Marilynn responds: 

I know which False Dilemma you’re using for this debate experiment – its False dilemma / False Choice (Hobson’s Choice) . The fallacy of the excluded middle, false dichotomy, false correlative, “either/or” fallacy and bifurcation involving a situation in which two alternative points of view are held to be the only options, when in reality there exists one or more other options which have not been considered. Hobson’s choice is “take it or leave it” take what is offered or get nothing.

So the Hobson’s choice you offer here is that abandonment by their biological fathers is essential to their existence. Had their biological fathers been required to support them the way people are made to support their children, those men never would have agreed to reproduce with our subject’s mothers and causing them never to be born lament their plight of genetic bewilderment. The false dilemma is that it seems we must allow some people to abandon their young in secret or millions of people will never have the chance to exist. Their fate rests on our shoulders unless we don’t think those people deserve to exist. Oh its so tricky!

The excluded middle of this false choice would be to focus our laws on how we treat individuals that are actually born. When those individuals are newly born someone has to be responsible for taking care of them or they’ll die. If a newborn is found in an alley starved and dead from exposure we would treat that neglect as a crime against the deceased infant. Who should the law hold accountable for that death? Who owed it to that child to try to keep him or her alive? Is the government the automatic parent of every person born who then picks and chooses parents based on the child’s best interests? That’s a pretty big burden for our government to take on. There would be an uproar if the government just randomly assigned people to care for infants they had nothing to do with creating. And while there are plenty of people who want to raise children they did not themselves create, there is not enough of them to handle the load if every newborn were unwanted. What would we do about the unwanted ones? Who should take care of them? What do they deserve? Who owes them the duty of providing physical and financial support if not the people who reproduced to create them then who? Another question is if people who have that responsibility should be able to sell their way out off the record before anyone knows its them that created the child.
.
The alternative to underwriting the abandonment of millions of future people would be to offer them the dignity of equal treatment upon their arrival. We could, treat all human beings as people who, as minor offspring, are entitled to the financial and physical support of the people who reproduced to create them, who, in turn will be responsible for the physical and financial support of their own minor offspring. We could as an alternative to off the record promises to abandon require on the record consent to relinquish just like people do when they give up children for adoption. That solution would not stop people from generously donating their offspring to people who want to raise them, they just could not do it all yellow bellied and cowardly like.

If being held responsible for the results of their reproductive behavior will make some people choose not to reproduce and give up their offspring, then so be it. There are millions of reasons why a person may decide not to reproduce at any given moment and we certainly don’t mourn the non-death of all the individuals that never existed because of it.
We cannot be so foolish as to believe that expecting individuals to behave responsibly toward their offspring will cost billions of people their lives because it will prevent them from ever being conceived. I’m sorry its just the biggest load of hooey anyone ever heard. Everything would be just dandy if all men were held to the same standard of care with regard to the support of their young.

Single women giving birth to half spring [donor-conceived offspring] really illustrate where it is that donor offspring have fewer rights because there is nobody fronting and making it look like they’ve lost nothing. Half spring are entitled to the support of their mother who qualifies as a person so she owes the kid her support. But donor offspring don’t have the same rights as full blooded people, remember they are half donor half person. Donors don’t owe their offspring anything – so it really shows what’s lost when single women do it. These rights are still lost when the woman is not single, it just seems like not such a big deal because they get supported by someone else so its almost the same. Of course its not because it means the person has to assume the false identity of being that person’s child.
No its not in the best interest of any person to be treated as less than human and less deserving of rights afforded to all other people. Its horribly distasteful to suggest their lives are dependent upon having been abandoned by one of the people that created them. Of course that’s not true and what an awful thing to imply. If I could personally go and pluck those words out of the air before they reached the ears of every person that’s ever been humiliated by being told that I would in a heartbeat.

I don’t know the Canadian publishing scene too well and am eager to go ahead and put this paper — which was written to respond carefully to Canadian law which says that reproductive technologies should take into account the health and well-being of offspring — out in the public square to foster and contribute to conversation.

Thus I am making the full unpublished paper available on this blog. Scholars who wish to have a Word version can contact me and I’ll send to it to you. The data in this paper was first reported in My Daddy’s Name is Donor: A New Study of Young Adults Conceived Through Sperm Donation.

Canada Today: Is it in the Health and Well-being of Offspring Not to Know their Progenitors?

