Introduction

Cross-border surrogacy has grown rapidly over the past two decades. Today, intended parents frequently travel beyond their home countries to pursue parenthood through assisted reproductive technologies. As a result, cross-border surrogacy now sits at the intersection of medicine, law, economics, and human rights. At the same time, rising demand has intensified debates around surrogacy ethical and legal issues, especially concerning exploitation, citizenship, and regulation.

This comprehensive article explains the meaning of surrogacy, examines Indian and international laws, explores ethical concerns, and analyzes current global trends.

What Is Surrogacy?

Surrogacy is an assisted reproductive arrangement in which a woman carries and delivers a child for another individual or couple, known as the intended parents. In modern medical practice, most surrogacy involves gestational surrogacy, where doctors implant an embryo created through in vitro fertilization (IVF). Therefore, the surrogate usually has no genetic connection to the child. As medical technology advances and social acceptance grows, surrogacy increasingly supports diverse families, including single parents and same-sex couples. At the same time, the rise of cross-border surrogacy has expanded access while also intensifying surrogacy ethical and legal issues related to consent, compensation, and parental rights.

Types of Surrogacy

1. Traditional Surrogacy

In traditional surrogacy, the surrogate’s own egg is fertilized using sperm from the intended father or a donor. Consequently, the surrogate becomes the biological mother. Because this biological link can complicate custody and parentage, many countries restrict or strongly discourage this method. Moreover, courts often face difficult decisions when disputes arise, which further highlights ongoing surrogacy ethical and legal issues. For this reason, traditional surrogacy now appears less frequently in regulated cross-border surrogacy programs.

2. Gestational Surrogacy

Gestational surrogacy clearly separates genetics from pregnancy. Doctors create the embryo using the intended parents’ gametes or donor material and then implant it in the surrogate’s uterus. As a result, this form dominates cross-border surrogacy arrangements worldwide. Furthermore, legal systems generally recognize gestational surrogacy more easily because the surrogate lacks a genetic relationship to the child. Consequently, intended parents often prefer this approach for both medical certainty and legal clarity.

Commercial vs. Altruistic Surrogacy

• Commercial surrogacy includes financial compensation beyond direct medical expenses. Therefore, it can provide meaningful economic support to surrogates; however, critics argue that payment may create pressure or unequal power dynamics. These concerns sit at the center of major surrogacy ethical and legal issues debated globally.
• Altruistic surrogacy allows reimbursement only for pregnancy-related costs. In contrast to commercial models, this structure aims to reduce exploitation and emphasize voluntary support. Nevertheless, limited availability in altruistic systems often encourages intended parents to pursue cross-border surrogacy, where regulations differ.

Ultimately, the balance between access, autonomy, and protection continues to shape international debate. As lawmakers refine policies and medical practice evolves, understanding these foundations becomes essential for addressing modern surrogacy ethical and legal issues responsibly.

Understanding Cross-Border Surrogacy

Cross-border surrogacy occurs when intended parents travel to another country to access surrogacy services that may be unavailable, restricted, or significantly more expensive in their home nation. In recent years, this practice has grown steadily as medical technology improves and global fertility networks become more connected. At the same time, social acceptance of diverse family structures has encouraged more individuals and couples to explore international options. Consequently, cross-border surrogacy now represents a major component of the global fertility landscape while simultaneously raising complex surrogacy ethical and legal issues.

Several key factors continue to drive this trend:

• Legal bans or restrictions in the parents’ home nation often prevent access to domestic surrogacy, thereby pushing families to seek lawful alternatives abroad.
• Lower medical or agency costs abroad make treatment financially feasible, especially when domestic procedures remain prohibitively expensive.
• Shorter waiting periods allow intended parents to begin the surrogacy journey more quickly, which is particularly important for those facing age-related fertility concerns.
• Availability of commercial surrogacy programs in certain jurisdictions provides structured medical, legal, and contractual frameworks that may not exist at home.

