The Bioethics of Fertility & Gender

Fertility and Gender consists of fourteen solidly Catholic essays from the Anscombe Bioethics Centre in Britain. Its authors include theologians, philosophers, and economists. By defending to the hilt the Church’s perennial moral teachings, they have produced a highly controversial book.

In the introduction, Anthony Fisher, O.P., bishop of Parramatto, Australia, reminds us that an abortion occurs every twenty-five seconds in Europe and is the main cause of death on the Continent. In succumbing to “socially condoned depravity,” Europe has dismissed the Church’s teaching as interfering with consumer choice. Sexual identity is seen as “chosen, socially invented or medically manufactured.” The Church stands as a bulwark against this madness, insisting that sexual identity is ontological, a permanent “biological reality informed by a rational soul in each person.”

The first four essays in the book under review are on marriage. Paul Mankowski, S.J., shows how the Old Testament’s overriding concern for fecundity entailed a risk that the family would become God’s rival. This is why Jesus used strong language against idolizing family ties (Lk. 14:26) and elevated spiritual allegiance over tribal loyalty (Mk. 3:32-35). In the Old Testament, too, making a gift to God of “the sexual potentiality of married love” was impossible because it was not yet “a sacrifice acceptable to God, in the manner of a lamb ‘without spot or blemish.'” Jesus paradoxically made this sacrifice possible by His teaching and, as Fr. Mankowski says, by “the emphatic example of his own celibate life.” As St. Paul recognized, the union of man and woman has been made sacred by its new relation to the “mystery of Christ and the Church.” Now “fruit” may be generated “by martyrdom and virginity as well as the marriage bed.”

Alexander R. Pruss describes romantic love as “a form of love, defined by a particular kind of union” — not a merely biological union but one “that does justice to a form of interpersonal love,” which stretches across time through the “uniquely personal act” of a lifelong commitment in marriage. When sexual acts are not part of this deep personal union or open to life, they deceive our yearnings for love.

Luke Gormally, former director of the Anscombe Centre, argues that politics today is governed by the ideology that sex is a private choice unrelated to procreation. In reality, sex cannot be detached from procreation; sexual complementarity exists for the reproduction of the species. A man has “only half” the capacity to reproduce and needs the “complementary capacity” of a woman in order to form a union “apt for reproduction.” The proper object of political action, therefore, should be to uphold “the good of marriage for the sake of the good of the child” in order to avert societal suicide.

Yet, once a population has embraced “a rationale for non-generative kinds of sexual activity,” there’s no reason left “to limit sexual activity to a marital relationship, the relationship which uniquely serves the good of the child.” Sodomy is especially subversive of marriage: “a homosexual lifestyle,” Gormally writes, “being radically unchaste and conspicuously hostile to the good of marriage, must be judged to have no reasonable claim to a place in society. Political authority with a sound conception of the common good of society, far from recognizing homosexual unions, would criminalize public manifestations of homosexual behavior, and otherwise would support efforts to help those with homosexual tendencies to live chastely.” Indeed, it would grant “no legal recognition of homosexual partnerships, as in civil partnership legislation.” Fifty years ago, this statement wouldn’t have raised an eyebrow, but today it’s downright explosive.

Anthony McCarthy observes that since marriage fosters the procreation and raising of children, it is no private “choice,” but a fundamental aspect of the common good. When a society encourages “substitutionary sex” like contraceptive sex and active homosexuality, it fails to uphold the principle that sexual activity has a telos in generating children. In a footnote, McCarthy shrewdly observes that “a society which normalizes sodomy is one which is far more likely (than say, a merely heavily adulterous society) to lose sight of the fact that sexual organs/activity have a telos at all.” Postmodern guru Michel Foucault claims that homosexuality and heterosexuality are only social constructs, but McCarthy retorts that the social function of sex, far from being relative to cultures, is “bound up with what is truly good for children.” Once substitutionary sex is widely practiced in society, it becomes “harder for the moral obligations generated by marriage to be honored in general.”

Doubtless the most controversial essay in this collection is Philip M. Sutton’s “Who Am I? Psychological Issues in Gender Identity and Same-Sex Attraction.” Sutton is the editor of Journal of Human Sexuality, a board member of the National Association for Research and Therapy of Homosexuality (NARTH), and a psychologist who helps people with “unwanted” same-sex attractions (SSA). He says there is no scientific evidence that SSA is determined by a specific genetic, social, or environmental cause. In 2008 the American Psychological Association admitted that homosexuality is “not innate” and that a combination of biological, psychological, and social factors influence its development; in 2009 it admitted that sexual orientation and behavior are not “immutable” in homosexuals.

Those who seek to be rescued from SSA recognize the increased medical and mental-health risks associated with same-sex activity, including STDs, substance abuse, AIDS, suicide, psychiatric disorders, and physical abuse. Sutton finds SSA often compensatory for a “gender-identity deficit” rooted in early childhood or adolescence. In men it is often a misguided quest for “unmet same-sex affective needs,” while in women it stems from habits of self-protection that lead to over-attachments. Both need “further intrapersonal and interpersonal development.” While SSA clients determine their therapeutic goals, the therapist must not yield to unreasonable demands for hormonal treatment or surgery, or for his approval of medically dangerous SSA behavior. Where such yielding is “mandated by law, conscientious objection may be warranted.”

