What is the cure for absolute infertility? Biomedicalisation and routinisation of surrogacy and uterus transplantation in Nordic medical journals

Abstract

This article investigates 20 years of discursive struggles in Nordic medical journals around the process of legitimating and routinising gestational surrogacy and uterus transplantation in Finland and Sweden. The comparative analysis through critical discourse analysis suggests that influential health care professionals have contributed to different levels of legal and cultural adaptation of the methods, prioritising non-commercial gestational surrogacy in Finland and uterus transplantation in Sweden. The article identifies central discursive turning points in the medical journal discussions by interpreting them against the background of medical and policy developments in Finland and Sweden during the analysed twenty-year period. Legitimation and routinisation of surrogacy and uterus transplantation were developed through biomedicalisation by representing them as infertility treatments and emphasising the relational dynamics between donors and recipients—a connection that in the Nordic context is often based on kinship or close relationships. The diagnosis of absolute uterine factor infertility was central to representing women as on the boundary between fertile and infertile, as they may have functioning ovaries. Through the biomedicalised rhetoric of equal opportunities for biogenetic motherhood, the diagnosed women’s ambiguous reproductive status was used to legitimise the two methods as cures for absolute infertility, thereby reinforcing hegemonic family and kinship norms.