台灣在推動代孕立法與實務上面臨諸多困難，這些困難源自倫理爭議、法律保障不足、傳統文化觀念以及缺乏完整配套制度，導致政策推進停滯，許多有需求的家庭不得不轉向海外尋求代孕服務，進而衍生跨境代孕的法律與道德風險。

在倫理與人權層面，反對者認為代孕可能造成女性身體商品化，將女性子宮視作「出租」或「買賣」的工具，尤其可能剝削經濟弱勢女性，使其在金錢誘因下被迫參與代孕，進而涉及人權問題。此外，代孕子女的權益亦是一大爭議，若孩子非委託父母所生，未來可能面臨身份認同與親權歸屬的問題，現行的契約與法律保障難以完全保障孩子的最大利益。

在法律與制度保障方面，代孕涉及多方關係，包括代孕母、委託父母、醫療機構與仲介公司，如何設計完善的契約以保障代孕母的健康、胎兒的安全以及委託者的權益，是現行草案和制度難以克服的挑戰。若仲介機構未受嚴格監管，更可能成為醫療單位的「白手套」，引發更多倫理與法律爭議。

文化與社會價值觀也是障礙之一。台灣傳統文化中根深蒂固的「無後為大」、「血緣傳承」觀念，使代孕制度在部分族群眼中被視為對父權文化的挑戰。即便同婚合法，單身女性或同性伴侶的生育權利在《人工生殖法》修法中仍存爭議，涉及性別平等與社會支持系統的廣泛考量。

跨國代孕問題則是另一層挑戰。由於國內禁止商業代孕，仍有大量家庭需求未減，不得不赴國外尋求代孕服務，這些家庭面臨高昂費用、法律風險以及潛在的倫理困境，進一步凸顯了國內制度的缺口。

支持者則認為，應保障生育自主權與個人生育選擇權，並主張透過完善制度設計，在非商業化前提下允許代孕，以滿足不孕家庭與同志家庭的生育需求。國際經驗顯示，在制度嚴謹、規範明確的環境下，代孕既可保障孕母尊嚴與健康，也能維護孩子與委託家庭的權益。

總結而言，代孕議題在台灣牽涉倫理、人性、法律與文化等多重層面，各方利益與價值觀衝突明顯，是長期爭議、難以達成共識的社會議題。制度設計若能兼顧倫理規範、法律保障與文化認同，或許能為這一議題提供可行的解決方案，但短期內仍面臨諸多挑戰。

Taiwan faces significant challenges in advancing surrogacy legislation and practice, stemming from ethical controversies, insufficient legal protections, traditional cultural values, and the lack of comprehensive regulatory frameworks. These obstacles have stalled policy progress, forcing many families with surrogacy needs to seek services abroad, which in turn creates cross-border legal and ethical risks.

From an ethical and human rights perspective, opponents argue that surrogacy risks commodifying women’s bodies, treating the uterus as a “rented” or “sold” asset. This is particularly concerning for economically vulnerable women, who might be pressured into surrogacy due to financial incentives, raising human rights issues. The rights of surrogate-born children are also a major point of debate. If the child is not biologically related to the intended parents, they may face future issues regarding identity and parental rights, and current contracts and legal frameworks are often inadequate to fully safeguard the child’s best interests.

Legally and institutionally, surrogacy involves multiple parties—including the surrogate mother, intended parents, medical institutions, and agencies—making it extremely challenging to design contracts and legal protections that ensure the health of the surrogate, the safety of the child, and the rights of the intended parents. If intermediary agencies are not strictly regulated, they could act as “fronts” for medical providers, creating further ethical and legal problems.

Cultural and social values present additional barriers. Deeply rooted beliefs in Taiwan about lineage and bloodlines, such as the notion of “having descendants as paramount” (無後為大), make surrogacy appear to challenge traditional patriarchal norms. Even though same-sex marriage is legal, reproductive rights for single women and LGBTQ+ couples remain contentious in amendments to the Assisted Reproduction Act, raising broader considerations of gender equality and social support systems.

Cross-border surrogacy further complicates the issue. Domestic prohibition of commercial surrogacy has not reduced demand, forcing many families to seek surrogates abroad, exposing them to high costs, legal uncertainties, and ethical dilemmas, highlighting the gaps in domestic policy.

Proponents argue for the protection of reproductive autonomy and individual choice, suggesting that surrogacy should be permitted under a well-regulated, non-commercial framework to meet the needs of infertile families and LGBTQ+ households. International experience shows that with rigorous regulations and clear rules, surrogacy can protect the dignity and health of surrogate mothers while safeguarding the rights of children and intended parents.

In conclusion, surrogacy in Taiwan involves complex intersections of ethics, human rights, law, and culture. Conflicting interests and values have made it a long-standing and unresolved social issue. While carefully designed frameworks that balance ethical standards, legal protections, and cultural acceptance could offer viable solutions, the challenges remain substantial in the near term.