Why the world wants American surrogates

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1:0310,000. That's the number of new businesses that join Odo per month. Join Odo today at Odo.com. That's oddoubleo.com. Here in the US, the surrogacy industry is booming, particularly for the wealthy and the famous. It's become a multi-billion dollar industry. But take a step outside the US and the picture looks really different. Paying someone to carry a pregnancy is banned or heavily restricted in most of Europe. And likewise in a number of other countries around the world, such as India, China and Australia. So the United States has become a global hub for commercial surrogacy. But as the practice has grown more popular and more accessible, so too have the ethical concerns. Late last year, the Wall Street Journal published this story about a Chinese billionaire who had dozens of children born in the US via surrogates.

2:04Then, over the summer, a legal battle erupted in Texas over the fate of a baby in which the surrogate rejected the biological parents' wishes and refused to have an abortion after the fetus was diagnosed with a severe heart defect. These kinds of cases have raised all sorts of questions around surrogacy. And those questions become even thornier when you take into account that a big portion of American surrogacy is in the service of foreign parents. From the BBC, I'm Asma Khalid in Washington, DC, and welcome to the Global Store, our show about where the world and America meet. Today on the show, why America has become the world's surrogacy destination? Why that could be about to change? Emmy Neatfeld is a reporter who covers reproductive technology and surrogacy. Now, sitting here in the US, I don't think that I fully understood that American surrogacy is a global story.

3:08But Emmy does. She has in fact been covering this issue for years and recently published this wild story in New York magazine involving a surrogate in Florida and a man from China, the baby's biological parent. The two are now in a legal dispute and it is being seen as a sort of test case. Emmy told me the story actually begins some years ago. During the pandemic, a man named Ted Joe, who lives in Suzhou, China, decided that he wanted to become a father. He is single and so surrogacy was his route to parenthood, but surrogacy is illegal in China. So he turned to the United States. He signed up with an agency who matched him with a woman in Florida named Kyla Simpson. And I'm like, I'm just a young black girl trying to make it. I had a daughter. You know, I also wanted to bless them want to be able to have a child. You know, she was in her mid 20s and she wanted to bless a family with a baby while also helping her own children. And so she signed a contract saying that her base rate would be $50,000 to carry a pregnancy.

4:12But there were extra bonuses like if she had twins, there were various lost wages. All in all, she'd get paid $130,000 almost from Ted Joe. So they did a double embryo transfer. They put in two male embryos and one of the embryos split and turned into triplets. Yep, you're right. The lady in there that was going my ultrasound was like, OK, I'm not trying to scare you, but I'm thinking I'm seeing something. I'm like, what are you seeing? I'm scared. She says, I think I see a third heartbeat. You see what in November 2024, she gave birth to those triplets. And he couldn't get a visa right away is is my understanding from reporting exactly like the visa in a way of the life. And so, you know, way applied, then you really have interviews. It's quite long. And I wait for more than one month. And he didn't realize that as a single man without a lot of assets coming from China, it would actually be quite hard under President Trump to get that visa.

5:17I still actually get my visa directly because I have like a reasonable reason. So the boys were born two months early and they were in the neonatal intensive care unit. It was not 100% clear that they would even survive. And so Joe asked, Kyla, would you take care of them for me every day? I came to that hospital and if it was a day where I'm just super exhausted and I couldn't make it, I'm calling all throughout the day. And so she pumps them milk, she breastfed them, she came to visit them at the hospital. And when they were discharged, she took them home with her. And Joe had hoped to come pick them up as they were leaving the hospital and that he would have their passports and their documents to return to China. But that wasn't what happened. Instead when the boys were a couple days old, he got a message from Simpson with pictures of the boys birth certificates. And the birth certificates did not list his name.

6:23Even though he had a parentage order from a judge in California saying that he was the legal parent. And that was dated also over 31st 2024. It basically stated that I have physical custody of them and that I'm able to make decisions on behalf of them. He didn't know this but Kyla Simpson had gone to vital statistics and they had changed the birth certificates to take his name off unless her and her husband. And she has said in court that she believes this is the right thing to do, that she believes this is what Florida law required. And she also wanted to get government benefits to pay for the kids medical care. But so Joe was in a hard spot because he did not have a visa and he thought I need these kids birth certificates to list me as the father in order to get that visa. And so he was in China and feeling really, really stuck and unsure how he could come back to get these kids. So we're going to come back to this story later because it is not just a single case study in Florida. I think it is a test case in some ways of that has much larger implications beyond the borders of Florida.

