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September
05
  10:35:00 PM

The ethics of transgender fertility

This month’s issue of LGBT Health contains a fascinating interview with two Boston fertility specialists who cater for gays and lesbians who want to become parents. Dr Samuel Pang, one of the first doctors to help gays have biological children through gestational surrogacy, says that his passion “is to get the word out to the LGBT communities that there are options available if people want to have genetically related children”.

Perhaps the most controversial aspect of their work is provisions for the fertility of boys and girls who are transitioning to the opposite sex. “For children and young adolescents, it is often the parents who are thinking about future reproductive capacity, because they would like the possibility of grandchildren, and because they are looking after the future interests of their children,” says Dr Anderson Clark, a reproductive biologist.

The problem is that puberty-suppressing treatment also impairs the children’s reproductive capacity. “Some trans boys (ie, girls) receive puberty-suppressing treatment and never produce mature ovarian follicles that could be stimulated for harvest and cryopreservation of eggs,” says Dr Clark. And the problem is accentuated with trans girls (ie, boys) because their spermatozoa are still developing. However, it has been done on individuals as young as 11. “The quantity of sperm collected from someone this young would likely be low and, for some individuals, may not be mature enough to fertilize an egg. But those sperm might be used with intracytoplasmic sperm injection (ICSI), a well-developed fertility treatment, once the individual is ready to have children,” says Dr Clark.

And the interviewer, Dr Evan Eyler, of the University of Vermont, remarks on the progress which has been made in the past 20 years:

“It was not all that long ago that lesbian couples with no infertility problems, simply needing donated sperm, were denied services on moral or religious grounds. At this point, lesbians without infertility problems are getting pregnant with donated sperm, and the type of work that you are describing is opening up additional options: Having one partner be the egg donor and the other partner carry the pregnancy, so that both have a biological relationship to the child, or maximizing fertility for lesbian and bisexual women who have infertility problems.
“Efforts focused on finding options for male couples to have their own biological children have also had some reasonable success. At this point, some couples with a transgender partner are getting fertility services, and transgender youth who are not yet at the point of considering reproduction are beginning to have options for fertility preservation. Most of the trans children and trans teens are not thinking about fertility preservation because of their youth, so it is the parents who are inquiring about these services in many cases, and you are discussing options with them.
“I am impressed by how far this field has come in just a couple of decades, both technically and politically.”

However, there are still ethical issues. The weightiest is the doctor’s responsibility for the fertility of young trans patients. “We cannot count on the transgender children and teens to think about it, because, when they are going through the crisis of gender identity, the last thing on their minds is having children in the future. They have much more pressing issues to deal with,” says Dr Pang.

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September
05
  9:35:00 PM

Let’s chill: New York’s egg freezing party

Commercialisation of IVF is crossing new frontiers in New York with “egg freezing parties” for career women who want to keep their options open. A company called EggBanxx will retrieve and store eggs – for about US$7,000 to $8000 per cycle. The first year of freezing is free. Here’s the pitch:

“EggBanxx is the affordable egg freezing solution created by women for women. We believe egg freezing should be easy, affordable and stress-free!   Through EggBanxx, women can preserve their fertility by freezing their eggs for later use at a fraction of the cost and at a reputable clinic. This elective procedure is becoming increasingly popular today with women who are holding off having children while furthering their education or career, or waiting to meet the right partner.” 

To promote its product, EggBanxx is organising “Let’s Chill” (what else could it be called?) parties in New York to discover how it works and how much it costs. The first one took place at the NoMad Hotel in Manhattan on August 12.

 “I don’t have a significant other . . . but I hope to one day and have kids,” one woman told the New York Post. “I want to take my fertility into my own hands, rather than put pressure on the person I have my next relationship with. I don’t want to be in the position when I’m in my late 30s and panicking because I haven’t found the right man and I’d compromise and take anyone off the street!”