Findings from a U.S. Study of 485 Adults Conceived Through Sperm Donation

Elizabeth Marquardt,[1] Norval D. Glenn,[2] and Karen Clark[3]

ABSTRACT

Marquardt, Glenn and Clark recently conducted a U.S.-based survey of 485 adults conceived through sperm donation using comparison groups of 562 persons who were adopted as infants and 563 people raised by their biological parents. This chapter reports their survey results regarding health and well-being outcomes.

The survey suggests that donor-conceived adults can have serious health and medical concerns regarding their conception and lack of knowledge about their origins. These include the possibility of accidental incest with persons to whom they are unknowingly related. Compared to the other subjects surveyed, donor-conceived persons are more likely to struggle with poorer mental health or substance abuse and to have experienced delinquency. Regarding well-being, the survey suggests that donor-conceived young adults can struggle with their origins and identity, the role money played in their conception and the relationships in their social families, which can be characterized more often than control subjects’ relationships, by confusion, tension, and loss. The majority of adult donor-conceived persons surveyed expressed strong support for the offspring’s right to know and a longing to know more about their biological father and his family. They report that they can struggle with the implications of possibly having a dozen, or scores, or even hundreds, of half-siblings. The study suggests that secrecy has harmfully affected some donor-conceived respondents.

On the basis of their survey and reading of the literature, the authors recommend that, to advance the health and well-being of the donor-conceived, that Canada and other nations (1) end anonymous donation; (2) require counseling for prospective donors and would-be parents; (3) encourage pediatricians and other health professionals outside the fertility industry to address the implications of treating children conceived through anonymous donations; and (4) design, fund and initiate the highest quality research projects on the health and well-being of donor-conceived people.

1.  Introduction

This chapter addresses the question, “Is it in the health and wellbeing of donor offspring not to know their progenitors?”  Our response to the question is based on a survey about the identity, kinship, well-being, and social justice experiences of donor-conceived adults. The research firm, Abt SRBI of New York City, made our survey instrument available through Survey Sampling International (SSI) in July 2008. SSI used an existing internet sample that includes more than a million households across the United States. By this method, we assembled a sample of 485 adults between the ages of 18 and 45 years old who reported that they were donor conceived.  Through the same method, we assembled and surveyed a comparison group of 562 similarly-aged persons who were adopted as infants, and a group of 563 people of the same age who were raised by their biological parents.[4]  A unique aspect of the study is that the large sample from which the respondents were recruited were people who had registered to receive web surveys on a wide range of topics.  Therefore, the respondents were not persons who might be assumed to have any particular point of view on families in general, or on donor conception in particular.[5]  The following two sections report the survey results regarding health and well-being outcomes.

2.  The Health of Donor Offspring

2.1  Incest Fears and Lack of Medical History

Adults conceived through sperm donation can have serious health and medical concerns about how they were conceived and about their lack of knowledge about their origins.  One such concern is the possibility of accidental incest.  Donor-conceived people can fear unknowingly dating one of their half-siblings, or worry that their future children might unknowingly date a child of one of their half-siblings. This concern is not unreasonable. Some sperm donors have large numbers of offspring, and prospective mothers from particular subgroups might favour certain kinds of donors. Although some sperm banks now serve a national and even global clientele, some can continue to have strong relationships with particular medical centres or certain medical practitioners. Offspring who are similar in age and conceived using sperm from the same donor could live in proximity to one another.

Donor-conceived people surveyed reported more concern about the possibility of accidental incest than the comparison groups.  Forty-six percent of donor offspring respondents, but only 17 percent of adopted adults surveyed and just 6 percent of those surveyed who were raised by their biological parents, agreed with the statement, “When I’m romantically attracted to someone I have worried that we could be unknowingly related.” Similarly, 43 percent of adult donor offspring respondents, and just 16 percent of adopted adults and 9 percent of those raised by their biological parents, agree, “I have feared having sexual relations unknowingly with someone I am related to.”  We asked donor offspring surveyed how they felt at age 15 about being a donor conceived person and how they feel now. Eighteen percent of donor-conceived respondents said that at age 15 they were “afraid about not knowing my medical history” and 15 percent said that, at the time they responded to the survey, they were “worried about my future children’s health or feelings.”

2.2  Mental Health, Addiction, and Delinquency

The survey results give rise to concern about the mental health and the possibility of addiction and delinquency among donor-conceived people.  The survey included three questions intended to offer insight into social and psychological outcomes for the donor offspring. The findings are especially illuminating because of how they can be compared to those persons who were not donor conceived.

The first question was, “At any time before age 25, were you ever in trouble with the law?” Twenty-one percent of donor offspring surveyed – more than one in five – said yes[6], compared to 18 percent of those respondents who were adopted and 11 percent of those raised by biological parents.