7:32But first I think it's useful for us to understand just how popular surrogacy is in the United States. Can you quantify it for us as an industry? Industry experts have estimated that it's more than 10,000 children per year in the United States. And the industry is experiencing really explosive growth. It's estimated to be a $9 billion industry in 2026 up from $5 billion two years ago. People who work in the industry say that 99% of the time things go really well. There have been some studies of surrogates and most American surrogates are happy with their experiences and feel like what they did was really fulfilling not only financially but also emotionally where they feel like they were able to give this amazing gift. And then people became parents who might not be able to otherwise and love and cherish those kids. And to be clear because we're going to talk about the ethics and the laws around surrogacy, there is no federal surrogacy law in the United States. Am I correct?

8:33Yes, there's zero, zero regulations of federal level, like directly impacting surrogacy. It's all state by state and states have very different laws and they can lead to conflicts between the states. And I think you mentioned a moment ago that surrogacy in the United States has been growing. And I find that really intriguing because it is not viewed, I would say broadly in the same way as being as politically divisive as some other reproductive issues here in the US say like abortion. And why has that traditionally been the case? In the United States, there are people who are conservative Christians who are opposed to IVF and who believe that embryos are full people and that destroying them is akin to murder. And so because most surrogacy involves IVF, you know, for those people, surrogacy is a non-starter. Yes, okay. So in the United States, about 90% of Republicans are in favor of in vitro fertilization. And within the surrogacy world, there are actually a lot of people who are pro-life Christians and who feel called by God to serve a family by providing them a baby.

9:47And it is very, very different than abortion. And there's even Christian surrogacy agencies here. But the criticism for surrogacy doesn't always come from the right. Gloria Senaman, icon of left wing feminism, was a really harsh critic of surrogacy. She condemned it and said that it turned women into commercialized vessels for rent. And my understanding is that the US has become a sort of global destination, a hub for a number of people from abroad to come and have children here in the United States. How did the US become such a popular surrogacy hub for people from other countries? Commercial surrogacy is such a big business in the United States largely because it's banned in most wealthy countries. And so countries allow altruistic surrogacy where a surrogate is not directly paid for her pregnancy. But commercial surrogacy where it's, you know, explicitly a... Don't lose your transaction. Exactly. That is verboten in almost every European Union country. And there have been a number of scandals that have really ended industries in other countries.

10:57And so there are a lot of historical stories of people being lured to the country under false pretenses and being confined, having their past words taken, essentially being enslaved for the purpose of commercial surrogacy. And that has led a lot of countries to crack down and say we don't want to be a part of this. You've described a situation in which despite limitations and restrictions in other countries, the industry has continued to grow here in the United States. And I don't know that I fully grasp how controversial surrogacy is in parts of Europe until I started having conversations with some of my European colleagues here at the BBC and understood that this is morally and ethically viewed as really problematic. And why is that? Many people feel that surrogacy is exploitative to women, that it amounts to renting a womb and that it commoditizes a woman's body and basically becomes the sale of children. And this attitude is super prevalent in Europe and has really worked its way into policies where you have countries like Italy that have not only banned surrogacy within its borders but have criminalized pursuing surrogacy abroad.

12:11This has also gotten some politicians in trouble. Jens Spahn, a prominent figure in German Chancellor Friedrich Meetz's Conservative CDU Party, has resigned from his position as parliamentary group leader over a baby. A senior German politician resigned his post after being accused of hypocrisy over hiring an American surrogate to have a child. Surrogacy is prohibited in Germany and Spahn had previously spoken out politically against legalising it. Although raising a child born via surrogacy abroad is not illegal, many found his behaviour hypocritical. Spahn has been critical of surrogacy in the past, in 2015 he said. As a gay man and a Christian, I personally find it very difficult to come to terms with the idea of a rented womb. On July 18, Spahn stepped down as chairman of the Conservative Parliamentary Group. He explained that his personal happiness and political office were no longer compatible. Politically, however, that of course does not settle the issue.

13:14And that shows how controversial the topic has become in Europe. And so then you have the United States. It is a wealthy country. Surrogacy is quite expensive here. Unlike in the UK, there's no government authority that's regulating IVF or other fertility treatment. And the free market can really operate on its own. And so over the years, more and more states have opened their doors to surrogacy. And there are no real restrictions here in what you can do. Sex selection is a routine part of IVF, even though it's banned in most other Western countries. And you can become a surrogate parent if you're old, if you're single, the child doesn't have to be genetically related to you at all. And you can have as many kids as you want. And there's one other big draw about surrogacy in America, which is that any child born here, even if it's via surrogacy, automatically receives citizenship. And that American passport is a huge benefit to many parents from other countries. Where are most of the people who are choosing to have surrogacy in the US? Where are most of them coming from abroad?

