Selling Genes, Selling Gender: Egg Agencies, Sperm Banks, and the Medical Market in Genetic Material

Rene Almeling University of California, Los Angeles

Eggs and sperm are parallel bodily goods in that each contributes half of the reproductive material needed to create life. Yet these cells are produced by differently sexed bodies, allowing for a comparative analysis of how the social process of bodily commodification varies based on sex and gender. Drawing on interview and observational data from two egg agencies and two sperm banks in the United States, this article compares how staff recruit, screen, market, and compensate women and men donors. Results show how gendered norms inspire more altruistic rhetoric in egg donation than in sperm donation, producing different regimes of bodily commodification for women and men. I conclude by discussing the implications of these findings for debates in sociology of gender about biological differences among women and men and the cultural norms attributed to these differences; debates in economic sociology about how social factors shape the expansion of the market; and debates in medical sociology about the intersection of the market and medical practice.

INTRODUCTION foreclose a rigorous examination of market practices. There are exceptions. Most notable are ommodification is a core concept in soci- Zelizer’s analyses of markets in life insurance Cological theory, but too often it serves as a (1979), children (1985), and intimacy (2005). conclusion to the research enterprise rather than Healy (2006) has recently built on this work and as a starting point for analyzing how social fac- on that of Titmuss (1971) by demonstrating the tors shape the process of assigning economic importance of organizations to the procurement value to market goods. This is especially true in and distribution of blood and organs. While the realm of bodily goods, where moralizing dis- these studies reveal much about the interplay courses about the sanctity of human life tend to between social and economic factors in markets for bodily goods, these particular markets are Direct correspondence to Rene Almeling, not strongly differentiated based on sex. In other Department of Sociology, University of California, words, while boys and girls and men and women Los Angeles, 264 Haines Hall, Los Angeles, CA populate these studies, left unexamined is 90095-1551 ([email protected]). Thanks to the egg whether the social process of assigning value to agency and sperm bank staff for generously sharing the human body varies based on the sex and gen- their time, and to Gail Kligman, Ruth Milkman, der of the body being commodified. Abigail Saguy, Carole Browner, Greta Krippner, This question is unavoidable when one con- Stefan Timmermans, John Evans, Adrian Favell, Jeff siders the twenty-first century medical market Ostergren, Gabrielle Raley, Kevin Riley, Daisy in eggs and sperm. Egg agencies and sperm Rooks, Lynne Zucker, and to Jerry Jacobs and the banks recruit young women and men to produce anonymous reviewers for helpful comments on ear- lier versions of this article. I gratefully acknowledge gametes for paying clients who are using repro- funding from the National Science Foundation, the ductive technologies to conceive children. In egg UCLA Center for Society and Genetics, and the donation, once a donor/recipient match is con- UCLA Center for the Study of Women. This project firmed, the donor takes hormones for about six received approval from the UCLA Office for the weeks, first to synchronize her menstrual cycle Protection of Human Subjects (#G02-04-071). with the recipient’s and then to stimulate egg

AMERICAN SOCIOLOGICAL REVIEW, 2007, VOL. 72 (June:319–340) 320—–AMERICAN SOCIOLOGICAL REVIEW production. Outpatient surgery is performed to monitor the process of egg and sperm produc- remove the eggs, which are mixed with sperm, tion before compensating donors. and, if fertilization occurs, the embryos are It is the very fact that these reproductive cells implanted in the recipient’s uterus. The are produced by differently sexed bodies that American Society for Reproductive Medicine allows for a comparative analysis of the extent (ASRM) estimates that 1 to 2 percent of women to which the market in eggs parallels the mar- undergoing treatment will require hospitaliza- ket in sperm. In each stage of the donation tion for ovarian hyperstimulation, and less than process, from recruitment to compensation, one patient in a thousand will require major how similar are the procedures at egg agencies surgery due to complications of egg retrieval. and sperm banks? If there are systematic dif- Compensation to egg donors varies substan- ferences, are these explained by biological dif- tially, both within particular agencies and in ferences between women and men? Or, given different regions of the United States, but the that this is an open market in genetic material, national average is around $4,200 (Covington are differences shaped by mechanisms theo- and Gibbons 2007). rized in microeconomics, such as the supply of Egg donation is physically invasive and risky and demand for egg donors versus sperm in a way that sperm donation is not, but sperm donors? Since the intent of those purchasing donation restricts a donor’s activities for a much gametes is to have children, do gendered cultural longer period of time. Men sign a contract and norms associated with motherhood and father- agree to produce sperm samples once or twice hood influence the procedures at commercial a week for at least one year, and each visit must donation programs? be preceded by two days of abstinence from Building on previous studies of sex and gen- sexual activity. Each bank has several small der, the economy, and medicine, I develop a rooms for donors furnished with sinks, chairs, theoretical framework in this article for ana- and pornographic magazines. Across the hall is lyzing bodily commodification that incorpo- the laboratory, where technicians process the rates biological, economic, cultural, and structural factors. Using qualitative interview sample, after which it is frozen and stored in the and observational data from two egg agencies bank’s offices until purchased by recipients for and two sperm banks in the western United use in artificial insemination. In contrast to States, I compare, stage by stage, how staff at women, who are paid regardless of how many commercial fertility agencies organize the eggs they produce, men are paid only for sam- process of egg and sperm donation. As my ples deemed acceptable based on sperm count analysis reveals, the market in genetic materi- and quality, things that can be negatively affect- al is organized differently depending on the ed by stress, sickness, or having abstained for type of body being commodified. Staff at med- fewer than 48 hours. Much less variation occurs icalized donation programs assign value to in sperm donor compensation. All donors with- reproductive cells and reproductive bodies based in a particular bank are typically paid the same, on economic definitions of scarcity and gen- usually between $50 and $100 per sample. dered cultural norms of motherhood and father- While biological differences between women hood. As a result, eggs and egg donors are much and men affect the process of donating repro- more highly valued than sperm and sperm ductive material, the products for sale in this donors. medical market, eggs and sperm, are parallel bodily goods in that each contributes half of the reproductive material needed to create an SEX AND GENDER IN embryo. Furthermore, there are organizational MEDICAL MARKETS similarities in how these commercial agencies To formulate an approach for answering the have developed stages in the donation process. questions raised above about the medical mar- Egg agency and sperm bank staff advertise to ket in genetic material, I draw on research in recruit gamete donors, employ a wide range of sociology of gender about the relationship criteria to screen applicants, and generate indi- between biological differences among women vidualized donor marketing materials to facil- and men and the cultural norms attributed to itate matches with recipient clients. They also these differences, research in economic sociol- SELLING GENES, SELLING GENDER—–321 ogy about how social factors shape the expan- reverting to tautological essentialism, in which sion of the market, and research in medical sex differences between women and men are the sociology about the intersection of the market beginning and end of explanations for gender and medical practice. inequality. To acknowledge bodily differences, Butler (1993) suggests a constructionist SEX, GENDER, AND REPRODUCTION approach, but argues that bodies are anything but empty, “natural” vessels waiting to be filled Central to an analysis of bodily commodifica- with cultural meaning. Instead, she argues that tion in this market is a long-standing distinction bodies themselves, differences and similarities, in feminist theory between “sex,” which is cannot be understood outside of social process- defined as biological differences between males es, which means that sex differences are just as and females, and “gender,” which is defined as socially constructed as gender differences (see the cultural meanings attributed to those bio- also Fausto-Sterling 2000; Fujimura 2006; logical differences (e.g., De Beauvoir [1952] Martin 1991). But what needs more elaboration 1989; Ortner 1974; Rubin 1975). Social scien- are the mechanisms through which sex differ- tists have paid more attention to gender, down- ences are constructed, both in terms of repro- playing biological sex differences in favor of ductive cells and reproductive bodies, and the analyzing how cultural norms of femininity and degree to which this construction is shaped by masculinity shape women’s and men’s differ- cultural definitions of gender. ential access to power. However, as Yanagisako and Collier argue, the failure to analyze sex is MARKETS AND COMMODIFICATION a mistake because “having conceded sex dif- ferences to biology in the interest of establish- It is not only gendered constructions of the bio- ing our scholarly authority over socially and logical body, but their production within the culturally constituted gender differences, we structural context of a medicalized marketplace have limited our project and legitimized assump- that must be included in an analysis of egg tions about sexual difference that return to haunt agencies and sperm banks. In recent decades, our theories of gender” (1990:132). social scientists have produced empirical stud- Even the social scientific literature on human ies of market processes that emphasize the social reproduction, which must necessarily refer to organization of particular markets (e.g., sexed bodies, is mostly concerned with preg- Abolafia 1996; Baker 1984; Smith 1989; White nancy, abortion, and birth, thus largely limiting 1981) and the cultural processes through which research to women’s experiences