For years I've been helping people in China, including many gay men, have children through surrogacy. Yet it was on a recent trip through China and Taiwan that I saw the future for gay families in those countries and across Asia.
I was one of the featured speakers at the Men Having Babies conference in Taipei last month. Men Having Babies is an organization whose goal is to provide resources to gay, bi and queer men for family-building through surrogacy. The group has helped build hundreds of families around the world.
I had been to many MHB conferences across North America and Europe. This one was different. The rooms were overflowing with attendees like I'd never seen, 300-plus in the course of the weekend.
The energy was electric, non-stop information and conversation flowing out of the meeting rooms and into the halls. Question-and-answer sessions were never long enough as the intended parents were eager for more.
Many Americans can't imagine sitting through six hours of panel discussions, followed by another three hours the next day, and hanging on every word the whole time. At the Men Having Babies conference in Taipei there seemed to be no daydreaming, no scrolling through Twitter on their phones. They listened and asked many questions, looking for the roadmap to this new dream of having a baby.
They weren't just interested in the information. They weren't just curious about gay family-building. They were yearning for it.
The possibility of gay family-building in China, and indeed across Asia, is truly brand new to most. Today in the United States, gay men see the possibility of having children all the time. We see examples on TV and in film. We see famous gay men like Elton John, Greg Berlanti and Andy Cohen using surrogates to build their families.
Yet in China, the idea of gay men having children is where the United States was when I was in my 20s. Being gay back then meant that you would never have a child. Very few adoption agencies would work with gay men, and surrogacy did not exist.
Today in China, gestational surrogacy is illegal for everyone, regardless of sexual orientation. Adoption is restricted to people in heterosexual marriages. This means gay people can't have kids.
Now gay men in China are seeing a new possibility. Places like California - with the most-inclusive surrogacy laws in the world - are now an option for more and more gay men across the Pacific who want to start their families.
At the Men Having Babies conference in Taipei, their enthusiasm was palpable.
They also wanted to know how their children would fare living with gay dads in Asia. One of the coolest parts of the conference was a panel that featured women whose gay sons had had children. In Asian culture, family is incredibly important. Yet people from older generations are often not ready to accept that their son is gay, in part because they believe that means they will never have grandchildren. Remember, many of them built their families at a time when they could have only one child.
These grandmothers talked about how their gay sons having children brought them together as a family, and how their acceptance of their son grew with the arrival of a baby. I've had gay patients in China tell me they have had this very experience with their parents. Learning how to talk with their parents about having a baby to add to the family, and navigate the coming-out process at the same time, is incredibly important.
"If I didn't have kids, my parents would have all the problems in the world," Raymond Yang told me. He grew up in China and now has two kids with his husband in California. He said one of his main jobs as a son, the eyes of Chinese culture, is to give his parents grandkids. Accomplishing that makes a lot of other family problems disappear. "That's our culture."
Many gay men in Asia have not yet come out to their parents for fear of rejection. Again, family is everything in their culture, and many of these gay men have preferred to live a life in secret rather than lose their family.
With adoption and surrogacy being illegal in China, they have not seen the possibility of expanding their family as a way to come out to their parents.
Now that's changing.
"I think the conference made the entire concept of family possible," Shelly Marsh of Men Having Babies observed after the conference. "This information just had not been offered to them before."
After the MHB conference I traveled to other cities in China and met with gay men in Beijing, Shanghai and Hong Kong. Raymond and I met dozens of gay men and couples eager and ready to start their once-impossible family-building journey.
I'm excited to see what comes of all of these conversations. The ability of gay men to have children has the real possibility of accelerating acceptance across China. Even on a small scale in a country of over a billion people, the ripple effect of this growing trend of gay families has the potential of building real change.
GUY RINGLER is a board-certified physician in both obstetrics and gynecology and reproductive endocrinology and infertility. He is a partner with California Fertility Partners.