The next question to probe social and psychological outcomes was, “Have you ever felt unable to control your use of alcohol or other substances?” Again, more than one in five – 21 percent – of the donor offspring surveyed said yes. This compares to 17 percent of adopted adults surveyed and 11 percent of respondents raised by biological parents.

The third question was, “Have you ever been prescribed medication for depression or other mental health problems?” In this case, those from adoptive families were the most likely to agree, with 42 percent of surveyed adoptees saying they have been prescribed medication for this reason. By comparison, 31 percent of the donor-conceived adults surveyed report that they had been prescribed anti-depressant medication, and 28 percent of those raised by their biological parents say the same thing.[7]

A visual representation of these outcomes with controls for age, gender, race, subjective family income at age 16, and mother’s education, is Figure 1 . The figure demonstrates that respondents who are donor conceived and who are adopted are more likely than those raised by their biological parents to struggle with these detrimental outcomes related to trouble with the law, substance abuse or poor mental health.  These outcomes remain even with controls for socio-economic status and other factors. The donor conceived and the adopted are twice as likely as those raised by biological parents to report problems with the law. The donor conceived surveyed are more than twice as likely as those raised by biological parents to report substance abuse problems (with the adopted falling between the two groups). The donor-conceived respondents are about 1.5 times as likely as those raised by their biological parents to report mental health problems (with the adopted respondents being closer to twice as likely as those raised by biological parents to report the same thing).

In the open-ended responses to the survey, some donor offspring offered comments that illustrated some of these findings:

I’ve never even thought about this before I took this survey, but yes I stay depressed a lot, and would like to know more about my donor’s family health.

I still have issues with this problem and am seeking professional help. It has helped me to become a stronger person but has scared me emotionally.

And:

I CUT MY SELF

Others shared comments that reflected the sensitivity of this subject for them and the sometimes difficult process of making sense of their donor conception and attempting to resolve the problems arising from their unusual origins:

I was uncomfortable with the fact that I was conceived this way at first. But through the support of my family and the positive environment they provided, I turned out fine.

This is a very sensitive subject for me, doing this survey felt like therapy!

I think everything was covered. I don’t feel like it is a big issue for me anymore because I’m an adult with a family of my own.

It’s what you choose to make of it.

And one spoke of her recent revelation:

I did not know until 3 weeks ago that any of this had happened. I lost a baby in my 6^th month and my mother inadvertently told me of their conception problems. This survey was actually a little spooky.

2.3.  Relevance of Family type to Mental Health, Addiction and Delinquency

We wondered whether the type of family into which donor-conceived people were born had an effect on their curiosity about their origins and their mental health.  The sample of 485 adult sperm donor offspring includes 262 persons conceived to heterosexual married parents, 113 conceived to single mothers, and 39 conceived to lesbian couples. We found that sperm donor-conceived persons from all three of these family structures share many attitudes and experiences.

But there are differences. For example, the donor conceived surveyed who are born to single mothers seem to be more curious and more distressed about their origins than donor-conceived respondents in families in which the adults members are part of a heterosexual or lesbian couple. With regard to mental health outcomes, those donor offspring conceived to single mothers are more than twice as likely as those respondents raised by their biological parents to have had problems with the law, and more than twice as likely as those raised by their biological parents to have struggled with substance abuse

Meanwhile, those donor-conceived respondents born to lesbian mothers seem to express somewhat less curiosity and less distress about their origins. Nevertheless, substantial minorities, and sometimes majorities, of the donor conceived surveyed who were born to lesbian couples do express these troubled feelings, and more than half report curiosity about their biological father and his family. With regard to mental health outcomes, those donor-conceived respondents born to lesbian couples appear nearly twice as likely as those respondents raised by their biological parents to say they have struggled with substance abuse. See Table 1.

The donor conceived surveyed report a variety of experiences.  But overall, they report that they are hurting more, are more confused, and feel more isolated from their families, than those respondents raised by their biological parents.

3.  The Well Being of Donor Offspring

3.1 Identity Struggles and Kinship Confusion

Young adults conceived through sperm donation can experience struggles with their origins and identities. In the survey, 65 percent of donor offspring agree that, “My sperm donor is half of who I am.” Forty-five percent agree, “The circumstances of my conception bother me.” Almost half report that they think about donor conception at least a few times a week or more often.