of reproduc- things become commodities (e.g., Appadurai tion (e.g., Franklin 1997; Gordon 1976; Katz 1986; Sharp 2000). Theorists note that the com- Rothman 1986; Kligman 1998; Luker 1984; modification of objects is likely to differ from Martin 1992). Within this literature, there are that of services (Appadurai 1986:55) or people few studies of egg and sperm donation. Among (Kopytoff 1986:86), but they do not elaborate those that do exist, most attention has focused on what these differences might be. on the recipients and offspring (e.g., Becker Thus, Zelizer’s research on the commodifi- 2000; Becker, Butler, and Nachtigall 2005; cation of persons provides a useful theoretical Tober 2001). Donors, in contrast, are typically framework on which to build. Her historical ignored, except when psychologists study their analyses of the emerging market in life insur- motivations for donating (e.g., Schover et al. ance (1979), the changing cultural and eco- 1991; Schover, Rothmann, and Collins 1992). nomic valuation of children (1985), and the Of the few social scientific studies of donors, social and legal interpretations of monetary researchers discuss either women’s motivations exchanges in domestic relationships (2005) each (Ragoné 1999) or men’s (Daniels and Lewis demonstrate the interrelationship between eco- 1996). Only Haimes (1993) has conducted a nomic and noneconomic factors in market gendered comparison of egg and sperm dona- processes. In contrast to conventional econom- tion, but the focus was on the regulatory delib- ic assumptions of the market as separate and erations of legislators in Britain. impervious, Zelizer (1988) formulates a socio- Sociologists of gender have yet to resolve logical model in which economic, cultural, and how to incorporate biological factors without structural factors interact to shape market 322—–AMERICAN SOCIOLOGICAL REVIEW processes. She writes, “As an interactive model, article will provide evidence of how organiza- it precludes not only economic absolutism but tional staff construct the meaning of donation also cultural determinism or social structural in interaction with those who provide human reductionism in the analysis of economic goods. processes” (1988:618). But as Zelizer’s theo- Missing from these studies on the organiza- retical project is most developed in the com- tional production of altruism is attention to how modification of intimate relationships, like those those organizations are gendered. Since Kanter’s between husband and wife or parent and child, (1977) classic study of a large U.S. corporation, this analysis of the medical market in genetic which found women in subservient, nurturing material builds on her work by examining the roles and men in positions of authority, sociol- intimate processes of bodily commodification ogists have demonstrated that organizational outside the family. structures, and the individuals who work with- My research also differs from Zelizer’s in its in them, are gendered (e.g., Acker 1990; focus on particular bodily goods as opposed to Milkman 1987; Williams 1995). More directly the commodification of whole persons. In this related to altruism, Arlie Hochschild (1983) sense, the anonymous provision of gametes compares women flight attendants and men more closely resembles blood and organ dona- debt collectors to conceptualize “emotional tion, even though open markets for these goods labor,” which includes managing feelings and do not exist in the United States.1 In his classic producing emotion to fulfill job responsibilities. study of blood donation, Titmuss (1971) Smiling flight attendants must exhibit empathy dichotomizes national blood collection regimes for the customer’s every concern, while debt predicated on the altruism or self-interest of collectors are required to manufacture anger donors. When he was conducting research in the with debtors over the phone. Hochschild argues 1960s, the United States relied on a mixed sys- that while emotional labor is required of both tem of paid and voluntary donors, which he women and men, the different requirements and compared with the wholly voluntary, centralized interactional contexts place an extra burden on blood collection system in the United Kingdom, women. As gendered and sexed organizations, concluding that voluntary systems produce safer egg agencies and sperm banks serve clients blood and are morally preferable to market- who wish to create families. This raises the based systems. He advocated for a system reliant question of whether in this market, altruistic on altruism in the United States, implicitly rhetoric, a form of emotional labor, is shaped by assuming altruism to be an individual charac- gendered cultural norms of caring motherhood teristic. and distant fatherhood (e.g., Chodorow 1978; Revisiting Titmuss’s claims, Healy (2006) Hays 1996). argues for a less normative, more explicit focus on how the organizational structure of blood and MEDICALIZATION organ donation results in variation in the rates of individual giving. He notes, “The individual Finally, I draw on research in medical sociolo- capacity for altruism and the social organization gy to incorporate a discussion of egg agencies of procurement are not separate questions but and sperm banks as medicalized organizations. rather two aspects of the same process. As Like other instances of medicalization, in which organizations create ‘contexts for giving’ they the medical profession gains authority to define elicit altruistic action differently across popu- conditions as requiring medical intervention, lations” (p. 67). As Healy’s research relies most- developments in reproductive technology, such ly on statistical data to highlight differential as artificial insemination and in vitro fertiliza- rates of altruism, qualitative data analyzed in this tion, have contributed to the definition of infer- tility as a medical “problem” (e.g., Conrad and Schneider 1980; Novaes 1998). In many cases, 1 The National Organ Transplant Act makes it ille- egg agencies and sperm banks are founded or gal to sell one’s organs. It is not illegal to sell blood, staffed by physicians, nurses, social workers, or but most whole blood donors are not paid. Individuals psychologists. Even when the staff at commer- do sell plasma (a part of blood), and sometimes peo- cial programs are not medical professionals, ple with rare blood types are paid to provide blood. they are representatives of a medicalized mar- SELLING GENES, SELLING GENDER—–323 ket in genetic material and, as such, have the and pricing of genetic material and the indi- power to shape the process of producing and viduals who provide it. The cultural factors are selling eggs and sperm. While medical sociol- the gendered norms of parenthood, with a focus ogists have discussed the ways in which the on altruistic rhetoric. The structural factors are practice of medicine is shaped by market forces the organizational context of medicalized, com- (e.g., Conrad and Leiter 2004; Light 2004; mercial egg agencies and sperm banks, includ- McKinley and Stoekle 1988), less is known ing their staged procedures for recruiting, about how these market pressures produce vari- screening, marketing, and compensating women ation in interactions in nominally medical set- and men donors. The primary research question tings. is: How do these biological, economic, cultur- Research on sex and gender, market process- al, and structural factors interact to shape the es, and medicalization provides scaffolding for market in eggs versus the market in sperm? the theoretical framework detailed in the next Previous research generates contradictory section, but the medical market in genetic mate- expectations, which coalesce around the bio- rial is not fully explained by any one of these lit- eratures. It is not so purely altruistic as blood or logical factors of reproductive cells and repro- organ donation because egg and sperm donors ductive bodies: receive financial compensation for providing reproductive cells to the paying clients of com- REPRODUCTIVE CELLS. One egg and one sperm mercial donation programs. Nor is it an occu- are needed to create an embryo. The first pos- pational category like Kanter’s secretaries or sibility is that this biological parallel, in which Hochschild’s flight attendants. But gamete dona- each cell provides half of the chromosomes, tion does occur in commercial programs pred- results in parallel procedures for recruiting, icated on the sexual differences between women screening, marketing, and compensating donors and men. It is within these medicalized organ- at egg agencies and sperm banks. However, the izations that various factors—biological bodies, female body has a limited supply of eggs while economic mechanisms, and gendered cultural the male body replenishes sperm. Moreover, norms—interact to shape processes of bodily extracting eggs from the human body is more commodification. difficult and risky than extracting sperm, a point made by the ASRM Ethics Committee (2000) THEORETICAL FRAMEWORK in justifying financial compensation for egg AND ANALYTIC AIMS donors. This leads to a second possibility, sug- Building on Zelizer’s tripartite model of a mar- gested by economic theory: eggs are a scarce ket, which incorporates economic, cultural, and resource compared to sperm, and thus women’s structural factors, I add biological factors as donation of eggs will be more highly valued than arguably significant to analyses of bodily com- men’s donation of sperm. A third possibility is modification. For the purposes of my analysis, raised by Martin’s (1991) analysis of metaphors the biological factors are the sexed bodily cells in medical textbooks, including those around the of eggs and sperm, which are produced by the bodily production of reproductive cells. She reproductive bodies of women and men donors.2 finds that “cultural ideas about passive females The economic factors are the supply, demand, and heroic males [are imported] into the ‘per- sonalities’of gametes” (p. 500), which suggests

