The changing reproductive landscape
George Winter discusses the changes taking place in reproductive health rights, exploring the healthcare professional's role in advising on moral rights
What is a right? This is one of many questions that are especially relevant, given a reproductive landscape that is undergoing contemporary upheaval, with previously accepted norms under critical scrutiny and, at times, attack.
The concept of a right being an essentially legal one was underlined when the Supreme Court in the US reversed the landmark Roe v Wade judgement of 1973. This removed a constitutional right that supported a pregnant woman's choice to have an abortion without excessive government restriction. Where do moral rights fit in? In the context of assisted conception, Warnock (2002) argues that although one cannot claim a legal right to such assistance, compassion demands that the infertile should be treated if they wished to conceive.
Advances in reproductive technology have also stimulated discussion around transgender individuals wishing to become pregnant. In 1999, Germaine Greer (1999) made the observation that ‘no so-called sex-change has ever begged for a uterus- and-ovaries transplant; if uterus-and-ovaries transplants were made mandatory for wannabe women they would disappear overnight’. But Greer's prediction has not necessarily been borne out. In 2020, the surgeon Mr Christopher Inglefield of the London Transgender Clinic (2022) called for trans women to be allowed womb transplants. Similarly, Obedin-Maliver and Makadon (2016) reported that they ‘provide guidance to clinicians caring for transgender men or other gender nonconforming people who are contemplating, carrying, or have completed a pregnancy’ and Jones et al (2019) asserted that ‘there is no overwhelming clinical argument against performing uterus transplantation as part of gender reassignment surgery.’
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