Transnational Surrogacy in Asia: Contexts and Regulations

According to a survey by the International Federation of Fertility Societies’ Surveillance (IFFS, 2022) of 90 countries, gestational surrogacy² is permitted and/or practised in 29 countries, 23 of which have some form of regulatory framework. Where surrogacy is legal, the most widely accepted model is altruistic surrogacy, while commercial arrangements are prohibited in most countries with the exception of a small number, such as Ukraine and several US states. Under altruistic(or non-commercial) surrogacy, surrogates receive compensation for medical expenses associated with pregnancy and/or income loss, whereas under commercial surrogacy, surrogates also receive remuneration for gestational services they provide (IFFS, 2022). 

Surrogacy regulations vary considerably across Asian countries, creating a constantly changing landscape. Countries such as Japan, Indonesia, Thailand, and India are among nations that allow altruistic surrogacy, while commercial arrangements are banned. In these jurisdictions, access is further constrained by eligibility requirements linked to citizenship, civil status, and sexuality. For instance, India banned commercial surrogacy for same-sex couples and single individuals in 2012, and for foreigners in 2015. Since 2022, only the altruistic form has been allowed. In Vietnam, altruistic surrogacy is legally available only to married heterosexual couples and single women. Thailand, once a major commercial surrogacy hub between 2006 and 2015, outlawed the practice in 2016. Currently, only altruistic surrogacy is allowed for heterosexual couples, who must have been married for a minimum of three years with at least one spouse being a Thai national. In addition, jurisdictions such as the Philippines, Taiwan, and Laos have no formal legal framework, leaving surrogacy neither explicitly permitted nor prohibited (Aguiling-Pangalangan, 2024; Nilsson, 2024). 

Factors Enabling Transnational Surrogacy in Asia 

Despite tightening regulations, transnational surrogacy has continued to expand across Asia, driven by a convergence of legal, economic, and social conditions. Favourable legal conditions play a crucial role, such as legal permission, weak enforcement, or absence of regulation in many Asian countries. For instance, India’s legalisation of commercial surrogacy in 2002 established the first Asian reprohub. When India imposed restricted surrogacy in 2015, regulatory loopholes in Nepal enabled the industry to relocate there (Attawet, 2021).

Economic disparities also shape both supply and demand. Lower surrogacy costs in Asian markets attract foreign intended parents, particularly where domestic surrogacy is costly and excluded from state-funded healthcare. Global inequalities in socio-economic capital, mobility and passport privilege enable commissioning parents—generally from wealthier countries—to procure reproductive labour of economically disadvantaged women in South and Southeast Asia (SEA) (Everingham and Whittaker, 2022). For many surrogate women in India and Thailand, the financial incentive provides a means to support their families, making surrogacy a rational, if risky, livelihood strategy (Whittaker, 2019; Attawet, Alsharaydeh, and Brady, 2024).

Restrictive legislation and logistical barriers in the home countries of intended parents further drive them to pursue surrogacy abroad. For example, Australia permits only altruistic surrogacy, which is tightly regulated and time-consuming to arrange. Furthermore, many countries explicitly exclude same-sex couples and single parents from eligibility for surrogacy. Under these conditions, Thailand arose as a prominent destination among Australian commissioning parents, including gay couples, due to its geographical proximity, affordability, and relative ease of access (Whittaker, 2019).

Political Economy Perspectives and Critiques 

The emergence of cross-border surrogacy markets has attracted significant scholarly attention, particularly from political economy perspectives that situate this practice within broader structures of global inequality. Central to these critiques are concerns about the commodification of reproductive labour and children. Spar (2005) conceptualises commercial surrogacy as market-driven exchange governed by supply and demand, involving multiple actors—clinics, brokers, intended parents, and surrogates—operating within an unequal global structure shaped by race, class, and gender hierarchies. Whittaker (2019) describes the Asian surrogacy industry as a ‘disruptive market’ that:

Empirical evidence demonstrates a wide range of exploitative practices that disproportionately disadvantage surrogates. An integrative review by Attawet, Alsharaydeh, and Brady (2024) shows that surrogates frequently endure unnecessary medical interventions and lack informed consent, transparency and autonomy. Many receive inadequate compensation and face risks of financial insecurity in cases of miscarriage or complications. High degrees of mobility in transnational arrangements heighten psychological trauma and health risks for both surrogates and children.

Possibilities of parenthood, however, are distributed along axes of social inequality. Stratified reproduction (Colen, 1995) is evident in commissioning parents’ preference for ova donors with desirable traits—such as being white, highly educated, and healthy—while gestational labour is outsourced to women in the Global South who contribute no genetic material (Vertommen and Barbagallo, 2022). This differential valuation reinforces racialised and classed hierarchies within global reproductive markets.

