'I just think it's weird': the nature of ethical and substantive non-ethical concerns about infertility treatments among Black and White women in U.S. graduate programmes.

In the United States, Black women's use of infertility treatments is relatively low, despite elevated or similar rates of infertility compared with White women. Ethical concerns about infertility treatments have been identified as a potential sociocultural factor contributing to these treatment-seeking disparities. Despite documented differences, the substance of these ethical concerns is unclear. Clarifying the nature of these concerns contributes to our understanding of the social forces that shape the contexts of infertility care. Using an intersectional and comparative analysis of semi-structured interviews with Black or African American and White women enrolled in U.S. graduate programmes, this paper investigates the nature and substance of ethical concerns about medicalized infertility treatments. Three central themes emerged: (i) ethical concerns were not binary; (ii) ethical concerns varied by modality, but not by race, and focussed primarily on infertility treatments involving third parties; and (iii) substantive non-ethical concerns were concentrated among Black women and were driven by discomfort with or preferences against treatments involving third-parties. The paper concludes with a discussion of the implications of these findings for researchers, providers, and policymakers.