This take is disgusting, and not surprising coming from a male OBGYN. When a government sends a letter to young people urging them to consider having children, it's not about informing them about AMH or to urge cessation of smoking as it affects sperm count; it crosses an ethical boundary between public policy and private life. Decisions about whether, when, and how to have children are the most personal decisions we make as humans, shaped by health, family, relationships, finances, identity, religion, and values. Even if framed as "informational", state messaging about fertility risks implies citizens’ bodies and family choices exist in service of demographic goals. This marginalizes those who are childfree by choice, LGBTQ+ individuals, people with infertility, or those delaying parenthood due to economic insecurity. The symbolism matters, and states have a *very sordid and sickening past as regards pronatalist and coercive population policies. If governments are concerned about declining birth rates, the appropriate response is to create conditions that allow people to freely choose parenthood. Period.
Thank you for your passionate response — these are exactly the kinds of conversations we need to have openly.
I want to be clear about what I actually supported: providing women with accurate, evidence-based information about their own reproductive biology — including ovarian reserve, the impact of smoking on fertility, and age-related changes — not a government directive about when or whether to have children.
Informed consent is the cornerstone of everything I have practiced and taught for over 50 years. I agree with you completely that reproductive decisions are among the most personal a human being can make, and that no government, physician, or letter should coerce or pressure anyone.
But there is a meaningful difference between coercion and information. Women deserve to know the full picture of their reproductive health — not to serve demographic goals, but because knowledge enables autonomy. Withholding that information in the name of protecting reproductive freedom is itself a form of paternalism.
The history of coercive pronatalist policy is real and sickening — you are right about that. That history is precisely why the delivery, framing, and intent of any public health communication matters enormously. I share your concern about that framing. Where I respectfully disagree is in conflating information with coercion.
This take is disgusting, and not surprising coming from a male OBGYN. When a government sends a letter to young people urging them to consider having children, it's not about informing them about AMH or to urge cessation of smoking as it affects sperm count; it crosses an ethical boundary between public policy and private life. Decisions about whether, when, and how to have children are the most personal decisions we make as humans, shaped by health, family, relationships, finances, identity, religion, and values. Even if framed as "informational", state messaging about fertility risks implies citizens’ bodies and family choices exist in service of demographic goals. This marginalizes those who are childfree by choice, LGBTQ+ individuals, people with infertility, or those delaying parenthood due to economic insecurity. The symbolism matters, and states have a *very sordid and sickening past as regards pronatalist and coercive population policies. If governments are concerned about declining birth rates, the appropriate response is to create conditions that allow people to freely choose parenthood. Period.
Thank you for your passionate response — these are exactly the kinds of conversations we need to have openly.
I want to be clear about what I actually supported: providing women with accurate, evidence-based information about their own reproductive biology — including ovarian reserve, the impact of smoking on fertility, and age-related changes — not a government directive about when or whether to have children.
Informed consent is the cornerstone of everything I have practiced and taught for over 50 years. I agree with you completely that reproductive decisions are among the most personal a human being can make, and that no government, physician, or letter should coerce or pressure anyone.
But there is a meaningful difference between coercion and information. Women deserve to know the full picture of their reproductive health — not to serve demographic goals, but because knowledge enables autonomy. Withholding that information in the name of protecting reproductive freedom is itself a form of paternalism.
The history of coercive pronatalist policy is real and sickening — you are right about that. That history is precisely why the delivery, framing, and intent of any public health communication matters enormously. I share your concern about that framing. Where I respectfully disagree is in conflating information with coercion.