The next few essays deal with the lack of chastity today in people ranging from teenagers to married couples. David Paton says that the perceived wisdom regarding teen pregnancies in England is at odds with the actual evidence. In the past decade England spent £250 million to give teenagers increased access to sex education, contraceptives, and abortions, yet it still has one of the worst track records for underage pregnancies in the Western world. Paton discusses the myths that stand in the way of changing course, such as that teen pregnancies will decline with greater confidential access to abortion. In fact, when parental consent is legally required prior to teen abortions, pregnancies decrease.

Dermot Grenham notes the very fine line between encouraging and forcing parents to have fewer children. He observes that those in the business of population control avoid the very term population control and speak instead of giving women “greater control over their fertility,” wrapping even their coercive policies in “women’s rights language.”

Kevin O’Reilly states that the virtue of chastity is needed to appreciate Humanae Vitae, which is grounded in the vision that sexual intercourse is a communion “both of the senses and the spirit.” Subverting the telos of sex leads to an “operative anthropological dualism” — isolated souls using each other’s bodies as “sites of mutual pleasure.” Far from being an obstacle to married love, chastity brings peace, tenderness, respect, and charity; it also establishes parents’ moral authority as educators. O’Reilly notes that since Humanae Vitae was promulgated in 1968 there has been a vast increase in pre-marital, extra-marital, and homosexual promiscuity, as well as a flood of pornography. He wonders if current attempts to sever Christ the Head from His Body the Church are not the logical result of the prevalent uncoupling of unitive from procreative sex.

Fr. John C. Berry deplores the “technical fix” of contraception in marriage. Married love, he writes, must be rescued from the technology that disfigures it and that alienates spouses from their own bodies. The Church teaches that it is never morally permissible to eliminate the “intrinsic life-giving meaning” of the sexual act. In his defense of Humanae Vitae, Bl. John Paul II warns that technology today threatens to “in­stru­­mentalize” and “enslave” us, rather than serving our “integral de­velop­­ment.” Periodic continence or self-mastery is the natural method for regulating the transmission of life; it shows respect for the human body, which is holy by virtue of its “divine creation and redemption.”

Anthony McCarthy and Alexan­der R. Pruss explain why the use of a condom in consensual marital intercourse is always morally wrong, regardless of whether a condom is used to block HIV transmission or to block procreation. It is anti-unitive and distorts the conjugal nature of the sexual act. McCarthy and Pruss explain why the principle of double effect does not apply here, and why abstinence is the right solution.

The final essays are on non-sexual conception. Mary Geach, a daughter of Elizabeth Anscombe, disagrees with those who claim that embryo transfer is neither unjust nor unchaste. In the case of in vitro fertilization (IVF), the genetic parents do not perform the marital act to beget the child but merely supply the materials. Therefore, they cannot be called the child’s progenitors. She says the marriage act is “imitated” in IVF: The man engages in solitary vice to produce semen, the woman allows an “intromission of impregnating kind,” and the technician cooperates with her in the act of embryo transfer.

Kevin L. Flannery, S.J., examines a much-debated passage in Dig­nitatis Personae, a magisterial document promulgated by the Congregation for the Doctrine of the Faith in 2008. This document deems artificial insemination immoral when the husband’s semen is collected outside the conjugal act but accepts it as moral when it is collected during the marriage act with an SCD (perforated condom) and later used in a Gamete Intrafallopian Transfer (GIFT). In this transfer, the sperm is placed by catheter in the wife’s fallopian tube to enable fertilization. Flannery observes that GIFT does not facilitate the original act but is a separate releasing, so the technician is a third active factor causing fertilization in a “new act.”

Pope Leo XIII condemned artificial fertilization in 1897, and John XXIII declared that man is not permitted to use the means “allowable in the propagation of plant and animal life” because human procreation is “the result of a personal and conscious act” subject to the “immutable laws of God.” Most of the teaching on this topic comes from Pius XII who in 1949 “formally excluded” artificial fertilization within marriage because it would be “effected by the active factor of a third party.” In 1956 he added that marriage did not give the “right” to this procedure “contrary to law and morality,” and in 1958 he condemned absolutely any type of artificial fertilization. Flannery concludes that Dig­nitatis Personae ignores the key principle of the “no third active factor.” Catholics are divided on the issue, but Flannery contends that a passage in a magisterial document cannot “cancel out the tradition,” and that Digni­tatis Per­sonae itself states that, on artificial fertilization, “the teaching of the magisterium is already explicit.”

Lastly, Helen Watt, former director of the Anscombe Centre, observes that non-sexual conception encourages “an exercise of excessive power and control over the child.” The man is at risk of feeling disassociated when his contribution “does not result from an interpersonal act with its own intrinsic dignity, but from a solitary, depersonalized act of providing sperm for a production.” Even when his sperm is collected in a perforated condom during the marital act, it amounts to “a withholding from the couple’s sexual union,” and the technician is the one joining the gametes. Given the rise of ethical treatments like NaProTechnology, couples who need help to conceive need not turn to “morally degrading procedures.”

Fertility and Gender is a cutting-edge book by sound Catholic scholars who are deeply engaged in questions of bioethics. It is well worth reading and pondering.