However, although cross-border surrogacy expands reproductive opportunity, it also creates significant legal and practical uncertainty. For instance, a child born in one country may not automatically qualify for citizenship in the intended parents’ country, which can delay travel, documentation, or parental recognition. Moreover, conflicting national laws may produce disputes over custody, compensation, or medical responsibility. Therefore, when multiple legal systems intersect, surrogacy ethical and legal issues become more complex and require careful legal planning, transparent agreements, and strong international cooperation to protect the rights of the child, the surrogate, and the intended parents alike.

Global Growth and Recent Trends in Cross-Border Surrogacy

International fertility tourism continues to expand alongside improving IVF success rates and rapidly changing family structures. Today, single parents, same-sex couples, and older individuals increasingly depend on cross-border surrogacy to achieve parenthood when domestic pathways remain limited or unavailable. As reproductive medicine becomes more advanced and accessible, intended parents actively explore global options that promise shorter timelines, specialized expertise, and clearer contractual arrangements. Consequently, cross-border surrogacy has shifted from a niche solution to a significant part of the worldwide fertility industry, while also intensifying ongoing surrogacy ethical and legal issues.

Recent global fertility market analyses estimate multibillion-dollar annual spending on surrogacy-related medical treatment, legal documentation, travel, and agency coordination. Moreover, several regions continue to emerge as major destinations due to supportive infrastructure and comparatively flexible regulation:

• Asia offers cost-effective medical care and experienced fertility clinics, although regulatory tightening in some countries has reshaped access.
• Eastern Europe provides structured legal frameworks and recognized parental rights in certain jurisdictions, which attract many international families.
• North America, particularly parts of the United States, delivers advanced medical technology and strong legal protections, albeit at significantly higher costs.

Nevertheless, high-profile scandals involving trafficking networks, abandoned newborns, or unpaid surrogates have raised serious global concern. Therefore, governments and international organizations increasingly prioritize stricter monitoring, transparent contracts, and enforceable protections. As a result, policy debates now focus heavily on resolving surrogacy ethical and legal issues while still preserving safe and ethical access to cross-border surrogacy for families who depend on it.

Surrogacy Law in India

India once served as one of the world’s largest hubs for cross-border surrogacy. Lower medical costs, skilled doctors, and permissive rules attracted thousands of foreign intended parents. However, concerns about exploitation and child rights led to sweeping legal reform.

The Surrogacy (Regulation) Act, 2021

India now permits only altruistic surrogacy under strict eligibility rules:

• Commercial surrogacy is banned.
• Only Indian heterosexual married couples (meeting age and infertility criteria) may access surrogacy.
• Single parents, live-in partners, and most foreigners cannot pursue surrogacy in India.
• A surrogate must be a married woman with at least one biological child.
• Close relatives are generally preferred as surrogates.
• National and state surrogacy boards regulate clinics and approvals.

Through these provisions, India aims to reduce exploitation and address surrogacy ethical and legal issues related to poverty-driven participation.

Impact on Cross-Border Surrogacy

Because foreign participation is prohibited, India has largely exited the cross-border surrogacy market. As a result:

• Intended parents shifted to countries like the United States, Ukraine, Georgia, and Mexico.
• Underground or informal arrangements briefly increased before enforcement strengthened.
• Legal clarity improved domestically but reduced reproductive access for international families.

India’s regulatory model highlights a global dilemma: protect surrogates while preserving reproductive autonomy.

International or Cross-Border Surrogacy Law: A Comparative Overview

International regulation of cross-border surrogacy remains highly fragmented. Because no single global treaty governs surrogacy arrangements, countries continue to adopt different legal frameworks shaped by cultural values, ethical priorities, and domestic policy concerns. Consequently, intended parents must navigate overlapping legal systems, while lawmakers continue to debate persistent surrogacy ethical and legal issues such as exploitation, citizenship, commercialization, and child protection. For this reason, understanding how key countries regulate surrogacy is essential before pursuing any international arrangement.