2 Referencing biology brings to mind recent devel- opments in evolutionary psychology, which argue men are more willing to donate sperm for research that pressures of natural selection shape human than for reproduction, inferring that masturbating in behavior (for a review, see Freese, Li, and Wade a clinic is too far removed from sexual intercourse, 2003). Providing genetic material to create children historically the mode through which reproduction is to whom one has no obligations might constitute an accomplished (p. 317). These findings might be ideal case study in this field, but in fact, donation pro- extended to egg donation. Rather than speculate grams reject most applicants, a significant organi- about the extent to which evolutionary mechanisms zational constraint on individual behavior. have shaped this market, I focus on how contempo- Furthermore, Emond and Scheib (1998) find that rary biological processes are valued. 324—–AMERICAN SOCIOLOGICAL REVIEW that eggs will be less valued than sperm because al office assistants. I attended two information of gendered inequalities. meetings for women interested in egg donation and observed for six days at the agency’s office. At OvaCorp in 2002, I interviewed the donor REPRODUCTIVE BODIES. Eggs and sperm are manager, several of her assistants, and two psy- produced by the reproductive bodies of women chologists who screen donors. I spent one day and men donors. The first possibility is again observing agency staff and attended a weekly that biologically, because gametes are required staff meeting, which included the agency direc- from one woman and one man to create an tor, a psychologist, the donor manager and her embryo, these reproductive bodies will be equal- staff, and a lawyer. ly valued. The second possibility, grounded in In sharp contrast to the two egg agencies, economic theorizing, is that donors are consid- sperm banks were more reticent about granting ered reproductive service workers. As egg agen- access.3 In 2002, I interviewed the marketing cies and sperm banks are not only gendered director of CryoCorp and toured the bank but but also sexed organizations, and because occu- was denied access to other staff. Through a dif- pational segregation by sex is associated with ferent contact, I returned to CryoCorp in 2006 income inequality, especially in service work to interview the founder/medical director, CEO, and care work (see England and Folbre 2005 for two recipient and two donor managers, donor an overview), this suggests that egg donors will recruiter, genetics counselor, and human be less valued than sperm donors. Yet this same resources manager. At Western Sperm Bank in association with caring suggests that donors 2002, I submitted a detailed research plan, might be perceived as altruistic helpers who are providing recipients the opportunity to have résumé, and writing sample before being children. Because “women, love, altruism and allowed to interview the donor manager, the family are, as a group, [viewed as] radical- research director, and donor/recipient staff per- ly separate and opposite from men, self-inter- son. In 2004, I interviewed the executive direc- ested rationality, work and market exchange” tor and toured the sperm bank. (Nelson and England 2002:1), a third possibil- In each of the four programs, I collected ity is that egg donors, who are contributing to blank donor applications, medical releases, legal a motherhood project, may be thought of as consents, and marketing materials. With the donating something more special than sperm exception of an interview with an OvaCorp donors, who are contributing to a fatherhood psychologist, I taped all interviews and obser- project. But while egg donors may receive more vations, and I transcribed and coded all inter- cultural validation, women’s association with the views, observational data, field notes, and family has historically resulted in economic written materials. penalties (Kessler-Harris 1990). To analyze the medical market in genetic material, I examine how staff at commercial programs organize the process of donating METHODS gametes into distinct stages. These include Data for the following analysis were gathered recruiting and screening donors, supervising at two egg agencies, Creative Beginnings and the construction of donor profiles, confirming OvaCorp, and two sperm banks, CryoCorp and “matches” between donors and recipients, and Western Sperm Bank (all pseudonyms), locat- monitoring donors during the production of ed in metropolitan areas in the western United eggs and sperm. Within each stage, I compare States. In each program, I interviewed staff the procedures at egg agencies with those at about how they organize the process of donat- sperm banks, but it is important to note that ing genetic material, including those with deci- these stages are analytical and do not occur in sion-making authority (e.g., the founder, the same order for egg and sperm donation. For executive director, and program managers) and those who have the most contact with donors (e.g., donor coordinators and office assistants). 3 Schmidt and Moore (1998) also discuss such In 2002, I interviewed Creative Beginnings’s “organizational gatekeeping” by sperm banks, which founder/executive director, assistant director, is probably related to the emphasis on anonymity in financial manager, office manager, and sever- sperm donation (see note 7). SELLING GENES, SELLING GENDER—–325 example, women are “matched” with a partic- protocols for dealing with donors and recipi- ular recipient before they undergo medical and ents.4 psychological screening. Men are screened Economic language permeates their talk, yet first, and then their sperm samples are made egg agency and sperm bank staff are very aware available for purchase. But the stages are anal- of being in a unique business. They discuss ogous even if they are not contemporaneous. “people-management” strategies and point out Within each stage, I examine how ideas about that they are not “manufacturing toothpaste” cells and bodies, supply and demand, and or “selling pens.” They also consistently refer to motherhood and fatherhood interact to shape the women and men who produce genetic mate- the commodification of eggs and sperm in rial as “donors” who “help” recipients, and they medicalized donation programs. refer to the donor-recipient exchange as a “win- win situation.” This confluence of economic logic with altruistic rhetoric develops through THE MARKET IN EGGS AND SPERM each stage of the donation process and results While commercial sperm banks have been in bodily commodification that occurs in very operating in the United States for decades, egg different ways for women and men. agencies only appeared in the late 1980s after the development of in vitro fertilization tech- RECRUITING “SELLABLE” DONORS nology. ASRM estimates that infertility affects about 10 percent of the reproductive-age pop- Programs advertise for donors in a variety of ulation in the United States. Now, as people forums (college newspapers, free weekly mag- enter the medical system, those with finan- azines, radio, and Web sites), hold “Donor cial means may consider fertility drug regi- Information Sessions,” and encourage previ- mens, surgical repair of reproductive organs, ous donors to refer friends, roommates, and in vitro fertilization, and other forms of “assist- siblings. Sperm bank advertisements highlight the prospect of financial compensation. They ed reproduction,” including egg and sperm often include cartoonish illustrations of sperm, donation. At egg agencies, most recipient and some even joke that men can “get paid for clients are heterosexual couples. In sperm what you’re already doing.” CryoCorp and banks, a larger proportion of single women Western Sperm Bank are located within blocks and lesbian couples make up the customer of prestigious four-year universities, and such base. advertising is directed at cash-strapped college Whereas Creative Beginnings has been open students. The marketing director of CryoCorp, for just a few years, OvaCorp was one of the which requires that donors be enrolled in or first agencies in the country to expand its have a degree from a four-year university, assisted reproduction services to include egg explains that the location was a deliberate choice donation. Both sperm banks have been open for because “the owners of the sperm bank thought more than 20 years, but CryoCorp is one of the that that was a good job match, and it really largest in the country while Western Sperm works out well for the students. They’re young Bank is a smaller nonprofit program with roots and therefore healthy. They don’t have to make in the feminist women’s health movement. a huge time commitment. They can visit the Despite institutional differences like tax status, sperm bank anytime.” Nevertheless, the staff at size, and date of establishment, the staff in both banks lament difficulties in recruiting men each program perceive their role to be service and offer hefty “finder fees” to current donors providers to recipient clients. To maintain their who refer successful applicants. businesses, they must recruit “sellable” donors who provide “high-quality” gametes to recip- ients who “shop” different egg agencies and 4 Gamete donation also occurs outside of com- sperm banks. In addition, staff cultivate net- mercial programs. With “known” or “private” dona- works with referring physicians, belong to pro- tion, the recipient recruits a friend, family member, fessional medical associations, set goals for or more recently, a donor from the Internet. Some expanding their businesses, charge a variety of infertility clinics, doctors’ offices, and universities fees for different services, and develop official also run small donor programs. 326—–AMERICAN SOCIOLOGICAL REVIEW

In contrast, Creative Beginnings receives blue-eyed? Are they tall? Are they Jewish? So several hundred applications from women each [I’m] not just looking at the [sperm] counts and the month, and OvaCorp receives more than a [health] history, but also can we sell this donor? hundred each day. The egg agencies adorn And anyone that’s [willing to release identifying their advertisements with images of plump information to offspring at age 18], obviously we will ignore a lot; even if they’re not quite as tall as babies and appeal to the joys of “helping” we’d like, we’ll take them. Or maybe if they’re a infertile couples; some do not even list the little chunky, we’ll still take them, because we amount donors will be paid. Creative know that [their willingness to release identifying Beginnings’s director explains the impetus information] will supersede the other stuff. behind her marketing strategy: “We appeal to the idea that there’s an emotional reward, that Likewise, in explaining the screening process they’re going to feel good about what they’ve for women applying to be donors, Creative done, that it’s a win-win situation, that they’re Beginnings’s office manager says that “this is going to help someone with something that a business, and we’re trying to provide a ser- person needs, and they’re going to get some- vice.” Later that day, her assistant notes that thing they need in return.” Indeed, both agen- recipients “basically go shopping and they cies report that “young moms are the best want this and they want that.” donors [because] they pay the best attention OvaCorp’s donor manager also emphasizes and show up for appointments” because they social characteristics, including educational understand the importance of a child to recip- level and attractiveness, in describing what ient clients. While the sperm bank staff explic- makes a donor “sellable”: itly acknowledge that donors are most You will find that a donor’s selling tool is her interested in a “job,” egg agencies are far more brains and her beauty. That’s a donor’s selling likely to reference altruism, even as they also point, as opposed to she’s a wonderful person. note that donors will get “something” in return. That’s nice. But bottom line, everyone wants either When a potential donor calls or e-mails a someone that’s either very attractive, someone program for the first time, the staff initiate an very healthy, and someone very bright. That’s her extensive screening process by asking appli- selling point/tool. That’s why I also work with cants about their age, height/weight ratio, fam- women who don’t have children, because I get a ily health history (including physical, mental, higher level of academia with a lot of our single donors because they’re not distracted by kids. and genetic disease), and social characteristics. Guidelines for age and height/weight ratios Research on how recipients select donors sug- are issued by ASRM and are stringently fol- gests that staff are responding to client inter- lowed by egg agencies to select donors who est in attractive and intelligent donors whose will respond well to fertility medications. Some phenotypes are similar to their own (Becker screening standards are based on biomedical 2000; Becker et al. 2005).5 Egg agencies and guidelines for genetic material most likely to sperm banks use education as a signifier of result in pregnancy, but many reflect client genetic-based intelligence, but as the donor requests for socially desirable characteristics. manager quoted above suggests, women with- For example, both sperm banks have height out children have more time to pursue addi- minimums of 5Ј8Љ or 5Ј9Љ. tional schooling (Rindfuss, Morgan, and Offutt Even some of the nominally biomedical fac- 1996). tors are better understood as social characteris- During this early phase of recruitment, egg tics, as in this description of screening standards agency staff also assess an applicant’s level of by Western Sperm Bank’s donor manager: responsibility, which is often glossed as “per- We have to not take people that are very over- sonality” or “helpfulness,” as in this quote weight because of a sellable issue. It becomes a from Creative Beginnings: marketing thing, some of the people we don’t accept. Also height becomes a marketing thing. When I’m interviewing somebody to be a donor, of course personality is really important. Are they 5 These studies are limited to heterosexual couples gonna be responsible? But immediately I’m also and do not include systematic comparisons of how clicking in my mind: Are they blond? Are they recipients select egg donors versus sperm donors. SELLING GENES, SELLING GENDER—–327

Assistant Director: Personality is a big thing. We While egg agencies and sperm banks are inter- always want this to be a positive experience, if it ested in responsible women and men who ful- is going to bring them to a different point in their fill their obligations, donors are also expected life instead of just doing it to do it. A lot of them to embody middle-class American femininity don’t care about the money, they just want to help or masculinity. Staff expect egg donors to con- somebody, and that’s all the more reason to con- form to one of two gendered stereotypes: high- tinue with them. ly educated and physically attractive or caring RA: So if donors don’t ever meet the recipient and motherly with children of their own. Sperm though, why would their personality matter tech- nically? donors, on the other hand, are generally expect- Assistant Director: Well, we don’t really look at ed to be tall and college educated with con- the personality for them to meet the recipient. If sistently high sperm counts. they have a good personality, then we can trust In terms of other characteristics, egg agen- them. They really want to go forward with this, cies and sperm banks work to recruit donors they’re more likely to continue with the process by from a variety of racial, ethnic, and religious getting their profile finished in a timely manner, backgrounds to satisfy a diverse recipient pop- get their pictures into us, and all the release forms ulation. In fact, race/ethnicity is genetically that they need. Then it just shows responsibility. reified to the degree that it serves as the basis At the same time, according to Creative for program filing systems. In Creative Beginnings’s director, the staff are respond- Beginnings’s office, there is a cabinet for ing to recipients who “want to know that the “active donor” files. The top two drawers are person donating is a good person. They want labeled “Caucasian,” and the bottom drawer is labeled “Black, Asian, Hispanic.” During a to know that person wasn’t doing it for the tour of CryoCorp, the founder lifted sperm money, that person’s family history is good, that samples out of the storage tank filled with liq- person was reasonably smart, that they weren’t uid nitrogen, explaining that the vials are fly-by-nights, drug abusers, or prostitutes.” capped with white tops for Caucasian donors, Intersecting with gendered expectations about black tops for African American donors, yel- egg donors having, or at least expressing, altru- low tops for Asian donors, and red tops for istic motivations, are class-based concerns in donors with “mixed ancestry.” All four pro- defining “appropriate” donors. grams complain about the difficulty of recruit- Sperm banks, in comparison, expect donors ing African American, Hispanic, and Asian to be financially motivated, and the staff speak donors, and Jewish donors are in demand for directly about responsibility rather than couch- Jewish clients. In one case, even though the ing it in terms of altruistic motivations. Western director thought a particular applicant was too Sperm Bank’s donor manager explains: interested in financial compensation, she was Aside from personality, the other thing that makes accepted into the program because she was me fall in love with a donor is someone that’s Catholic, reflecting an interest in diversifying responsible. It is so rare to get someone that’s truly the donor catalogue. responsible, that comes in when they’re supposed The final phase of recruitment involves to come in, or at least has the courtesy to call us reproductive endocrinologists, psychologists, and say, “I can’t make it this week, but I’ll come and geneticists or genetic counselors, who in next week twice.” Then of course the second serve as professional stamps-of-approval in thing that makes him ideal is that he has consis- producing reproductive material for sale. tently very high [sperm] counts, so I rarely have Applicants are examined by a physician and to toss anything on him [i.e., reject his sperm sam- tested for blood type, Rh factor, drugs, and ple]. And then, I guess the third thing would be sexually transmitted infections. Both egg agen- someone that has a great personality, that’s just adorable, caring, and sweet. There are donors, that cies require a psychological evaluation and their personalities, I think ugh. They have great the Minnesota Multiphasic Personality [sperm] counts, they come in when they’re sup- Inventory, but neither sperm bank requires that posed to, but I just don’t like them. That’s a per- donors be psychologically screened. All four sonal thing, and I think, huh, I don’t want more of programs require donors to prepare a detailed those babies out in the world. family health history for three generations (and 328—–AMERICAN SOCIOLOGICAL REVIEW thus do not accept adoptees); in some programs, employ a range of medical and social standards this history is evaluated by genetic counselors to garner “sellable” donors, and “invest” in or geneticists, who might request specific genet- medical and genetic screening. But comparing ic tests.6 In at least one case, though, a positive how staff evaluate both the donors and their result for cystic fibrosis was not enough to dis- genetic material in terms of marketability qualify an “extraordinary” egg donor. The direc- reveals how gendered stereotypes shape the tor of Creative Beginnings explains: definition of “high quality” eggs and sperm. All the time there are calls coming in about prob- Despite findings in the psychological literature lems or questions. Like today, there is a donor that both egg and sperm donors report a range who’s mixed. She’s got Black and Caucasian, and of altruistic and financial motivations (Schover her cystic fibrosis screening turned out that she’s et al. 1991; Schover et al. 1992), egg agency a carrier. She’s a really pretty girl, and the recipi- advertisements appeal to women’s altruism ent really wants her badly because she’s fair while men are informed of a job opportunity. In skinned, she’s very pretty, and the recipient knows the screening process, both women and men that this donor is extraordinary. But then [the recip- are screened for infectious and genetic diseases, ient’s] torn because her husband’s saying well, do suggesting parallel concerns raised by the we want to introduce something into our gene exchange of bodily tissue, but “girls who just pool? They could go ahead and use her, but the hus- band just has to be tested to see if he’s a carrier. want to lay their eggs for some quick cash” are rejected while men are expected to be interest- Staff at each of the four programs view donor ed in making money. screening as a staged process that requires more These gendered assumptions about donor of a monetary investment at every step. motivations correspond to traditional gendered According to one of OvaCorp’s psychologists, definitions of parenthood (Hays 1996), a link the psychological screening in egg donation is between individual reproductive cells and cul- often performed before the medical tests tural understandings of motherhood and father- because it is cheaper. Similarly, in sperm dona- hood that is made especially clear in the tion, banks confirm that a donor passes one set psychological evaluations, which are required of tests before advancing him because, accord- only of egg donors. Part of each session is devot- ing to a Western Sperm Bank donor screener, “at ed to evaluating the psychological stability of the each step of the game we’re spending more potential donor, but women are also asked how money on them.” CryoCorp’s marketing direc- they feel about “having their genetics out there.” tor takes this rationale a step further: Sperm banks do not require that men consider Once someone goes through our screening process, this question with a mental health profession- it’s in our best interest to continue them in the al, suggesting that women are perceived as more program because we’ve invested a huge amount of closely connected to their eggs than men are to money. We’ve spent thousands and thousands of their sperm. dollars just to screen the donors. So the more vials The vast majority of women and men apply- we can collect from any given donor before they ing to be donors at commercial fertility pro- drop out of the program, the better. Especially if grams are not accepted. Both sperm banks reject that donor’s a popular donor, we want our clients over 90 percent of applicants because of the to be able to have vials from that donor. need for exceptionally high sperm counts, In this, the first stage in the process of donat- required because freezing sperm in liquid nitro- ing genetic material, there are structural simi- gen significantly reduces the number that are larities in that both egg agencies and sperm motile. Both egg agencies estimate that they banks expend funds to advertise for donors, reject over 80 percent of women who apply. In short, donor recruitment is time-intensive, rig- orous, and costly. As staff sift through hundreds of applications, the initial framing of egg dona- 6 There is less screening of recipients. Creative Beginnings asks for recipients’ health histories and tion as an altruistic win-win situation and sperm doctors’ names to confirm that they actually do donation as an easy job shapes subsequent “need” egg donation. OvaCorp and both sperm banks staff/donor interactions, from constructing indi- require certification that recipients are working with vidualized donor profiles to the actual produc- a doctor. tion of genetic material for sale. SELLING GENES, SELLING GENDER—–329

