‘Bioethics still has important work to do in helping to secure status equality for LGBT people’ writes Timothy F. Murphy in a recent Bioethics editorial. The focus of his piece, however, is much narrower than human rights, medical care for LGBT people, or ending the HIV/AIDS pandemic. Rather, he is primarily concerned with sexuality and gender identity, and the medical intersections thereof. It is the objective of this response to provide an alternate account of bioethics from a (...) Queer perspective. I will situate Queer bioethics within Queer studies, and offer three ‘lessons’ that bioethics can derive from this perspective. These are not definitive rules for Queer bioethics, since it is a field which fundamentally opposes categorizations, favoring pastiche over principles. These lessons are exploratory examples, which both complement and contradict LGBT bioethics. My latter two lessons – on environmental bioethics and disability – overlap with some of Murphy's concerns, as well as other conceptions of LGBT bioethics. However, the first lesson takes an antithetical stance to Murphy's primary focus by resisting all forms of heteroconformity and disavowing reproduction as consonant with Queer objectives and theory. The first lesson, which doubles as a primer in Queer theory, does heavy philosophical lifting for the remainder of the essay. This response to Timothy F. Murphy, whose work is certainly a legacy in bioethics, reveals the multiplicity of discourses in LGBT/Queer studies, many of which are advantageous – even essential – to other disciplines like bioethics. (shrink)

As the saying goes, “The road to hell is paved with good intentions.” And in the recent burst of clinical attention being paid to the needs of lesbian, gay, bisexual, and transgender patients, good intentions abound. But while this long‐overdue interest in LGBT health care aims to highlight important gaps and bring into relief serious issues in health care delivery for LGBT persons, such work can inadvertently reinforce both the marginalization of sexual minorities and the cultural norms related to sexuality, (...) gender identity, and the conventional family. To ensure that positive outcomes for LGBT patients are inextricably paired with those noble intentions, we advocate for a new, queer bioethics—a methodology of scholastic, bioethical, and critical scrutiny that not only addresses the needs of LGBT persons in health care settings but also considers the perspectives, histories, and feelings of such parties. (shrink)

Bioethics, Volume 36, Issue 3, Page 328-335, March 2022.

Beginning with a rumination on the AIDS-inspired poetry of Thom Gunn, this article by the guest editors introduces the special issue of the Journal of Medical Humanities titled “Queer in the Clinic.” After providing an overview of the historical legacy and contemporary dilemmas of LGBTQ persons in biomedical practice, the authors describe the rationale of the issue and the contributions included.

This essay examines dominant notions of reproductive identity in feminist bioethics from a queer-crip perspective by considering the “reproductive situation” in Germany of people who are classified as disabled and people who are classified as queer. I analyze the ways in which such people are excluded from the understandings of reproductive identity that figure prominently in German feminist bioethics, and argue that feminist bioethics in Germany, which has become a well-established part of important bioethical institutions, (...) reflects many, if not most, of the neo-eugenic developments that characterize more recognizably mainstream bioethics. I also show that feminist bioethics constitutes the reproductive subject as nondisabled, intelligibly gendered, and heterosexual. (shrink)

In the dialogue between Timothy F. Murphy and Cristina Richie about queer bioethics and queer reproduction in this journal, significant points of the emergent and extremely important discussions on lesbian, gay, bisexual, transgender and queer bioethics are raised. Richie specifies correctly that queer bioethics can either complement or contradict LGBT bioethics and the queer standpoint against heteroconformity and heterofuturity is decisive here. As the field of queer bioethics is such (...) a recent and essential part of consideration for bioethics and as it is still evolving, the objective of this intervention is to provide both an overview of important milestones of queer bioethics and to highlight that queer bioethics is not mono-logic and monolithic. To exemplify queer bioethic's ‘many-headed monsters’, queer reproduction is revisited and complemented by a European viewpoint. It is central to my argument and here I disagree with Richie that to be against heterofuturity does not necessarily mean to be against queer reproduction. However, I also argue that there are other reasons why queer reproduction should not be pursued at all costs. Finally, I discuss the most recent debates on race, class and citizenship, for example, queer necropolitics. These points still need to be addressed in queer bioethical agendas. (shrink)

