The Surrogacy Crisis in Greece and How the World Should Respond

Sep 17

This story is truly a nightmare. It would be easy for me — a staunch advocate of surrogacy who writes about and promotes the practice for queer men — to avoid it. However, that would be a disservice to the truth and the complexity of surrogacy. I want to take this opportunity to discuss what has transpired in Greece, as it does highlight the concerns around assisted reproductive technology (ART), but it also can serve as a beacon for better regulation across Europe and the world.

The Mediterranean Fertility Institute in Crete (https://www.ivfgreece.com/) is described on their website as:

‘One of the first clinics in Greece that managed to obtain the certification ISO 9001:2015 and following the recommendations of the ‘Greek National Authority of Assisted Reproduction’ (G.N.A.A.R.), we operate as an IVF Clinic and Cryopreservation Bank by the law and the international standards. Wishing to keep that level in the IVF lab also, we accepted to go through a check to present the certification of BS EN 15224:2012’ (1).

Despite presenting on their website a facade of internationally recognized standards and certifications, presentations at international medical conferences, and an outline of Greek surrogacy laws (2), the Institute has been shuttered with eight of its staff arrested in August 2023 after allegations of 182 incidents in which women were exploited as gestational carriers (GCs) or egg donors (3).

According to the Greek authorities, the leadership of the Mediterranean Fertility Institute actively recruited ‘vulnerable foreign women’ to donate eggs and become GCs. The GCs were paid 300 to 600 euros monthly, while the clinic would charge intended parents (IPs) between 70,000 and 100,000 euros (3). The women who were exploited came from Georgia, Ukraine, and Romania (4). The Greek Health Ministry has acted swiftly, and even before the investigation has been finalized, the President of the National Authority for Assisted Reproduction, Professor Nikolaos Vrachnis, was dismissed given he was responsible for all assisted reproduction facilities in Greece and their licenses (5).

This is truly an atrocious and heinous situation. Desperate for any financial incentive, these vulnerable women were coerced into egg donation and surrogacy. It’s a travesty for these women. Also, the heterosexual IPs who have used the clinic in the past are now scrambling to get DNA testing on their children to see if the eggs used were theirs or from these forced donors (6).

Before going into the global implications for surrogacy that can result from this, it would be good to review what the laws are in Greece. Until this incident, Greece was viewed as a ‘surrogate-friendly’ country with a complete and comprehensive regulatory framework for medically assisted human reproduction, with provisions for altruistic gestational surrogacy since 2002. Greece’s legal framework for ART has been described as one of the most progressive regimes in the modern legal world (7). Since 2014, it was no longer necessary to be a permanent resident in Greece, thus allowing non-Greek IPs to legally apply for surrogacy (8). However, gay and other queer men are not allowed to pursue surrogacy in Greece (9).

Given the relatively open policies of Greek IVF and surrogacy arrangements, it has become a popular destination for heterosexual couples, especially from Australia. When the news came to light, at least 60 Australian families were currently working with the Mediterranean Fertility Institute in Crete (10). In fact, Sam Everingham, the founder of Growing Families (https://www.growingfamilies.org/), a not-for-profit organization that guides Australian families through surrogacy, had directed numerous families to the Institute. The reason so many Australians have opted to pursue surrogacy overseas is because Australia has extremely rigid laws around surrogacy, including the following:

All Australian states and territories have criminalized commercial surrogacy.
It’s illegal in Australia to advertise for an altruistic surrogate.
It’s illegal for Australian residents of the ACT, NSW and QLD to enter into commercial surrogacy arrangements overseas.
Overseas surrogacy arrangements may not fulfill the requirements for a transfer of legal parentage under Australian state and territory law because the surrogate is included on the child’s birth certificate.
If any Australian laws are broken overseas, people can be arrested and jailed when they return home (11).

Until this incident, Greece was viewed as a legal and safe option for Australians to pursue altruistic surrogacy and in a more efficient time frame than within Australia. However, many Australian women now fear this scandal in Greece will ruin their hopes of building their own families (12).

However, there are those in Australia who are working to change the country’s surrogacy laws, stating they are outdated and force people to go overseas. Advocates want to make it easier for people to pursue surrogacy within the country, so that it can be regulated, ensure there is no abuse, and guarantee that everyone in the process is safe.

These advocates have pointed to the U.S. as a model that could be followed for safe, well-regulated, commercial surrogacy:

“Whereas if you go to the US, there is money involved — and it’s actually significantly more money — but we know that the surrogates are screened mentally and physically and everybody gets independent legal advice. And while money might be part of the motivation, it’s not the sole motivation, [surrogates] are engaged and informed, and they have decision-making power” (13).

This has always been my perspective as well. Set up a system that is based on trust, medical and psychological expertise, and compensate everyone. The Australian advocates for new commercial surrogacy laws echo this as well, stating:

“The IVF doctors, the lawyers and the counselors are compensated for their role in the arrangement. I think it’s only fair for surrogates to receive compensation for the time, effort, risks and pain involved with carrying a pregnancy and giving birth” (13).

A similar reaction to the news in Greece also appeared in Ireland (14). University of Galway family law lecturer, Dr. Brian Tobin, acknowledges that couples will continue to pursue surrogacy arrangements, and that it would be ‘unrealistic’ to try and ban the practice. However, in order to avoid future situations such as occurred in Greece, Dr. Tobin states that ‘the best possible domestic surrogacy regime here in Ireland’ is what is needed.’ By continuing to improve Irish surrogacy legislation from 2022, there will hopefully be a way of deterring people from going to jurisdictions where there are legal and ethical concerns.

These perspectives from Australia and Ireland to expand and improve their domestic surrogacy regulation is a welcome evolution from the tragedy in Greece. However, I hope that this scandal does not cause a further backlash within the European Union with regards to surrogacy. In March 2023, an EU parliamentary discussion regarding surrogacy stated the following:

‘The practice of surrogacy violates the rights of the children — turning them into victims of trafficking in human beings — and the fundamental rights and physical integrity of the women who are used as surrogate mothers’ (15).

Given this sentiment, and the rampant anti-surrogacy legislation and actions occurring in Italy that I wrote about in a previous article (https://medium.com/@babymoonfamily/why-every-lgbtq-person-especially-intended-parents-ips-should-be-furious-at-italy-right-now-cfb8a4382532), there is appetite in the EU to clamp down on surrogacy. I hope that this situation in Greece will not provide fuel to the fire.

Instead, may it help EU and legislators around the world see what advocates in Australia and Ireland have already observed. The solution is not more restrictions, but rather more open, transparent, and protective regulations to allow all people the dream of building their family in their home country.

References:

GreeceCrisisEuropeSurrogacyRainbow Families

Bryan McColgan, MD

The Surrogacy Crisis in Greece and How the World Should Respond

Psychological ‘Labor’ for Queer Dads-to-Be

Will More Queer Parents and Their Children Make the World a Better Place?

BABYMOON FAMILY