CONSTRUCTING DONOR PROFILES to recruit recipient clients. The director of Creative Beginnings explains that she would Once applicants pass the initial screening with prefer not to have profiles on the Web site program staff, they are invited to fill out a because she thinks they are impersonal, but “donor profile.” These are lengthy documents that she needs them to be “competitive” with with questions about the donor’s physical char- other programs. For donors, the profiles are acteristics, family health history, educational the primary basis upon which they will be attainment (in some cases, standardized test selected by a recipient. Typically, recipients scores, GPA, and IQ scores are requested), as also consult with staff about which donors to well as open-ended questions about hobbies, choose; in rare cases, egg recipients will ask to likes and dislikes, and motivations for donating. meet a donor, but under no circumstances are Once approved by staff, egg donor profiles, sperm recipients allowed to meet donors. If a along with current pictures, are listed on the donor’s profile is not appealing, recipients are agency’s password-protected Web site under the not likely to express interest in purchasing that woman’s first name. The donor then waits to be donor’s reproductive material. selected by a recipient before undergoing med- This explains why programs spend a great ical, psychological, and genetic screening. In deal of energy encouraging applicants to com- contrast, sperm banks do not post profiles until plete the questionnaires, and, in the case of egg donors pass the medical screening and produce donation, to include attractive pictures. During enough samples to be listed for sale on the an information meeting for women interested in bank’s publicly accessible Web site. Western egg donation, Creative Beginnings’s staff offer Sperm Bank’s donor manager explains: explicit advice about how donors should appeal From the moment the donor is signed on, it’s real- to recipients: ly nine months before we even see any profit from them. They have six months worth of quarantine Assistant Director: The profile really gives recip- [for HIV], and then another three months before ients a chance to get to know you on another level, we can really release enough inventory so that even though it’s anonymous. It feels like it’s per- people aren’t upset at us. If we release five vials, sonal. It feels like they’re making a connection with and 20 women call, only two women are gonna be you. They want to feel like it’s less clinical than just happy. The others are gonna be really upset that looking it up on the Web site, and they want to see that’s all we got on him this month. which girl best suits their needs. It’s about who looks like they could fit into my family, and who Sperm banks are much more concerned about has the characteristics that I would like in my off- donor anonymity, so men’s profiles are assigned spring? You can never be too conceited or too an identification number and do not include proud of your accomplishments because they real- current photographs.7 Both banks do offer a ly like to feel like wow, this is a really special and “photo-matching service,” in which recipients unique person. And they want to feel like they’re helping you just like you’re helping them. They pay staff to select donors with specified phe- know that money is a good motivator, but they also notypes. want to feel like you’re here for some altruistic pur- Profiles serve as the primary marketing tool poses. So I always say to let your personality show, for both the program and the donor. For dona- but also you can kind of look at the question and tion programs, posted profiles represent the think, if I were in their position, how would I want full range of donors available and thus are used somebody to answer that question? I don’t want you to be somebody that you’re not, but think of being sensitive to their needs and feelings when you’re answering them. That’s the big portion of 7 Throughout its long history, artificial insemina- it. The pictures is another portion. We always ask tion has been marked by extensive secrecy (Daniels for one good head and shoulder shot. It’s whatev- and Golden 2004). In contrast, according to an er is your best representation, flattering, and lets OvaCorp psychologist, egg agencies, especially those you come out. in the western United States, are built on the pre-exist- Donor Assistant: You don’t want something ing model of surrogacy programs, which are less where your boobs are hanging out of your top concerned about anonymity than are sperm banks. [laughter]. These people are not looking for sexy More historical research is needed on sperm and egg people. donor programs and the extent to which develop- Assistant Director: We get girls who send in pic- ments in one influenced the other. tures from their homecoming dance, but everybody 330—–AMERICAN SOCIOLOGICAL REVIEW

takes those pictures where they’re half-wasted and While egg agencies specifically use the terms they’ve got their drink in one hand and their cig- “help” and “altruism” in advising donors about arette in another. Recipients don’t need to see it. profiles, the sperm donor manager does not It’s like your parents, ignorance is bliss. specify what other motivation the donor is Egg donors are encouraged by agency staff to expected to have besides financial compensa- construct properly feminine profiles for the tion. He is only supposed to revise the profile recipients, who are continually referenced as an with the “also” in mind. These gendered coach- oblique “they” who will be reading the donors’ ing strategies result in statistically significant answers and making judgments about their moti- differences in the number of women and men who report altruistic and financial motivations vations. Although it is important for the “girls” in response to the profile question “Why do to let their “personalities” shine through, the you want to be a donor?” (Almeling 2006).8 recipients do not necessarily need to know about Both egg agencies and sperm banks believe their flaws, like wearing revealing clothing, that donor profiles offer recipient clients “reas- drinking, or smoking. surance” in the form of extensive information If a donor’s profile is deemed unacceptable about the donor. The director of Creative by staff, or if she sends in unattractive pictures, Beginnings explains that infertility “is emo- agencies will “delete” her from the database. tionally devastating, and [recipients] feel like Creative Beginnings’s office manager explains, they have no control. So those first appoint- “We have to provide what our client wants, and ments, sometimes people are really excited that’s a specific type of donor. Even though about the profiles because they want to see [the recipients] may not be the most beautiful what the people are like that we are going to be people on the face of the earth, they want the supplying to them. They’re really happy when best. So that’s what we have to provide to them.” they see the quality of the donor and the amount In contrast, sperm recipients are not allowed to of information they get.” Similarly, the donor see photographs of donors, and thus men’s phys- screener at Western Sperm Bank notes that “it’s ical appearance is not held to the same high hard on the recipient end to be taking this leap standard as is women’s. of faith, buying reproductive fluid from unseen, Sperm bank staff will take extra time with unknown strangers, so I understand the desire donors who discuss only financial motivations to know as much as you possibly can. So we try in their profiles, but they are much less explic- and glean stories about [the donors], and then it about the need to appear altruistic. This it’s just nice reassurance for the recipients, that dynamic is clear as Western Sperm Bank’s donor these are real people.” In the same breath, staff manager explains how she came to understand draw on both economic and social understand- the importance of profiles: ings to describe donors as “real people” who are “supplied” to recipients. [Prior to this job,] when I worked on the infertil- Egg agencies and sperm banks use donor ity side, women would come in with their little profiles to recruit clients, and recipients who donor vials. Some of them would show me the select particular women and men based on [donor profile and say] doesn’t he sound wonder- details about eye color, family health history, ful? And of course this is all they’ve got. This is their person, this little sheet. So [the bank’s screen- ers] will look at [the profile] and if someone’s sort of negative, to really question the donor. Do 8 Preliminary data collection at a university-based you really mean that money is the only thing for infertility clinic in the southern United States, which you? And if it is, we are honest enough to just leave offers both egg and sperm donation, suggests that it that way. But a lot of times [donors will] say, well, these differences do not simply result from gamete it’s not just the money, it’s also. [So the screeners donation occurring in sex-specific firms. A nurse will say] why don’t you rewrite this little portion responsible for screening donors uses the same pre- to reflect that also? The new [screeners] became liminary questionnaire for both women and men, more conscious and willing to put in the effort to but most egg donor sheets include a scribbled note make more complete answers because they did about why the woman wants to donate (e.g., “why— care about what was presented to the recipients, to wants to help” or “why—loves kids”). None of the give them a fuller image of what the person was sperm donor forms include these notations about like. motivations. SELLING GENES, SELLING GENDER—–331 favorite movie, and SAT scores begin to think recipient who is in the process of choosing a of the donor as that profile. But donors are not donor: producing unmediated texts that travel from Executive Director: We have a donor that I’d like keyboard to Web site display. Gendered cultur- you to look at .