A sociologist examines contemporary engagements of queer bodies and identities with fertility biomedicine. Drawing on social science, media culture, and the author’s own empirical research, three questions frame the analysis: 1. In what ways have queers on the gendered margins moved into the center and become implicated or central users of biomedicine’s fertility offerings? 2. In what ways is Fertility Inc. transformed by its own incorporation of various gendered and queered bodies and identities? And 3. What are the biosocial (...) and bioethical implications of expanded queer engagements and possibilities with Fertility Inc.? The author argues that “patient” activism through web 2.0 coupled with a largely unregulated free-market of assisted reproduction has included various queer identities as “parents-in-waiting.” Such inclusions raise a set of ethical tensions regarding how to be accountable to the many people implicated in this supply and demand industry. (shrink)

ABSTRACT This article takes Judith Butler’s epistemological problem of “framing” alongside Dana S. Belu’s notion of “reproductive enframing” to analyze whose bodies lie outside the borders of who is considered the appropriate reproductive citizen. Are all bodies subject to reproductive enframing under a totalizing technological ideology that Martin Heidegger refers to as Gestell? Or, does Belu’s notion of “partial enframing” allow a space to queer, or upset, our current understanding of such ideology? By queering the way that we currently (...) view assisted reproductive technology, can we widen the frame or cross its borders? In this article, I am primarily concerned with the necessity to queer French reproductive policy, though the questions I raise can be extended to any critiques of ART. (shrink)

This short essay provides an overview of the Visual Studies section of the special issue “Queer in the Clinic.” Addressing the impact of visual culture on queer experiences in the clinic, the author offers thoughts on the graphic artwork of Edie Fake and Brain Cremins’s essay included in this issue. Arguing that contemporary and historical visual assessments of the LGBTQ clinical subject are vital contributors to queer bioethical debates, she explains relevant concepts such as “radical somatic transformation,” (...) “the nature of bodily possibility,” and Walter Benjamin’s “world of secret affinities.”. (shrink)

In this paper, I attempt to bring together two topics that are rarely put into conversation in the philosophical bioethics literature: lesbian, gay, bisexual, and queer family equality on one hand, and, on the other, the morality of such alternative reproductive practices as artificial insemination by donor, egg donation, and surrogacy.2 In contrast to most of the philosophical bioethics literature on ARP, which has little to say about queer families, I will suggest that the ethics of (...) ARP and the respect for and protection of queer families are, in fact, intimately related topics.The connection can be clearly seen by considering the shape of the LGBQ rights.. (shrink)

Biohacking involves individuals determining, developing, and directing relevant activities to meet their personal biological goals. Biohacking fertility is a resilient method that trans and genderqueer people use to meet their reproductive and family-planning needs in the face of historic medical marginalization and oppression. In this study, nine participants were recruited from three different Facebook groups specific to queer and trans fertility, family planning, pregnancy, and parenting. Each participant’s posts and comments to their respective Facebook group(s) were analyzed, followed by (...) interviews with participants. A total of 1,155 Facebook posts were collected. Biohacking activity—understood as a web of activity including gathering information, applying knowledge to personal circumstances, and sharing personal experiences and knowledge—was found in each of the three groups. Participants identified these online groups as safer spaces to learn more about their own fertility and find community. Participants were active in these groups to biohack their fertility at home and to become empowered at the doctor's office or fertility clinic, ultimately achieving agency in their fertility and family planning. (shrink)

The proliferation of personal data collection practices fundamentally reshapes how society is ordered and commercialized, and demands reconsideration of the possibilities for a just and equitable s...

