Dig into the history of artificial donor insemination even a little, and it reveals itself to be fraught in that special, messed-up way unique to stories of medical progress.

The very possibility of its effectiveness was shrouded by social assumptions — for centuries, infertility was thought to be the sole province of women, and to be caused by everything from “unbalanced living” to studying too hard. Even after male infertility was recognized, solving the problem meant secret procedures on unwitting patients: the first woman who had a child with donor sperm never found out that her husband wasn’t the father, and for decades afterwards doctors hid donor identities from infertile couples, or even used their own sperm. People who stood against donor insemination did so for reasons that now seem dated (e.g. “against God’s will“); people who tried to move it forward did so for reasons that now seem completely atrocious (e.g. eugenics). And up until 1964, every state in the US considered kids born via ADI to be products of adultery, and therefore legally illegitimate.

Dr. William Pancoast performed the first successful artificial insemination on an infertile couple in 1884. The husband “was delighted with the idea, and conspired with the Professor in keeping from the lady the actual way by which her impregnation was brought about.”

By the early 1980s, though, most of this had been sorted out — at least for straight couples. The Uniform Parentage Act guaranteed that any dad who signed a ADI contract along with his wife had legal parentage. Frozen sperm banks popped up all over the place, enabling parents to choose their donors. Some of the social stigma had rubbed off.

A 1980 cartoon (via Dayton Daily News)

If you were coming in with social stigma already, though, forget about it. At this point, lesbians and single mothers were still denied medical help and sperm bank access. There were practical ways around this — many women did, and still do, inseminate at home, with sperm from known donors and with or without the help of midwives (all those turkey baster jokes come from somewhere). Support groups distributed self-insemination pamphlets and held educational workshops where they practiced squirting water into their cervixes.

Aspects of this were lovely — it was community-based, implicitly radical, and less expensive. But there were definite disadvantages as well. For one thing, until the late ’80s, sperm quarantine and STI testing were the responsibility of the doctor. If no doctor was involved, it could be difficult to make sure everything was a-ok. In addition, those who performed ADI without a doctor faced legal barriers — many states only granted accurate parental status to people inseminated “by a licensed physician” (amazingly, this is still true today).

Two Fenway Health workers with a sperm tank. (via Northeastern University Archives)

In the mid-80s, this slowly began to change — thanks largely to groundbreaking clinics like Boston’s Fenway Health. Fenway Health is currently the largest LGBT health and research center in the United States. But in 1983 it was only twelve years old and, like most preteens, hadn’t quite come into its identity yet — in the words of an early member, rather than seeking out a particular clientele, FH “made sure we didn’t exclude anyone.” But that inclusivity attracted marginalized people.In 1983, sensing a need, FH founded their Alternative Insemination program, one of the first in the country. The AI Program taught lesbian couples and single women about fertility cycles, procedural costs, the legal aspects of having kids, and at-home insemination techniques. Mental health staff provided counseling, and the clinic’s doctors helped people get sperm from licensed banks.

The program was born in a difficult time. Initially, Fenway didn’t advertise AI for fear of repercussions, relying on the grapevine to get the word out. Tons of people were firebombing reproductive rights organizations, and the AIDS crisis, which was just starting, required most of Fenway Health’s resources (though AI provided a hopeful counterpoint — as Holly Ladd, who was Chair of the Board in 1983, said, “thank God Fenway was birthing babies at the same time it was burying brothers… it’s a significant statement for the community about the continuum of life”). But it grew and changed, and by 1993 the AI Program included optional in-office insemination services. They hope to soon expand into obstetric care.

The Ansin Building today (via Wikimedia Commons)

By offering this infrastructure, Fenway Health has helped thousands of women have children. And by now, many other medical providers have caught up — there are at least four places in Boston alone that offer ADI services to everyone. Sadly, other extremely important aspects of the reproductive experience still lag behind — by and large, insurance companies won’t cover the cost of ADI if a woman is technically able to conceive without medical intervention (as one staffer put it, “they don’t count social infertility”). Even as medicine outstrips its former biases, laws and corporations are still struggling to catch up. I think this is what is known as “unbalanced living,” and we all know the consequences of that.

For a more explicitly academic take on some of these issues, I highly recommend Vanessa Fernando’s “The turkey baster as revolutionary”: Lesbian Self-Insemination and Processes of (Bio)medicalization in the United States.” as well as Laura Mamo’s “Queering Reproduction.” Much of the information about Fenway Health comes from Thomas Martorelli’s “For People, Not For Profit: A History of Fenway Health’s First Forty Years.”