Or as EggBanxx’s marketing director described her own egg-freezing experience, “The pressure is off, and I feel so empowered. I can now concentrate on my career and becoming who I want to be before having children!”

So how does EggBanxx make its money? It acts as a broker for egg retrieval by its network of IVF clinics around the US and for low-cost finance. It also offers a 15% discount on what IVF clinics charge for the procedures and medications.

All over the world, fertility experts warn women that their fertility is finite, that after 35 it drops sharply and that it is best to have children early. But freezing cannot guarantee a baby, especially since most women who freeze their eggs have entered an era of declining fertility. According to a survey by the American Society for Reproductive Medicine, the average age at which women freeze eggs is 34 – already late.

Lord Robert Winston, a British IVF pioneer, argues that egg freezing is “a confidence trick” that allows avaracious IVF clinics to exploit the fears of desperate women. “Women are spending vast amount of money on this treatment but the success rates simply aren’t there. In fact less than 10% of the women who do it end up getting pregnant,” he says. 

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September
05
  4:58:00 PM

Berlin opens memorial to euthanasia victims

 

A memorial to the 300,000 victims of Nazi euthanasia programs was opened in Berlin this week. It is striking piece of modern architecture: a 30-metre-long wall of blue glass in the open air near the Berlin Philharmonic.   

“The Nazi murders of disabled people are among the most inhumane acts of history,” says Berlin’s mayor, Klaus Wowereit. “It is high time that these victims of Nazi inhumanity finally receive their own memorial.” 

The regime had several methods of killing the mentally and physically disabled: starvation, lethal injections or chambers filled with carbon monoxide gas. The so-called T4 program became a trial run for the gas chambers of Auschwitz and other death camps. About 70,000 of the deaths occurred at the program’s headquarters at Tiergartenstrasse 4 in Berlin, thus giving the program its name, Aktion T4.

“We must denounce the inhumane distinction between a worthy and an unworthy life,” said Monika Gruetters, Germany's state minister for culture and media. “Every human life is valuable - that's the message of this memorial.”

 

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September
05
  4:57:00 PM

“We have a right to know our parents”

There are calls for a change in birth certificate regulations after a woman conceived by sperm donation had her adopted father erased as parent.

Emma Cresswell, 26, has won a six-year legal battle to have the man who she thought was her father removed from her birth certificate. Cresswell only discovered as an adult that she was conceived by a sperm donation, following a heated argument with her adopted father. Incensed at being deceived by her parents and feeling increasingly distant from her mother’s partner, Cresswell fought to have her adopted father’s details taken off her legal documents.

“I had thought I was one person for so long and then I found out that a whole side of that wasn’t true”, She said.

Cresswell is now campaigning for biological parentage to be stated in addition to legal parentage on a child’s birth certificate. Dr. Marilyn Crawshaw of the University of York agrees:

“The birth certificate gives you nothing to go on. I know of people who believed they were at risk of genetically transmittable diseases because they thought the parents named on their birth certificate were their biological parents.”

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September
05
  4:41:00 PM

Scientists one small step closer to memory alteration

Scientists from MIT say they have managed to manipulate ‘good’ and ‘bad’ memories in mice, in a study that may have significant impact on research into human memory alteration.

The study, published in a recent edition of Nature, examined the neuronal circuits thought to be responsible for triggering memory recall in mice. The researchers said they successfully used optogenics technology to activate circuits bearing specific memories.

Researchers created good memories in male mice by giving them time with groups of females, whilst bad memories were created by electrocuting the mice’ feet. The researchers then studied the way the mice reacted when the memories were activated in an empty space. When ‘bad memory’ circuits were activated, the mice ran away from the space, whilst when ‘good memory’ circuits were queued the mice stayed.

The results are said to indicate the existence of a precise physiological substrate for individual memories. This may mean that one day scientists will be able to ‘turn off’ particular distressing memories in patients suffering from conditions such as Post-Traumatic Stress Disorder.

