Ok, who brought the cheese and grapes because we’re about to have a virtual fertility book club! First rule of fertility book club – don’t talk about fertility book club. Well, unless you’re going to promote it on Social Media. Then go for it! Also, being fertile or infertile isn’t a prerequisite to join. Here, we judge you more on your choice of wine than we do your fecundity.
There has been so much talk about The Handmaid’s Tale thanks to Hulu. Whether it’s chatter on social media or articles, there has been talk about how the book/show relates to surrogacy, infertility and women’s reproductive rights in general. I’m an infertility advocate, a former fertility patient and have worked in the reproductive space for several years now so this particularly interested me. Oddly enough though, I had never seen the show or even read the book but I was speaking to several of my colleagues about the buzz it was generating and their responses fascinated me.
I decided to invite a few to put down their remotes and pick up the actual book. Yes. The book. Printed on paper with words and all. We wanted to see the “original source” and discuss what we thought was accurate, what was less than accurate and why the book has been so triggering for many who are struggling to conceive.
Below, some of my friends (who also happen to be fertility professionals) discuss the book based on the questions I put together after finally reading it. The questions below are more fertility focused but still hit on so many big issues. If YOU have read the book, I also hope you’ll share your comments below. For now, let me introduce you to the members of the book club! They are:
Sharon LaMothe - Surrogacy Expert
Annie Kuo - Principal of Emerald Fertility Consulting
Carrie Van Steen - Fertility Coach & Patient Advocate
Me: Why do you think The Handmaid’s Tale (HMT) has been triggering to the infertility community?
SHARON: From my perspective, this book could be triggering because there is a large population that are infertile and there is the pressure to conceive no matter how humiliating the process. I am not an “Intended Parent” (people who want to have children but are not able to use conventional methods to do so) but I have struggled with secondary infertility. For me, the struggle to have a second child was embarrassing. The expectation to have that second child within a certain number of years seemed always up for discussion (my kids are 9.5 years apart). Needless to say, once my daughter came along, there were no more questions NOR expectations.
LISA: We are being led through the experience in the book by the oppressed one, not the oppressor. In this case, the oppressor is the wife. Impossible for me not to feel an abundance of sympathy for our heroine. She might get to become pregnant, but not with someone she loved and she would never keep that baby or raise her biological child. Who didn't I feel sympathy and empathy for? The wives are portrayed the way that we often feel when struggling with infertility; old, damaged, barren, useless, desperate. Of course, we're triggered.
CARRIE: Anyone that has been in treatment for infertility, especially for a long period of time will be triggered by this book. As a "recovering patient" I can completely understand the pressure Offred feels every month and how monotonous it all becomes. It angers me probably because I know so much both personally and professionally, and I know that having a prior pregnancy doesn't make you "proven," so many women experience secondary infertility.
ANNIE: The singular pressure that the handmaids experience to prove their fertility and their value to society; indeed, a life or death matter by the time they reach their third Commander without success is incredibly triggering to the infertility community. Fertility is the basis of the handmaids’ value. Their roles are to have non-erotic, completely emotionless sex with high-powered men to provide society with children. The fact that they are stripped of their pre-existing relationships, including with spouses, children, and money, and have a proverbial gun to their heads (“get pregnant by the third Commander or else”) before meeting a tragic fate is weighted with pressure, something that the infertility community is well familiar with. So much pressure that women (like Moira) try to escape, and some (like the handmaid who preceded the narrator at her current job) commit suicide. In the infertility community, depression peaks after a couple years of the struggle to conceive or maintain pregnancy. Unfortunately, divorce and suicide are not uncommon.
ME: Tough question to answer but SHOULD it be triggering? I ask because some have said it’s not an accurate representation of the current state of fertility issues.
LISA: Given how the book portrays those that need "services" that we infertile folks use, of course it's triggering! It's impossible to ignore the implications of how donors and gestational surrogates might feel without a choice. At this moment in time, what the book depicts is not how infertility treatment and services work in our country -- not even remotely. But it's uncomfortable, at the least, to see a link between when someone has choice and what that really means. When the choice is between life and death, is it really a choice? When someone is paid $8,000 for eggs or $20,000 and up for carrying a baby, and that's going to keep their family afloat for a year; that's a degree of separation that's uncomfortable for most of us.
