As a clinician interested in contemporary families and donor conception, a recent newspaper article caught my attention. Two men, now happy parents of a little girl, explained they had mixed both of their sperm for insemination of the donor ovum, "so we would not know who the father was." I wondered why this family decided it was preferable not to know which father had a genetic link to their daughter?
What would be the consequence of knowing? What might be the impact of not knowing? These are complicated and not easily answered questions.
Throughout the history of mankind—the history of families—genetic lineage has mattered. But are we currently in a post-genetic age? We now know that two unrelated people share 99 percent of their DNA in common. As the psychoanalyst Harry Stack Sullivan once asserted, we are all more simply human than otherwise. I believe this is true. Bloodlines and genetic links are less relevant today. We are all part of the human family. And yet, I think there are still reasons why our children need to know something about their genetic origins.
I am familiar with these issues from my work with individuals and couples seeking to have children with the help of donor gametes (donor sperm, donor ovum, donor embryo). Couples often struggle with the reality that one partner will have a genetic link to their child, and the other will not. It can also be a challenge to identify or explain the donor’s genetic contribution to their child, and by extension, the donor’s place in their family. After all, while we know that genetics are important, and can directly impact who we are, we also know that there is something mysterious and complex about most genetic links.
In counseling sessions prior to donor conception, I encourage my clients to consider their definitions of family, the consequences of secrets, and the different meanings, for them, of genetic connection. Until recently, anonymity was one of the most common features of donor conception. Children who have grown up knowing about donor conception often understand their parents have minimal information about the donor. However, today there are options for families who want to know more about their donors—on paper, in person, or through information released to their child when she reaches maturity. All these options make it easier for family members to understand that the donor is another person, a special person with whom the child shares a little more than 99 percent of his DNA.
If donors are known to recipients from the start, families are offered more possibility: kids grow up knowing more about who the donor is, if this donor has helped with the conception of other children and/or has children of his or her own. Kids can choose to contact the donor, or not. Whatever meaning genetic connection has—or will have—in today’s world, these children will have access to it.
Medical doctors and mental health professionals currently follow the guidelines of the American Society for Reproductive Medicine and advise parents to tell their children the full story of their donor conception, preferably at a young age. Children have a right to this information, and parents can benefit from discussing the topic openly.
Most parents who have children with assisted conception are immensely grateful. However, disclosure to their very young child might not seem age-appropriate. And as children grow older and enter school, parents often worry that children will feel stigmatized, hurt or disappointed should they learn their conception stories. In my experience, these fears most often reflect parental anxiety about the donor conception. Fortunately, children do not come into this world—no matter how they were conceived—with ideas about the best way to be born. They are happy to love the families they have, and their curiosity usually centers on how important they are to the different people in their family.
Tolstoy famously wrote, “All happy families are alike, each unhappy family is unhappy in its own way.” Perhaps a part of that difference reflects each family’s comfort with being known to each other, and the pressure not knowing or pretending not to know can create. When all members of a family know about the contribution of donor conception, children and parents can contemplate the meaning of their unique story. Each member of the family can feel secure in their efforts to know themselves and each other.
Nancy Freeman-Carrol, Psy.D., is Supervising Analyst at the William Alanson White Institute and an active member of the Mental Health Professionals Group of the American Society of Reproductive Medicine. She is in private practice in Manhattan.