14:21The best estimates are from pre-pandemic. And it showed that about 40% of surrogate pregnancies in the United States were from people living abroad. Wow. So 40% of all surrogacies in the United States. Yeah. And China was by far the largest, with about 40% of the intended parents coming from China. To that point, then, on China, Joe, the man who's story you've been following, he is from China. And he used a surrogate, as we said, who lives in Florida. And they are now in the midst of a big legal fight. In Joe's case, the relationship began on a good note. Both Joe and Simpson were Christians, and they bonded over their faith. They shared a friendly, positive relationship during the pregnancy. But after the kids were born, Simpson started to have her doubts about who Joe was and what his motivations were. When the boys were born, he gave them two different last names. So two of the sons got the last name, DSYY, and the other got the last name, Done.

15:26And neither of those last names is Joe. And Joe had an explanation for this. He said, Done was his mother's last name, and that DSYY was another way to spell Joe. But a nurse in the hospital suggested to Simpson. She said, You know, I have Chinese ancestry, and in China, we would never do this. And this made Simpson start to worry that Joe might be a trafficker. And as the weeks and months went on, she began to worry that he planned to separate and sell the babies. And so Simpson becomes afraid for these kids, and she had agreed to help Joe get them back to China. But that didn't happen. Now I just find that she had such kind of like feeling or emotion. She didn't have to keep the voice. She wanted to keep the voice. And Joe started to worry, because it had been months. His kids were, you know, four months old. He still hadn't seen them.

16:28And he no longer believed that Simpson was going to follow through. And so eventually he hired people to come to Simpson's house, pick up the boys, get their documents, and then fly them back to China. I now feel comfortable doing all of these things, and you're not going to get them. I'm not handing them over to no strangers. It really wants you to get my babies back. If it's possible for me to get my babies back, let's look at Carey Bout. So, um, fast forward. I wouldn't say FBI told me to not hand the children over for nothing. Fumtech presents uncertainty strikes. I was surrounded. The aisle and the options were closing in. There were paint rollers, satin and matte finish, angle brushes, and natural bristles. There were too many choices. What if I never got my living room painted? What if I couldn't figure out what type of paint to use? What if I just used Fumtech? I can hire a top rated pro that knows everything about interior paint. Easily compare prices and read reviews. Fumtech knows homes. Download the app today.

17:41I mean, I want to acknowledge that this story ends up having so many twists and turns, not all of which we will have the time to explore here in this episode. But I think it is helpful in following along that I explain a few things here. At this point in the story, the children are still in the US and have not been handed over to Joe, their biological dad. But then there is this awful tragedy when the babies are about nine months old. One of the triplets, a boy named Chris, he dies. And according to your reporting, he has found unresponsive in his crib. An autopsy later indicated that his death was caused by complications from an infection. This is another shocking turn of events in this story. And Kyla Simpson talks about how devastating this was for her. I broke down. They had to pull me out of her own. And because I was kind of like Chris say something. That was like my most bubbly baby. So the story has already become a tragedy because of the loss of this baby. And then what happens next to me in this fight between Simpson and Joe?

18:49This only came to a head earlier in 2026 after Simpson had applied to terminate Joe's parental rights in order to adopt these kids. And that's what the legal case in court is about now. Yeah, Simpson argues that she is the only family that these boys have ever known. I say our case because blood doesn't matter to me. Color doesn't matter. I birthed Joe has an order from a California court saying that he is the legal parent because the embryos were transferred to Simpson in California. I see. I see. And now she is trying to claim that she is the parent. She is trying to adopt these children. First she tried to adopt them. And now she's claiming that the parentage order is not valid because it was issued in California. But the boys were born and spent the first 20 months of their life in Florida. You had a year and a half to do all that you needed to do. But to now rip them from everything they've known.

19:51Yeah, because the children are now well over a year old. Yeah, they're almost two. The Florida Attorney General stepped in intervened in this case to try to get that California order thrown out. Tonight we have an update to a first-class news investigation. We're now learning Florida's Attorney General has intervened in the case involving a St. Augustine surrogate mother. The Attorney General filed an emergency motion asking the court to prevent the boys from leaving the US. I imagine that could have so many implications even for US citizen families who might have a surrogate in one state or the other. That probably opens up a whole can of worms legally. Yeah. And it has huge implications for families with children born via surrogacy. But it also has more general implications for parents in the United States where you could be legally recognized as someone's parent in one state, cross state lines. And then suddenly that question is up for debate. That question is still ongoing. There has not been a resolution yet in court.

