At Tuesday night’s debate, seemingly stung by Kamala Harris’s assertion that IVF treatments have been curtailed “under Donald Trump’s abortion bans,” the former Republican president declared, “I have been a leader on IVF, which is fertilization. The IVF — I have been a leader.” To show exactly how much he knew about the reproductive technology, he repeated the word “fertilization” a few moments later.
It is true that Trump came out against the Alabama State Supreme Court decision, in February, restricting access to IVF, and that in late August he said he would make the procedure free. “Under the Trump administration, we are going to be paying for that treatment,” Trump told NBC News. “We’re going to be mandating that the insurance company pay.”
You might call this offhand proposal half-baked. (Trump surprised his own advisers with the comment, NBC later reported, and his campaign has refused to provide more detail. A person close to the campaign said there may not actually be a plan.) You might also notice that his remarks were totally contrary to his prior opposition to similar health-care-coverage mandates, and to his party’s refusal to vote for analogous measures in Congress.
Trump is aware that most Americans are deeply unhappy with the right-wing drive to ban or limit IVF, which is currently most accessible to wealthier, whiter people — people who could plausibly vote Republican. The fact that the proposal faces opposition from his own party and no conceivable path to being enacted was, of course, beside the point. As with his waffling abortion stance, the protests of social conservatives on IVF may even serve to make him look more independent, when they don’t make him look incoherent.
But in the wake of this latest apostasy — positioning himself as a champion of “fertilization” — it’s been illuminating to listen to what, exactly, normally loyal elements of the right have objected to, and to observe these responses alongside newly resurfaced comments from Trump’s chosen running mate, J.D. Vance. It’s clear that the socially conservative wing of the party opposes the freedom that IVF allows, especially for those whose life choices do not fit the right-wing ideal.
The Alabama court decision last winter left plenty of people scratching their heads about why the party lamenting the declining birth rate would oppose something that leads to more babies. That court’s reasoning, citing state law as well as the Dobbs decision that overturned Roe, was that frozen embryos were “extrauterine children,” subject to the same protections and compensations of children walking the Earth, thus putting common IVF practices of freezing, storing, and disposal at risk. Anti-abortion activists had long quietly opposed IVF, largely on the same grounds, but as long as Roe v. Wade stood, there was little will or capacity to do much about it.
But since Trump has thrown his nominal support behind access to IVF, a new variety of opposition has come to light. Opponents of the treatment have made clear, directly and indirectly, through both open statements and calculated omission, that they reject the technology because it could make it easier for women to resist their preferred social script: having babies early and in the context of a heterosexual marriage.
In a tweet to J.D. Vance following Trump’s IVF proposal, Students for Life president Kristan Hawkins, an influential voice in the anti-abortion movement, wrote: “It makes zero sense for the GOP to be encouraging families to delay childbirth by trying to promote an IVF mandate in healthcare insurance plans.” (Hawkins also opposes contraception and abortion.) Conservative author and self-described child advocate Katy Faust was even less euphemistic. When she recently catalogued her objections to IVF on X — she is opposed to the intentional and unintentional destruction of embryos, as well as surrogacy — someone replied that the right needed to “find the root cause for infertility in America.” Faust responded: “The vast majority of people who are ‘infertile’ spent their peak fertility on careers, travel, and finding themselves.” In other words, female selfishness was the culprit. And, by extension, IVF, for providing a false sense of security. Inability to conceive due to factors unrelated to age, such as endometriosis, male infertility, or prior medical treatments, such as chemotherapy, are simply ignored, presumably as collateral damage.
Of course, in addition to allowing more options for heterosexual couples, increased access to IVF could mean more children for queer people and single women. Patrick Brown, fellow of the Ethics and Public Policy Center, argued in Compact magazine, in response to Trump’s suggested mandate, that the policy would place “the federal government firmly on the side of viewing parenthood as an individual right, rather than as something properly existing within the context of a couple.” IVF, he claimed, wasn’t a solution to declining birth rates, but rather a contributor: “The increased availability of IVF has coincided with accelerated declines in global birth rates, not their revivification. Indeed, the technology can lead some women to assume they can delay marriage and parenthood until their late 30s or early 40s with little problem — only to find out too late they were wrong.” Of course some women do find out it’s too late for them, but Brown implied that the entire enterprise was a sham. Sean Tipton, a spokesman for the American Society for Reproductive Medicine, translated this approach: “What they do here is take a little kernel of biological reality, and they twist it for their own ideological purpose.”