The role that money played in their conception disturbs a substantial number of donor–conceived respondents. Forty-five percent agree, “It bothers me that money was exchanged in order to conceive me.” Forty-two percent of donor-conceived respondents, compared to 24 percent of respondents from adoptive families and 21 percent of respondents raised by biological parents, agree, “It is wrong for people to provide their sperm or eggs for a fee to others who wish to have children.”

For donor offspring respondents, family relationships can be characterized by confusion, tension, and loss. More than half (53 percent) of donor offspring surveyed agree, “I have worried that if I try to get more information about or have a relationship with my sperm donor, my mother and/or the father who raised me would feel angry or hurt.” Forty-three percent of donor offspring surveyed, compared to 15 percent of adopted persons and six percent of those raised by their biological parents, agree, “I feel confused about who is a member of my family and who is not.”

When they grow up, more than half (57 percent) of donor offspring surveyed agree, “I feel that I can depend on my friends more than my family” – about twice as many as those respondents who were raised by their biological parents.

In the study, the majority of donor-conceived adults express a longing to know more about their biological father and his family. More than two-thirds of adult donor offspring surveyed – a full 70 percent – agree that “I find myself wondering what my sperm donor’s family is like.” Similarly, 69 percent agree that “I sometimes wonder if my sperm donor’s parents would want to know me.”

Donor offspring can express more pain over the loss of a biological parent than those who are adopted. In a striking difference, nearly half of the donor offspring surveyed (48 percent) compared to about a fifth of adopted adults surveyed (19 percent), agree that “When I see friends with their biological fathers and mothers, it makes me feel sad.” Similarly, more than half of the donor offspring surveyed (53 percent, compared to 29 percent of the adopted adults surveyed), agree that “It hurts when I hear other people talk about their genealogical background.” Both groups of respondents – the donor conceived and the adopted – may not know about and did not grow up with one or both biological parents and those parents’ families, but the donor offspring overall express more pain, sadness, and confusion about this loss of connection with kin.

The theme of “looking for my father everywhere” recurs among donor offspring who responded to the survey. Some have been told a few details about their biological father – these tend to be about his height and the colour of his hair and eyes. Donor-conceived respondents report that these few details can be on their minds when they are walking down the street, riding a bus or scanning a crowd. “Could that be him?” they ask themselves. In the survey, 58 percent of donor-conceived people agree that “When I see someone who resembles me, I often wonder if we are related.” (Forty-five percent of adopted adults surveyed and 14 percent of respondents raised by their biological parents also agreed with that statement.)

In circumstances of adoption, relationship breakdown or deception regarding the conception, children might have fathers they do not know, and they may wonder if they have unknown half or full siblings somewhere out there.  But it is unlikely that they would have large numbers of unknown siblings.  By contrast, donor-conceived adults must grapple with the possibility that they could be one of many, perhaps scores, perhaps even hundreds, of half-siblings conceived using one man’s sperm samples that were divided into vials and sold to women all over the country or all over the world.

In sum, donor-conceived respondents report that they can suffer from the loss of their biological father and his whole family – half of their entire heritage. They report that they can struggle also with the implications of possibly having a dozen, or scores, or hundreds, of half-siblings. Their brothers and sisters might live on the other side of the world or the country. They might live in the same town. They might live next door.

4.  The Right to Know

The study suggests that secrecy has harmfully affected some donor-conceived respondents.  Almost half of donor offspring respondents (47 percent) agree with the statement, “I worry that my mother might have lied to me about important matters when I was growing up.” By contrast, only 27 percent of adopted respondents agreed with the statement as did 18 percent of people surveyed who were raised by their biological parents.

Similarly, 43 percent of donor offspring, compared to 22 percent and 15 percent of respondents raised by adoptive or biological parents respectively, agree that “I worry that my father might have lied to me about important matters when I was growing up.” In the open-ended responses to the study, one donor-conceived adult responded, “[I am] currently not on seeing or speaking terms with family because of this.”

