that in the open donor arena that the child has the opportunity to contact the sperm donor when they're 18, if they wish to do so.

Tell us more about that. And have we had enough years to know how this actually works out in practice?

Valerie Bauman

So what the vast majority of banks do now is either anonymous, which hopefully goes away, because I really, truly believe anonymous sperm donation is unethical, and open ID at 18. And what that means is they will tell you the name and the identity of the sperm donor. That in no way guarantees that that donor will be willing to meet that child or maintain any kind of relationship, or even just answer questions via email.

Ultimately, if you're child number 72 knocking on this person's door, because there are no limitations on how many children can be created by one donor at a certain bank, and many of these donors go to multiple banks, then you are never going to have the emotional and time bandwidth to actually engage and create a meaningful relationship or just give simple answers to those children about where they come from.

And as you see in my book, that is heartbreaking and devastating for some of these now adult donor-conceived people. I think people are not made aware that if they buy sperm from a sperm bank, there is no guarantee that an 18-year child is going to get all these questions answered. Now, I do want to say there is work done by a fantastic developmental psychologist named Susan Golombok out of the UK that shows the vast majority of outcomes for children of single mothers by choice and donor-conceived children are very positive, a lot of times because these children are had with intention.

Unlike overarching stats for single mothers, they tend to have much better outcomes in life. But you just can't predict how they're going to feel about wanting to know the donor that helped create them. Some of them don't care.

Some of them do. Some of them desperately want a relationship. Some of them just want one meeting and that's it.

The point is, you will never know. As much as you wound up different than your parents expected you to wind up, be prepared for your child to surprise you and give them the best options available to make their own decisions and have their own feelings and be individuals unto themselves.

Mark Masselli

We talked a little earlier about expenses. People with limited means may have trouble covering those, but we know in 15 states require some private insurers to cover some fertility treatment, but significant gaps in coverage remain. Do you think policymakers should look at changes that would eliminate the challenges with insurance?

Valerie Bauman

Absolutely. I mean, I personally believe everyone should have the right to access assisted reproductive care. Making IVF accessible and making any reproductive assistance available, including the outrageously expensive medications, is one of the first steps.

There are a lot of women out there who aren't maybe as educated or cautious or more desperate and who are meeting men at motels off the side of the highway two hours away from where they live and getting sperm donated without seeing STI tests, without getting genetic testing done, without taking all the steps to protect themselves. By making these costs so insurmountable, we are thrusting women and couples into this desperate place because of, again, the biological imperative is not going to go away. Society can shake its finger and say, well, you shouldn't have a kid then, but the fact is it's going to happen and we can't just stick our head in the sand.

Margaret Flinter

Valerie, you may have mentioned this. I am interested in hearing more about either ethical or legal responsibilities of a sperm donor to reveal genetic or biologic health issues. How much testing or information in the network that you're describing, how much is required in that area of the donor?

Valerie Bauman

Nothing is required. It's the I think it's up to the recipient to say, I only want to work with a donor who is willing to do this. But I would also caution against assuming you're protected by going through a sperm bank.

There's a very famous case about the Zytec sperm bank that used a donor for, I think, 16 years, and he produced at least 36 children that they know of. He advertised himself as having a PhD and being this great musician, when in truth, he had schizoaffective disorder and was a convicted criminal.

Mark Masselli

Let me get one last question in. Can you tell us about the best way to inform children about how they were conceived? Is it necessary conversation?

And when should it occur?

Valerie Bauman

From all the studies that I've read and the experts, psychologists that I've spoken with, you should start talking to your child about where they come from before they can even speak. I'm seven months pregnant, and I'm talking to my baby about the fact that a man helped me create him. I think I'm going to be putting together a book, a storybook that talks about who that donor is and how they came to come into the world.

You never want your child to grow up and say, I remember the moment that I found out I was donor conceived. If it's part of their story, their origin story, for as long as they can remember, you've done something right.

Margaret Flinter

Valerie, thank you again so much for taking the time to meet with us today and share your story. Thank you.

This transcript and show description was generated using AI tools. The audio is the official record of the show.