“…These wealthy patients/clients use their purchasing power to weigh various national options against each other when choosing where to seek their care ( Speier, 2016 ). Proximity may be a factor (recall that Canada and Mexico are the top sending countries into the USA), together with the legal clarity on US citizenship for children and parental status for intended parents ( Courduriès, 2018 , König, 2018 , Levine et al, 2017 , Smietana, 2017 ). The shutting down of certain ART markets to CBRC clients (such as India and Thailand) directs people to the USA, especially gay men who have few national options outside of the USA ( Jacobson, 2018 , Smietana, 2017 , Stuvoy, 2018 , Whittaker, 2019 ).…”