Banning Surrogacy: Moral Panics and Regulatory Failure

While the biomedical industry tends to frame surrogacy as a progressive solution that expands reproductive rights and family-making, broadening its target customers base to include gay and single parents, the practice simultaneously provokes discomfort within legal and socio-cultural spheres. In Thailand, two high-profile scandals sparked international condemnation and tarnished the country’s reputation as a ‘baby factory’. In August 2014, the media reported the ‘Baby Gammy’ case, which involved the abandonment of a surrogate child with Down syndrome by his Australian intended parents. Around the same time, another story revealed a Japanese man who had fathered fifteen babies through surrogacy in Thailand, raising suspicions of human trafficking. These incidents contributed to the 2015 legal ban on commercial surrogacy for foreigners, same-sex couples, and single individuals (Whittaker, 2019).

Unintended Consequences of Banning Surrogacy

Rather than eliminating commercial surrogacy industry, legal bans result in geographical relocation and underground operation, as illustrated in Attawet’s (2021) mapping of the sequences of emergence of new markets after reprohub closures. Following the prohibition of surrogacy for same-sex couples in India in 2013, services moved to Nepal, while new markets also boomed in Thailand. After the closure of surrogacy services in Thailand and Nepal in 2015, new hubs emerged in Cambodia, and later Laos. To further bypass national regulations, surrogacy is arranged in ‘hybrid’ forms, dividing the surrogacy process into stages—embryo transfer, gestation, and delivery—occurring in different countries (Attawet, 2021). For example, Thai surrogates undergo medical check-ups in their home country, then travel to Cambodia or Laos for embryo transfer. They remain in Thailand throughout their pregnancies, before flying to China, the country of the intended parents, to deliver and transfer the babies. However, the segregated process also means that surrogates have to travel greater distances on multiple occasions, being exposed to higher travel-related and legal risks, thus adding extra layers of vulnerability (Nilsson, 2024). These developments expose the failure of surrogacy regulation due to weak enforcement, legal loopholes, and the absence of cross-border coordination, particularly within the SEA region. Whittaker (2019) notes that enforcement capacity in SEA countries is often limited by resource constraints and fragmented legal frameworks. The relatively open borders within the region further complicate efforts to monitor the movement of ova donors, intended parents, and surrogates. 

Ultimately, the restriction of surrogacy fails to protect those it is supposed to support and instead heightens precarity for all involved. For surrogates, bans eliminate a potential livelihood in the absence of viable economic alternatives. For intended parents, especially queer individuals, criminalisation and the changing legal landscape generate legal ambiguity and emotional distress. Many face the risk of inadvertently breaking foreign laws, having children born stateless, or being denied legal parentage and custody (Vertommen and Barbagallo, 2022; Attawet, Alsharaydeh, and Brady, 2024)

Altruistic Surrogacy as a More Morally Acceptable Model?

In response to public backlash, countries such as India and Thailand now allow only non-commercial arrangements. This approach rests on the assumption that commercial arrangements commodify surrogates’ bodies, whereas altruistic models preserve ethical integrity. The progress of Vietnam’s regulation on surrogacy, by contrast, has moved from complete restriction to a conditional approach. From 2003, all forms of surrogacy were prohibited, although only administrative penalties were imposed. The fines proved ineffective, and surrogacy continued covertly. In 2015, the law was revised to permit altruistic surrogacy on the conditions that surrogates must be close relatives of intended parents. Similar kin requirements for surrogates in altruistic arrangements can be found in the legislation of Cambodia, Nepal, India, and Thailand.³ With this requirement, altruistic surrogacy is justified as an act of reciprocal care or ‘gift-giving,’ motivated by familial solidarity rather than profit (Hibino, 2019; 2022). 

While the binary division of commercial and altruistic surrogacy is common, they are not clearly defined and vary according to different legislations, such as in types and amounts of payments for surrogates (Horsey, 2024), and this ambiguity can lead to distorted application. In practice, even altruistic surrogacy can be exploitative, such as power hierarchies within families which may coerce women into becoming surrogates for wealthier or more senior relatives. Evidence from Vietnam shows that brokers fake documentation to certify kin relations between intended parents and surrogates. 

Several factors explain why altruistic surrogacy is not an ideal choice and, instead, intended parents prefer to engage with commercial arrangements. In some contexts, infertility is regarded as a private, stigmatised matter that the intended parents do not wish to disclose to family members or relatives. Moreover, suitable family members may not exist, may not meet legal requirements regarding age, health, or spousal consent, or may refuse to participate (Hibino, 2019; 2022). 