Countries Allowing Commercial Surrogacy

United States

Several U.S. states legally recognize compensated gestational surrogacy and enforce detailed contractual protections that establish parental rights before or shortly after birth. Therefore, the United States remains one of the most legally secure destinations for cross-border surrogacy, supported by advanced medical technology and well-developed court procedures. However, high financial costs often limit access, which continues to raise broader surrogacy ethical and legal issues related to inequality and affordability.

Ukraine and Georgia

Ukraine and Georgia have historically permitted commercial surrogacy for married heterosexual couples and granted automatic legal parenthood to intended parents. As a result, both countries became major global hubs for cross-border surrogacy. Nevertheless, recent geopolitical instability, evolving regulations, and safety concerns have complicated international participation. These developments highlight continuing surrogacy ethical and legal issues connected to political risk, regulatory enforcement, and the protection of surrogates and newborns.

Countries Allowing Only Altruistic Surrogacy

United Kingdom

The United Kingdom permits altruistic surrogacy while prohibiting commercial profit. Intended parents must apply for a parental order after birth to obtain full legal recognition. This cautious approach attempts to balance reproductive freedom with safeguards against exploitation, thereby directly addressing key surrogacy ethical and legal issues.

Canada and Australia

Canada and Australia follow similar altruistic-only frameworks that restrict payments to reasonable pregnancy-related expenses and impose regulatory oversight. However, limited surrogate availability and long waiting periods often encourage citizens to consider cross-border surrogacy, which reintroduces complex jurisdictional and ethical challenges.

Countries Banning Surrogacy

France, Germany, Spain, and the Nordic Nations

France, Germany, Spain, and several Nordic countries prohibit all forms of surrogacy, including altruistic arrangements. Despite these prohibitions, some citizens still pursue cross-border surrogacy abroad. When families return home, courts must determine whether to recognize foreign parentage and citizenship. Consequently, these situations generate difficult surrogacy ethical and legal issues involving legal identity, nationality, and the long-term welfare of the child.

Global Legal Outlook

Overall, the absence of a unified international framework continues to drive demand for cross-border surrogacy while simultaneously deepening regulatory complexity. Therefore, stronger international cooperation, clearer parentage recognition rules, and consistent protections for surrogates and children remain essential for addressing modern surrogacy ethical and legal issues in a rapidly evolving global landscape.

Major Cross-Border Surrogacy Ethical and Legal Issues

As cross-border surrogacy continues to expand, ethical and legal concerns have become more visible and more urgent. Although this reproductive pathway creates meaningful opportunities for intended parents, it simultaneously raises complex surrogacy ethical and legal issues that affect surrogates, children, medical professionals, and governments. Therefore, policymakers and practitioners must evaluate these concerns carefully while balancing reproductive autonomy with human rights protections.

Exploitation and Economic Inequality

One of the most debated surrogacy ethical and legal issues involves the potential exploitation of economically vulnerable women. In many cross-border surrogacy arrangements, intended parents travel from wealthier countries to regions where surrogates may accept lower compensation due to financial pressure. While some advocates argue that regulated compensation can provide empowerment, income stability, and healthcare access, critics warn that unequal bargaining power may undermine genuine consent. Consequently, ethical regulation must ensure fair payment, independent counseling, and informed decision-making for every surrogate.

Citizenship, Statelessness, and Legal Identity

Another critical challenge arises when children born through cross-border surrogacy do not automatically receive citizenship in either the birth country or the parents’ home country. Because nationality laws differ widely, newborns may face temporary statelessness, delayed travel documents, or uncertain legal identity. These outcomes intensify surrogacy ethical and legal issues by directly affecting the child’s fundamental rights. Therefore, governments increasingly recognize the need for clear parentage recognition and streamlined nationality procedures.

