Procréation médicalement assistée (PMA) is a catch-all term and includes IVF (in vitro fertilisation), artificial insemination and surrogacy. Surrogacy is illegal in France and so is not under discussion.
Currently, PMA is reimbursed only for medically diagnosed infertile heterosexual couples (if the woman is under 43). But President Emmanuel Macron promised to make it accessible to all women this year during his election campaign.
A study by Ifop has shown that 52% of LGBT people want children, including 62% of lesbian women. Although a majority of French want to open PMA to more people, some doctors want it strictly restricted to medical reasons.
We spoke to two of those involved in the debate.
FOR
Laurène Chesnel, spokeswoman for the association INTER-LGBT.
Currently, assisted reproductive technology is not prohibited to single and lesbian women but it is not allowed.
The law of 2013 [Mariage pour tous] gave couples the right to adopt and thus the right to be recognised as a family but to start a family they have to go abroad.
Going to a foreign country is an issue. It is not accessible to everyone - it costs between a few thousand and tens of thousands of euros, according to the processes women need. It is also risky for their health as a medical follow-up is not available in France.
But, on the other hand, other women who cannot afford to go abroad sometimes make a deal with a stranger on the internet. They know nothing about him or his medical background.
It is dangerous and can also result in legal problems as the father can suddenly decide to recognise his child and ask for joint custody. Opening up PMA will allow women to choose when and in which conditions they have a child.
People opposing the expansion are concerned about the father role, but women often meet someone afterwards. This person will not be the biological father of the child but in reality a lot of men raise children that are not theirs today. The most important thing is the upbringing of the child.
Concerning lesbian couples, the child will have two mothers so two different authority figures. Spain has allowed ART for 30 years and we can see that children do not have any problems.
Women wanting to stay single with a child is fine too. There are thousands of single-parent families and it works. The idea of monetising sperm comes from a kind of American fantasy. But there is no reason to pay for a sperm donation and nobody will ever choose the father from a catalogue.
In Europe, the doctor actually has to choose for you, according to certain medical criteria.
The most important issue is for everyone to have the same rights.
There is no reason for a heterosexual couple to have access to ART when a homosexual couple doesn’t.
It is a question of non-discrimination and freedom for women.
AGAINST
Bertrand Lionel-Marie, spokesman for the bioethics department of Les Associations Familiales Catholiques.
We forget about the social consequences on children who will be created without a father. We all have a father, or at least we can all put a face to a father, but now we want to erase the father figure for the desire of a woman.
The man is reduced to his sperm. There is a difference between a woman and a man, between the maternal figure and the paternal figure. It is too easy to say that a woman can have the role of the father.
There will also be social consequences on the role of medicine and on the principles of bioethics in France.
The role of medicine is to heal people and there is already a lot to do. Our system is under tensions, l’Assurance Maladie is in debt and cannot cover everything, especially comfort treatments.
It is said that ART will be reimbursed but it is not a sickness. We confuse people around the true role of medicine. In the principles of bioethics, donations have to be free but with an expansion we will have to think about it again because there are not enough gametes [sperm] in France. Belgium, for example, has to buy gametes in Denmark because they are in the same situation.
This lack of gametes means giving sperm or eggs is not insignificant to people. When we give eggs or sperm, we also give a part of our genetic heritage.
Another predictable consequence is the authorisation of surrogacy in the next years. In the name of equality, men will ask to have access to surrogate mothers. It is most likely to happen although it is not being spoken about at the moment.
We cannot prevent women going to other countries to have access to ART but this does not mean France has to follow the rules of neighbouring countries.
France has a special conception of bioethics, based on human dignity, and it has to defend it. It is not because a technique is available that we need to use it without questioning the consequences.
We make women believe that this will be a liberation but it is not true. It is an illusion to think you can have a child at 40 in the same conditions as when you were in your twenties. And we often forget to say the success rate of an artificial insemination is around 10%, and 25% for IVF.
