Saturday, September 05, 2015

Better Off Without a Father? Sperm Donation, Honesty, and Family Design

The conservative right-wing often express concerns about children growing up in lesbian or single mother families - that is, children growing up without a father. They generally seem to think that heterosexual couple-headed families are the best kind, and kids in any other kind of family are at psychological risk.

Ironically, however, in one segment of the population, having a father in the home may be a disadvantage. No, I'm not talking about kids with abusive fathers - that's too obvious. I'm talking about kids conceived using donor sperm.

There are three main kinds of families who use donor insemination - there are lesbian couples, there are single mothers by choice, and there are heterosexual couples dealing with male infertility or genetic disorders.

Research into children raised apart from one or both biological parents, for whatever reason (adoption, sperm/egg donation, etc), consistently shows that those who were told early and often about their origins fare much better than those who found out later in life. It hurts to be lied to, especially by the people you trust most.

A preschooler has no preconceptions about how a family should be formed - if you tell them that you found them in an orphanage or went to a doctor to get 'special baby-making juice' from another man because Daddy's special juice didn't work, they'll just accept it as another part of this weird wide world they're discovering. As they grow, their understanding will deepen, but their basic reaction will stay the same. But if you don't tell them, as they grow older, they'll gradually figure out where babies usually come from, and if they're being raised by a heterosexual couple, they'll make a very natural assumption. They'll base their identity off of that assumption, looking for their parents' traits in themselves. And then, to find out that that assumption was wrong can be devastating.

Unfortunately, many heterosexual couples who use sperm donation haven't gotten that message. In this study, they surveyed adolescent and adult donor sperm offspring who were members of the Donor Sibling Registry, an organization for the offspring from donor sperm and their families to track down half-siblings and biological fathers. One of the questions they asked was 'how old were you when you found out you were conceived using donor sperm?'

It should come as no surprise that all children raised in single-mother or lesbian families knew their origins by the age of 15, with most (87% in single-mother families and 88% in lesbian families) having found out by the age of 7. In contrast, heterosexual couples tended to be less honest. A third of offspring only found out when they were over 18 years of age, with 41% finding out over the age of 15. Most were eventually told by their mother, but 6% found out without either parent telling them - some told by other family members, and one overhearing a conversation between parents. There were too few to analyze, but I suspect the sense of betrayal would be especially high if the child found out without parents intending to tell.

They also asked how the respondents felt when they found out (if they were old enough to remember), and how they feel now about being donor-conceived. Compared to individuals told during childhood (4-11 years), those told during adulthood (18 or older) were significantly more likely to report feeling confused (69%), shocked (75%), upset (44%), relieved (38%), numb (38%) and angry (38%) - suggesting that being told was a strongly emotional and mostly negative experience for them (those told in adolescence showed intermediate reactions). In contrast, those told in childhood reported feeling mostly curious (71%, this emotion was common in all three age groups), with the next most common emotion being confused (37%). Overall, this suggests that the reaction was far less distressing if they were told before the age of 12.

Current emotions mirror the pattern found at disclosure, with individuals who found out in adulthood being more likely to feel currently feeling angry, relieved, shocked or ashamed. In contrast, most of those who found out in childhood reported feeling simply curious about the donor, and otherwise unconcerned with the method of their conception. (Relief was mainly seen in individuals who had suspected something was up, or in those whose social father had a hereditary medical condition.)

It also affected their relationships with their parents differently. With regards to their feelings toward their mother, those who found out in childhood were much more likely to report no change at all in how they felt about her. In contrast, those who found out later showed a mix of sympathy and appreciation of her honesty combined with a sense of betrayal and anger at being lied to.

In heterosexual couple families, the relationship with their social father was similarly affected. Although smaller sample size lessened the ability to find correlations, those who found out as adults were much more likely to feel betrayed. In contrast, most who found out in childhood felt sympathetic of their father's struggles with infertility, or else reported no change in relationship.

Another study suggests that even if offspring don't find out, keeping their origins a secret can adversely affect family functioning. They studied a sample of young adults conceived by sperm donation and raised in heterosexual couple families, 71% of whom had learnt of their conception after the age of 16. Although all the subjects had eventually found out, those who reported that parents avoided the topic of sperm donation (as parents who are keeping it secret must do) also reported parents avoiding other sensitive topics as well, such as avoiding discussion of friendship, sexuality, negative events and relationship issues. In addition, the subjects felt that overall family functioning was poorer. In addition, a study focusing on heterosexual couples who had used assistive reproduction techniques found that mothers who kept their child's origins secret reported more feelings of distress around parenting.

So, why are heterosexual couples so reluctant to tell their children about being conceived by sperm donation? Certainly, part of the reason is because they are more capable of hiding the truth. Most children learn at a young age that a typical family includes a mother and a father, and children raised by single mothers or lesbian couples will almost certainly ask why they don't have a father. When faced with such a direct answer, most mothers will tell the truth.

But comparison of different kinds of assisted reproduction reveal a more complicated situation. Heterosexual couples who used IVF or surrogacy with their own gametes are far more likely to tell their children about their origins, as seen in many different studies - here, here, here, and here. In addition, couples who used surrogacy with the surrogate's or a donor's eggs were more likely to tell children about their gestational history than their genetic origins.

It's ironic really - many parents who are secretive about gamete donation insist that it's irrelevant. However, surely being conceived by IVF with parents' own gametes is far less relevant to the child than being conceived with a donor gamete, and yet heterosexual couples are more honest about IVF, not less. This suggests that this is more wishful thinking than their true motivation.

Interestingly, fathers are typically more reluctant to discuss donor conception than mothers - and not just because they're the non-genetic parent. In this study, fathers in both sperm donation and egg donation couples judged genetic parenthood to be less important than mothers did, and both types of fathers were more likely than mothers to worry that contact with the donor could be harmful to their child. In this study and this study, fathers of oocyte-conceived children were less likely than their mothers to have told other people, such as family members, friends or medical professionals.

Although fathers and mothers generally agreed on their intention to tell or not tell the child, this study found that about half of couples using donor gametes came to an agreement after discussing differing opinions. In most such cases, the mother was initially in favour of telling while the father was against it, and the final decision was based on who won the argument. This implies that if it weren't for the father's opposition, most of the mothers would have told.

So, why is it that men are so much more reluctant to discuss donor conception? And, given the evidence that telling early and often is better for the children, how do we convince them to tell?