“Imagine you can go in and find a particular traumatic memory and turn it off or change it somehow,” said David Moorman, an assistant professor of psychological and brain sciences at the University of Massachusetts Amherst. “That’s still science fiction, but with this we’re getting a lot closer to it.”

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September
05
  4:26:00 PM

“Common sense” prevails in the Ashya King saga

Ashya King, 5, has been reunited with his parents after they were released from a Madrid jail on Wednesday.

Ashya, who recently had a severe brain tumour removed, has been at the centre of an international police investigation after his parents took him from a British hospital against doctors’ advice. Brett and Naghemeh King were concerned that he was receiving inadequate care in the UK and wanted him to receive proton beam treatment abroad. Mr. and Mrs. King were imprisoned in Madrid for 72 hours after British police issued a European Arrest Warrant. Charges of ‘child cruelty’ were dropped on Tuesday.

Criticism has been levelled at British authorities for their ‘heavy-handed’ approach. In Question Time British PM David Cameron said that the police decision to issue the warrant “didn’t chime with common sense”. A Downing Street spokesperson said that the Home Office is expected to launch an enquiry into the police response. 

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September
05
  3:55:00 PM

Catholic Church exposes forced adoption network

A Chilean priest is being investigated for coercing single women into give up their babies for adoption.

Fr. Gerardo Joannon of the Congregation of the Sacred Hearts of Jesus and Mary (SSCC) was allegedly part of a network of priests and doctors that coerced single pregnant woman to agree to adoption arrangements after birth. It is alleged that the women who resisted had their babies taken after birth and were told they had died. An investigation conducted by the Catholic Church found that Fr. Joannon participated in at least two adoptions where mothers were anesthetised and told after labour that their baby had passed away.

The SSCC began the initial investigation into the matter. A spokesman for the group has condemned Joannon’s actions. “[his actions] were totally unacceptable. It was very important for us to speak out and speak with a strong voice”, said SSCC priest Fr. Sandro Mancilla.

Chilean Judge Mario Carroza has order Fr. Joannon to remain in the country whilst a police investigation continues. 

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August
30
  11:37:00 PM

On the front line of the war on Ebola

The war on Ebola is creating heroes. The media have focused on Kenema Government Hospital (KGH) in Sierra Leone, where the country’s first case was diagnosed. More than two dozen of its doctors, nurses and support staff have been infected and died. Science, one of the world’s leading journals, published an early online paper on the Ebola virus on Thursday. Six of the authors are already dead, five from Ebola, all from KGH.

The New York Times highlighted the work of Josephine Finda Sellu, the 42-year-old deputy nurse matron, a brisk, cheerful and courageous  woman. “There is a need for me to be around,” she told the New York Times. “I am a senior. All the junior nurses look up to me.” If she left, she said, “the whole thing would collapse.”

“There are times when I say, ‘Oh my God, I should have chosen secretarial,’ ” she says. But nursing “is the calling of God.” The Times describes the difficult and dangerous work of those who continue to serve:
“… the front line is stitched together by people like Ms. Sellu: doctors and nurses who give their lives to treat patients who will probably die; janitors who clean up lethal pools of vomit and waste so that beleaguered health centers can stay open; drivers who venture into villages overcome by illness to retrieve patients; body handlers charged with the dangerous task of keeping highly infectious corpses from sickening others.
“Their sacrifices are evident from the statistics alone. At least 129 health workers have died fighting the disease, according to the World Health Organization. But while many workers have fled, leaving already shaky health systems in shambles, many new recruits have signed up willingly — often for little or no pay, and sometimes giving up their homes, communities and even families in the process.”

The United Nations System Coordinator on Ebola, David Nabarro, says that people fighting the virus – healthcare workers and survivors – are to  be commended:

“People who are battling Ebola virus disease are courageous people. People who are supporting them are courageous people. This courage is extraordinary. When I hear and see that people have survived Ebola virus disease, I see them as people who not only have demonstrated huge courage but also who have massive potential. Increasingly, these people are volunteering to serve to support the treatment of others who are actually still infected with the virus. Increasingly, they are becoming ambassadors for the community of people who are at risk of Ebola virus disease.”