Parentage Disputes and Contract Enforcement

Legal conflicts sometimes emerge if intended parents separate, refuse custody, or disagree with medical decisions during pregnancy. Additionally, disputes may arise over compensation, medical complications, or unexpected disabilities. In cross-border surrogacy, these disagreements become even more complicated because multiple legal systems may claim jurisdiction. As a result, courts must interpret contracts across borders, which deepens existing surrogacy ethical and legal issues and creates uncertainty for all parties involved.

Commercialization and Commodification Concerns

Critics frequently argue that commercial cross-border surrogacy risks treating pregnancy and childbirth as market commodities. They worry that financial incentives could overshadow dignity, autonomy, and long-term welfare. Conversely, supporters emphasize reproductive freedom and the surrogate’s right to make informed economic choices. This philosophical divide remains central to global debates on surrogacy ethical and legal issues, and it continues to shape national legislation.

Child Welfare and Long-Term Rights

Ultimately, the well-being of the child must remain the primary consideration in every cross-border surrogacy arrangement. Experts increasingly call for transparent birth records, access to genetic information, psychological support, and lifelong legal protection. Without these safeguards, unresolved surrogacy ethical and legal issues may affect identity formation, emotional health, and social recognition.

Moving Toward Ethical Regulation

Taken together, these concerns demonstrate that cross-border surrogacy requires balanced, rights-based governance rather than simple prohibition. Strong legal frameworks, international cooperation, and enforceable protections can reduce harm while preserving reproductive choice. Therefore, addressing modern surrogacy ethical and legal issues remains essential for building a just and sustainable global surrogacy system.

Case Studies in Cross-Border Surrogacy

Real-world events continue to reveal both the promise and the vulnerability embedded in cross-border surrogacy. While international arrangements can successfully help families achieve parenthood, specific incidents also expose serious governance gaps and persistent surrogacy ethical and legal issues. Therefore, examining landmark cases provides valuable insight into how law, policy, and ethics interact in practice.

Baby Manji (India, 2008)

The Baby Manji case remains one of the earliest and most influential examples of legal uncertainty in cross-border surrogacy. In this situation, a Japanese couple commissioned a surrogate in India. However, the couple separated before the child’s birth. Consequently, questions immediately arose regarding custody, nationality, and legal parentage. Because Indian and Japanese citizenship laws did not align, the newborn initially faced documentation barriers that complicated travel and guardianship. Ultimately, court intervention prioritized the child’s welfare, yet the dispute clearly exposed unresolved surrogacy ethical and legal issues, particularly the risk of statelessness and the absence of coordinated international legal frameworks.

Thailand Policy Reversal (2015)

Thailand once functioned as a major destination for affordable cross-border surrogacy. However, high-profile abuse scandals, including cases involving exploitation, abandonment, and unethical agency practices, triggered intense public concern. As a result, the Thai government introduced strict legislation that effectively banned foreign commercial surrogacy. This sudden policy shift demonstrated how quickly national responses can change when surrogacy ethical and legal issues reach a crisis point. Moreover, the ban displaced international demand to other countries, illustrating how restrictive laws in one jurisdiction can reshape global surrogacy routes rather than eliminate the practice.

Ukraine War Evacuations (2022–2024)

More recently, the conflict in Ukraine created an unprecedented humanitarian challenge for cross-border surrogacy programs operating in the region. Because Ukraine had been a prominent hub with legally recognized parental rights, many international intended parents already had ongoing pregnancies when the war escalated. Consequently, clinics, surrogates, and newborns required emergency evacuation, cross-border medical transfers, and rapid legal coordination to secure citizenship and safe passage. These events highlighted how geopolitical instability can intensify surrogacy ethical and legal issues, especially regarding child safety, contractual responsibility, and continuity of medical care.

Lessons for Global Governance

Taken together, these case studies demonstrate that cross-border surrogacy operates within fragile legal and social systems that can shift suddenly due to personal disputes, political pressure, or armed conflict. Therefore, stronger international cooperation, clearer citizenship pathways, and enforceable protections for surrogates and children remain essential. Without such safeguards, recurring surrogacy ethical and legal issues will continue to challenge families, courts, and governments worldwide.