|.|. She just donated in the last cou- al norms, formalized through organizational ple of days, 27 eggs, and she had 23 beautiful processes, result in expectations that women embryos, and her name is Meredith .|.|. She is reflect altruistic sentiments beneath an attrac- beautiful and bright and tall, and she has a degree tive photograph, while sperm donors are vague- in fine arts I think, and she’s a student, a real good ly encouraged to provide a “fuller image.” While student .|.|. Photography school .|.|. It’s a good the recipient is actually buying eggs or sperm, place for us to get donors [laughs]. All that equip- this genetic material becomes personified ment and film costs a lot of money .|.|. She’s a real- through the donor profile, and it is this gendered, ly bright, classy lady .|.|. Take a look at Meredith, commodified personification of the donor that she’s a great opportunity .|.|. And I think Heidi would be a great choice .|.|. I love ’em all! .|.|. And the recipient is purchasing. check out Heidi too because she’s still an option for you, but not much longer. People are going to MATCHMAKING AND FEES go after her soon. Somebody’s going to grab Meredith too because she just finished a cycle .|.|. Donor profiles are used to attract recipient No, it would be like six weeks before she could do clients to a particular program, and a match is one .|.|. But Heidi is ready to go .|.|. Go look .|.|. made when a recipient chooses a specific donor. Okay, bye, you’re welcome.10 In egg agencies, a recipient chooses a particu- lar egg donor, who then is medically and psy- Both the donor and her embryos are labeled chologically screened before signing a legal “beautiful,” and she is “bright” and “a really contract with “her couple.” In sperm banks, good student,” which provides an innocuous there is a limited “inventory” of sperm vials explanation for why she needs money from egg from each donor, and this supply is replenished donation. Positive descriptions such as these as men continue to donate throughout their help agencies create a sense of urgency about year-long commitment to the bank. The vials are the donor being “grabbed” by some other recip- listed in the bank’s “catalogue,” so a recipient ient if the caller does not act quickly. This strat- who calls to place an order is advised to choose egy is helpful in confirming a match, because two or three different donors to ensure that at as OvaCorp’s donor manager explains, “99.9 least one will be available for purchase. percent of the time [recipients] will go with [a Matches are the primary source of income for donor], especially if they know someone else is agencies and banks, and the staff work hard to waiting.” confirm them. Recipients are urged to browse Egg agencies find some donors easier to donor profiles, but staff also take the time to dis- match than others. The most sought-after are cuss various donors’attributes, thereby shaping “repeat donors,” who have proven their relia- recipients’perceptions.9 This intermediary role bility by completing at least one donation cycle, is made clear in the following excerpt, which is or “proven donors,” whose eggs have resulted one side of a telephone conversation between in pregnancy for a previous recipient, thus pro- Creative Beginnings’s executive director and a viding evidence of fertility. All sperm donors are screened for exceptionally high sperm counts, so sperm banks do not label their donors as 9 While recipients receive extensive information “proven.” In fact, neither sperm bank had ever from donor profiles and staff, this flow of informa- considered dropping a donor whose sperm had tion does not go both ways. Sperm donors are not not resulted in any pregnancies. Some donors given any information about who purchases their are also labeled “popular” because their profiles sperm, Creative Beginnings’s donors are given vague, generate almost daily calls from potential recip- nonidentifying information (e.g., the recipients are ients visiting the Web site. OvaCorp’s donor “schoolteachers in their forties who have been try- manager, leafing through a profile she had just ing for a long time to have children”), and OvaCorp donors are given a short letter called a “bio” written by the recipients to the donor explaining why they are using egg donation. 10 All names have been changed. 332—–AMERICAN SOCIOLOGICAL REVIEW received, says “I can tell when I can match a girl For each visit to the bank in which they pro- quick”: duce a sample deemed acceptable based on Well number one, she’s attractive. Number two, she sperm count and quality, men are paid $75 at has a child, which is a huge plus. I mean look CryoCorp and $50 at Western Sperm Bank (the [shows RA picture and profile]. And the kindest latter is a nonprofit that charges less for sperm). woman. She has a really good background. See, Sperm samples that do not pass the banks’ definitely it’s not for the money. She makes 65 requirements are discarded, and the donor grand a year. Great height and weight. Obviously receives no compensation. Acceptable samples Hispanic, and I start reading a little bit about her, are usually split into several vials, which are and she has phenomenal answers about why she cryogenically stored at the bank until purchased wants to do this. She’s given the couple total lead- by a recipient. One of the sperm banks charges ership, and that’s wonderful. She can travel because a minimal fee to register clients with the bank she’s in Texas. So she’d be an easy match. Young, ($50), but sperm vials all cost the same amount 26, young child. There’s definitely proven fertili- of money: $215 at CryoCorp and $175 at Ј Љ ty. 5 7 , 110 [pounds]. She’s Caucasian enough, Western Sperm Bank.11 she’s white enough to pass, but she has a nice CryoCorp, one of the largest sperm banks in good hue to her if you have a Hispanic couple. Educated, good family health history. Very out- the country, lists 125 donors on its Web site going. Easy match. Easy match. and distributes approximately 2,500 vials every month. Western Sperm Bank lists 30 donors This stream-of-consciousness perusal of a donor and serves just 400 recipients each year. Creative profile reveals the intersection of sex and gen- Beginnings lists more than 100 egg donors on der with race and class in defining popular its Web site catalogue and had 23 active donors. The donor’s own child attests to her donor/recipient matches in the summer of 2002. body’s ability to create pregnancy-producing OvaCorp, one of the largest egg agencies in the eggs. Her relatively high salary and eloquence country, catalogues nearly 500 donors and had on the page demonstrate her altruism. And her more than 100 active matches that summer. “hue” makes her phenotypically flexible to Both egg agencies charge recipient clients an match either Caucasian or Hispanic recipients. agency fee of $3,500 in addition to the donor’s If a donor is not currently available, as is the fee and her medical and legal expenses.12 case with many of the most popular donors, In direct contrast to the set amount paid to then an egg recipient can “reserve” her for a sperm donors, the final stage of confirming an future cycle. If a sperm donor’s vials are “sold egg donation match is negotiating the donor’s out” for that month, recipients can be placed on fee. First-time donors are paid the least, around a waiting list. Sperm recipients also have the $4,000, and with each additional cycle, espe- option of creating a “storage account,” in which cially if it results in a pregnancy, the fee will they buy multiple vials of a particular donor’s increase. In the process of confirming a match sperm to guarantee its availability if they do not over the phone, Creative Beginnings’s office become pregnant during initial inseminations. manager explains to the recipient how the “mar- In explaining this system, CryoCorp’s market- ket” determines donor fees while also commu- ing director blurs the line between the donor and nicating that the donor would “love to work with you”: the donor’s sperm when she discusses the bank’s “inventory”: Office Manager: We got your message yesterday We do limit the number of vials available on any about Denise, and I spoke with her this morning given donor by limiting the amount of time a donor .|.|. Denise said that she’d love to work with you, can be in the program. All of our specimens are available on a first-come, first-serve basis. We are dealing with human beings here, and the donors have finals and they don’t come in, and they go 11 Sperm banks do charge more for vials of away for the summer. So our inventory is some- “washed” sperm, a procedure required for intrauter- what variable. So we suggest [recipients] open a ine insemination but that is not associated with a storage account, which just costs a little bit addi- donor’s characteristics. tionally, and then purchase as many vials as they 12 To maintain comparability between the four want. agencies, all figures are for 2002. SELLING GENES, SELLING GENDER—–333

love to be your donor. We’re going to get her start- a “sure bet” because her eggs consistently result ed on the preliminary stuff as far as the genetic in recipient pregnancies: evaluation, the psychological, and probably even having her first doctor’s visit .|.|. You have our Donor Manager: We’re going with Helen. I told her she was getting 10 [thousand dollars]. contract? .|.|. I just wanted to confirm her fee with Donor Assistant: [The recipient] said I don’t you .|.|. It’s $5,000 .|.|. It’s actually how it starts out care what she’s asking for, he says I want a baby. for donors in Los Angeles .|.|. It’s actually not on Director: I always felt that we would give her the high end .|.