The American Society for Reproductive Medicine (ASRM) has redefined the term “infertility.” The diagnosis used to mean the inability to conceive after one year of heterosexual intercourse without contraceptives. That’s a medical definition with clear criteria for application.
The new definition includes what we might call sociological circumstances as well as physical infecundity. From the ASRM press release:
Washington, DC — Today, the American Society for Reproductive Medicine (ASRM) Practice Committee issued a new definition of “infertility” as follows:
“Infertility” is a disease, condition, or status characterized by any of the following:
- The inability to achieve a successful pregnancy based on a patient’s medical, sexual, and reproductive history, age, physical findings, diagnostic testing, or any combination of those factors.
- The need for medical intervention, including, but not limited to, the use of donor gametes or donor embryos in order to achieve a successful pregnancy either as an individual or with a partner.
- In patients having regular, unprotected intercourse and without any known etiology for either partner suggestive of impaired reproductive ability, evaluation should be initiated at 12 months when the female partner is under 35 years of age and at six months when the female partner is 35 years of age or older. [Emphasis added.]
In other words, gay and lesbian people are considered “infertile” — even if they are medically capable of initiating a pregnancy — solely because they choose not to engage in heterosexual intercourse.
Elderly people are also considered infertile because of “age,” which is at least factually accurate, even though their inability to conceive is not caused by a medical malady but due to the normal physical changes caused by natural aging. People who do not want to engage in a sexual relationship could, it seems to me, also be considered infertile since it applies to the status of wanting to have a child on one’s own.
The ASRM makes it very clear that redefining homosexual people as “infertile” is a primary purpose of the redefinition:
“This revised definition reflects that all persons, regardless of marital status, sexual orientation, or gender identity, deserve equal access to reproductive medicine. This inclusive definition helps ensure that anyone seeking to build a family has equitable access to infertility treatment and care,” said Jared Robins, MD, ASRM CEO.
Except it isn’t “equitable.” Non-chaste heterosexuals of child-bearing age will still have to demonstrate medically that they are physically infertile to be included in the definition. Non-heterosexuals and the celibate will be deemed infertile by their choice of sexual partners or desire to have a baby without having sex.
Here is my interpretation of the redefinition consequences:
- This change marks another triumph for the subversive word-engineering project that elevates subjective desires and feelings over scientific facts. If, as a matter of policy, the ASRM wanted to open the door to insurance coverage for reproductive-health services to non-heterosexuals or people who are celibate across the board, it should say that. But don’t redefine “infertile” to include people who are physically fertile based on their “status.” That corrodes the very concept of objective truth and accurate medical definitions.
- There are few definitional limitations to attaining reproductive-health services based on “infertility” in the redefinition — except for sexually active, fertile heterosexuals of child-bearing age — including, one presumes, among the elderly, the celibate, and those who have been sterilized. In other words, we can all choose to be infertile now.
- Follow the money. Providing IVF and reproductive-health interventions is a multi-billion-dollar industry. This redefinition — which is in accord with the law in states such as California — and, I believe, proposed HHS regulations — makes it highly likely that health insurance and social benefits will one day pay for these expensive interventions essentially on demand across the board.
And we wonder why clarity is illusive and it is so hard to control medical costs.