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No One Left to Care: The Ignored Demographic Crisis

South Korea has a total fertility rate (TFR) of 0.75 children per woman — the lowest in the world. Even assuming the fertility rate stabilizes, for every 100 people alive today, there will only be five great-grandchildren. In three generations, the nation will have withered to near extinction.

South Korea is an extreme case, but it is hardly alone. Chile has a TFR of 1.13 (18 great-grandchildren per 100 current people — assuming birth rates do not continue to fall or that young people do not flee the collapsing country); Thailand has a TFR of 1.20 (22 great-grandchildren); Finland has a TFR of 1.30 (27 great-grandchildren). Contrary to common messaging, this is a widespread problem affecting diverse populations. In fact, the majority of countries around the world have sub-replacement birth rates.

One critical reason for concern is the sustainability of systems such as Social Security. The ratio of workers to beneficiaries has declined from 5.1:1 in 1960 to 2.8:1 today. Evermore retirees are dependent on the labor of increasingly few workers, who are being squeezed to keep the system afloat. These welfare programs cannot persist at the current numbers — and their collapse would be catastrophic. Around 1 in 10 Social Security recipients would be unable to pay their bills if checks were delayed by just one month. Beyond Social Security, many people’s retirement security is embedded in systems which presuppose economic and population growth.

Demographic collapse also imperils cultural diversity. Cultures are carried by people. And, as communities become barren of economic opportunities, individuals will face increasing pressure to abandon their homelands. Languages, traditions, and identities will increasingly fade away as the communities which sustain them disappear. This is not merely a poetic lament — UNESCO reports that a language dies every two weeks, often as a result of demographic and economic displacement.

It’s also important to note that, in most developed countries, people want more children than they are able to have. Around 90% of Americans either already have children, want children in the future, or wish they had children in the past. Among those over 45, the average ideal number of children — if they could do it again — is 2.6, far above the current TFR of 1.62. A majority of childless people over 45 wish they had at least two. Pronatalism, then, is not merely about economic or cultural survival. It’s about enabling people to live the lives they already want — lives stymied by economic precarity, social atomization, and institutional failure.

Environmental concerns are legitimate. More people means more consumption. But the relationship between population and environmental degradation is neither linear nor fixed. Today’s most urgent ecological crises — carbon emissions, habitat loss, resource depletion — stem primarily from unjust and unsustainable systems of production and consumption. Ironically, many of the countries facing demographic collapse have the lowest per-capita environmental footprints. While a shrinking, aging population may slightly reduce emissions in the short term, it also drains the labor, creativity, and vitality needed for long-term ecological stewardship. Rather than treating people as liabilities to the planet, we should recognize that future generations — if raised with care, education, and ecological values — are our best hope for building a sustainable world. To shape the future, humanity must first persist into it.

Some have characterized demographic concerns as a right-wing issue. There’s some truth to this. Figures like Elon Musk and J.D. Vance have been among the most vocal about this problem. But the ideological provenance of a problem is no reason to ignore its substance. Conservatives shouldn’t dismiss climate change because it’s associated with the left; likewise, progressives shouldn’t disregard demographic collapse just because its loudest messengers are on the right. Moreover, demographic collapse is coming regardless of who cares about it; to cede the problem to one’s ideological adversaries is to forfeit influence over its solutions.

Some argue that immigration can counteract low birth rates, but this misunderstands the nature of the problem. Immigration may delay some of the effects of demographic collapse, but it cannot resolve them. Immigrants from high fertility countries quickly see their fertility decline upon arrival. Moreover, native citizens also experience falling fertility in response to high immigration rates. Furthermore, viewing demographic decline as a mere numbers game misses the central concern: age structure. A graying population places immense burdens on younger generations, regardless of total population size. Most importantly, as noted earlier, demographic collapse is a global phenomenon. Of the top ten countries of origin for US immigrants — only one, Guatemala — has above-replacement fertility. Immigration allows rich countries to persist by drawing vitality from nations facing the same underlying problem. It’s a demographic shell game, not a solution.

If immigration isn’t viable long-term, what is? The most common answer is financial incentives — paid parental leave, subsidized childcare, and child tax credits. However, while parents would surely appreciate more money in their pockets, recent interventions seem to suggest that such subsidies do not substantively raise birthrates. Poland and Hungary spend 3.5% and 5% of their GDP on pro-natal policies respectively, yet have seen only modest gains in birth rates.

Because concerns about fertility decline are more common on the right — and because fertility was higher in poorer, more patriarchal societies — some suspect that pronatalism is a Trojan Horse for restricting women’s freedom. Setting aside principled objections to such repression, the data shows that restricting abortion and contraception is not a durable fix. Fertility may rise briefly, but the gains do not persist and in fact may invert as people adjust to their new, more repressive realities.

So, if immigration, coercion, and cash transfers don’t suffice, what might? The answer is unclear. Some researchers hold out hope for the efficacy of modified wealth transfers, such as income tax reductions, removing sales taxes on goods related to childcare, or modifying incentives around Social Security. Others advocate for expanding access to — and increasing research into — fertility treatments, allowing individuals to delay family formation without giving it up entirely. More still point out the tight link between housing and fertility, suggesting we need to loosen up zoning codes to allow for the production of more family-friendly housing.