In this article, I explore the ethical dimensions of same-sex reproduction achieved through epigenome editing—an innovative and transformative technique. For the first time, I analyse the potential normativity of this disruptive approach for reproductive purposes, focusing on its implications for lesbian couples seeking genetically related offspring. Epigenome editing offers a compelling solution to the complex ethical challenges posed by traditional gene editing, as it sidesteps genome modifications and potential long-term genetic consequences. The focus of this article is to systematically analyse (...) the bioethical issues related to the use of epigenome editing for same-sex reproduction. I critically assess the ethical acceptability of epigenome editing with reproductive purposes from multiple angles, considering harm perspectives, the comparison of ethical issues related to gene and epigenome editing, and feminist theories. This analysis reveals that epigenome editing emerges as an ethically acceptable means for lesbian couples to have genetically related children. Moreover, the experiments of a reproductive use of epigenome editing discussed in this article transcend bioethics, shedding light on the broader societal implications of same-sex reproduction. It challenges established notions of biological reproduction and prompts a reevaluation of how we define the human embryo, while poses some issues in the context of gender self-identification and family structures. In a world that increasingly values inclusivity and diversity, this article aims to reveal a progressive pathway for reproductive medicine and bioethics, as well as underscores the need for further philosophical research in this emerging and fertile domain. (shrink)

Our study of queer women patients and their primary health care providers in Halifax, Nova Scotia, reveals a gap between providers’ theoretical knowledge of “cultural competency” and patients’ experience. Drawing on Patricia Benner’s Dreyfusian model of skill acquisition in nursing, we suggest that the dissonance between the anti-heteronormative principles expressed in interviews and the relative absence of skilled anti-heteronormative clinical practice can be understood as a failure to grasp the field of practice as a whole. Moving from “knowing-that” to (...) “knowing-how” in terms of anti-heteronormative clinical skills is not only a desirable epistemological trajectory, we argue, but also a way of understanding better and worse ethical practice. (shrink)

Queer perspectives have typically emerged from sexual minorities as a way of repudiating flawed views of sexuality, mischaracterized relationships, and objectionable social treatment of people with atypical sexuality or gender expression. In this vein, one commentator offers a queer critique of the conceptualization of children in regard to their value for people's identities and relationships. According to this account, children are morally problematic given the values that make them desirable, their displacement of other beings and things entitled to (...) moral protection, not to mention the damaging environmental effects that follow in the wake of population growth. Objectionable views of children are said even to have colonized the view of lesbian, gay, bisexual, and trans people who – with the enthusiastic endorsement of bioethics – increasingly turn to assisted reproductive treatments to have children. In the face of these outcomes, it is better – according to this account – that people reconsider their interest in children. This account is not, however, ultimately strong enough to override people's interest in having children, relative to the benefits they confer and relative to the benefits conferred on children themselves. It is certainly not strong enough to justify differential treatment of LGBT people in matters of assisted reproductive treatments. Environmental threats in the wake of population growth might be managed in ways other than devaluing children as such. Moreover, this account ultimately damages the interests of LGBT people in matters of access, equity, and children, which outcome is paradoxical, given the origins of queer perspectives as efforts to assert and defend the social interests of sexual and gender minorities. (shrink)

The concept of sex selection for “family balancing” is based on the notion that a family is “balanced” when it includes children of “both genders.” Clinics that offer IVF for family balancing present it as an option for couples who “want to experience the joy of raising both a male and female child”. Families with at least one child of each gender are claimed to have gender diversity and to provide more enriching experiences to all family members. Some theorists call (...) these families “balanced”, while others acknowledge that such a term could be pejorative, implying that families with children of one gender are unbalanced and, thereby, lesser. These theorists... (shrink)

