Ethical Surrogacy in the United States: What Intended Parents Should Know

Recent media coverage has renewed attention on surrogacy in the United States. When public discussion focuses only on extreme or unethical examples, the outcome is predictable: more distrust, more political pressure, and more confusion for Intended Parents and Surrogates who simply want an ethical, safe path to family building.

The most constructive way forward is not to argue with headlines, but to define clearly what ethical surrogacy looks like in practice—and to make those standards visible, repeatable, and transparent.

Surrogacy in the U.S: Strong Medical Care, State Based Laws, and Clear Standards

Surrogacy in the United States is governed at the state level. Ethical programs operate with legal parentage processes, informed consent, and medical oversight through licensed fertility clinics. The most reputable programs also align their screening and support practices with established medical guidance, including the American Society for Reproductive Medicine recommendations for gestational carrier programs.

ASRM’s 2022 committee opinion was developed to make screening, evaluation, psychoeducational counseling, and legal guidance more consistent. It incorporates recommendations from the CDC, FDA, and the American Association of Tissue Banks and represents a widely recognized standard of care for ethical gestational surrogacy programs.

What Ethical Surrogacy Looks Like in Practice

Ethical surrogacy is defined not by speed or volume, but by care, boundaries, and accountability.

What good looks like includes:

• True informed consent with clear, understandable explanations of medical and legal steps

• Independent legal representation for Surrogates and Intended Parents

• Psychological evaluation and psychoeducation for both parties

• Medical protocols designed around health and safety, not pressure

• Ongoing support that continues after delivery, including postpartum resources

This is how ethical agencies protect Surrogates, Intended Parents, and the long term wellbeing of children.

A Current Key Issue: Escrow Safety and Financial Transparency

One of the most important conversations in the surrogacy field right now is financial protection. Industry reporting has highlighted cases where funds were mishandled, creating harm for Intended Parents, Surrogates, and ongoing journeys.

A core best practice is keeping financial handling completely separate from agency operations by using a qualified third party escrow provider.

What Intended Parents and Surrogates should look for in an escrow provider

• A dedicated escrow company that is separate from the agency’s operational accounts

• Appropriate licensing where applicable, along with strong compliance processes

• A meaningful bond amount or other protections designed to safeguard client funds

• A secure escrow portal with transparent transaction visibility

• 24/7 login access so Intended Parents can verify balances and disbursements in real time

• Clear written policies for approvals, disbursement schedules, and documentation

  
  

How ACRC Surrogacy approaches escrow

At ACRC Surrogacy, we prioritize clear financial separation and responsible fund management. We support the use of licensed third party escrow providers so client funds are never blended with agency operations and Intended Parents and Surrogates have transparency, documentation, and protection throughout the journey.

New York Is a Special Case: Surrogacy Agency Licensure Matters

Another major issue in the current landscape is that some non licensed agencies attempt to operate in states with stricter requirements.

New York is unique. It is currently the only U.S. state that requires surrogacy agencies to obtain a gestational surrogacy program license from the New York State Department of Health (NYSDOH) under the Child Parent Security Act.

This licensure process is rigorous and resource intensive, which is why only a small number of agencies nationwide have successfully obtained and maintained New York licensure.

New York Surrogacy Licensing: What Intended Parents Should Know

New York requires surrogacy agencies to hold a gestational surrogacy program license issued by the NYSDOH.

This license involves a comprehensive review of an agency’s policies, financial practices, screening protocols, and compliance with state protections for Surrogates and Intended Parents.

Key points to know:

• If your clinic, legal process, or Gestational Carrier is based in New York, you must work with an NYSDOH licensed surrogacy program

• Only a small number of agencies nationwide have obtained and maintained this license due to its complexity and ongoing compliance requirements

• Working with an unlicensed agency in New York may create legal, medical, and financial risks

ACRC Surrogacy is licensed in New York through the NYSDOH, meeting one of the most comprehensive surrogacy regulatory standards in the United States.

Drawing Bright Ethical Lines

Ethical leadership also means stating clearly what is not acceptable.

Ethical surrogacy has no place for:

• Coercion or pressure of any kind

• Missing or unclear informed consent

• Secrecy that removes accountability

• Financial practices that put Surrogates or Intended Parents at risk

• Any process that treats children as outcomes rather than individuals

Trust is built through transparency, boundaries, and protections that can be explained in plain language.

ACRC Surrogacy’s Commitment to Ethical Practices and Clear Guidance

At ACRC Surrogacy, ethical responsibility is foundational to every journey we support. Our role is to provide clear standards, responsible guidance, and compassionate oversight at every stage.

ACRC Surrogacy is also licensed in New York through the New York State Department of Health, meeting one of the most rigorous regulatory requirements for surrogacy program oversight in the United States.

Our approach is rooted in:

• Best practice screening and psychoeducation consistent with leading medical guidance in the field, including ASRM recommendations

• Independent legal support and clear documentation

• Third party escrow practices that prioritize separation, protection, and transparency

• Respect for Surrogates and thoughtful preparation for Intended Parents

• A child centered approach grounded in long term wellbeing

  
  

As a trusted surrogacy agency in California and a New York licensed surrogacy program, serving domestic and international Intended Parents, we believe ethical surrogacy must be clear, consistent, and accountable.

Choosing an Ethical Surrogacy Agency in the United States

When selecting a surrogacy agency, Intended Parents should ask:

• Do you use third party escrow and keep agency operations separate from client funds

• Can I access a transparent escrow portal with ongoing visibility

• Do Surrogates and Intended Parents receive independent legal representation

• Do you follow established screening and counseling guidance for gestational carrier programs

• If I am pursuing surrogacy in New York, are you licensed with the NYSDOH

  
  

Moving Forward With Clarity and Confidence

Surrogacy is built on trust. When ethical standards are defined, shared openly, and followed consistently, trust grows for Surrogates, Intended Parents, children, and the broader community.

The future of surrogacy depends on leadership that shows clearly what good looks like.

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