From reproductive violence to empowerment: reconquering power in assisted reproduction - a qualitative study.

People who use medically assisted reproduction (MAR) outside the legal and/or medical framework are generally on the margins of the dominant procreative norm, making them particularly vulnerable to a wide range of reproductive violence such as legal restriction to medical care, discrimination or mistreatment. The aim of this study was to explore experiences of reproductive violence among people living in France who sought MAR either abroad or without medical assistance. Semi-structured interviews were conducted between 2022 and 2023. Almost half of the interviewees (n = 28/69) had been confronted with reproductive violence during their MAR journey. Although the French bioethics law extended access to MAR to single women and female same-sex couples in 2021, participants described how the shortage of gametes fuelled all forms of reproductive violence, encompassing psychological, economic and physical violence. Our findings revealed an intersectional dimension to these experiences, particularly affecting individuals with non-heterosexual identities, older age or higher body weight. Single women appeared particularly exposed to such violence. However, faced with reproductive violence, many participants demonstrated resilience and empowerment, notably through support from social networks and associations. This solidarity helped them to develop strategies of resistance and avoidance. From personal difficulties and experiences of violence at the institutional level and in care, people moved on to awareness of systemic violence, encouraging them to support their peers. Awareness led them to denounce reproductive injustice and even to demand changes in MAR organisation and care.