FEATURE/Redefining a family: The quest to amend Taiwan's Assisted Reproduction Act

[Editor's Note: This is part 2 of a two-part feature looking into Taiwan's debate on amending the Assisted Reproduction Act, which took effect in 2007. Read part 1 here.]

By Evelyn Yang, CNA staff writer

Amid years-long discussion in Taiwan about amending the Assisted Reproduction Act, which has not been updated since its inception some 20 years ago, activists and experts have been urging the government to grant single women and lesbian couples access to reproductive technology.

However, these calls have been met with resistance from certain pockets of society, with some questioning the impact of a potential increase of "single-parent families," and others raising concerns over the health of babies born through artificial reproduction.

These debates came amid two public hearings earlier this year, followed by an announcement in mid-May by the Ministry of Health and Welfare that it is planning to amend the Assisted Reproduction Act to legalize surrogacy, with stringent conditions.

The ministry is also considering including single women and same-sex couples in the legislation, according to the draft amendments.

A single revolution

"Making single women eligible under the act would be great for those who haven't found a partner yet and are worried about declining fertility as they age," said Sunny Wang, who froze her eggs two years ago.

"But I also hope that support systems, such as subsidies for in vitro fertilization (IVF) and childcare, will be established to increase people's desire to have children," she told CNA.

The 38-year-old always wanted to get pregnant before turning 40 but has not yet met the person she wants to marry. For her, having children is more important than stepping into a marriage.

With years of experience as a kindergarten teacher, Wang felt what matters most in building a family is love and that the children are taken good care of.

Despite this, she is well aware of the tough process single women and same-sex couples have to go through to have children due to the challenging nature of artificial reproduction.

An arduous journey

One example is Mota and City, a lesbian couple. Their journey to parenthood began when Mota underwent IVF in Cambodia in 2019, shortly after same-sex marriage became legal in Taiwan.

IVF is a treatment that involves taking eggs from the ovaries, combining them with sperm in a lab, and placing them back in the uterus, in the hope of a pregnancy occur.

Mota, 41, became pregnant via IVF and gave birth to their daughter Doby in Taiwan in 2020. The family of three now live in a lively and cozy Taipei home.

Reflecting on their unconventional path to family life, Mota admitted that she had never imagined marrying a woman, let alone starting a family with one.

After the pair tied the knot in 2019, Mota was keen to have a child right away, but City was more hesitant due to the eight-year age gap between them.

"I told her that you can never be fully prepared for everything in life, you just have to go for it," Mota recalled.

Since then, the two embarked on a bumpy journey seeking artificial reproduction overseas.

The entire procedure was riddled with all kinds of difficulties. Mota suffered from high and low blood pressure, gestational diabetes, and ascites before and during the pregnancy, but thankfully, the baby was born healthy after nine months.

City, Mota's partner, who is now 33 years old, also underwent IVF in Cambodia two years after Doby was born.

Although she thought her pregnancy journey would be easier given her younger age, tragedy struck at 37 weeks when the baby's heartbeat stopped. "When I was told I thought it was a sick joke," City recalled.

"A year has passed, but I feel like it's so difficult to have a kid. So many people have children after getting pregnant by accident. We had to pay millions, but still, things can go wrong," she said.

Despite the challenges, the couple remains eager to expand their family and has already spent nearly NT$2 million (US$61,856) on overseas treatments in the past four years.

They hoped the government acknowledges the needs of same-sex parents and establishes better protocols so parents do not have to jump through more hoops to be recognized as the "true parents" of their children.

Moving forward

Reese Li (黎璿萍), secretary-general of Taiwan LGBT Family Rights Advocacy, said she hopes LGBTQ+ individuals will no longer be treated as "second-class citizens" and will have access to reproductive technologies, especially given that Taiwan legalized same-sex marriage five years ago.

Li also highlighted the significant pressure and stigma faced by single women who want to have children, especially in Asian societies where marriage before childbirth is considered the "done" thing.

Meanwhile, Wu Chia-ling (吳嘉苓), a National Taiwan University Department of Sociology professor, said there were lingering doubts over including single women in the law due to concerns about "encouraging single-parent families."

"It's not just single women or same-sex couples who need to prepare for parenthood," Wu noted. "Everyone should have sufficient information before starting a family."

Technically, artificial reproductive technologies are, undoubtedly, playing an increasingly important role in Taiwanese society.

In 2023, around one-tenth of the 135,000 newborns were conceived using IVF or other artificial reproduction methods, said Lai Tsung-hsuan (賴宗炫), head of the Assisted Reproductive Center at Cathay General Hospital.

These technologies were significantly contributing to "addressing Taiwan's declining birth rate," said Lai, who was positive about widening the scope of the law to include single women and lesbian couples.

This would eliminate the need for people to travel overseas to access treatment and allow more people to benefit from Taiwan's medical advancements, he added.

Following the May announcement by the health ministry, the proposal regarding expanding access to single women and same-sex couples will be open for public feedback until July 13, with the aim of it undergoing Cabinet review by the end of the year.

After that, all eyes will be on whether, and if so how far, the government decides to go in amending the act.

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