SHARON: I don't think this book should be triggering but that's just me. This book is not about surrogacy. It isn't even about traditional surrogacy (which is when a surrogate uses both her eggs and uterus making it her biological child). Because this book was written in 1985, Louise Joy Brown (the first “test tube” baby) was only 7 years old and IVF was still being perfected. The first gestational surrogacy was achieved in 1986. I mention this because HMT’s "world" could have used science. But for the sake of the book, religion comes into play. I am sure, out of all the readers, Christians should be the ones triggered. It relies heavily on the bible and warping the biblical passages to a degree that serves the men in charge.
Me: Do you think the comparison in several other articles about the HMT to surrogacy is fair?
ANNIE: I see the comparisons to surrogacy because of third party reproduction (using another woman’s egg and uterus) but I think the situation in the HMT is more accurately like abduction, rape, and servitude. The handmaids are being held against their will, stripped of all dignity, forced to have sex with military men they do not love, deprived of any erotic pleasure they might otherwise get from sexual intercourse, propositioned by “helpful” doctors for secret sex and by the Commander’s wives for sex with stand-in sperm providers (like Nick, the chauffeur). The humiliations are extreme. My understanding of surrogacy as it is practiced today in the U.S. is that surrogates and gestational carriers by and large receive very humane, respectful treatment.
SHARON: I think they are very far from reality of surrogacy as it stands today here in the United States. Even in India, this would not be called surrogacy. This is rape. This is enslavement. This is kidnapping. This is inhumane.
LISA: This book is no more about surrogacy than it is about adoption. Our heroine and those in her position, have no rights and only the most basic of choices: life or death. There's no compensation for their efforts and they don't enter into any agreement willingly. There is no pretense of informed consent.
CARRIE: I think it depends on the article you’re reading. Sadly, politics suffocated a lot of the pieces on HMT and surrogacy. I did like the comparison Women's Health shared though.
Me: A few in the infertility community have said they related to the commander’s wife, Serena Joy. Keeping in mind that she does support keeping the fertile women enslaved, what are your thoughts on that?
CARRIE: I did relate to Serena a lot because of the sadness and anger you feel when you are put in the position of having to make those tough choices. She needed control in her life to accept the fact that she now required her own handmaid.
ANNIE: I could see why some in the infertility community would identify more with the Commander’s Wife given that she is not able to conceive and must resort to any means necessary to bear a child. She sacrifices both her genetics and the experience of carrying a child. I felt sympathy for Serena Joy when she discovered her husband was playing Scrabble with the handmaid; any extracurricular time encroaching upon friendship, rather than a mere functional relationship between the Commander and handmaid must have been the ultimate betrayal. We see a disturbing dynamic in the HMT that plays out today -- women oppressing women. The oppressed minority (all women) are controlled by a group drawn from its own ranks. These Aunts and Wives (especially the ruthless Aunts, who use violence) are crucial to enforcing the status quo possibly even more than their oppressors.
SHARON: I have no sympathy for her other than the fact that she is a woman who is also enslaved, just on a higher level. I wonder what would happen if she were to ignore the "dress code" or if she refused to do the "impregnation" ritual? I have the idea that she would have been sent away and another would have taken her place. She has no power to release Offred or any of the other women in that household.
Me: Considering what's going on in India and surrogacy (click here to read one piece on it), do you feel it's like Handmaid's Tale and that the book "came true" in certain societies?
CARRIE: In a way, I can see how a lot of these women were forced into it for financial reasons, but other than that I feel it's not a comparison to the book.
SHARON: Let’s face it; even the Indian women have a choice. They could defy anyone who wanted them to be surrogates only for the money (husbands, in-laws, etc.). Their own children are not kidnapped and given to others. Science is used to impregnate them. Some are poor, true, but those women in the book were from all walks of life and enslaved with the only choices were to comply or be sent away.
LISA: I think it's a much larger question than that. To quote from that article, "My children supported my decision saying bearing a child was better than selling a kidney, which I was considering too.” When people are reduced to selling any part of themselves to be able to sustain themselves and their families, we're in trouble. Let's remember too that these are not biological children for the Indian women. This is surrogacy, even if the details of it are not sitting well with a lot of us. I don't know the answer about whether it's right, moral or just. But I don't think it's the Handmaid's Tale either.