Furthermore, Vertommen and Barbagallo (2022) argue that the altruistic approach obscures the labour involved in surrogacy and denies surrogates recognition as workers entitled to wages and protections. Framing it as ‘gift-giving’ not only reinforces patriarchal ideals of unpaid care work but also erases the material and emotional labour that surrogacy entails, which feminists have long demanded be recognised and fairly compensated. 

As the changing landscape of surrogacy regulation in Asia illustrates, outlawing commercial surrogacy and/or only permitting altruistic forms can be seen as primarily a reactive measure to moral panics, rather than a thoughtful regulatory response. Moral panics refer to the extreme social-political response or feeling to a certain event, social group, or individual that seems to be a threat to the social order and moral condition of the society, thereby justifying the measures imposed by the authorities to control or suppress (Cohen, 2011). In the case of surrogacy, legal restriction and public outrage reflect societal and moral discomfort, as it disrupts idealised notions of motherhood, family, kinship and heteronormative family structures, which altogether serve as fundamental drivers of moral panics. While altruistic surrogacy is deemed to be more ethical, it remains susceptible to commercialisation, coercion, and fraud. It can still be commercialised and exploitative, while simultaneously imposing new barriers that exclude many social groups from safely and legally accessing surrogacy.

Queer Reproductive Justice & Queer Family-Making

Given the complexity of surrogacy practices, alternative frameworks are needed to centre queer communities’ reproductive experiences. Scholars have proposed queer reproductive justice as an analytical and advocacy framework, building upon the foundations of reproductive justice. While a political economy lens exposes the structural inequalities shaping transnational surrogacy, it is often used to critique those who choose surrogacy, including queer individuals, as complicit in exploitative systems or as enacting consumer choice within neoliberal logics (Stuvøy, 2018). In contrast, queer reproductive justice, building on the broader framework of reproductive justice, offers a more inclusive approach that centres non-normative family-making practices, including through surrogacy.

Grounded in the activism of women of colour, reproductive justice encompasses three fundamental rights: the right to have a child, the right not to have a child, and the right to parent with dignity in a safe environment. This framework highlights both negative rights (freedom from state interference) and positive rights (state obligations to provide enabling conditions), and critiques policies that promote reproduction in service of national or economic agendas (Ross and Solinger, 2017). Reproductive justice therefore serves as a more comprehensive framework that links individual’s reproductive rights to broader social justice and human rights (Luna and Luker, 2013). It challenges the assumption that ‘choice’ is universally available and illuminates how intersecting structures of oppression, such as gender, class, race, and ableism, shape and constrain reproductive decision-making. Over time, reproductive justice has evolved to include diverse subfields such as environmental reproductive justice (Hoover, 2018), cripping reproductive justice (Ginsburg and Rayna, 2023), and queer reproductive justice (Mamo, 2018; Smietana, Thompson, and Twine, 2018).

Queer Reproductive Justice Framework

Mamo (2018) conceptualises queer reproductive justice as a bridge between reproductive justice and queer politics, which fundamentally challenges ‘the natural, normality, normalization and normativity’ (p. 25). This framework calls for a critical reimagining of reproduction and kinship, decoupling them from biological, racialised, and class-based hierarchies. It affirms and validates diverse, non-normative kin-making practices, including chosen families and non-biological ties, while also remaining attuned to the political, economic, and social structures that govern reproductive access and meaning. As Falu and Craven (2023) note, ‘[q]ueerness, to its fullest potential, is still not yet here until reproductive justice also encompasses queer lives, queer communities, and queer losses’ (p. 219). They apply this framework to the understudied issue of queer reproductive loss, calling for scholarship and health care systems to move beyond biological reproduction and embrace the full spectrum of queer reproductive experiences. Similarly, Ferrara (2023) implicitly draws on queer reproductive justice to critique cisnormative paradigms that render trans and intersex reproduction invisible.

Nonetheless, queer scholars remain cautious of the prevailing rhetoric of reproductive ‘choice’ offered by ART for LGBTQIA+ parents. As Smietana, Thompson, and Twine (2018) point out, such narratives reflect neoliberal values that obscure the deep structural inequalities shaping access to reproductive technologies. The commodification of reproductive labour in surrogacy, they note, cannot be separated from the historical legacies of colonialism, imperialism, racism and global economic inequality. Leibetseder (2025) further warns that the calls for equal access to ART risk reinforcing Western-centric, heteronormative family ideals while marginalising queer kinship of choices (Freeman, 2007)—which, often perceived as threatening to social order, are routinely excluded from policy frameworks. 

