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Social infertility

24 Jun 2018

That's the official medical diagnosis typically given to single women and same sex couples in Australia who are trying to conceive.

 

As opposed to heterosexual couples who may have difficulty conceiving for some actual medical reason, single women and same sex couples are labelled as being infertile for social reasons.  Even if all their "bits" are working just fine, and they're not experiencing any kind of actual medical infertility whatsoever.  It's also a term which has been deemed horribly offensive to people who are actually medically infertile.

 

And the number of single women and same sex couples wishing to start families is growing.

 

Prior to my first appointment with my fertility specialist, I went to an information session held by the clinic I had settled on treatment with.  I made the trek one evening after work from my office in the city, amid a bit of a torrential downpour, down to the clinic's main premises in East Melbourne.  I arrived sodden at the clinic, already feeling a bit undignified, and of course saw that there were a large number of heterosexual couples already waiting for the session to begin.  I tried to put aside any twinges of regret or longing or jealousy at those couples' apparent fortune of having someone to share this process with.  I reminded myself that doing this alone also allows me to do it on my own terms.  And experience and knowledge of human nature has taught me that a percentage of those couples are probably miserable anyway - I know of more than one couple whose marriages have not endured repeated failed IVF cycles - but I was comforted also to see that I wasn't the only woman there alone, and that one or two same sex couples were there too.  Imagined or otherwise, I felt something like a sense of solidarity with the others there who didn't fit the "traditional" image of a family.  It made me feel a little less like a social leper - which is really how the term "social infertility" makes me feel, if I'm really honest, and I wonder if it's intended to by the people who coined it.  Subscribers to society's dominant paradigms have always found ways of lumping anyone they think isn't like them into the category of "other" and marginalising them accordingly.  It's gone on for all of history - a very tribal, raw impulse: "you can't sit with us".

 

I know though that there are many people who are experiencing actual medical infertility that feel that way too.  Anecdotally, friends and acquaintances who have gone through IVF (some successfully, some not) have spoken about the inadequacy, shame and disappointment they have felt at not being able to conceive naturally.  Neither of the sexes are alone in this either.  Society attempts to condition women to want to be mothers (not to say that this is what all women want, of course).  Archetypal images of the mother, the nurturer, the fertile birther of children have permeated almost every culture for as long as humanity has existed.   For men, virility has always been held up as essential to masculinity.  If either sex is faced with falling short, it's understandable that they would internalise a lot of resulting shame - being "less than a man," or "not a whole woman".  These perceptions are all nonsense of course.  It's that tribal mentality again that we all still subscribe to, whether or not we are conscious of it, even if we actively struggle against it.  That mentality may have served some kind of Darwinian survival purpose back when we were still using rocks for tools, but it has no place in our culture now, and it needs to be stamped out.

 

I even felt this judgement from my general practitioner, when I visited him to obtain a referral to see my fertility specialist for the first time.  I explained to him the purpose of my visit and what I needed from him.  I handed over a slip of paper with the name and address of the fertility doctor I wanted to see.  Looking at his computer screen as he spoke, he asked me if I had a partner.  I said no.  "Just haven't met the right person," I explained, as if it was any of his business, but it's a line I've become very accustomed to saying.  He then made a sort of half-joke - which was really a veiled criticism - that perhaps my standards are too high.  I laughed politely, because I wanted that referral too badly to call him out on what was really a pretty offensive comment.

 

What I wanted to say was that if anything, my standards have been too low and the men I've fallen in love with would have made terrible husbands, let alone parents.  That the men I've dated in recent years have been more like boys pretending to be adults;  largely wanting in responsibility and accountability.  They might wear suits to work and do a good job of looking like they've got it together, but underneath, a lot of single straight men my age still lack the emotional intelligence required to have a real relationship based on true equality.