ANNIE: I don’t see the HMT as literally coming true in India even though both scenarios include surrogacy-like arrangements and suggests exploitation. Examining the India scenario in more detail; it’s the usual exploitation vs. empowerment debate. Some academics frame what is happening in India as “reproductive trafficking.” Cash-strapped Indian women from rural areas go to city centers and offer their bodies for surrogacy as a last resort for money. It’s often surrogacy or giving their kidneys. The HMT does not give the handmaids this choice -- kidney or uterus. In the HMT, the women are banned from reading. In India, poor women are often already illiterate. What concerns me the most is that many Indian women are opting into surrogacy arrangements without proper information and education about the process. This is often due to illiteracy or lack of technological understanding (many surrogates may assume they will conceive by having sex with the biological father, as executed in the HMT).
Me: Here in the United States, there have now been several protests entailing women dressing as the Handmaid (In Washington on June 27th to protest the proposed GOP Health Care Bill and in Ohio on June 13th to protest Senate Bill 145, an anti-abortion law to name just two). Why do you think it's resonating so much with women here in general in America as a form of protest?
ANNIE: There is rich symbolism in the HMT (or maybe we should call it depraved symbolism) on reproductive rights. The HMT symbolizes the subjugating of women’s bodies under the control of external forces and the whims of men and government policies (often made and controlled by men who, let’s face it, don’t bear the physical responsibility of pregnancy, getting an abortion, or giving birth). When government policies treat women merely as childbearing vessels without regard to our personal liberties over our own bodies, the stage is set for repressive measures eroding women’s rights over birth control, childbirth, and abortion. Those red and white costumes have impact!
SHARON: Slavery though forced pregnancy. That's what happens when women's choices are removed. When there is no birth control or chance for abortion. When these options are taken away then women resort to back alley abortions and herbal "teas" as birth control (back into the dark ages). This was one way where men would have had some control over women back in the day but NOW, if women didn't have these options and had more children, men would (should) have more responsibility to provide for their kids and the woman forced to bare them.
CARRIE: There will always be an uprising of certain groups. I didn't see how modeling the handmaids in this protest made sense to me.
LISA: I get their point. It's about choice and lack of ability to make one's own choice. I think it's likely effective because it is so visually evocative. It certainly gets the attention of the media. It's a ridiculously scary time in our country. There's a lot of fear given that many of us feel we have an unstable government and that we cannot count on certain rights like birth control and the right to choose an abortion. The obvious irony of that combination: birth control and abortion likely escapes very few of us. Listening to young adults in this country, and seeing how the incidence of IUDs have gone up; it hasn't escaped our notice either. They are terrified that access to birth control will be restricted and are opting for a method that may or may not be right for them just to ensure that they will be protected against unwanted pregnancies. Because they understand on the other side of this, that an unwanted pregnancy will be harder and harder to take care of in a way that makes sense for them.
Me: One of the things we discussed was how male infertility was not acknowledged in the book. Do you think that's still the case today and why?
SHARON: I believe there is a more of a spotlight on the male factor especially in the past few years, but I feel the female factor is the one more spoken about. You don't see male celebrities coming out about needing a sperm donor. Gay couples (or singles) don't have the same stigma because everyone knows they need eggs and a uterus. Sperm donation seems to be aimed at lesbians and single women where sperm freezing seems to be for those entering chemo or soldiers heading out to a war zone. Male infertility needs its own spot light but until the stigma is lifted, like it is for women, it will be the in the background and whispered about as a possibility (just like in this book).
LISA: To me, one of the biggest gifts of the HMT is Margaret Atwood's ability and decision to show what she does. She chooses to let us feel the confusion, limitations of the men. She chooses, interestingly enough, not to show us that with the wives. That this is a patriarchal society is clear. That the veneer that men have no part in the trouble conceiving is paper thin, but still so important. Other men being willing to step in and allow the Commanders to be the "fathers"- what is that about? Is it to be helpful, important, to have sex? While the men are not nearly as objectified and oppressed as the women, the author certainly makes sure that we see that neither are they the victors in most traditional senses.