Donor conception has long been shrouded in secrecy.[8]  The common practice of anonymous donation protects the donor from having to confront the truth that a child might be born from his or her body. Many parents choose not to tell their children about their donor conception, and anonymity protects such parents from having an “outside” party intrude on their family.[9]

As Blyth and Frith have detailed in Chapter 9, the governments of many nations have begun to focus on the rights of the offspring. In recent years, nations such as Britain, Sweden, Norway, the Netherlands, Switzerland, New Zealand, and some Australian states have banned anonymous gamete donation. Croatia has recently considered such a law. Advocates for this reform refer in part to the United Nations Convention on the Rights of the Child[10], ratified by all but two member states in 1989 (Somalia and the United States), which states that “the child shall …have the right from birth to a name, the right to acquire a nationality and, as far as possible, the right to know and be cared for by his or her parents.”[11] Transcripts of debates at the time demonstrate that the drafters of the convention understood the word “parent” to be the child’s mother and father. The “right to know” one’s parents makes no sense unless these people are understood to be biological parents.[12]

Arguments against banning anonymity tend to be based on concerns that the supply of gametes will consequently fall.  As Frith and Blyth have demonstrated in Chapter 19 , that argument is suspect.  In any event, the question of whether banning anonymity will lead to an increase or a decrease in sperm and egg donations is secondary. The primary question is whether the state ought actively to deny some citizens the knowledge of who their parents are. Several nations have rightly decided that the answer is no.

In our survey, the majority of grown donor offspring expressed strong support for the offspring’s right to know. When asked if they believed that donor-conceived persons have the right:

1. To have non-identifying information about their sperm donor

68 percent of donor-conceived respondents, 78 percent of adopted, and 73 percent of those raised by biological parents say yes.

2. To know the identity of the donor

67 percent of donor-conceived respondents 52 percent of adopted, and 52 percent of those raised by biological parents say yes.

3. To have the opportunity to form some kind of relationship with the donor

63 percent of donor-conceived respondents, 48 percent of adopted, and 47 percent of those raised by biological parents say yes.

4. To know about the existence and number of half-siblings conceived with the same donor

64 percent of donor-conceived respondents, 62 percent of adopted, and 62 percent of those raised by biological parents say yes.

5. To know the identity of half-siblings conceived with the same donor

62 percent of donor-conceived respondents, 54 percent of adopted, and 55 percent of those raised by biological parents say yes.

6. To have the opportunity as children to form some kind of relationship with half-siblings conceived with the same donor

62 percent of donor-conceived respondents, 49 percent of adopted, and 52 percent of those raised by biological parents say yes.

The donor conceived surveyed are actually somewhat more cautious than the adopted respondents and those raised by their biological parents regarding their right to have non-identifying information about their sperm donor.  But regarding having knowledge of the identity of their sperm donor and even the possibility of having a relationship with him, the adopted and those raised by biological parents begin to feel less strongly, whereas donor conceived respondents firmly support these rights. Moreover, all three groups support the right to know about the existence and number of half-siblings, even though those raised by biological parents might not have given the issue much thought before responding to the survey. And again, regarding the right to know the identity of their half-siblings and to have the possibility as children of having a relationship with them, the support of the adopted and those raised by biological parents weakens, while nearly two-thirds of the donor conceived surveyed continue to support these rights as well.

In the open-ended question on the survey, some donor offspring asserted their firm belief in the child’s right to know:

I definitely think that all sperm and egg donors should be easily accessible and the children should definitely have the choice to find out who they are and be able to contact them.

I think it is someone’s right to know where and who they come from, to know their identity.

I think that children have a right to know ANYTHING in this situation. Also, the sperm donor should be told when they have conceived a child, and asked if they would like a relationship.

It is important to know your identity.

Secrecy about the fact of donor conception appears to be associated with harm.  In the study, those donor offspring surveyed whose parents kept their origins a secret (which creates the possibility that the donor offspring will learn the truth in an accidental or unplanned way) were substantially more likely as adults to report depression or other mental health issues (51 percent), having struggled with substance abuse (36 percent) or having had problems with the law (29 percent). See Table 2.

While openness appears to be vital to the health of donor offspring, openness alone does not appear to resolve the complex risks to which young people may be exposed when they are conceived through sperm donation.  Donor offspring who say their parents were always open with them about their origins (which are 304 of the donor offspring in the study) still exhibited an elevated risk of negative outcomes. Compared to those raised by their biological parents, the donor offspring surveyed whose parents were always open with them are more likely to have struggled with substance abuse issues (18 percent, compared to 11 percent raised by their biological parents) and to report problems with the law (20 percent, compared to 11 percent raised by their biological parents). See Table 2.

5. Survey Limitations

In order to recruit a large number of sperm donor offspring for this study, we employed a methodology that is very nearly representative, but not perfectly representative, of 18-45-year-olds living in the United States in July 2008. The survey is representative of Americans who signed up for web-based survey panels, who may differ in unknown ways from Americans as a whole. We believe this bias is unlikely to be substantial. Furthermore, many of our analyses are comparative across types of conception, and it is unlikely that selection into the sample would bias these comparative analyses in any meaningful way. Such a bias would result only if respondents with different origins were systematically more or less likely to have different reasons to choose to be part of the million American households willing to participate in web-based surveys.  We can think of no reason why that would be the case.

