How Do You Want Your Eggs? The Medical Management of Kin-Making and Reproductive Inequalities in the United States and India

Abstract

Abstract Scholarship establishes that assisted reproductive technology (ART) implementation often stratifies the logics of who can (and should) reproduce. However, we know less about how social inequalities inform practices and reproductive logics within fertility clinics and across contexts. Mobilizing the concept of strategic naturalization and denaturalization (SN/SD) – the conceptual reconfiguration of an egg’s heritable components – this article addresses that gap. Examining clinic-based egg donation arrangements in Kolkata, India, and the United States’ San Francisco Bay Area, it addresses when and why reproductive logics are developed using SN/SD and how this development varies based on a country’s race, class, and gender dynamics. Using participant observation and in-depth interviews, this study explains why certain traits are conceptualized as genetic versus social during donor-patient matching and highlights variation across sociocultural sites. In both sites, actors use SN/SD to reimagine eggs to confer social advantage, navigating three structural and contextual axes while doing so: (1) clinical structures and policies, (2) donor pool characteristics, and (3) degree of technological reliance. Though resulting logics to reimagine donor eggs vary, reproductive strategies in both sites ultimately reflect existing social hierarchies that prioritize norms associated with hegemonic upper middle-class families.