 

I think that this is overwhelmingly a cultural issue;  one that we are all contributing to, even if unwittingly.  If men had to deal with all the rubbish that women deal with daily, they'd lose their shit.  Many men have been raised having been doted on by mothers who adored them.  Mothers who were almost always in charge of the mental load of household management, even if they had a male partner.  And whilst being adored isn't in and of itself a bad thing, raising children to expect a woman to look after them and organise their homes - and that a man need not be accountable for himself or his mistakes - is an incredible disservice we are doing to our children.

 

A throwaway example?  When B and I split up, after I moved out, he had to call me to ask me how to use the dishwasher and the washing machine that had been in our apartment for the previous two years.

 

No wonder women identify male incompetence as a subtle form of misogyny.  Recent studies have even indicated that straight married women are more stressed out by their husbands than they are by their children, and this is due in part to a lack of support from the husband in managing the household and family.  In a recent documentary made by two Spanish women called "Singled Out", which follows the lives of five women over 30 in different parts of the world, a sociologist hypothesised that men are looking for a kind of woman who no longer exists;  whilst women are looking for a kind of man who doesn't exist yet.  Guys, we know you can do better.  We're just waiting for you to roll up your sleeves and do the work with us.

 

The ABC in Australia wrote that if we want to cure social infertility, we have to first cure discrimination.  And I can't say that the term "social infertility", and the government's treatment of these women, doesn't feel like an insidious institutionalised kind of sexism to me.  Women with social infertility are not covered by the Australian government's subsidised health scheme, Medicare, and must instead pay full out-of-pocket expenses which would equate to around $12,000 per IVF cycle (with the Medicare rebate, a cycle ends up being around $5,000-$6,000 out-of-pocket).  This is the reason why, at my first appointment with my fertility specialist two weeks ago, she explained to me that I was going to have to undergo two or three cycles of artificial insemination (properly known as inter-uterine insemination, or "IUI") before beginning actual IVF treatment.  This is because, after two or three failed IUI attempts, my doctor will be able to demonstrate to Medicare that there are actual medical reasons for me to move on to IVF, which has a greater success rate of around 30%-35% for women in my age group.  At over $2,000 out-of-pocket per IUI cycle (not including medication), and with only a 10-12% success rate, being obliged to undergo multiple rounds of IUI is an expensive way to get the government to acknowledge you.

 

It was also a bit of a slap in the face to be told by the city’s only fertility clinic that bulk bills (meaning, they don’t charge more than the Medicare scheduled amount, and therefore patients pay fewer out-of-pocket expenses) that they don’t assist single women or same sex couples because they don’t deal with donor sperm. Ever. 

 

No wonder women who can't afford the process are accepting sperm from willing friends and self-inseminating at home.  There's even a Tinder-style app created by two Melbourne men, called "Just a Baby", designed to match people wanting to conceive without having to go through a clinic.

 

At least I am trying this now, instead of ten years ago - up until 2010 when the Assisted Reproduction Act 2008 (Vic) came into effect, it was actually illegal for a single woman in Victoria to undergo IVF treatment at all if they weren't medically infertile (even as a full-fee paying patient).  That piece of legislation is also the reason I have had to undergo police checks, child protection checks and as many as six counselling sessions with psychologists and nurses before I will be approved for treatment.

 

Starting this process is not something I take at all lightly.  It's something I've thought about doing for many years, and I am going to be unpicking all of the emotions within me - both those I am aware of and those I am not - at every turn.  I've even questioned whether or not I'm being selfish in intentionally bringing a child into the world that will not know its father.  I remember the day I made my first phone call to book my initial appointment with my fertility specialist.  I was at work at the time.  The staff member I spoke to asked me without any apparent judgement in her voice whether I would be bringing a partner along.  Even so, when I hung up the phone, I quite suddenly started to cry quietly at my desk.  I was feeling a mixture of things.  I was joyful and excited at having taken the first step towards having a child;  deeply sad that I was doing it alone without a partner to share it with and lean on for support;  and overwhelmed at the poignancy and intensity of both of those things.  Feelings that sometimes seem to come out of nowhere, but which sit under my calm and cheery exterior as I deal with doctors, nurses and staff, whether I am aware of it or not.

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