Safeguards and Best Practices for Intended Parents

Families who plan to pursue cross-border surrogacy should follow clear and structured precautions to protect the rights, safety, and dignity of everyone involved. Because international surrogacy arrangements span multiple legal systems and medical environments, careful preparation is essential. Furthermore, proactive planning helps reduce disputes and directly addresses key surrogacy ethical and legal issues such as informed consent, citizenship, compensation, and long-term child welfare.

1. Obtain Legal Advice in Both Countries

Intended parents should first seek qualified legal counsel in the surrogate’s country and their home country. This dual guidance ensures that contracts comply with local regulations, parental rights receive recognition, and post-birth citizenship procedures proceed smoothly. Without proper legal preparation, families may encounter serious delays or uncertainty during the cross-border surrogacy process.

2. Verify Clinic Licensing and Medical Standards

Parents must carefully review clinic accreditation, licensing status, and documented success rates before starting treatment. Reputable clinics follow transparent medical protocols, provide consistent prenatal care, and maintain ethical oversight. Consequently, selecting a trusted provider significantly lowers health risks and strengthens accountability in cross-border surrogacy arrangements.

3. Ensure Independent Counseling for the Surrogate

Ethical practice requires that the surrogate receive independent psychological counseling and separate legal representation. This safeguard confirms that her participation is fully informed and voluntary rather than influenced by pressure or misunderstanding. Therefore, this step directly addresses major surrogacy ethical and legal issues related to autonomy, fairness, and potential exploitation.

4. Confirm Citizenship and Travel Documentation Early

Because nationality laws vary widely, intended parents should coordinate passport, visa, and citizenship procedures before the child’s birth. Early communication with embassies and legal authorities prevents complications that could otherwise affect the newborn’s legal identity or ability to travel home after cross-border surrogacy.

5. Maintain Clear and Transparent Contracts

Finally, families must use detailed written agreements that define compensation, medical decisions, parental responsibility, and dispute-resolution mechanisms. Transparent contracts reduce ambiguity, protect all parties, and reinforce ethical compliance.

By following these safeguards, intended parents create a safer and more responsible path through cross-border surrogacy while proactively minimizing serious surrogacy ethical and legal issues that could arise during this complex international journey.

Policy Recommendations for Ethical Cross-Border Surrogacy

Experts across law, medicine, and human rights increasingly call for coordinated international regulation to manage the rapid growth of cross-border surrogacy. Because national laws remain inconsistent and sometimes contradictory, families, surrogates, and children often face uncertainty. Therefore, policymakers must pursue reforms that both protect fundamental rights and preserve ethical access to reproductive care. Addressing these priorities directly responds to persistent surrogacy ethical and legal issues that continue to shape global debate.

International Agreements on Parentage Recognition

First, governments should develop multilateral or bilateral agreements that recognize legal parentage across borders. Clear recognition would prevent situations in which children born through cross-border surrogacy become stateless or experience delays in citizenship and travel documentation. Consequently, harmonized parentage rules would strengthen child protection and reduce legal disputes.

Minimum Health and Compensation Standards for Surrogates

Second, international frameworks should establish baseline medical care, insurance coverage, and fair compensation standards for surrogates. Consistent safeguards would reduce exploitation risks while still respecting the surrogate’s autonomy. Moreover, transparent medical oversight would directly address serious surrogacy ethical and legal issues related to safety, coercion, and unequal bargaining power.

Central Registries for Transparency and Child Welfare

Third, policymakers could create secure national or international registries that document surrogacy arrangements, medical histories, and legal outcomes. Properly regulated registries would improve transparency, support long-term child welfare, and enable evidence-based policymaking. At the same time, strict privacy protections must remain central to any registry system within cross-border surrogacy governance.

Strong Enforcement Against Trafficking or Coercion

Finally, governments must implement robust monitoring, licensing, and criminal enforcement to prevent trafficking, fraudulent agencies, or forced participation. Without meaningful enforcement, even well-designed laws cannot resolve ongoing surrogacy ethical and legal issues.