CARRIE: I think that to this day, most men are still looked at last in this process. Unfortunately, if it's ever brought up even socially, it's made as a joke. Women are told to track their cycles and check for ovulation. They are tossed Clomid (a hormone in oral form) for months, poked and prodded until nothing is proven wrong with them, and only after all that do they check a man’s fertility. As stated in the book, there is no such thing as a sterile man anymore. Not officially. There are only women who are fruitful and women who are barren, that's the law.
ANNIE: More and more, people are understanding that the causes for infertility are shared equally between men and women. Women have historically borne the brunt of the “blame" for infertility; something the HMT focuses on but also alludes to as unfair. A few characters in the book, such as the doctor and Serena Joy, acknowledge that it may be the men who are the issue versus the handmaids who are getting shuttled around. Male factor infertility seems to be coming out of the shadows in terms of the media raising awareness, and more patients and infertility advocates willing to publicly address it. But there is still a good deal of stigma around male infertility, since it is rather emasculating to contend with being the cause for the failure to conceive. Men’s health is a family issue and when there is infertility, it is a couples’ problem and must be faced as a team. This concept is incredibly important as the feelings of the man often get overlooked.
Me: What do you think Margaret Atwood was trying to say (if anything) about fertility?
ANNIE: When women are reduced to their fertile value, everyone loses. Women have much more to contribute to society besides reproductive value. Celebrities like Jennifer Aniston and Oprah Winfrey have spoken for this. We should recognize that a woman is not less of a woman because she is infertile. Margaret Atwood characterized her novel as a cautionary tale about post-feminist complacency. Assuming that women have already “won” our rights and no longer need to fight or worry about them may very well lead to the dilution or erosion of those rights. I know she argues for universal human rights, meaning the rights of women as full and equal citizens, and wonder if she uses fertility as a platform to argue for the full value of women, since that is often how a woman values herself and how society values women.
SHARON: I am not sure that she is saying anything about fertility unless it's the only thing women are good for (in this book). The author may have been highlighting the ways we could lose our fertility with war, chemicals, poor nutrition, depression, smoking, etc. but I don't believe that is the main gist of this book.
CARRIE: I really think her focus was more on surrogacy and the suppression of women.
LISA: This book, to me, was about society, not fertility. It was a sociological look at the pendulum swinging from one side of the spectrum to the other. What was terrifying was that the period before the clamp down on all human rights in this book is not so different than where we are right now. What the author described had only a whisper of truth in 1985, but is a fairly accurate description now, in terms of the sex trade, violence, racism, misogyny and more.
Me: Looking back on the book (written in 1985), knowing what we know, do you think any of it "came true" OR are we headed in the direction of Gilead?
SHARON: No, we will never get to that point. I don't believe that with all the science we have today, we would ever stoop to this low of enslaving woman and forcing them to give up their own flesh and blood.
ANNIE: I do think that we are seeing a decline in fertility, largely due to environmental factors and conditions affecting future fertility before a child is even born. Male infertility in particular is rising because of a sperm count crisis. Reports claim that as many as one in five healthy young men between the ages of 18 and 25 produce abnormal sperm counts and that men are on a path to becoming completely infertile within a few generations. A science writer even suggested that if scientists from Mars were to study the male reproductive system, they might conclude that mankind was destined for rapid extinction. Conversely, the number of women giving birth after age 35 is rising, so for what it is worth, we could see some version of Gilead in terms of compromised fertility requiring extensive medical treatments that include third party reproduction (including surrogates, or gestational carriers) - hopefully without the handmaids.
CARRIE: I am afraid that we may be heading into something similar way down the road with the way infertility has become so prevalent, but on the flip side science gets better every day.
LISA: Ending in a retrospective of 2195, the world was redrawn and appeared to be healed. There was no horror at how the world was then, merely interest and speculation. The last piece of the book describes, unemotionally, what had occurred. It explains almost everything, including that Offred, Of Fred, likely survived to speak into a tape recorder and leave the tapes behind. I think all of us would have been more comfortable reading this book, holding ourselves apart, had this felt more like the science fiction it was touted to be. One truth is that it's not removed enough from us; not in 1985, nor in 2017.
So, what do you think? Again, these are all important issues and whether you agree or disagree with any of the above, the more we talk about these matters, hopefully, the more we can learn from one another and achieve a level of understanding. Imagine that – no flame wars, just communication. Thoughts?