|. I do understand what you’re say- maybe 12, she’s done it so many times. ing. It’s just that the way we’ve done it with all of Donor Manager: Well, why don’t we give her our donors is we go off what the market is telling 12 on confirmation of pregnancy? us to do, and usually donors in the Los Angeles Director:Yeah, something like that. Just because area start off at $5,000. It’s usually donors in she’s gone so many times. Ventura County or north that start at a lower fee. Donor Manager: She’s made a whole bunch of If the donor goes through an additional cycle, then money. we increase the fee. So if Denise had donated Director: And the [recipients] can afford it. before, her fee could be $6,000. Donor Manager: So why don’t we do it as a gift? At OvaCorp, highly educated donors command Director: Yeah. We’ll do 10, and then 2,000 on confirmation of pregnancy, or first trimester, or higher fees, and due to the difficulty in main- whatever you want to do. You know there’s going taining a diverse pool of donors, both egg agen- to be a pregnancy. cies often increase the fee for donors of color. In negotiating with clients, staff continue In this stage of the process, a donor’s attrib- their intermediary role by trying to determine utes, encapsulated in the profile and extolled by what recipients can afford while also securing staff, are used to generate income for the pro- the highest possible fee for donors, in part to cul- grams through matches, but the economic val- tivate donor loyalty in a metropolitan area with uation of women’s eggs is more intimate than several other egg agencies. If recipients are per- that of men’s sperm. Women are paid to produce ceived as wealthy, the staff will often ask for a eggs for a particular recipient who has agreed higher donor fee, as when an assistant men- to a specific price for that donor’s reproductive material. At the same time, staff tell recipients tions that “gay men, single men have a lot of the “donor would love to work with you,” while money, and they think nothing of seven, eight they inform donors that the recipients just “loved thousand dollars.” However, staff do not appre- you and had to have you.” Thus, egg agencies ciate “girls that really ask you to negotiate” a structure the exchange not only as a legalistic higher fee. Creative Beginnings’s director economic transaction, but also the beginning of expresses “disappointment” in these women, a caring gift cycle, which the staff foster by saying, “I really don’t like that. It’s really uncom- expressing appreciation to the donors, both on fortable, and couples don’t like it.” behalf of the agency and the agency’s clients. If recipients experience a “failed cycle” with OvaCorp’s donor manager explains, “We an egg agency’s donor, the staff might offer a have the largest donor database. The reason is discounted rate on the second cycle. In some we treat them like royalty. They are women, cases, the staff will even explain the situation to not genetics to us. A lot of times a couple does- donors and ask them to accept a lower fee. n’t meet them, so we want them to feel our Neither sperm bank reports offering discounts, warmth, feel the reality that we’re so grateful for but in an effort to help recipients afford sperm what they’re doing for us, as well as because donation, one of the banks uses a payment plan they’re making our couple happy.” Likewise, called “CareCredit,” a name that perfectly CryoCorp’s marketing director notes, “We have encapsulates the blurring of emotional and eco- to walk that tightrope and make sure the donors nomic spheres in medicalized markets. are happy, because if we don’t have happy Staff within particular agencies also consult donors, then we don’t have a program, and yet with one another about appropriate fees for dif- make sure the clients are happy as well [laughs], ferent donors. During a weekly staff meeting, the so we’re always mindful of that.” But in the donor manager and the director of OvaCorp sperm banks, a “happy donor,” whose repro- discuss a match between a wealthy recipient ductive material is purchased by many different and a woman they call “an ace in the hole” and recipients months after he has produced it, is not 334—–AMERICAN SOCIOLOGICAL REVIEW predicated on being placed in the position of with the bank indefinitely. If an egg donor per- “loving” and “being loved by” extremely grate- forms well in her first cycle, then agencies hope ful “future parents.” to match her with future recipients. However, OvaCorp’s donor manager is careful not to ask PRODUCING GENETIC MATERIAL: JOB OR a woman too early about another cycle. She explains, “If it’s a first-timer, I won’t ask her to GIFT? do it again until she’s cleared the cycle because Programs screen applicants for “responsibility,” I don’t want her to think I’m being insistent and staff must carefully monitor donors as they upon a mass-producer. I’ll say, there’s another fulfill contractual obligations to produce genet- couple that would love to work with you. ic material. Egg agency staff are always on the However, let’s just concentrate on this one cou- phone with donors and doctors to find out when ple that we’re talking about.” women begin menstruating, start fertility shots, But women who attempt to make a “career” miss doctors’ appointments, and schedule egg of selling eggs provoke disgust among staff, in retrievals. Creative Beginnings’s director part because they violate the altruistic framing explains, “Most of the donors are very consci- of donation. Egg agencies generally follow entious, and especially our donors, because we ASRM guidelines limiting women to five look for girls that are going to be compliant cycles, recommendations designed to minimize and do things right.” To maintain “inventory,” health risks. However, it is not concern for the sperm bank staff are continually assessing which woman’s health that the OvaCorp donor man- donors miss appointments, need blood drawn for ager expresses in this denunciation of one such periodic disease testing, or register unusually egg donor: “She’s done this as a professional. low sperm counts. According to a donor screen- It’s like a career now. I said, there’s something er, Western Sperm Bank must be vigilant about that girl. Then I called [the director of because donors “are creating a product that another egg agency], and she’s like ‘oh yeah, we’re vouching for in terms of quality control.” why’s she calling you? I won’t work with her In each of the four programs, staff identify the anymore, she worked with me eight times.’I said donor’s responsibilities as being like those in a eight times?! She’s got four kids. She’s on the job, but in the case of egg donation, it is under- county. Yeah, I remember that name.” stood to be much more meaningful than any reg- Sperm banks also limit the number of vials ular job. At the information meeting for potential from each donor. The focus, however, is not on egg donors, Creative Beginnings’s director the donor so much as efficiently running a busi- explains, “You get paid really well, and so you ness without offending the sensibilities of the have to do all the things you do for a normal job. bank’s clients. CryoCorp’s CEO explains: You have to show up at the right time and place There’s an ongoing debate of how many vials and do what’s expected of you.” Her assistant should you collect from any one donor. If you adds, “If you really simplify the math, it’s $4,000 have 10 donors and collect 10,000 vials from all for six weeks of work, and it’s maybe a couple of them, and you have to replace one [donor hours a day, if that. And to know that you’re because of genetic or medical issues], it’s taken a doing something positive and amazing in some- hit to your business. If you wind up with 10,000 donors and only collect 10 vials from every sin- body’s life and then getting compensated for it, gle one, you’re inefficiently operating your busi- you can’t ask for anything better than that.” ness. You need to figure out what that sweet spot Agency staff simultaneously tell potential is. But then there’s the emotional issue from a pur- donors to think of donation “like a job” while chaser. If a client knows that with x thousand vials also embedding the women’s responsibility in out there that there could be 100 or 200 offspring, the “amazing” task of helping others. what’s that point where it just becomes emotion- Contact between staff and donors does not ally too many? With my MBA hat on, we are not necessarily end on the day of the egg retrieval collecting enough vials per donor because we’re or when sperm donors provide their last sample. not operating as efficiently as we should. With my customer relations consumer hat on, we’re col- Sperm donors must return to the bank for HIV lecting the right number of vials because clients testing six months after they stop donating, and perceive that it’s important to keep that number to men who agree to release identifying informa- something emotionally tolerable. At what point tion to offspring must update their addresses do you say that’s just not someone I want to be the SELLING GENES, SELLING GENDER—–335

so-called father of my child because there’s just pensation. She’s like, “Okay, I’ll give her $15,000, way too many possible brothers and sisters out seven-five per girl.” She had twins. there? Here, the monetary value of the recipient’s gift Given the extensive investment required to to the donor is explicitly tied to the number of screen gamete donors, one would expect pro- children she had as a result of the donor’s eggs, grams to gather as much reproductive material making the line between gift and sale indistin- as possible from each donor. Instead, women are guishable. discouraged from becoming “professional” egg In egg donation, the earlier stage of fee nego- donors and men are prevented from “father- tiation gives way to an understanding that donors ing” too many offspring. In keeping with the focus on altruism in egg are providing a gift, to which recipients are donation, both OvaCorp and Creative expected to respond with a thank-you note, and Beginnings’s staff encourage recipients to send many choose to give the donor a gift of their the donor a thank-you note after the egg own. In sperm donation, men are far more like- retrieval. This behavior is not present in the ly to be perceived as employees, clocking in at sperm banks. In many cases, egg recipients also the sperm bank at least once a week to produce give the donor flowers, jewelry, or an addition- a “high-quality” sample. Indeed, this framing of al financial gift, thereby upholding the con- donation as job leads some men to be so structed vision of egg donation as reciprocal removed from what they are donating that when gift-giving, in which donors help recipients and a new employee at Western Sperm Bank excit- recipients help donors. Creative Beginnings’s edly told a donor that a recipient had become director explains that if recipients ask her “about pregnant with his samples, she said it was like getting flowers for the donors, I ask them not to “somebody hit him with this huge ball in the do that because flowers get in the way. The middle of his head. He just went blank, and he donor’s sleeping, and she’s not thinking about was shocked.” During his next visit, the donor flowers. If you want to get a gift, get a simple explained, “I hadn’t really thought about the piece of jewelry because then the donor has fact there were gonna be pregnancies.” The something forever that she did something real- ly nice.” This rhetoric even extends to account- donor manager describes this state of mind as ing practices; while three of the programs “not uncommon.” inform donors that they will be sent a 1099 tax As Rayna Rapp (2000:xiv) notes, form, which is designed for independent con- “Contemporary biomedical rationality .|.|. [is] tractors providing a service, one of the egg operating to reproduce older forms of gender, agencies considers the donor’s fee a nontaxable ethnoracial, class, and national stratification “gift” from the recipient. even (or perhaps especially) on its technologi- The most extreme case I heard of postcycle cally ‘revolutionary’edges.” Indeed, these gen- giving was reported by OvaCorp’s donor man- dered portrayals of selfless motherhood and ager: distant fatherhood fit a very traditional pattern, Donor Manager: I paid a donor $25,000. That’s and this sperm donor’s reaction exposes the only because it was $10,000 for the donor’s fee, and reflexive application of gendered norms in the then when their kids were born, they gave her an medical market in genetic material. While most additional gift of $15,000. egg donors will never meet their genetic chil- RA: Are you serious? dren, women are expected to reproduce well- Donor Manager: Oh yeah. That was a gift to her. They said, what do we do? Well, you bought me worn patterns of “naturally” caring, helpful and [the donor] a pair of $3,000 earrings. They’re femininity, guiltily hiding any interest they a very wealthy couple. I love them. She had [the might have in the promise of thousands of dol- earrings] made by somebody in Italy. Mine had lars. This same emotional labor is not required rubies at the end of them, the donor’s had emer- of sperm donors. Men, who are more likely to alds, and the couple’s, hers had sapphires. So when be contacted through the banks’identity release her girls were born, she says maybe I’ll get her some more earrings. I said the likelihood of her programs, often do not even consider that chil- wearing those earrings is very slim [because] she’s dren will result from regular deposits at the really low-key. I said, give her a financial com- sperm bank. 336—–AMERICAN SOCIOLOGICAL REVIEW

