Elton John’s Baby and Unregulated Global Surrogacy

Other articles on surrogacy can be found at: global surrogacy and surrogacy.

The birth of Sir Elton John’s son on December 25, 2010 was celebrated in the international media. He and his partner, David Furnish, have a civil union and they are a high-profile same-sex couple. When they inquired about adopting a young boy in the Ukraine, they were denied this opportunity because of Elton John’s age (over 60) and his single status; civil unions are not recognized in Ukrainian adoptions and, as such, he could not apply as a married individual. Turning to surrogacy was not a simple matter, even with the infinite financial resources of the couple. This is due to the fact that surrogacy is outlawed on British soil and, as a result, the couple contracted with a California-based surrogate. However, British citizens may purchase surrogate services elsewhere and Elton John and David Furnish are certainly not the first family to be built with “out-sourced” surrogates in another nation.

With Sir Elton John’s successful and highly publicized surrogacy arrangement, the “effect” of star-power and the use of surrogacy on the general population remain to be seen. It is far more financially obtainable as an option today to average people. What has historically been a very expensive option costing $50,000-plus, global surrogacy has become more affordable in recent years largely due to the medical tourism model in India.  An individual or couple may contract for surrogate services for as little as $12,000 plus travel costs. Intermediaries who act like headhunters identify women to carry out this “service” with little oversight and clinics with sophisticated medical services are constructed where surrogates live in dormitories or pregnancy camps. The ethical quagmires related to this business model, now expanding to other nations such as Guatemala, are considerable. While there have been calls for regulation of surrogacy, and some nations like the UK outlaw it, the new global context requires greater consideration especially when one considers the vulnerabilities of deeply impoverished women in developing nations.  

Superstar influence on the social consciousness and how families are built via alternative strategies is relevant. What some have called the “Brangelina Effect” was the beginning of a booming inter-country adoption industry in Ethiopia after Angelina Jolie adopted Zhara in that deeply impoverished nation.  Now, as thousands of people have flocked to Ethiopia in recent years to build their families through adoption, there are grave concerns about corruption and the exploitation of vulnerable women and their children by sophisticated inter-country adoption agencies. The abuses include concerns about child sales and other unethical and illegal practices.

All of this is further complicated by the fact that with the exception of Ethiopia, inter-country adoption is undergoing a significant decline. A practice which affected an estimated 45,000 children in 2004 may have had as much as a 50 percent downturn or more since that time because of a variety of reasons, including implementation of international standards to prevent child sales and theft. However, the demand for healthy babies rages on and it is a billion dollar industry. While the sale of children is prohibited around the world, it happens every day.  And, while surrogacy on a case-by-case basis may be ethical and well-planned, it is hard to believe that such an approach when practiced on a large scale assembly-line style in developing nations will be done so in a fair and just manner.

Much remains to be seen related to this emerging business model and exactly how vulnerable women will be protected. One thing is guaranteed, the activity will be marketed as a win-win “opportunity” for poor women and the individuals and families who seek to build their families in this manner. Oprah Winfrey already weighed-in on global surrogacy, highlighting the practice in India and happy US “customers.” While involvement in global markets is important for marginalized peoples, especially women, one should not underestimate the need for oversight and ethical standards. Without international regulation, I predict dire human rights abuses when the activity is practiced en masse in nations with histories of organized crime and human rights abuses. First on my list of concerns is Guatemala, a nation with notorious problems related to violence against women and human trafficking and it is time for a rapid response to insure the rights of vulnerable women. How that should be done remains to be seen, but one proposal is international private law. Regardless, the time to act is now!

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  • crowepps

    One thing is guaranteed, the activity will be marketed as a win-win “opportunity” for poor women and the individuals and families who seek to build their families in this manner.

    It may be win-win for the poor women who need the money and the families who want to buy a pregnancy, but I don’t think it’s hard to see where this could be a real disaster for the children involved.  It’s hard enough to explain adoption to kids — trying to put together a jolly age appropriate book to explain egg buying and renting a uterus is going to be a real pip!


    “Where Did Our Baby Come From?

    A Little Bit Here, A Little Bit There.

    Some For Rent and Some For Care.

    Our Baby Came From Everywhere!”

  • karen-smith-rotabi

    Yes, the identity of children born of surrogacy arrangements with poor and vulnerable women is going to be truly complicated, especially when they are genetically 1/2 Indian or Guatemalan or… 

    And, then there are issues of Eugenics and that is another serious issue which will inevitably have consequences for the offspring on an individual level, but also for all of us. The quest for the perfect baby should concern us all and question is, will we learn from world history?

