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Patients, citizens and consumers: logics of choice and care in Swedish egg donation narratives
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Arts, Centre for Gender Research. Uppsala University, WoMHeR (Centre for Women's Mental Health during the Reproductive Lifespan).ORCID iD: 0000-0003-4579-2067
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Reproductive Health.ORCID iD: 0000-0002-2253-4682
(English)Manuscript (preprint) (Other academic)
Abstract [en]

This interview-based study, conducted in Sweden, advances feminist and queer scholarly debates on the logics of choice and care in medically assisted reproduction. It focuses on conception with donor eggs as a reproductive method, where the medical scenarios entail that decision-making in clinical practice and family-making intertwine. In addition, it examines experiences of both receiving and donating eggs or gametes across the life span. Drawing on Annemarie Mol’s critique of choice logics and autonomous decision-making in care practices, we argue for the value of centring patienthood within feminist scholarship on egg donation. Our analysis demonstrates that the positive sense of patienthood reported by egg donors in public clinics—who repeatedly emphasised that they were well cared for—was contingent upon their utility to the clinic. Turning to recipient narratives, we show how becoming a consumer of fertility care involved a shift in responsibility for the practice. Our findings reveal a paradox: when interviewees travelled outside Sweden to access donor gametes, the consumer logic that expanded their choices simultaneously diminished their position as patients. This, we suggest, exemplifies Mol’s argument that choice does not necessarily equate to better care.

Keywords [en]
Egg donation, qualitative interviews, patientism, logics of care, dual patienthood, fertility travel
Keywords [sv]
äggdonation, kvalitativa intervjuer, patientism, omsorgslogiker, dubbelt patientskap
National Category
Gynaecology, Obstetrics and Reproductive Medicine
Identifiers
URN: urn:nbn:se:uu:diva-575369OAI: oai:DiVA.org:uu-575369DiVA, id: diva2:2026781
Available from: 2026-01-10 Created: 2026-01-10 Last updated: 2026-01-21
In thesis
1. Caring for conception: The ontological politics of gamete donation practices in Sweden
Open this publication in new window or tab >>Caring for conception: The ontological politics of gamete donation practices in Sweden
2026 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

This thesis examines reproductive decision-making in practices of egg and gamete donation. Adopting a multi-sited ethnographic approach and drawing on Annemarie Mol’s empirical philosophy, the thesis analyses policy documents, focus group discussions with fertility practitioners, and individual interviews with donors and recipients. 

A focus of the thesis is to show how politics emerge from the various enactments of kinship and medical categories as deployed in practices of reproductive donation. Departing from a relational ontology as suggested in Science and Technology Studies (STS), the thesis argues that the categories of children/parents, donors/recipients, and patients/providers are not given but need to be actively negotiated in legal texts, clinical practice, and patient narratives. By focusing on reproductive practices for single women, queer and lesbian couples in a Swedish context, the study explores how a practice-oriented reading of ontology enables a ‘queering’ of egg donation practices.

Focusing on policy, the analysis shows that children’s right to donor information from the ‘special medical record’ is based on a temporal paradox and premised by a symbolic rather than material understanding of genetic relatedness, thereby failing to account for diverse needs within different family forms. Examining fertility practitioners’ clinical reasoning, the thesis further demonstrates how a standard model of egg donation – based on single donation to heterosexual couples – continues to shape clinical practice. Analysing donor and recipient narratives through Mol’s concept the logic of care, the thesis proposes that egg donation entails a form of dual patienthood. By showing how different enactments of kinship and medical categories become tied to different versions of the good and responsibility in reproductive decision-making, the thesis advances a practice-based analytical framework for studies on egg and gamete donation. 

The thesis contributes to queer and feminist scholarship on reproductive decision-making by focusing on ontological politics and logics of care, thus placing questions of gamete donation in a new framework. Empirically, the thesis contributes knowledge on the usages of donor eggs among queer and lesbian couples in Sweden. The first study to examine fertility practitioners’ reasoning following Sweden’s legal change on combined gamete donation, it also offers recommendations for policy and practice.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2026. p. 142
Series
Uppsala Interdisciplinary Gender Studies ; 9
Keywords
Reproductive decision-making; Egg donation; Double donation; Embryo donation; ROPA (Reciprocal IVF / partner donation); Clinical decision-making; Family-making; Ontological politics; Logic of care; Patientism; Ethics-in-practice; Feminist ethics of care; Multi-sited ethnography; Empirical philosophy; Interdisciplinary STS, Reproduktivt beslutsfattande; Äggdonation; Dubbeldonation; Embryodonation; ROPA (Reciprocal IVF / partnerdonation); Kliniskt beslutsfattande; Familjebildning; Ontologisk politik; Omsorgslogik; Patientism; Etik i praktiken; Feministisk omsorgsetik; Multi-situerad etnografi; Empirisk filosofi; Tvärvetenskaplig STS
National Category
Gender Studies Gynaecology, Obstetrics and Reproductive Medicine Public Health, Global Health and Social Medicine Medical Ethics
Research subject
Gender Studies
Identifiers
urn:nbn:se:uu:diva-575413 (URN)978-91-513-2715-0 (ISBN)
Public defence
2026-02-27, Humanistiska teatern, Thunbergsvägen 3C, Uppsala, 10:00 (English)
Opponent
Supervisors
Note

Paper I - Disicplined Parents

Paper 2 - Egg donation beyond the standard model

Paper 3 - Patients, citizens and consumers

Paper 4 - Donor-conception as field site

Available from: 2026-02-03 Created: 2026-01-11 Last updated: 2026-02-03

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Elenis, Evangelia

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Citation style
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