A second limitation of our sampling strategy is that we were forced to rely on the responses of people who know that they are sperm donor offspring. It is unclear whether sperm donor offspring who are ignorant of their origins differ meaningfully from those who know their origins or from those raised by their biological or adoptive parent(s). Studies can follow donor-conceived persons from childhood, if the legal parents consent to having their minor children participate in such a study. But once the participants became adults, ethical issues would arise where researchers knew that adult study participants are sperm donor conceived but did not reveal this truth to the participants themselves.

A third limitation of the survey is that respondents are often asked to report retrospectively on their experiences, which could be subject to some recall bias (although all three comparison groups are subjected to the same recall bias). Nevertheless, the current study is, we believe, a contribution to knowledge of sperm donor offspring and is particularly useful because it includes large samples of sperm donor conceived people, adoptees, and people reared by their genetically-related parents, and it focuses on the experiences of the sperm donor conceived.

6.  Recommendations

Based on the survey and our reading of the literature currently available to date, we propose these recommendations for Canada and other nations:

1. End anonymous donation

Canada should follow the lead of Britain, Sweden, Norway, the Netherlands, Switzerland, and other nations, and end the practice of anonymous donation of sperm and eggs. Government-funded registries should be established to help those born before the law is changed to find members of their biological family who wish to meet.

2. Require counseling

Prior to conceiving children by donor gametes, prospective donors and parents should be required to receive counseling. The counseling should include a full exploration of what is known about the life course experience of donor offspring.

3. Pediatricians and other health professionals should address the implications of treating children conceived through anonymous donations

The Canadian Paediatric Society and similar societies throughout the world, and members of other health professionals who attend to children regarding the following should consider and develop policy regarding:

a) the practice of anonymous donation;

b) the deliberate conception of children who will have dozens or hundreds of unknown half-siblings;

c) the decision of parents not to tell their children or their children’s doctors the truth about the child’s biological origins; and

d) the lack of regulation requiring sperm and egg banks to track the health of donors and to keep parents informed about genetic diseases that donors might develop in the future.

The wisdom and ethical nature of these practices should no longer be within the power solely of fertility doctors. It is time for pediatricians and other health professionals to consider and to take a firm stand on these issues of urgent importance to a generation of young people.

5. Initiate highest quality research projects

In Canada and internationally, there is an immediate need for major, large-scale, longitudinal research on the topic of the well-being of donor offspring to be designed, funded, and launched.

[end]

***  Significantly different from raised by biological parents at p < .001 (two-tailed tests)

**    Significantly different from raised by biological parents at p < .01 (two-tailed tests)

Raised by biological parents is the reference group.

Table 1

Percentage of Respondents Who Reported Each of Three Conditions, By Origin

Among donor conceived

Donor conceived

(N=485)

Adopted

(N=562)

Raised by biological parents   (N=563)

Lesbian mothers (N=39)

Married hetero-sexual parents

(N=262)

Single mother (N=113)

       Problems with the law

22^a

18^b

11

13

20^c

26^ae

Mental health problems

32^d

43^a

28

32

30^d

32^e

Substance abuse problems

22^a

17^b

11

21

17^cf

26^ae

Notes: Ns vary slightly by outcome due to missing data. Percentages are column percentages.

^a Significantly different from raised by biological parents at p < .001 (two-tailed tests)

^b Significantly different from raised by biological parents at p < .01 (two-tailed tests)

^c Significantly different from raised by biological parents at p < .05 (two-tailed tests)

^d Significantly different from adopted at p < .001 (two-tailed tests)

^e Significantly different from adopted at p < .05 (two-tailed tests)

^f Significantly different from donor conceived single mother at p < .05 (two-tailed tests)

(1) Adults who at some point were raised as children by a divorced or single parent can be present in all categories in this table.

(2) An average of the responses of the three groups of donor conceived in this table does not equal the numbers reported for mental health, delinquency, and addiction outcomes among the donor conceived generally, because a small number of respondents reported a different type of family structure at birth (e.g., heterosexual unmarried parents) or checked “don’t know,” “prefer not to answer,” etc.

(3) Results for offspring of lesbian couples are not reported as significant due to the sample size (N=39) of those offspring, similar to other studies.

