My wife and I have been dealing with some infertility issues. Simply put, we would like to have children–in the near future if possible–and it seems that this will require some extra medical attention. As I perused our insurance policy to find out what of this extra attention would be covered, I was disappointed to discover that infertility services and medications are not included in our plan; in fact, they are explicitly excluded. I know very little about the actuarial science involved in designing these policies, so I can only speculate about why this might be the case. Whatever the reason, it seems that we may have to pay out-of-pocket for any fertility treatment we seek with this insurance.
At about the same time that I discovered this, I received an email announcing that, as of the upcoming school year, my insurance policy will be covering “transgender services” (their term, and I do not know what all it entails).
Before I go on, let me be clear: I am not writing this post to take issue with transgenderism or with my insurance policy. But I am struck by how this coincidence captures something significant about current cultural dynamics. I do not suggest that my policy is universally representative; I’m sure there are some insurance policies that cover infertility services and do not cover transgender services. Some states even have an infertility coverage mandate. That said, I believe that this new policy is an illuminating artifact of our society, and although it is not entirely representative of insurance policies in general, it is not alone in its representation of ongoing shifts in our cultural values.
Simply put, my insurance policy seems to privilege medical treatment relating to an individual’s sexual/gendered identity over his or her procreative identity. Sexuality seems to be principally conceptualized as an individual expression/experience. What does this say about our society? If some future archaeologist were to discover this policy, what might she conclude about the culture that crafted it?
Let’s assume that the purpose of a student health plan is to allow those enrolled in it to get the medical care they need and deserve without prohibitive personal cost. The school which pays for the policy obviously does not want to pay for services that it is not obliged to provide. It wouldn’t want to, for example, cover the costs of plastic surgery for any students desiring a nicer-looking nose, just as it wouldn’t want to imply that people “deserve” to have weekly massage therapy. These are things we generally agree people do not necessarily need or deserve. So, somewhere along the line, there are value judgements made about what people are entitled to, and what institutions are obliged to provide their constituents.
If we take my insurance policy as the creation of those values, it would seem that our society values self-realization (specifically sexual self-determination and expression)–and this is explicitly distanced from the context of childbearing. We seem to think that people have a basic right to express themselves as individuals, but not necessarily as parents; they are entitled (and encouraged) to have sex, but not to have children. It would seem that we believe that someone with gender dysphoria has some fundamental right to receive medical treatment relative to that condition, while someone with PCOS is not entitled in the same fundamental way to analogous treatment.
I see in this an individualistic bias. Self-determination contrasts with social imposition as expression does with suppression. As we exalt the individual, we tend to abase the social. After all, it is against the social context (culture, tradition, roles, norms) that individuals assert themselves; that is the backdrop to all individual behavior. When we focus on the individual in the foreground, our view of the social background blurs. While this bidirectional movement and refocusing has undeniably benefited certain marginalized populations, it does so at a cost. We cannot sustain both our traditions and our revolutions, even though there is arguably good in both. Eventually, in the shuffle, something of value on one side or the other is lost.
I see my insurance policy as one example of this. And, assuming it is not unique, I think it should give us pause: In almost imperceptible ways, we seem to be subverting biological family–a basic social unit. While there is some value is transcending biology, I worry that a society that rejects it will be like a kite without a tether.
In our exaltation of the individual, we have decontextualized sex, destigmatized non-normative sexuality, and deinstitutionalized sexual relationships. Although, as I’ve said, some good has come of this, I am not sure whether the net result of this movement will be more constructive or destructive to society. As we try to tear down the relics of past ages, what do we build in their stead? We may be moving forward, but we seem to do so in increasingly individualistic ways. And what comes of this great oxymoron–the individualistic society? We are convinced that we are destined for Utopia, and that the path before us is clear. But as I look back, I worry that somewhere along the way, we may have misread the signs. I fear we are driving towards Myopia.