Infertility is distressing, says Max Pemberton, but it’s a condition the NHS can ill-afford to treat, I of course clicked over to take a read. Boy howdy, I was not prepared for what I read. The crux of Mr. Pemberton's article is that the NHS (the UK's National Health Service) should stop funding all IVF procedures. He goes on then to list the justifications for this argument. His column starts out cautiously, almost tip-toeing towards his argument: "...I thought long and hard about the reaction it [this column] would provoke... It is not my intention to add to people’s grief."
It isn't long though before Mr. Pemberton drops all the nicities and goes for the jugular (emphasis mine):
But is this something that is really a medical problem? Some sociologists argue that the inability to have children is actually a social condition that has been recast as a disease. Society places an expectation on individuals to reproduce and become parents and so childlessness is a status that does not readily fit within society’s cultural norms. Pathologising and categorising it as an 'illness’ is a way of managing this difference from the norm.*record scratch*
I'm sorry, did you just say my disease is a social condition? Excuse me while I pick my jaw up off the floor.
Besides using 20-year old sociology research as the basis of this particular argument, it's just plain wrong. Despite the World Health Organization's classfication of infertility as disease in late 2009, Mr. Pemberton is of the opinion that infertility is merely a social condition and that parenting is a desire, not a right. He goes on (again, emphasis mine):
While childlessness is distressing, it is not associated with long-term disability, morbidity or mortality. It is not a disease. Rather, it is about people unable to have something that they want. This is not what the NHS is there to remedy.Mr. Pemberton - Max, can I call you Max? Considering I conversed with you for nearly an hour on Twitter Monday? Right, so...
Max - You've missed the mark on so many levels. Let me break it down for you:
Infertility is NOT a social condition. In our little Twitter tete-a-tete, Max shared with me a study from 1992 by Becker & Nachtigall titled, Eager for medicalisation: the social production of infertility as a disease. If you click over for the PDF, it's a doozy of a study. So I took a read and was dismayed to learn that not only was their interview sample size only 43 couples, but the interviews were conducted in 1984. So the data was nearly a decade old by the time this study was released. Not only that, but seeing as how much infertility treatment and ART have advanced even in just the last decade alone, I can't imagine the gap in treatment advancement in practice between 1984 and 1992. And then there's the bigger issue of using a nearly 20-year old study with 30-year old data (and nearly verbatim from the abstract, I might add) to gauge a medical issue that has undergone radical advancement in the last 20 years.
Infertility IS a global public health crisis. In the United States, infertility is estimated to affect 1 in 8 couples. In the UK, that estimate stands at 1 in 7. In Canada? Try 1 in 6. Globally, in developing countries? The World Health Organization estimates that "1 in 4 ever-married women of reproductive age in most developing countries are infertile because of primary or secondary infertility." [Source.] Infertility is highly treatable, with as many as 80% of patients able to be successfully treated. And yet, in the United States, it's a highly treatable disease that is most routinely denied coverage. Why would you advocate for your country to strip away that same coverage? Socialized healthcare or otherwise, at least the NHS recognizes that infertility is a public health need and provides appropriate coverage.
Infertility IS a quality of life issue. While infertility in general may not be life-threatening, it is life-altering. Regardless of whether it's male or female factor, there exists a disfunction of basic human reproductive capacity. Considering that procreation is perhaps one of the strongest driving biological instincts aside from self-preservation, the inability to conceive or carry a pregnancy to term then disrupts a basic life function. A myriad of other medical issues can then result, most notably mental health consequences. To suddenly take away a benefit or to somehow say a disease is not worthy of treatment only further compounds the impact on an infertility patient's quality of life.
Sadly, many of the Letters in today's Telegraph agreed with Mr. Pemberton's opinion. The fact of the matter is, it's easy to throw the infertility patients under the bus. We're an easy target because so many people see parenting as a lifestyle choice.
But you know what Max?
I didn't choose this. I didn't choose to be unable to have my own children. I didn't choose this disease.
And neither did the 3.5 million people infertility affects in the UK.
UPDATE: This post was selected as a 2011 BlogHer Voice of the Year in the Perspectives category. I am deeply honored and humbled to have been recognized in a field of truly outstanding submissions and bloggers. Please take a moment to click the link and read the posts from the other honorees.