In this age of DIY Health—a present that has been described as a time of “ludic capitalism”—one is constantly confronted with the injunction to manage risk by means of making healthy choices and of informed participation in various self-surveillant technologies of bioinformatics. Neoliberal governmentality has been redacted by poststructuralist scholars of bioethics as defined by the two-fold emergence of, on the one hand, populations and on the other, the self-determining individual—as biopolitical entities. In this article, we provide a genealogical-phenomenological (...) schematization (GPS analysis) of the narration of cancer in relation to “sexual minority populations.” Canonical discourses concerning minority sexualities are articulated by means of a logic of “inclusion and reification” that organizes the interiorization of norms of embodied relationality, and a positive liaison with biomedical technologies and techniques in the taking up of a rhetorical style of biographical compliance. Neoliberal DIY Health logics conflate participation with agency, and institute norms of recognition that constrain visibility to: citizens who make healthy choices and manage risk, heroic cancer stories, stories of the reconstruction of states of normalcy, or of survival against all odds. Alternatively, we trace the performative articulations of queer narrative practices that constitute an ephemeral, nomadic praxiology—a doing of knowledge in cancer’s queer narration. Queer cancer narrative practices represent a relationship to health and embodiment that is predicated, not on normalcy, but predicated on troubling norms, on artful failure, and on engaging in a kind of affective mapping that might be thought constitutive of a speculative bioethical relation to the self as other. (shrink)

This essay introduces a series of poems by six authors: Rafael Campo, Susan Holbrook, Katie Price, Trish Salah, Qwo-Li Driskill, and Brian Teare. I argue that the poems demonstrate that a queer bioethics, whether literary or medical, must dispense with commonplace assumptions about the ways in which selves, especially queer selves, are represented in language. Instead, poetry’s sound-sense and avoidance of language-as-usual can serve as an analogy for modes of approach, analysis, and even recognition that do not (...) receive official sanction; the non-linear modes of reading required by contemporary poetry can serve as methodological models for a queer bioethics. (shrink)

The clinic is a loaded space for LGBTQI persons. Historically a site of pathology and culturally a site of stigma, the contemporary clinic for queer patient populations and their loved ones is an ethically fraught space. This paper, which introduces the featured articles of this special issue of the Journal of Bioethical Inquiry on “Bioethics, Sexuality, and Gender Identity,” begins by offering an analysis of scrutiny itself. How do we scrutinize? When is it apt for us to scrutinize? (...) And what are the benefits and perils of clinical and bioethical scrutiny? Bearing in mind these questions, the second half of this paper introduces the feature articles in this special issue in response to such forms of scrutiny. How, why, when, and in what ways to sensitively scrutinize LGBTQI persons in the clinic are the aims of this piece. (shrink)

In the last several years, queer and trans people have grown in prominence in our public discussions of policy, education, health care, and other spaces of social life. Politicians, health care practitioners, and average citizens are increasingly aware of our existence and the particular challenges we present, albeit this awareness is often not well-intentioned or informed. Indeed, according to the 2015 U.S. Transgender Survey, trans people, in particular, specifically avoid accessing needed health care due to either fearing negative interactions (...) with health care providers or being unable to afford health care, and those who do manage to... (shrink)

Given the resurgence of scientific studies on the etiology of homosexuality in the wake of the AIDS epidemic, this article considers the effects these studies had on contemporaneous queer filmmakers. By using the subject of criminality as a way to talk about homosexual causality, queer films of the 1990s illustrate that contemporary scientific studies on homosexuality were historically and politically situated in relation to cultural anxieties about other forms of deviance. This article focuses on films that dissect the (...) hetero-normative tendency to amalgamate forms of deviance in order to distinguish between the diseased and the healthy. Such products of New Queer Cinema highlight this amalgamation of criminality and homosexuality in order to challenge demands by the LGBT community of the 1980s and 1990s for “more positive images” in film. This article argues that queer filmmakers have manipulated the image of the queer criminal to usurp the medical tendency to biologize and pathologize the notion of queer transgression. In such a way, queer films that enthusiastically dramatize the queer outlaw perpetuate myths about homosexuality in order to dissect and discredit them. (shrink)