  • crowepps

    Explaining the choices of poor and vulnerable women will be easy; ‘your mother was hungry and earned her food by ‘working’ at growing babies for those who fed her’.  What’s going to be really hard is explaining the choices of the rich and entitled people who purchase the pregnancies.  Buying an egg or renting a uterus isn’t a story that can be passed off with even the dubious rescue myths of ‘your mother couldn’t take care of you’ or ‘your mother chose to give you a better life’.


    The issues of eugenics may be outdated, since it focused on biological superior offspring in the belief that physical weakness, poverty and immorality were biologically linked, and (with the exception of some heritable diseases) the present state of science seems to indicate those problems are instead psychological and sociological artifacts of a failure to invest in and protect children.  It seems pretty ludicrous to me to insist children have a “right to life” while simultaneously denying them a right to food, shelter, clothing, decent education and medical care.

  • crowepps

    Highly recommend reading this entire story.  Brings up lots and lots of different points about surrogacy and pregnancy and the urge to reproduce.


    Wondered, myself, just how the ‘twinlings’ are going to feel as teens and adults about their parents having publicized this ‘unique story’.  Mommy may be happiest with complete openness and honesty (especially centered around her drama) but I find it hard to believe the offspring will be 100% positive about being cast in “The Twinlings Show”. 



  • bglickstein

    As a public health nurse and health reporter I have been following this unregulated industry for many years with great concern. There is little interest in regulating this multi–billion dollar industry and the issues just continue to get more complex and free-wheeling.  The bigger questions of increasing infertility in women and men (delayed childbirth and age one factor) related to environmental toxins are not being addressed. I asked a fertility specialist from a major teaching university in CA at a conference was there any data about the health of the women who have undergone multiple attempts at IVF exposed to hormones and other drugs. He quickly replied no. When I asked him if there was any data he said he didn’t think it was being studied because the hormones were safe.

    There’s a great award-winning documentary, Made In India, about global surrogacy by Rebecca Haimowitz & Vaishali Sinha. This paragraph comes from their web site about the film “Made in India” is a feature length documentary film about the human experiences behind the phenomena of “outsourcing” surrogate mothers to
    India.  The film shows the journey of an infertile American couple, an
    Indian surrogate and the reproductive outsourcing business that brings
    them together. Weaving together these personal stories within the
    context of a growing international industry, MADE IN INDIA explores a
    complicated clash of families in crisis, reproductive technology, and
    choice from a global perspective.”



    Thank you,

    Barbara Glickstein, RN, MPH, MS

    Co-Director Center for Health, Media & Policy
    Hunter College City University of New York
    Producer & Host Healthstyles
    99.5 FM Pacifica Radio


  • judy-walker

    Maybe it’s time to legally limit surrogacy to relatives.  This would go a long way to limiting this new form of imperialism.


  • arekushieru

    But, doesn’t that work on the assumption that, just because one is a family member, they will want the same things as their relative?  I think it’s rather discriminatory to both the relatives and to anyone outside the family.  Just as discriminatory as I believe limiting living organ donations to family members is.

    Maybe the solution is to eliminate all monetary incentives, include screening, etc….  But, I don’t  know enough about this to say, really.

  • cmarie

    This is actually more in regard to adoption but a good resource     http://www.brandeis.edu/investigate/gender/adoption/guatemala.html

    Also regarding international adoption http://www.foreignpolicy.com/articles/2008/10/15/the_lie_we_love

    And now that Guatemala is Hague complient regarding adoption there are people who seek to profit through surrogacy in that country    http://www.rhrealitycheck.org/blog/2010/05/20/human-rights-business-reproduction-surrogacy-begins-replace-international-adoption-guatemala#comment-42933   (full circle)

    Also I’m not sure that limiting surrogacy to family members will eliminate exploitation.  I remember in college I had a room mate who was the absolute idolized favorite of her parents.  She already had reason to believe fertility would be a problem for her in the future.  I remember her once telling me that her mother had promised to carry a pregnancy for her if she couldn’t and (almost as an after thought) “or of course I’m sure my sister would do it for me too.” and I thought “God help your poor sister if she has any objections to this arrangement”.  The mother who “volunteered” had already lost multiple pregnancies as a young woman and almost certainly would never be considered as a candidate to be a surrogate but with these family dynamics, I hate to think of the tremendous, unrelenting pressure that could be directed at a less favored daughter, especially if she is very young.