Together, these coordinated reforms could make cross-border surrogacy significantly safer, more transparent, and more ethically grounded while still respecting reproductive freedom and the diverse paths families take toward parenthood.

Future of Cross-Border Surrogacy

Medical innovation continues to reshape reproductive care across the world. Improved IVF success rates, advanced genetic screening, and safer pregnancy monitoring now allow more families to pursue parenthood with confidence. As these technologies become more accessible, global demand for cross-border surrogacy will likely expand further. At the same time, growing social acceptance of single parents, same sex couples, and later age parenting continues to normalize assisted reproduction. Therefore, cross-border surrogacy will remain an important pathway for individuals who cannot build families through domestic options alone.

However, future growth will depend not only on medical progress but also on responsible governance. Governments must still confront persistent surrogacy ethical and legal issues, including unequal access, exploitation risks, unclear citizenship rules, and inconsistent parentage recognition. Without thoughtful regulation, these challenges could undermine trust in cross-border surrogacy systems. Consequently, policymakers are increasingly shifting toward balanced legal frameworks that protect surrogates and children while still respecting reproductive freedom.

In many regions, lawmakers now favor regulation rather than complete prohibition. Clear licensing standards, enforceable contracts, medical safeguards, and transparent oversight can reduce harm while allowing ethical participation. Furthermore, international dialogue may gradually produce shared principles that guide safe cross-border surrogacy practices across jurisdictions. Although full legal uniformity remains unlikely in the near future, steady cooperation can still improve protection for all parties involved.

Ultimately, the future of cross-border surrogacy will depend on maintaining this balance between innovation and responsibility. If governments, medical professionals, and legal systems continue to address core surrogacy ethical and legal issues with care and transparency, cross-border surrogacy can evolve into a safer and more equitable global practice that supports both family creation and human dignity.

Conclusion

Cross-border surrogacy offers hope to families who cannot conceive naturally or access domestic programs. Yet it also raises profound surrogacy ethical and legal issues involving exploitation, citizenship, commercialization, and child welfare.

India’s strict altruistic model, the United States’ regulated commercial approach, and Europe’s prohibitions together show that no universal solution exists. Moving forward, international cooperation, transparent regulation, and human-rights protections will shape the future of cross-border surrogacy.

Ultimately, ethical responsibility must guide every participant, including governments, doctors, agencies, surrogates, and intended parents. Only then can cross-border surrogacy remain both a path to parenthood and a system grounded in dignity and justice.

References

• Surrogacy legal overview and global differences – explains how surrogacy laws vary widely around the world, including commercial and altruistic models. https://en.wikipedia.org/wiki/Surrogacy
• Surrogacy: Ethical and Legal Issues (PubMed Central) – a peer-reviewed article discussing ethical, commercial, and legal complexities in surrogacy. https://pmc.ncbi.nlm.nih.gov/articles/PMC3531011/
• Surrogacy Abroad: Legal Pathways and Challenges for Indian Couples – detailed legal explanation of India’s surrogacy law and cross-border implications. https://www.ibanet.org/surrogacy-abroad-legal-pathways-for-Indian-couples
• International Comparison of Surrogacy Laws – comparative chart showing differences in legal frameworks across countries. https://prsindia.org/billtrack/prs-products/international-comparison-of-surrogacy-laws-2713
• Ethical Considerations on Surrogacy – updated ethical analysis including risks and protections for surrogates and intended parents. https://pmc.ncbi.nlm.nih.gov/articles/PMC11879172/
• International Approaches to Surrogacy Regulation – scholarly discussion on the interests shaping global surrogacy laws. https://www.theregreview.org/2024/03/02/international-approaches-to-surrogacy-regulation/
• Latest Surrogacy Law in India (2025) – up-to-date summary of India’s regulatory framework, eligibility, and restrictions under current laws. https://www.ivfsurrogacy.in/latest-surrogacy-law-in-india/