Life Goes On (1989–1993) was the first television series in U.S. history not only to introduce a recurring teenaged HIV-positive character but also to feature an actor with Down syndrome in a leading role. Drawing new connections among disability studies, queer theory, and bioethics, I argue that Life responded to American disability rights activism and the AIDS epidemic of the early 1990s by depicting sex education as disability activism. By portraying fulfilling sexual relationships for its disabled protagonists, Life (...) challenged heteronormative and ableist underpinnings of marriage, sexuality, reproduction, and sex education and imagined transgressive queer/disabled alliances that often surpassed those of activists of its cultural moment. By representing homophobia, AIDS-phobia, and ableism as intertwined oppressions, the series conjured an expansive vision of sexual justice and pleasure, one that included and united teenagers, intellectually disabled people, and seropositive people—populations whose sexualities have generally been regarded as pathological or nonexistent. (shrink)

This article considers the late 19th-century medical invention of the category of the homosexual in relation to homosexuality’s moment of deliverance from medicine in the 1970s, when it was removed as a category of mental aberration in the Diagnostic and Statistical Manual (DSM). With the rise of the AIDS pandemic in gay communities in the early 1980s, I argue that homosexuals were forcibly returned to the medical sphere, a process I call “the painful reunion.” Reading a collection of queer (...) narratives across the 20th century, I show that historical and contemporaneous medical events prompted the mobilization of seropositive and queer artists at century’s end to rehabilitate, revise, and offend the historiography of queer illness. Collectively, my conclusions redefine our understandings of queer theory and queer politics as distinctively 1990s projects invested in the present to ones that purposefully aim to challenge the past. (shrink)

Hastings Center Report, Volume 52, Issue 1, Page 10-11, January/February 2022.

This paper draws on findings from qualitative interviews with queer and trans patients and with physicians providing care to queer and trans patients in Halifax, Nova Scotia, Canada, to explore how routine practices of health care can perpetuate or challenge the marginalization of queers. One of the most common “measures” of improved cultural competence in health care practice is self-reported increases in confidence and comfort, though it seems unlikely that an increase in physician comfort levels with queer (...) and trans patients will necessarily mean better health care for queers. More attention to current felt discomfort in patient–provider encounters is required. Policies and practices that avoid discomfort at all costs are not always helpful for care, and experiences of shared discomfort in queer health contexts are not always harmful. (shrink)

Phenomenological interviews with queer women in rural Nova Scotia reveal significant forms of trauma experienced during labour and birth. Situating the accounts of participants within both phenomenological and intersectional analyses reveals harms enabled by structurally embedded heteronormative and homophobic healthcare practices and policies. Our account illustrates the breadth and depth of harm experienced and outlines how these violate core ethical principles and values in healthcare.

