Matilda Lindgren: Caring for conception: The ontological politics of gamete donation practices in Sweden

Abstract

This thesis examines reproductive decision-making in practices of egg and gamete donation. Adopting a multi-sited ethnographic approach and drawing on Annemarie Mol’s empirical philosophy, the thesis analyses policy documents, focus group discussions with fertility practitioners, and individual interviews with donors and recipients. 

A focus of the thesis is to show how politics emerge from the various enactments of kinship and medical categories as deployed in practices of reproductive donation. Departing from a relational ontology as suggested in Science and Technology Studies (STS), the thesis argues that the categories of children/parents, donors/recipients, and patients/providers are not given but need to be actively negotiated in legal texts, clinical practice, and patient narratives. By focusing on reproductive practices for single women, queer and lesbian couples in a Swedish context, the study explores how a practice-oriented reading of ontology enables a ‘queering’ of egg donation practices.

Focusing on policy, the analysis shows that children’s right to donor information from the ‘special medical record’ is based on a temporal paradox and premised by a symbolic rather than material understanding of genetic relatedness, thereby failing to account for diverse needs within different family forms. Examining fertility practitioners’ clinical reasoning, the thesis further demonstrates how a standard model of egg donation – based on single donation to heterosexual couples – continues to shape clinical practice. Analysing donor and recipient narratives through Mol’s concept the logic of care, the thesis proposes that egg donation entails a form of dual patienthood. By showing how different enactments of kinship and medical categories become tied to different versions of the good and responsibility in reproductive decision-making, the thesis advances a practice-based analytical framework for studies on egg and gamete donation. 

The thesis contributes to queer and feminist scholarship on reproductive decision-making by focusing on ontological politics and logics of care, thus placing questions of gamete donation in a new framework. Empirically, the thesis contributes knowledge on the usages of donor eggs among queer and lesbian couples in Sweden. The first study to examine fertility practitioners’ reasoning following Sweden’s legal change on combined gamete donation, it also offers recommendations for policy and practice.