Queer Family Formation and Queer Kinship

Central to queer reproductive justice is queer kinship, which challenges normative ideals of family-making. Stigma surrounding queer kinship stems from moral panics that render queer individuals unfit for childrearing and position queer family formation as disrupting the traditional nuclear family models (Smietana, Thompson and Twine, 2018). Instead, queer kinship envisions multiple pathways to belonging and intimacy, extending beyond institutional categories of marriage and parenthood to include platonic partnerships, polyamorous relationships, co-parenting, and other relational forms. Such kinship practices are grounded in care, mutual support, and social justice, and they resist the erasure of marginalised histories (Freeman, 2007; Leibetseder, 2025). 

Yet, even within queer feminist scholarship, perspectives on family-making diverge. Some scholars critique the pursuit of biologically-related children via surrogacy, arguing that this resembles heteronormative ideals and reinforces dependence on legal marriage and familial institutions (Leibetseder, 2025; Mamo, 2018). As biological kinship remains a key criterion for parental recognition, queer families may face heightened legal risk and marginalisation, such as difficulties obtaining birth certificates, citizenship, or custody for surrogate children, under inconsistent and exclusionary laws that vary between legislations (Leibetseder, 2025). 

Nevertheless, it is crucial not to dismiss the genuine desire for biological parenthood expressed by many queer individuals and couples (Smietana, Thompson, and Twine, 2018). These desires can coexist with commitments to non-normative kinship practices. While this essay does not delve into the complexities underlying queer desires for biological reproduction, I argue that such aspirations, when pursued with respect for the dignity and safety of surrogates, should be granted the same legitimacy as other forms of queer family-making. 

Revisiting the Feminist Debates on Surrogacy and the Way Forward

The broader conceptualisations of social justice and kinship offered by queer reproductive justice complicate feminist debates on surrogacy, which often frame surrogacy as either a site of agency or oppression, monetisation or exploitation. Revisiting these debates through both feminist and queer perspectives allows for a more nuanced understanding of reproductive labour and choices, embracing the diverse ways of family-making and simultaneously avoiding the reproduction of social injustice. 

Feminist positions on commercial surrogacy are notably polarised. Whittaker (2019) identifies two dominant perspectives: liberal feminists, who view surrogacy as an expression of reproductive choice and bodily autonomy, and Marxist and radical feminists, who critique surrogacy as a form of patriarchal medicalisation, commodification, and exploitation. These positions align with two broader conceptualisations of surrogacy: abolitionist and reformist (Maniere, 2017). The abolitionist stance calls for the prohibition of surrogacy, citing concerns over the commodification of women’s bodies and babies, the reinforcement of racial and gender hierarchies, and the alienation of labour under market-driven logics, which often demand the emotional detachment of surrogates from newborns. In contrast, reformists complicate simplified narratives of choice and agency by centring the lived experiences of surrogates and advocating for regulatory frameworks that address exploitation without erasing women’s reproductive labour and autonomy.

This divide echoes debates surrounding the decriminalisation of sex work. Scholars such as Stacey (2018) and Vertommen and Barbagallo (2022) urge caution against equating all commercial surrogacy and sex work with exploitation and trafficking. Instead, they argue for recognising these forms of embodied labour as legitimate work deserving of rights and protections. Lewis (2017) similarly positions surrogacy as a stigmatised form of body labour, calling for its destigmatisation and the recognition of reproductive labour as politically and materially valuable. 

At the heart of these debates is a tension between viewing surrogates as agents or victims. When situated within broader systems of structural oppression and intersecting class, race, gender, disability, and global inequalities, it becomes difficult to draw definitive conclusions about the extent to which surrogates exercise genuine agency in participating in transnational surrogacy. Nonetheless, mainstream scholarship and media representations often overemphasise the vulnerability of surrogates, while neglecting the voices and conditions of intended parents. This imbalanced representation risks reinforcing a reductive moral binary in which surrogacy is perceived as inherently exploitative and thus in need of abolition. 

The familiar dichotomy of wealthy, privileged intended parents versus poor, marginalised surrogates oversimplifies and obscures the lived realities of those involved. Queer and single parents are particularly vulnerable to moral panics and legal-social discrimination against non-normative families. They may also face significant financial strains in their pursuit of parenthood, including mortgaging property (Smietana, Thompson, and Twine, 2018). By reinforcing simplistic stereotypes, public discourse diverts attention from the global capitalist structures that sustain the transnational surrogacy industry.

