The medical definition of infertility is, like all scientific definitions of disease, a simple statement of biology gone awry. It is defined as the physiological inability of a sexually intimate couple, in which the woman is within the typically fertile years of life, to achieve a pregnancy after 12 months of trying. 

But this definition of infertility, like so many seemingly basic concepts related to sexuality, is no longer good enough for activists and progressive bioethicists. 

Under this definition, the infertile would include not only those who suffer from a mechanical or hormonal impediment to pregnancy, but also those whose life choices, or social circumstances, make natural reproduction impossible.   

Two powerful motives are driving this effort to redefine infertility. 

One, the diagnosis of infertility triggers a cascade of “goods” ranging from societal sympathy to insurance coverage of hugely expensive artificial methods like in vitro fertilization (IVF) and surrogacy. 

Two, some progressive activists, in the name of inclusion, hope to lift every sexual arrangement to the social level of the naturally occurring family, the only arrangement that “organically produces children through the complementarity of the sexes.

What makes an individual or a couple socially infertile? Simply wanting a child for 12 months and failing to conceive, even when the individual or couple has done nothing that would naturally lead to pregnancy (heterosexual intercourse) is enough to trigger a “diagnosis” of social infertility. 

This redefinition of infertility would allow same-sex couples to be diagnosed as infertile, even though they are perfectly healthy and could reproduce in an opposite-sex relationship. It would also include any middle-aged or elderly woman, and any single person who isn’t sexually active.

Physicians can, of course, treat the diseases that underlie medical infertility with hormonal injections or surgical procedures. There is, however, no medical treatment for the social infertility of a single man or that of a same-sex couple whose sex is always sterile.

Hence, progressive bioethicists propose redefining the word “treatment.” Instead of reversing or mitigating a physiological impediment, treatment would mean the artificial production of a baby, because the only way for the socially infertile to reproduce is through the very expensive (and ethically dubious) means of egg buying, embryo creation, and surrogacy.

Such a redefinition would have huge implications. If the World Health Organization (WHO) classes single men and healthy women who want children as “infertile,” it will essentially create a “right to reproduce” for every individual on the globe. 

In countries with socialized medicine, there will be pressure to not only provide IVF to healthy men and women, but even to provide commercial surrogacy. 

The latter is especially troubling in light of the ethical issues of labor, exploitation, and inequality surrounding surrogacy. In our own country, 15 states now mandate health insurance coverage for medical infertility. 

One lesbian couple sued the state of New Jersey for discrimination. They wanted their medical insurance to pay for semen, insemination, and even IVF. This despite the fact that the New Jersey law is based on a finding of a medical impairment and also wouldn’t apply to post-menopausal women who are naturally infertile. 

The concept of  “reproductive justice” is now being repurposed. What was once a rallying cry for radical abortion license has now become a demand that every person who wants a child is absolutely entitled to one. 

Rather than being used to right injustice in regimes with cruel anti-natal policies (e.g., China) “reproductive justice” is being used to drive the reimagining of children. They’re not the joyful results of the sexual and psychological complementarity of men and women that naturally produces families, but rather simple commodities for adults to procure at will. 

And if there is a positive right to a commodity, then it follows that all people should have the same access to it. Even if that means that the government should pay $100,000 for the rental of a poor woman’s womb to give a man a child.  

The multibillion-dollar fertility-industrial complex will be the big winners if infertility is redefined, as will those who are intent on abandoning the naturally occurring family as the foundation of society. 

And the losers? Well, the very concepts of disability and treatment, which will, in the name of a twisted kind of justice, go from elegant simplicity to tortured euphemisms and, of course, the commodified children and exploited women of this brave new world.