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Posted on May 19, 2015 at 4:05 AM

In my last
, I discussed some of the problems with the definition of infertility,
including that it is based mainly on women’s bodies, which implies that men are
less likely or not likely to be infertile, and it is based on heterosexual
activity, which implies that single individuals and/or individuals in the LGBTQ
community cannot experience infertility. I also distinguished between physiological
infertility (i.e. infertility due to a biological condition such as low sperm
count or blocked tubes) and social infertility (i.e. situational infertility,
such as whether one has a partner and if so, if that partner is fertile and
together one and one’s partner have the “right” parts to reproduce
biologically). In this blog, I want to reflect more on that it means to be infertile
and how the role social desire (i.e. the social desire to have biological
children) plays in diagnosing this condition.

Imagine two women with the same exact circumstances: they
are both 30 years old, in long term heterosexual relationships, and have been
having unprotected sex regularly for the last 3 years. The only difference is
that one woman, Jessica, wants to have biological children, while the other
woman, Katie does not. Should they both be classified as infertile? How does
their desire to have or not have biological children shape their medical
diagnosis? Should their partners be labeled as infertile too? Does it matter
whether Jessica and Katie are physiologically or socially infertile in
classifying them as infertile? Does their partners’ interest in having
biological children or lack thereof factor into determining if Jessica and
Katie are infertile?

The comparison between Jessica and Katie shows that the social
desire to have biological children plays a role in determining infertility. People
can live their entire lives without ever knowing that they are physiologically
or socially infertile if they do not actively try to conceive biological
children. Unlike other medical conditions where symptoms of the condition lead to
the diagnosis, the absence of a pregnancy combined with the social desire to
have biological children often precipitates the diagnosis of infertility. (Of
course there are exceptions to this, such as a women diagnosed with endometriosis
due to painful periods who finds out that she may have reduced fertility.) Without
the social desire to have biological children, people may not feel the need to
investigate the absence of pregnancy even if they are heterosexually active
without using protection precisely because there are not interested in
achieving pregnancy.

Are there other medical conditions that require us to look
at people’s social desires in order to determine if they have that
condition? Similar to infertility, here are two more examples of medical
conditions individuals could have but not know it because of their social
desires: sexual dysfunction if the individual is not at all sexually active and
activity induced asthma if the individual is not very physically active. What
role should social desire play in determining whether individuals have these
medical conditions? Do these examples different from infertility in significant

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI’s online graduate programs, please visit our website.  

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