Table 2

Percentage of Respondents Who Reported Each of Three Conditions, By Origin and By How They Found Out About Their Origin

Among   donor conceived

Raised by biological parents   (N=563)

Adopted

(N=562)

Parents always open about con-ception   (N=304)

Parents kept con-ception a secret

(N=120)

Parents revealed con-ception at age   12 or younger (N=35)

Parents revealed con-ception at age   13 or older

(N=52)

       Problems with the law

11

18^b

20^b

29^ae

17

17

Mental health problems

28

43^a

29^dg

51^a

31

33^eg

Substance abuse problems

11

17^b

18^bf

36^ad

19

26

Notes: Ns vary slightly by outcome due to missing data. Percentages are column percentages.

^a Significantly different from raised by biological parents at p < .001 (two-tailed tests)

^b Significantly different from raised by biological parents at p < .01 (two-tailed tests)

^c Significantly different from raised by biological parents at p < .05 (two-tailed tests)

^d Significantly different from adopted at p < .001 (two-tailed tests)

^e Significantly different from adopted at p < .05 (two-tailed tests)

^f Significantly different from donor conceived, parents kept a secret at p < .001 (two-tailed tests)

^g Significantly different from donor conceived, parents kept a secret at p < .05 (two-tailed tests)

Are you in the NYC area? Go see it on January 29th at the Soho Digital Art Gallery. Screening times and information here. More screenings to follow at the same location that week, and more to come around the country.

You can also order the DVD.

Congratulations, Jennifer!

Although (as you know) I agree with you about many donor conception issues, I do have a criticism of “My Daddy’s Name is Donor.”

As I understand it, when subjects were surveyed, the questions within each section were asked in random order, but the sections themselves were always asked in the same order.

So the questions reported on page 102 of MDNID — about mental health problems, alcohol or substance abuse, and trouble with the law — were always asked AFTER the questions in the earlier sections.

With all due respect, I’d argue this is a design flaw in the survey, because it means that by the time respondents answer those three questions, respondents who were raised by two bio-parents have experienced a very different survey than respondents who were either donor-conceived or adopted.

Specifically, the donor-conceived were asked a lot of questions which could direct them to focus particularly on their insecurities about their backgrounds.

First, in the case of those DC respondents whose parents weren’t open with them, they were reminded that their parents kept their origins secret from them (p 86).

Then they were asked questions like:

“The circumstances of my conception bother me.”

“It bothers me that money was exchanged in order to conceive me.”

“It hurts when I hear other people talk about their genealogical background.”

“When I see friends with their biological fathers and mothers, it makes me feel sad.”

They were asked if they felt “special” or “curious” about their background, but also terms like “freak of nature,” “angry,” “lab experiment” and “abandoned.”

It is only AFTER all those questions that people are asked to consider mental health, substance abuse and trouble with the law.

That means that the folks who are DC have just been through what can reasonably be described as an emotionally harrowing series of questions which get at some huge existential questions about their own lives; questions that, in any reasonable person, could provide great anxiety.

And the folks who have bio-parents have taken an entirely different survey, one that is shorter, less emotional, and has far less potential to feel intense or provoke anxiety.

I’d expect that if you took any group of people, asked half of them a series of harrowing, anxiety-producing questions about their backgrounds, and then asked both halves if they’d had trouble with the law, mental health or substance abuse, you’d get elevated reports of trouble from the group that had been through the extended questioning. Even if both groups were alike in all other ways.

When you look at the differences between donor-conceived people whose parents were always open with them, and those raised by bio-parents (pg 112), there’s barely any difference between DC respondents and bio-parented respondents on mental health problems. The other difference are relatively small — 82% of DC and 89% of bio-parented didn’t report substance abuse problems, and 80% of DC and 89% of bio-parented didn’t report any troubles with the law.

How much of that difference represents a genuine difference between the two groups, and how much represents the effect of extremely different questions that the two groups had been asked leading up to those three questions? I don’t think there’s any way to know.

If there’s another study like this, I’d strongly suggest that all the questions that are asked of DC respondents but not of bio-parented respondents should be asked after other questions are completed. To do otherwise risks biasing the responses.

* * *

Some folks might respond that it doesn’t matter, because what’s being asked about is objective; surely people will answer objective questions the same way, regardless of the context around the questions. But that’s definitely not true. For example, we know from medical studies of abortion that the answer to the question “have you had an abortion”? is highly dependent on context; someone worried that they have a medical problem is much more likely to honestly report their reproductive history than another person would be.

Especially when dealing with issues that people may be ashamed of — such as arrests, mental health issues, and a history of substance abuse — it’s not safe to assume that people will always recall the objective truth regardless of context.

