China not only owns a disproportionate amount of American debt, but a new report reveals it also rents a disproportionate number of American wombs.
In July, researchers using data from the Society for Assisted Reproductive Technology Clinic Outcome Reporting System found that Chinese nationals make up the largest percentage of foreign surrogacy contracts in the United States. This report — in the journal Fertility and Sterility, which is published on behalf of the American Society for Reproductive Medicine — compared the demographics of domestic and international intended parents. The latter category refers to men and women who are foreign nationals but come to the United States to hire an American surrogate to bear their child(ren). The rent-a-womb industry is disproportionately fueled by Chinese nationals (13.4 percent), followed by France (2.9 percent).
Of these foreign nationals, which come mainly from China, many are men over the age of 42 (33.9 percent compared to 26.2 percent of domestic intended parents). They are also far more likely than prospective domestic parents (roughly 74 percent as opposed to 54 percent) to use preimplantation genetic testing. This allows intended parents to select the “ideal” embryo based on the child’s sex, health, lack of genetic anomalies, and even eye, hair, and skin color. While sex-based abortion is illegal in some states, preimplantation genetic testing provides intended parents with an effective workaround.
Researchers used data from 2014–2020 (the most recent years available). In recent years, the number of surrogacy cycles increased from 3,538 cycles in 2014 to 8,145 cycles in 2019. In 2020, the total number of cycles decreased marginally to 6,909 presumably due to Covid-19 travel restrictions. A surrogacy cycle refers to each time a doctor implants an embryo in a surrogate in hopes of conceiving a child.
Not all surrogaty cycles succeed in going from an implanted embryo to a live birth. In fact, it’s common for surrogates to carry twins, triplets, or quadruplets. Intended parents may require the surrogate to abort one or multiple babies under the “reduction of fetus” contract clause. Because of this, we don’t know exactly how many babies were born from these cycles. Perhaps half or more of the 8,145 cycles in 2019 resulted in a live birth.
Furthermore, 75 percent of foreign intended parents used facilities in California. These findings confirm what anecdotal data already pointed to: Chinese nationals are taking advantage of an unregulated market in the United States, centered in the Golden State, that deals with the creation and selection of human life itself. What’s more, we have no idea who these children or their parents are.
In interviews with NPR (here, here, here, here, and here), CNN, and The New York Times dating back as far as 2014, foreign Chinese intended parents openly discussed why they sought surrogacy in the United States. They noted that China effectively bans all forms of surrogacy.
Despite lifting its one-child policy in 2016, China’s birth rates continue to decline. For some families, this change came too late as couples aged beyond their natural ability to bear children. In other cases, men struggle to find a willing female partner, especially given the cultural preference for career over family.
The other reason reports have widely addressed is the desire for citizenship.
Birthright citizenship stems from a contested interpretation of the 14th Amendment, which is intended to ensure that all children born in the United States gain and maintain the full rights of U.S. citizenship. Such children receive a birth certificate, a Social Security number, a passport, and access to education services. Australia’s birthright citizenship law requires a child to remain in-country for a decade to secure citizenship. In the U.S., by contrast, surrogate-born children need only be born here, even if they’ll spend much of their lives in their parents’ country of origin.
Having a child with an American surrogate has another benefit: It allows wealthy Chinese nationals to craft a boutique “baby-making” experience. As one Chinese man said in an interview with NPR, “As long as you know what you want and you have the money, having children in the U.S. will always bring advantages.”
The American “rent-a-womb” industry is the byproduct of reproductive technology that augments the success of surrogacy, permissive legal structures passed in 2013 that grant easy access to parenthood via surrogacy in California, and, of course, the lure of automatic citizenship.
This industry likely grew in earnest beginning in the 2010s. As a result, we have about eight years until we could see an increase in green card applications from such surrogate-born children turning 21.
We need not assume that Chinese nationals using American surrogates are doing so to undermine the United States. Many may just want to fulfill their dream of parenthood. But it is reasonable to suspect that the Chinese Communist Party (CCP) will exploit this dream to expand its influence in the United States. It’s common to hear stories of the CCP pressuring its citizens, under threat of harm, to pass along information from research and academia, strategically purchase farmland, or exert their influence in Hollywood.
The United States, with its permissive surrogacy policy, is an outlier. Most developed nations have outlawed at least international for-profit, commercial surrogacy. This includes France, Italy, India, Thailand, Nepal, Taiwan, Germany, Portugal, Spain, Australia, New Zealand, Canada, Brazil, Denmark, and Britain, among many others. These countries recognize how exploitative the practice is, despite the potential for economic gain. When India outlawed commercial surrogacy in 2015, for example, it forewent an annual $2.5 billion (USD) market.
Lawmakers on the state and federal levels should carefully examine the commercial surrogacy industry. The first step is to pass a law that clarifies the limits of birthright citizenship. The 14th Amendment was not written with surrogacy in mind. One way to reduce demand in the American rent-a-womb market is to ensure that surrogate-born children of foreign nationals cannot maintain citizenship.
Second, lawmakers should hold the American Society of Reproductive Medicine and fertility facilities in California accountable for their complicity in this active market by launching a special report examining international surrogacy. From the American Society for Reproductive Medicine’s official “Chinese Special Interest Group” to its legal preference for unregulated access to surrogacy, there’s plenty of corruption for a report to uncover.
No foreign national has the right to a child created and born in the United States. It’s time for Congress to put an end to this odious practice. Congress should enforce laws that respect American citizenship and work to protect the safety and well-being of children over the preferences of adults in foreign countries.