Queer reproductive justice provides a more comprehensive framework to navigate these tensions. It critiques the exploitative conditions that characterise commercial surrogacy, while remaining open to mutually respectful arrangements, including kinship ties between surrogates, intended parents, and children. Its vision also extends beyond the altruistic model requiring biological or kin-based ties between surrogates and intended parents, recognising the possibility of care and mutually respectful relationships. As discussed previously, restrictive legislation may push surrogacy into unregulated and exploitative spaces; therefore, robust regulation grounded in an ethic of care and accountability is much needed (Stuvøy, 2018; Mamo, 2018). While dismantling the global inequalities underpinning surrogacy will require long-term structural change, more immediate interventions should prioritise expanding access to dignified and secure livelihoods for women and for people who can become pregnant, including surrogacy where it is freely chosen. 

Given the serious legal, ethical, and health concerns associated with commercial surrogacy, it is understandable that some scholars and policymakers call for its abolition. Arguments for prohibition often highlight the risks of exploitation, psychological harm, and unequal power relations embedded in transnational arrangements. Accordingly, Attawet, Alsharaydeh, and Brady (2024) recommend the development of an international legislative framework that bans commercial surrogacy without penalising the surrogates. In contrast, Horsey (2024) argues that international regulation is unlikely possible due the absence of international consensus on surrogacy, and instead contends that national-level regulation is more feasible. Such an approach will enable intended parents to access domestic services rather than crossing borders. I broadly agree with this view, as it may reduce the unequal distribution of reproductive labour and the stratified reproduction structured along race, class, and nationality. Geographic proximity may also facilitate sustained care, mutual support, and enduring relationships between surrogates, intended parents, and children. 

While the scope of this article does not examine in detail the ethical and legal complexities of surrogacy legislation, several countries demonstrate that comprehensive regulatory frameworks can function effectively. Canada offers one example, providing supportive conditions for LGBTQIA+ family-making through surrogacy while safeguarding the rights and health of surrogates (Gruben, Carsley, and Czarnowski, 2024). Finally, I argue that, rather than criminalising commercial surrogacy, a more ethical and effective solution lies in recognising surrogacy as labour and regulating it accordingly, ensuring fair compensation, legal protection, and bodily autonomy for surrogate workers. Additionally, policies must confront the root causes of reproductive injustice and restrictive definitions of family. In this light, punitive bans do not resolve exploitation but instead signal a broader reluctance to engage with the complexities of reproductive justice in an unequal global landscape.

Conclusion

Feminist political economy offers a powerful lens for understanding how transnational surrogacy is embedded in global systems of inequality, with Asian markets providing a salient example. This approach reveals how value is extracted from women’s bodies within the surrogacy business and highlights the often-invisible reproductive labour that demands recognition and fair compensation. However, focusing solely on exploitation and commodification risks triggering the moral panics that drive the prohibition of commercial surrogacy, which potentially causes more harm than good. Such a perspective may also reinforce a moral binary that positions all commercial surrogacy as harmful, while overlooking the complex motivations and lived realities of those involved.

To move beyond this impasse, queer reproductive justice provides an expansive and intersectional framework. Building on Mamo’s (2018) work, I argue that queer reproductive justice offers a twofold perspective on commercial surrogacy debates. First, it demands legal recognition and enabling conditions that allow queer individuals to realise their reproductive and family-making aspirations free from discrimination and exclusion. Second, it insists that these rights are inseparable from the reproductive justice of surrogates and gamete donors, calling for solidarity, ethical interdependence, and care across all parties involved in reproductive arrangements. 

While scholarship on queer reproductive justice has predominantly focused on Western contexts, this framework remains largely absent from Asian analyses and advocacy. Applying this lens in Asian settings is novel and essential, as it would open space for a radical reimagining of reproductive possibilities beyond biological and heteronormative family models, while demanding fairness and protection for those performing reproductive labour. Ultimately, achieving justice in transnational surrogacy requires resisting simplistic solutions like prohibition and instead embracing rights-based, care-centred, and coordinated regulation. Through such an approach, we can support the reproductive autonomy of both surrogates and intended parents, and work towards more equitable, inclusive, and dignified reproductive futures, not only in the Asian region but worldwide.

ORCID iD 

Thien-Kim Nguyen-Trinh https://orcid.org/0009-0004-2536-6858

Funding

No financial support was received for the research, authorship, or publication of this article.

Declaration of Competing Interests

The author declares that they have no competing interests. 

Statement on AI Use

The author declares that the artificial intelligence (AI) tool Claude Ai was used to assist in manuscript preparation. AI was used solely for language editing and proofreading, and all content, interpretation, and conclusions are the author’s own.