The abstinence approach to sex education remains influential despite its demonstrated ineffectiveness. One bill forbids the “promotion” of “gateway sexual activity,” while requiring outright condemnation of “non-abstinence,” defined so loosely as to plausibly include handholding. Bioethics seldom (if ever) contributes to sex-ed debates, yet exploring the pivotal role of medical discourse reveals the need for bioethical intervention. Sex-ed debates revolve around a theory of human flourishing based on heteronormative temporality, a developmental teleology ensuring the transmission of various supposed social (...) goods through heterosexual marriage (Halberstam, 2005). Heteronormative temporality also constitutes a moralized discourse in which the values of health and presumed certainties of medicine serve to justify conservative religious dictates that otherwise would appear controversial as the basis for public policy. Overall, this analysis explores how moralized medical discourses compound existing injustices, while suggesting bioethics’ potential contributions to moral and political analysis of sex-ed policies. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Anonymous Versus Open Donation and Queerness as Political:Comments on Groll's Conceiving PeopleAmanda Roth (bio)1. IntroductionIn this commentary on Daniel Groll's 2021 book Conceiving People: Genetic Knowledge and the Ethics of Sperm and Egg Donation, I examine a number of the book's major themes, especially around the idea that donor-conceived children have a significant interest in genetic knowledge and therefore, donor-conceiving parents are morally required to use an open donor.1 (...) I point to some concerns about Groll's case for this view and, in doing so, highlight the way in which taking up an LGBTQ+ perspective complicates and undermines the case against anonymous donation. The major theme of my comments is that the open versus anonymous decision is not merely an ethical decision, but a political one.My comments are organized around a few of the book's major themes, so I'll begin with laying out the most relevant themes in some detail. I then take up four points to consider in more depth. In so doing, I'll be drawing on my own scholarly perspective on issues of nontraditional reproduction, which is informed by my own social positionality in relation to family matters; this means that I (not so subtly) bring a queer perspective to the discussion of Groll's book. The through-line of my comments is this: While I agree with and appreciate much of Groll's approach, I want to stress the sense in which gamete donation is not just an ethical issue, but a political one, given its implication in bionormativity (and heteronormativity). I wonder if a deeper acknowledgment of the political nature of the issues might lead to moral conclusions that are different from those that Groll comes to, even assuming similar ethical values as starting points.2. Groll's major claims(1) Claim 1: Disclosure to donor-conceived offspring—in the usual case at least—is morally required given the intimacy argument: [End Page 166]The intimacy argument suggests that keeping "the secret" about donor conception involves intentional deception and undermines the proper intimacy of parent-child relationships (Groll 2021, 36–49).(2) Claim 2: Anonymous donor conception is (generally) morally impermissible because of the significant interest view.Donor-conceiving parents can reasonably foresee that their children will likely develop a significant interest in genetic knowledge. Significant interests "matte[r] quite a lot to the person who has [them]," "tak[e] up a space … in a person's mental economy" and/or "pla[y] a structuring role in a person's life and self-conception" (Groll 2021, 62–3). But not all donor-conceived people take such an interest in genetic information, and this information is not necessary for identity construction or psychological wellbeing (Groll 2021, 58, 61).2 Rather, multiple routes to self-identity exist, the genetic route being one among the options. Moreover, one needn't experience any loss in not taking this route; however, for those who take it up, genetic knowledge is objectively valuable and nonfungible (Groll 2021, 81–9). This is because genetic knowledge is uniquely relevant to the identity-related question "Who am I?" (Groll 2021, 112–3).3Groll argues that donor-conceiving parents should assume that their child will form such an interest because this is empirically a "good bet." Further, significant interests—at least when they are worthwhile (that is, not trivial and not morally objectionable)—are connected to one's wellbeing by the wellbeing principle: In satisfying a non-instrumental significant worthwhile interest, one's life goes better (Groll 2021, 62). It follows, then, that parents ought to choose open donors since (to simplify) parents are obligated to promote their children's wellbeing (ibid).4Counter to what one might expect, Groll does not take his ethical case against anonymous donor conception to justify prohibition of the practice. This is because wronging children in this way is within the realm of (unethical) choices we allow parents to make without societal interference.5 Moreover, to aim regulation at anonymous donor conception could reinforce bionormativity and target already marginalized families for special negative attention (Groll 2021, chapter 8).(3) "Claim" 3: Groll's own personal... (shrink)

With a few notable exceptions disability studies has not taken account of intersexuality, and it is principally through the lenses of feminist and queer-theory oriented ethical discussions but not through ‘straight’ bioethics that modes valuing intersex difference have been proposed. Meanwhile, the medical presupposition that intersex characteristics are inherently disabling to social viability remains the taken-for-granted truth from which clinical practice proceeds. In this paper I argue against bioethical perspectives that justify extensive and invasive pre- and post-natal medical (...) interference to eradicate intersex. I argue instead that to constitute the necessary conditions for the recognition of the intersexed child as a person, a life valid in its own right, clinicians must refrain from aggressive interference. Clinical specialists presuppose that intersexed children will be socially disabled and unrecognizable as persons; frustrated by the general failure of traditional interventions to assign a sex, clinicians are now pursuing prenatal technologies, including selective termination, to erase intersex. (shrink)

The following Acknowledgments were omitted in the original publication.