Course BASIC_Graduate level learning material about the challenges of human reproductive medicine in a changing Europe

2021-1-HU01-KA220-HED-000027613 - COHRICE

Teachers Guide

6. The interplay of reproductive technologies and social transformations

(Basic)

The following teacher guide assists instructors in helping students engage thoughtfully in their own learning process. The method is action-based, aiming to encourage participants to understand various perspectives' truths in a given situation beyond the scientific, privileged viewpoint. For instance, it addresses how a patient's distrust of a doctor due to different cultural backgrounds can lead to an identity crisis. The goal is to reconcile and respect the viewpoints of different parties within the context of cultural encounters, rather than merely convincing them.

 If students can process each topic with the help of these tasks, they will be able to perform their daily work more sensitively and authentically. Most of the tasks, using various techniques, urge participants to critically examine the "accepted," generally unquestioned knowledge. For example, we may ask them to imagine themselves in others' roles and argue from their perspective, or to gather their everyday knowledge, assumptions, and cultural biases, which are often difficult to see due to their familiarity.

The exercises can be used flexibly, depending on the presenter's style. It is advisable to use a flip chart or board to clearly note and display the thoughts raised by the students for the entire group to see. It is also advisable to lead the discussions as openly as possible because, in these tasks—perhaps unlike the usual format of lectures and exercises—many good and unexpected responses come from the group.

The exercises were created in alignment with the slides, directly following the topics of the presentation.

Slides 1-3
Begin your presentation with a thought-provoking question: ask students for their opinion on whether cultural needs drive the continuous development of communication technologies, or if it's the opposite, where technology generates new needs. Conduct a vote to assess opinions.

After this short introduction, display the figure from slide 2, and emphasize that technological changes and social transformations are typically deeply interconnected in every field.

Then outline the logic of your presentation so that the students can follow where you are in your train of thought! Repeatedly refer back to this logical sequence in your presentation. The slide (slide 3) titled 'Debated topics' illustrates the overall structure of the entire presentation.

Slides 4-6
The first topic generally addresses the question: how do reproductive technological changes continuously raise unforeseen questions? As an introduction, slide 4 displays the progress of ART, illustrating the main milestones of its development. Slide 5 - 6 focuses on two aspects: firstly, it demonstrates how in the fertilization process the roles and amounts of parties involved change; secondly, it examines the changing meaning of human body parts, such as sperm and eggs, in various processes. These two issues serve as examples, but there are numerous other questions that could be researched in a similar manner.

To provoke student engagement, ask them to look at slide 5 - 6 and identify different imagined or real people who would reject the given form of ART based on the arguments on the slide. After this exercise students can share their findings in pairs. In the entire group, it can be asked how many people were able to think of a personal acquaintance at any point.

The aim of the exercise is for students to recognize that the acceptance of technological advancements is far from straightforward - and this is not just a theoretical question. For example, deeply religious Christians may reject the process of insemination, while a very liberal, open-minded couple may be averse to fertilization using a donor.

At slide six, it's worth asking the question of what other issues could be further explored in the stages of ART development. Let's try to gather as many of these questions as possible. For instance, solutions can be examined from the perspective of their potential impact on emotional attachment, whether in a romantic relationship or in the mother-child relationship. Or, solutions can be examined from the perspective of their impact on the health of embryos - both physically and mentally.

Slides 7-10
The second topic shows how biological sex, social gender, gender identity, and social roles could not be consistent. Here are some ideas to clarify the different concepts and their possible incongruities: 

Ask students to collect as many gender-based traditional messages often told to children in one minute, such as 'Boys do not cry!’  After the exercise ask students to create messages which were the most difficult or bothering for them. Finally, explain to them that the messages they have gathered reflect societal expectations toward a particular gender, which parents typically convey to children based on their biological sex. The fact that certain messages bothered them illustrates well how biological sex and societal expectations often conflict. 

Ask students to imagine a 5-year-old boy based on his biological sex. Then, consider that this boy identifies herself as a girl. In pairs, collect thoughts on the potential difficulties she might face during a typical day at kindergarten.  Explain to students that while in the previous case societal roles and expectations could be problematic on their own, this exercise demonstrates the difficulties that can arise in everyday life when biological sex, gender identity, and societal roles and expectations are not aligned. Ask the students to try to depict the relationship between social roles, gender identity, and biological sex.

Ask the students to work in pairs and come up with scenarios based on what they have learned so far, where gender identity, biological sex, and social roles are incongruent, but reproductive technologies still enable couples to fulfill their desires.

Slides 11-19
The third topic introduces the changes of individual and family life paths. 

Discuss with the students the concept of biological clock. You can even ask them to draw a cartoon and imagine what a biological clock might say!  Explain the terms fertility, the role of the main sexual hormones and their course during an individual lifepath in women. Explain certain fertility indicators such as AMH or antral follicle count and their limitations in predicting fertility. 

Ask the students about their experience of family planning in our time. Compare that to the last century. Ask the students about their opinion, why these differences emerged in family planning.  

HIghlight that social changes introduced the concept of the biological clock, as a product of postponed family planning. Before showing slide 15, lead them to understand that the biological temporality of fertility is not aligned with social timing at all, and this concept gains meaning from that discrepancy.

Project slide 16 Ask one half of the group to gather dilemmas from the perspective of the mother and father, ask the other half to collect medical-health dilemmas, and the third to raise social (even regulatory) issues.

After the group has collected its own set of problems, go through the slides 16-19 together.

Slides 20-24
The fourth topic is the influence of multicultural societies on ART. Due to globalization, these diverse value systems become visible to different people, and their customs and desires can easily be questioned by others and themselves. In multicultural societies, it is particularly important for professionals to be prepared to encounter value systems with different dispositions, worldviews, or seemingly ambivalent values.

A significant trend in European cities in recent decades, especially in the context of increasing globalization, is the growing proportion of people with a migration background. For example, in Austria in 2021, 25% of residents had a migration background, while in 2000, the same figure was 12.38%. Within Austria, in Vienna in 2019, this percentage was almost 46%. However, in multicultural societies, structural racism is strongly observed within institutions.

Awareness of cultural differences is crucial because both overexoticizing and neglecting can be problematic. Furthermore, many challenges related to fertility and sexual health in people with a migration history are intersectional, involving factors such as social position, class, religion, cultural and ethnic background, and education level. For instance, a Syrian woman with a university diploma might perceive her infertility differently than a Syrian woman from a working-class background with an elementary level of education. Similarly, for a Muslim couple who migrated to England, the cost and age-related constraints of fertility interventions can add additional layers of complexity.

Views and opinions expressed are however those of the author(s) only and do not necessarily reflect those of the European Union or the Foundation for the Development of the Education System. Neither the European Union nor entity providing the grant can be held responsible for them.