Others, however, are pessimistic on the efficacy of policy and insist that demographic collapse is an essentially cultural problem. Researchers point to the (unsurprising) connection between marriage and fertility and the need to support those looking to get and stay married. Proposals include not shaming those who get married young or have larger families, normalizing working from home, and destigmatizing intergenerational living. Others point to examples such as Mongolia and Georgia and argue that the key to fixing this problem is raising the status of parents. More still emphasize changing norms around parenting to encourage equitable household labor, alleviate burdens from both parents,  and better align with scientific realities.

The prospect of unmitigated demographic collapse — vanishing cultures, faltering economies, fractured communities — is frightening. But it also presents a rare opportunity to rethink the systems and values that structure modern life. Rather than resigning ourselves to decline, we can rise to the challenge of sustaining human flourishing.

The future belongs to those who show up.

Commodification and Exploitation in Egg Donation

image of ovarian follicles

Egg donation is a form of assisted reproductive technology (ART) in which a woman donates eggs to equip another woman to conceive a child. The process of egg donation usually involves in vitro fertilization technology, as the eggs undergo fertilization in a laboratory, or alternatively, the unfertilized egg can be frozen and stored to be used at a later time. Regulated according to guidelines set by the American Society for Reproductive Medicine, this form of ART has gained momentum in the US and around the world since the first child was born from egg donation in Australia in 1983. In the US today, egg donation accounts for about 18% of IVF births.

While the allowance of compensation for egg donors varies by the country, egg donors in the US are compensated up to $8,000 on average for the retrieval of eggs. While egg donation is a sought-after fix for those unable to conceive and stands to provide real benefits to donors and recipients alike, this form of IVF can be a sensitive subject as it raises a number of medical ethics questions.

A common concern raised by medical ethicists regarding egg donation is the type of consent obtained in the process of donating eggs. Although most donor recruiting agencies cite altruism and reliability as the most desirable qualities in a donor, the incentive of monetary compensation could hinder a donor’s capacity to make coherent and informed decisions. Studies have shown that donors motivated by financial incentives suffer more emotional trauma from the process and have a higher probability of regretting their decision than women who express altruistic motivations. In part to avoid risking the commodification of motherhood, nations such as the UK and Australia have ruled any form of monetary compensation to the egg donor to be illegal.

However, Lori Andrews (1992) notes that more often than not, “when society suggests that a certain activity should be done for altruism rather than money, it is generally a woman’s activity.” In agreement with Andrews, sociologist Anna Curtis argues, in her 2010 article Giving ‘Til It Hurts: Egg Donation and the Costs of Altruism, that women should be sufficiently compensated if egg donation is to remain legal in the US, due to the health risks the procedure poses, the emotional strain a donor is subjected to by donating an egg, and the time spent going through and recovering from the procedure.

Due to the technical and invasive nature of egg donation, donors may lack a complete understanding of all the potential short-term as well as long-term risks associated with donating eggs. Curtis also argues that the donors’ emotional investment can cause them to downplay the risks of the procedure. Curtis’ research suggests that not only did donors experience joy over a successful donation, but they also felt guilty when the procedure failed. When Curtis questioned donors regarding their knowledge of health risks associated with egg donation, she found that the women claimed to give “little or no thought to the possible short- or long-term risks involved in donating, despite their ability to list many of these very risks,” demonstrating that even if the donors are aware of the risks, they may not seriously consider the likelihood of these risks affecting them in the future, possibly because of their emotional investment in the egg donation process.

Furthermore, egg donation is a costly process — not only in terms of the emotional and physical strain put on the donor, but also in terms of the financial expenses for the recipient. The inequality of access to ART means that reproductive technology is a viable option exclusively to the wealthy. The feasibility of egg donation must therefore be analyzed recognizing that there may be a large demographic of infertile individuals who would choose ART to conceive a child had they the financial means, but are not able to so due to the high cost of reproductive technology.

The eugenic commodification of egg donors is an additional ethical concern regarding egg donation. Advertisements directed towards egg donors usually depict specific racial, physical, and intellectual characteristics as desirable, making it clear that the agencies are recruiting a certain type of woman whether it be based on ethnicity, height, or even scores obtained on standardized tests. This emphasis on eugenics perpetuates the commodification and exploitation of women’s bodies, reducing the female body to a product with reproductive value.

With these ethical concerns in mind, infertility specialists, agencies that recruit egg donors, as well as recipients of the donated egg must consider the multifaceted implications of egg donation when assessing regulations regarding egg donation. By doing so, individuals and agencies alike can make equitable and informed decisions concerning the emotional, physical, and monetary costs of egg donation to both the donors and the recipients.

Sexism in Birth Control Research

Changes in mood, pain, depression, increased or decreased libido, and weight gain are all common side effects for women who choose hormonal birth control. Recently, news broke that a study of hormonal injections as birth control for men was stopped earlier than planned after men experienced various adverse side effects – all of which women have been experiencing for decades when using hormonal birth control. Due to these effects, the study was terminated earlier than planned.

Continue reading “Sexism in Birth Control Research”