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August
30
  9:39:00 PM

Is fear of nursing homes a reason for Dutch euthanasia?

A Dutch euthanasia clinic is being investigated for helping an elderly woman to die because she did not want to live in a nursing home. This is the second time in four months that the Levenseindekliniek (End of Life Clinic) in The Hague has been reprimanded.

Even in the Netherlands, where euthanasia has been legal since 2002, the clinic is controversial. It was set up to cater for patients whose own doctors refused to perform euthanasia and is financed by private health insurance. (Click here for the Leveneindekliniek FAQ.) In the two years after it opened in March 2013, 322 people were killed there.

The official euthanasia monitoring committee says that the clinic had not observed the formal guidelines for euthanasia. In the latest case, a woman in her 80s had been partially paralysed after a stroke. Twenty years ago she declared that she did not want to live in a nursing home, a position she reaffirmed 18 months ago.

However, in order to qualify for euthanasia in the Netherlands, a patient must be ‘suffering unbearably’. The clinic’s doctors decided that this was the case, based on some of her gestures and her repeated use of the words ‘kan niet’ (a common Dutch expression meaning more or less ‘no way’) which they interpreted as ‘I can’t go on any longer like this’.

The commission disagreed. ‘The doctor has based his decision solely on the fact that the patient was in a nursing home,’ says its report. In fact, she seemed relatively happy there.

The clinic says on its website that it stands by its decision to euthanase the woman. ‘If we only have one percent doubt about a euthanasia request, we will not go ahead,’ says its director Steven Pleiter.

The authorities are studying whether to proceed with a prosecution – something which apparently has not happened since euthanasia was legalised. Euthanasia has many supporters in the Netherlands. This week the Dutch Right to Die Association, NVVE, announced that it has signed up its 150,000th member. 

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August
30
  12:23:00 PM

More surrogacy abandonment stories emerge

An Australian couple has copped a media bashing over their alleged abandonment of a Down syndrome twin born to a Thai surrogate mother. But with the enormous publicity given to the case, similar cases are beginning to emerge elsewhere. Aussies are not the only “heartless bastards” in the world of surrogacy.

In the UK, the tabloid press described the case of Amy, a child with congenital myotonic dystrophy, a rare inherited condition which causes babies to be “floppy” and developmentally delayed. She was the twin of a healthy boy. Both were born to “Jenny”, a British woman who had entered into a non-legally-binding contract with a couple.

But when the commissioning woman learned about Amy’s disability, she refused to take her. She told Jenny over the phone: “She’d be a ****ing dribbling cabbage! Who would want to adopt her? No one would want to adopt a disabled child”. She took the healthy boy.

In fact, Jenny – who is legally the mother under British law – has effectively adopted her and is raising her with her partner and their other children. She says: ‘Amy is 100 per cent our daughter. I love her as much as my other children.’

And in the United States, a lesbian couple, Keston and Andrea Ott-Dahl, have related their own story of a Down syndrome baby. Andrea agreed to become a surrogate for friends, a lesbian couple who were using sperm from a gay friend. However when tests showed that the baby had Down syndrome, her friends, Silicon Valley executives, asked Andrea to abort it.

She was reluctant to agree, as she had had a bad experience after a previous abortion. She describes the day when she and Keston decided to keep the baby and raise it with their other two children as “the happiest day of my life”. Some legal complications ensued, as the commissioning couple initially attempted to enforce an abortion clause in their contract.

Their daughter Delaney is now a year old and thriving. Keston has even written a book, "Delaney Skye: How One Formerly Ableist Lesbian Mother Opened Her Eyes When The Baby She And Her Partner Created Under A Surrogacy For Friends Is Diagnosed With Down syndrome" and is blogging about their experience. 

"

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