The first time I witnessed someone using a “keyless” car, I was astonished. They could simply walk up to their car, open the door, press a button, and the car would start. When I tried to recreate this magic for myself, I quickly realized that I couldn’t even get into the car, let alone take it for a joyride. I was so amazed by this new technology that I didn’t stop to realize that it only worked for the person who had the key, even if said key was nowhere in sight.
When it comes to medical innovations, the confusion that I experienced around the keyless car is a sentiment commonly felt by much of the technology’s target population. So much effort is put into the research and design process that by the time we get to the implementation phase the idea has been stripped and rebuilt so many times that we forget to ensure that it can be used by the very people we claimed to be designing it for.
While this is common in almost every arena, my current focus is on the newly developed technique of in vitro gametogenesis (IVG). The basic idea of IVG is to recreate the process of gametogenesis outside of the human body. Normally the body creates either specialized egg or sperm cells, and during reproduction, the sperm fertilizes the egg that will eventually become the embryo. This technology is still in the research and design phase, but that is precisely why it’s so important to have this conversation now. IVG is currently being discussed as a revolutionary possibility for cisgender same-sex couples[1], but I worry that in reality, it may never serve this target audience in the way that it is currently projected to.
Navigating fertility as a queer person often involves a series of hoops to jump through, and unfortunately, this issue can be exacerbated by the very innovations that we thought would help. Imagine that someone buys you a new car (IVG technology), but they never give you the key (a straightforward path to said technology that doesn’t involve peeling back layers upon layers of bureaucratic red tape). There is no point in having a car without the key, so you call the dealership (insurance company) and explain your situation. They tell you that you are in luck because they help people with key replacements all the time. The only caveat is that they require you to confirm loss of the key (infertility) by searching for it (trying to conceive naturally) for a period of time before they will be able to help you. You explain that you never had the key in the first place (could not physiologically conceive a child naturally), but they insist that this is simply their policy for new vehicles (innovative technologies).
From an ethical standpoint, is it enough to develop the new technology and stop there? Is it enough to innovate with hopes of helping specific communities if we never make sure that said innovations get to them? My stance is simple: No. Innovation is an important step, but it isn’t the final one. Just because we build it does not mean that the people who need it most will be able to use it. It is our moral responsibility to do everything in our power to alleviate the barriers to our technology, not to stack them higher. I’m hopeful that IVG will be what breaks the current pattern and that it will one day deliver on its promises to the queer community.
In short, if you give someone a car, make sure you give them the key too.
[1] Spar, D. L. (2020, August 12). The Poly-Parent Households Are Coming. Retrieved September 12, 2020, from https://www.nytimes.com/2020/08/12/opinion/ivg-reproductive-technology.html