20:52The family court, which is the lowest level of court ruled that Joe is the legal parent that that order is valid. Simpson's attorneys have filed an appeal and there's an emergency stay, which means that for the time being nothing is going to happen as the case works its way through the legal system. So we're having this conversation. Where are the boys at the last hearing they were living in California with a nanny. The woman who carried them as a surrogate does not have custody of them. And neither does Joe. Yeah. And they're currently banned from leaving the country. Ah, I see. I mean, into that point they have US birthright citizenship, which I mean, you brought this up earlier and it does make me wonder how much this idea of birthright citizenship factors into part of the incentives to have a child via surrogacy in the United States. It is a huge part of it. Agency is really actively advertised that if you do surrogacy in the United States, your child will be an American citizen and can have all of those opportunities that citizenship opens up.

22:02And this has become a super politically divisive issue because many on the right see this as exploiting birthright citizenship or trying to purchase an American baby. Which I mean, birthright citizenship, very political issue. In fact, it was ruled on by the Supreme Court earlier this year. It did. And after the Supreme Court ruled that birthright citizenship would stay on the Trump issued additional executive orders, one banning birth tourism and one that says that children born via surrogacy to foreign intended parents should not be given American passports. That is already being challenged in court, but it's a strong move to try to prevent people from coming here. Are surrogacy laws are being abused to me of people from places like communist China that are using surrogacies to have a kid to become American citizens in late July. Senator Rick Scott invoked chialisms in case on the US Senate floor to advance his nationwide bill banning intended parents from China and other hostile foreign regimes.

23:08And they're just abuse in the system. And so that's got to stop. He's trying to get support for it and proposing that Americans shouldn't do surrogacy for for countries that are essentially our enemies creating new American citizens who could one day come in and infiltrate our political system. I see. There's there's also Florida version of Senator Rick Scott's law. Governor Ron DeSantis has signed legislation within Florida cracking down on surrogacy contracts between Floridians and citizens of China, Russia, Iran, North Korea, Venezuela and Syria. So going forward theoretically chialisms said would not even be able to enter into a surrogacy contract with someone from China. We have spoken about a few isolated cases that have raised really thorny ethical questions. But I do think it's worth noting that surrogacy is used by a number of people who have really happy families. I don't want to pay to picture that all surrogacy cases end in disaster because that's not accurate.

24:11Yeah. It seems like some of these high profile cases around surrogacy here in the United States may be complicating some Americans views on surrogacy. Do you see a shift going on? Even over the last few months surrogacy has really become a wedge issue where people are seeing these cases where surrogacy goes wrong. And they're sometimes seeing tabloid versions of these really complicated cases. And they're saying, you know, we cannot abide by this. This needs to stop. And it is definitely generating a lot more opposition than even the spring. Do you see the United States status as a sort of global surrogacy hub changing and becoming endangered as a result of these very public and at times very painful cases of surrogacy gone wrong? I think that's a real risk. People are seeing these international cases where things go wrong.

25:14And they're feeling like birthright citizenship is being exploited. And so there's increasing pressure to crack down on international and childhood parents coming to the United States to have babies here. In Florida, the Attorney General intervened in a French gay couple's parentage order and is trying to dispute that they are the legal parents of their surrogate child. And the Attorney General is saying that this is unconstitutional, that surrogacy is modern day slavery. And if he succeeds, it would essentially ban all surrogacy in the state of Florida. The Texas Republican Party has made part of their platform an opposition to IVF. And so you are seeing state after state adopt these anti-IVF anti-surrogacy positions that will probably make a big impact in a couple years. And you might end up seeing a landscape where American surrogacy is not allowed anymore, but it will probably be for very different reasons than is the case in Europe and other countries.

26:24Because of this conservative Christian opposition to IVF and the destruction of embryos and because of anti-abortion arguments. For so long, things were driven by the market. And many people thought that was positive because the government was not interfering into saying who can have children and who can't. But now people are seeing enough of these horror stories and loopholes that I think people are really scared by it. And that there's so much political momentum tied up with that. That it's kind of hard to imagine a bipartisan, moderate, bill being passed that allows commercial surrogacy to continue, but that creates safeguards to prevent some of these worst cases from happening. And me, thank you very much for joining us on the Global Story. I really appreciate you bringing your reporting to the show and sharing it all with us.

27:25Thank you so much for having me, Esma. That was Emmy Neapfield, a journalist who covers reproductive technology and surrogacy. And if you all have any thoughts on today's episode, please do get in touch. We really love hearing from listeners. Our email address is The Global Story at BBC.com. And reminder that here on the Global Story, we go in depth every weekday on one big story about where the world and America intersect. If you're also looking for a way to catch up on the latest headlines from around the world, then we recommend checking out our sister show, The Global News Podcast. Our episode today was produced by Valerio Esposito. It was mixed by Travis Evans. Our digital producer is Charlie Firth. Our executive producer is Martin Powers. Our senior news editor is China Collins. And I'm Esma Khalid. Thanks as always for spending some time with us. We'll be back again tomorrow.

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