Not long after Trump’s IVF “announcement,” reporters unearthed some adjacent comments from J.D. Vance, who seems to have spent a lot of time in the last few years talking about whether women are fecund and if they aren’t, what purpose they could possibly serve to society. (These conversations rarely involve an actual living human woman with a speaking role.) Republicans used to occupy themselves with criticizing the easier-to-attack reproductive decisions of low income women of color — “welfare queens” producing “crack babies,” to use their noxious shorthand. But Vance is unafraid to go after the presumed life choices of educated, affluent women, using the vocabulary of the manosphere.
In these resurfaced interviews, Vance states that the “whole purpose of the postmenopausal female” is to care for grandchildren, and that what’s wrong with journalism and elite society can be explained by “miserable” infertile people who “passed the biological period” of fertility. “One of the weird lies the elites have been told is that it’s very easy to start a family when you’re 45,” he said in a 2021 podcast interview retrieved by Media Matters. “Well, human biology — God says otherwise.”
It’s of course true that starting a family at 45 is not “very easy” — assuming any human on Earth has ever actually been told that it was. But Vance is uninterested in making it easier for any person facing infertility to have access to care: In June, he voted against the Right to IVF Act, a suite of bills that would, among other provisions, mandate coverage for IVF in private and public plans. Vance’s game, on IVF, has often been to leave the technology out of the story altogether, presenting a picture of women’s lives in which it doesn’t exist — and in which delaying having children is riskier — while voting to keep it fairly inaccessible.
Paired with Vance’s disapproval of the sexual revolution for encouraging people to end even abusive marriages, his elision of IVF adds up to a not-so-subtle coercion aimed at women: Marry the first schmuck who’ll have you and reproduce as early as you can, without access to contraception or abortion, lest you end up a childless cat lady. Should women be choosy, or unlucky, or pursue meaning through avenues other than parenthood, they’ll be cautionary tales rather than medical success stories.
Needless to say, American women do not need to be told that fertility is fleeting. The backlash to feminism in the 1980s and early ’90s made the phrase “biological clock” so ubiquitous that it was a tagline in an Oscar-winning performance, and though it’s transmogrified, the panic is still with us. (Millennials like me came of age reading about the pained fertility journeys of Gen-Xers; I know more than one person who thought they had to have a baby by 30 or else never.) The public conversation is also replete with accounts of the heartache of infertility: Michelle Obama recounts the experience in her memoir and told Good Morning America, “The biological clock is real — because egg production is limited. And I realized that as I was 34 and 35.” Happily for the Obamas, they had options: “We had to do IVF.” Did Senator Tammy Duckworth have to say it any more plainly, or prominently, than when she declared from the stage at the Democratic National Convention this year, “My struggle with infertility was more painful than any wound I earned on the battlefield”? The woman is a double amputee from grenade fire, for God’s sake.
The full array of assisted reproductive technology, including IVF, is rarely covered by insurance, is stressful and time consuming, and though success rates have risen over time, does not provide any sort of guarantee of a healthy pregnancy or baby. As Barbara Collura, president of RESOLVE, which advocates for infertility coverage, told me, “No little girl is growing up wishing to build her family through IVF.”
For those who end up needing it, it is a lifeline. In 2022, about 2.5 percent of all births were a result of assisted reproductive technology, adding up to just over 91,000 babies. That number might be quite a bit higher if more people had access, free of disapproval of how they got to that point. Sean Tipton, a spokesman for the American Society for Reproductive Medicine, said: “We don’t ask people questions like how did your nose get broken? We just cover it and treat it. Somehow for reproductive medicine everyone gets to judge how the patient got where they are.” Often there is no clear answer.
Tipton could point to no comprehensive data on the reasons, or even just underlying diagnoses, people seek fertility treatment, but there’s at least one clue in the qualitative work of anthropologist Marcia C. Inhorn. In Motherhood on Ice, she interviewed over 150 well-educated women about why they froze their eggs in hope of future parenting. What she found was that most of them hadn’t yet found a male partner who was equally ready and willing to parent when they were. Maybe if their male peers had spent a little less time on “careers, travel, and finding themselves.”
On Thursday, Democratic Senate Majority Leader Chuck Schumer said he would bring back the Right to IVF Act back to the floor. Last time around, the only Republicans to vote for it were Susan Collins and Lisa Murkowski. Perhaps Trump will step up and be a leader on fertilization by urging his party to support bills that would do exactly what he promised, making IVF not only legal but accessible through insurance. Probably not. In the meantime, his willingness to say anything for power has gotten a lot of people to say what they really think.