DISCUSSION a specific recipient client, as eggs cannot yet be frozen like sperm. Men must build enough Casual observers of the market in genetic mate- “inventory” for their profiles to be posted to the rial point to biological differences between Web site, and their vials are available on a first- women and men and consider them explanation come, first-serve basis. Stored by the hundreds enough for the greater economic and cultural in large tanks, men’s donations resemble a stan- valuation of egg donors. Indeed, individual dardized product more so than the eggs that are women have fewer eggs than individual men removed from an individual woman and placed have sperm, and egg retrieval requires surgery into “her” recipient a few days later. This is while sperm retrieval requires masturbation, a comparison made by many program staff in this probably partly responsible for the different study. But shifting the lens from individual bod- approaches to compensation, in which men are ies to the market in genetic material reveals an paid a standard rate only for those samples oversupply of women willing to be egg donors. deemed acceptable. While most egg donors Both the year-long commitment and stringent receive the market rate, it is common for a requirements make men difficult to recruit, woman’s characteristics (such as prior dona- while hundreds of women’s profiles languish on tions, race, and education level) to increase her agency Web sites, far outstripping recipient fee. The personalistic one-to-one relationship demand. Despite this abundance, egg donor between altruistic egg donor and grateful egg fees hold steady and are often calibrated by recipient is codified into an actual gift exchange staff perceptions of a woman’s characteristics when staff encourage recipients to write a thank- and a recipient’s wealth. Moreover, these high you letter or provide a small token of appreci- levels of compensation coexist seamlessly with ation. Bank staff do not request similar displays altruistic rhetoric because agency staff draw on of gratitude to sperm donors. cultural norms of motherhood to construct egg Neither the biological differences between donation as a gift exchange. women and men nor the economic law of sup- It is not that altruistic rhetoric is completely ply and demand fully explain the medical mar- absent in sperm banks, or that men cannot make ket in genetic material. Reproductive cells and a couple of thousand dollars a year providing reproductive bodies are filtered through eco- weekly samples, but the dynamic interplay nomic and cultural lenses in a particular struc- between biological, economic, cultural, and tural context, that of medicalized egg agencies structural factors differentiates the market in and sperm banks. It is not just that individual eggs from that in sperm in each stage of the women have fewer eggs than individual men donation process. In recruiting marketable have sperm, or that eggs are more difficult to donors, both egg agencies and sperm banks extract, that results in both high prices and con- place advertisements listing biological require- stant gift-talk in egg donation, but the close ments (e.g., age), but egg agencies emphasize connection between women’s reproductive bod- the ability to help while sperm banks portray ies and cultural norms of caring motherhood. In donation as a job, an early distinction shaped by contrast, men are much more difficult to recruit, gendered stereotypes of parenthood that is main- but are paid low, standardized prices because tained throughout. The greater cultural accept- sperm donation is seen as more job than gift. As ance of egg donation probably results in more a result, both eggs and egg donors are more women applicants than men, and staff screen highly valued than sperm and sperm donors in women based on biological factors like medical this medical marketplace, where it is not just history, but also under review are a woman’s reproductive material, but visions of middle- physical appearance and stated motivations. class, American femininity and masculinity, Men’s health history is similarly scrutinized, and more to the point, motherhood and father- and those willing to release identifying infor- hood, that is marketed and purchased. mation to offspring, arguably an altruistic ges- ture, are preferred, but responsibility, height, CONCLUSION and sperm count ultimately define the ideal donor. Zelizer’s tripartite model, discussed earlier in Once accepted into a donation program, a this article, effectively challenges two long- woman’s profile will be used to match her with standing claims about the market. By empiri- SELLING GENES, SELLING GENDER—–337 cally demonstrating how the interaction of eco- on a different set of gendered stereotypes about nomic, cultural, and structural factors shapes caring motherhood and distant fatherhood. particular markets, she undermines claims that But it is not only sex and gender that influ- money and intimacy are fundamentally incom- ence the valuation of eggs and sperm. Egg agen- patible or that economic exchanges are reducible cies and sperm banks have difficulty recruiting to nothing but culture or nothing but structure. diverse donors, so an African American woman She concludes, “The cases of life insurance and might be paid a few thousand dollars more, the pricing of children show that the process of while sperm banks might relax height restric- rationalization and commodification of the tions to accommodate a Mexican man. This world has its limits, as the market is transformed paradoxical finding, that women of color are by social, moral, and sacred values” (1988:631). often compensated at higher levels for their As would be expected from Zelizer’s research, reproductive material than are white women, there is no separation between economic and directly contradicts intersectionality theory, cultural spheres in which the economic valua- which contends that race, gender, and class tion of genetic material trumps the cultural combine to increase women’s disadvantage (e.g., framing of altruistic donation. But it is not until Hill Collins 2000; Roberts 1997). In this mar- biological factors are included in the model, ket, race and ethnicity are biologized, as in ref- making possible a comparison of how different erences to Asian eggs or Jewish sperm, and it kinds of bodies are valued, that it becomes clear is one of the primary sorting mechanisms in how these social processes of commodification donor catalogs, along with hair and eye color. vary based on whether the reproductive cells This routinized reinscription of race at the genet- come from a woman or a man. ic and cellular level in donation programs, which Feminists have historically avoided biologi- as medicalized organizations offer a veneer of scientific credibility to such claims, is worri- cal explanations, which is understandable given some given our eugenic history (Duster 2003). the regularity with which sex differences are ref- This analysis of the medical market in genet- erenced to deflect criticism of social inequali- ic material demonstrates how essential it is for ties. But decades of research on women’s sociologists to attend to biological factors while disadvantage do not lead one to expect a mar- simultaneously resisting essentialized biologi- ket in which women are paid more than men, cal explanations. While reproductive cells and and where having a child can actually make a bodies are the salient biological factors in this woman a more desirable candidate. These unex- market, sociologists working in other contexts pected findings are explained, however, once the are likely to encounter other biological factors. body is taken into account, both in its materi- For example, in blood donation, it may not be ality, including differentiated reproductive sex and gender per se, but biologized assump- organs, and in the meanings associated with tions about sexuality that shape who is allowed this differentiated materiality, such as econom- to give, as when the Food and Drug ic interpretations (e.g., eggs as scarce resource) Administration does not allow “men-who-have- and cultural readings (e.g., women as nurturing). sex-with-men” to donate because of assump- Thus, as Butler (1993) theorizes, the body tions about HIV risk. Incorporating biological does matter, but biology does not provide a set factors into sociological analyses can also mean of static facts to be incorporated into sociolog- measuring the physical effects of gendered ical analyses because biological factors alone do inequalities. For example, while Hochschild not predict any particular outcome. Indeed, discusses the biological basis of emotion, she empirical investigations into the meaning and does not focus on the biological consequences interpretation of reproductive cells and bodies of different kinds of emotional labor. She con- reveal considerable variation in different social cludes that women flight attendants experience contexts. For example, whereas Martin (1991) more cognitive dissonance than do men debt col- finds that metaphors in medical textbooks priv- lectors, but the long-term biological effects of ilege male bodies, in this medical market, some manufactured smiling may actually be less of these same “biological facts” result in high- severe than those of manufactured anger, which er monetary compensation and more cultural has clear cardiovascular implications (Rose and validation for women—validation that is based Lewis 2005). 338—–AMERICAN SOCIOLOGICAL REVIEW

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