Same-Sex Inability to Reproduce Is Not Infertility, and Redefining It Serves Money and Ideology
Source: Nathanael Blake. "No, Two Men Failing To Make A Baby Together Is Not 'Infertility'." October 20, 2026. thefederalist.com
The Gist
The author argues that two men (or a single person) who can't have a baby aren't 'infertile' in a medical sense, because that outcome is just biology. He says calling it infertility is a way for the fertility industry to get insurers to pay for expensive baby-making services, which he views as turning children into products and exploiting women. He also grounds his objection in the Christian view that children should come from marriage.
Conclusion
Redefining infertility to include same-sex couples and single people is wrong: it denies biological reality, perverts the nature of insurance and medicine, and serves the profit motives of the fertility industry. Insurers and policymakers should therefore not treat it as infertility, which would mean paying for it.
Premises
- Infertility properly means a man and a woman failing to conceive through intercourse. It does not include same-sex couples' inability to reproduce, which follows from the complementary roles of the sexes in human reproduction.
- Two men being unable to conceive together is the predictable, expected outcome of their biology, not an unfortunate medical malfunction.
- Insurance exists to pool risk against unforeseen misfortune, and medicine exists to heal. Covering a certain, non-pathological outcome would turn insurance into a subsidy and medicine into the provision of a product.
- The push to redefine infertility is driven by money as well as ideology. Private equity dominates the fertility industry and wants insurers and governments to pay for its services.
- The commercial reproduction industry (paid gametes, rented wombs, customized embryos) treats children as commodities and harms children and women, including children deprived of a mother or father and exploited surrogates.
- From a Christian standpoint, children are gifts of God, properly begotten within marriage, so turning procreation into a technical process sold to anyone is sacrilege.
Assumptions
- Infertility should be defined by the biological norm of male-female reproduction, not by a person's desire or need for family formation.
- Medicine's legitimate scope is limited to curing pathology and does not include enabling family formation.
- Insurance may cover only unpredictable, pathological conditions, not predictable ones.
- The NEJM authors' motives, and the industry's, are primarily financial and ideological, not compassionate.
- Harms found in some surrogacy and fertility practices apply generally to the proposed expansion of coverage.
- A Christian understanding of procreation and marriage is an appropriate moral basis for public definitions and policy.
- Same-sex marriage rests on the premise that men and women are interchangeable.