My response:

Hi Barry,

Yes, I remember tussling with you over this soon after the study was released.

It is true that there were some questions we only asked of donor conceived persons, because the questions were so specific to donor conception that they would be nonsensical to anyone else (such as “At age 15 what feelings best describe how you felt about being a donor conceived person?” or “Which words or terms best describe what the phrase “sperm donor” means to you?”)

But there were plenty of what you might consider emotionally charged questions we asked of all three groups – the donor conceived, the adopted, and those raised by biological parents. Questions such as “Growing up, I sometimes felt like an outsider in my own home,” or “I worry that my mother may have lied to me about important matters when I was growing up” and even some that may sound pretty bizarre to most people raised by biological parents,
such as “I have feared having sexual relations unknowingly with someone I am related to.” So all three groups had confronted some pretty intimate and perhaps troubling questions before being asked those more straightforward questions about being prescribed medication for depression or other mental health problems, struggling with substance abuse, or having been in trouble with the law before age 25.

You may have a point that having already bathed in that emotional soup of the earlier questions their responses to the fairly objective mental health/substance abuse/delinquency questions could have been affected, but I’m not sure what can be done about that. We could have asked the mental health/substance abuse/delinquency questions earlier in the survey but then you could argue that recalling those troubling episodes in their lives might shape how they responded to the other, more subjective, questions if they came later.

With a background in survey research yourself, you are familiar with the challenge of designing surveys. Any survey has its limitations and its design can be critiqued. I hear your critique. I still think we produced something useful and there is much more to be done.

At the present time, in the United States, if you apply to adopt and state that you plan to lie to your children about their origins for their entire lives, you will be told to learn more about adoption and the best interests of adopted children. Indeed, from my experience of American social workers, most would consider your intention to lie to your children about their origins a form of child abuse.

And yet, the infertility industry considers this a perfectly reasonable stance for parents using donor gametes. I can only conclude that infertility specialists, as a rule, are not friends with psychologists. Whether this is a by-product of their busy lives or perhaps an intentional rejection of the social sciences is difficult to say. However, the result of this highly unfortunate miscommunication between people who understand cell structures and people who understand human beings is that donor-conceived people are back where adoptees were fifty years ago – confused, traumatized and angry. And rightly so: confusion, trauma, and anger are appropriate psychological responses to being lied to by those closest to you.

This is one of the most articulate portrayals I have read of this current contradiction, including, as you so well put it, the only apparent conclusion one can reach that perhaps “infertility specialists, as a rule, are not friends with psychologists.”

For one who is so well-spoken, I was disappointed by your relative inarticulateness in trying to take on –something, I cannot exactly tell what — that you did not like in the piece I wrote and/or the reports it was based upon. You point out that most donor conceived people are not told the truth about their status and today most adopted people are, and then say I should have, in our study reported in My Daddy’s Name is Donor, compared “apples to apples,” that “you cannot compare the psychological outcome of a 20-something donor-conceived adult who was told about DI two days after her father died to an adoptee who has known his identity from birth.”

You then say the data tables at the back of the report are “inscrutable,” but it doesn’t seem to me that you scrutinized them very carefully. For one thing, we make clear that for the purposes of this report we only analyzed the 485 donor conceived persons in our sample who knew they were donor conceived (and not the additional ones who thought they might be). Table 4 on page 112, whcih you seem to refer to without giving a page number or table number, makes clear that a surprising 304 donor conceived adults in our sample said their parents had “always been open” with them about their conception. The same table makes clear that those whose parents tried to keep it a secret in general have far worse outcomes than those whose parents were open with them. But it’s also clear, from the same table, that even those whose parents were open with them had elevated risks of negative outcomes compared to those who were adopted or raised by their biological parents.

You say we “did no regression analysis to examine the effect that late discovery might have had on participants’ feelings about donor conception.” We did all kinds of analyses of this data set and reported them in this 134 page report with marginal frequencies and all tables available at the end. There is tons more work we could continue to do with the same data set. That’s a great idea to look specifically at those 52 donor conceived adults whose parents told them the truth at age 12 or older, and/or the 120 whose parents tried (and apparently failed) to keep it a secret. Would you like to write that paper with me?

I am sorry that you don’t like my organization or the money that was used to pay for this study, as you suggest in your piece. But I cannot see any evidence, from you, to support your claim that this study is “rife” with “political bias” that some “peer reviewers” somewhere would have rooted out but apparently you cannot. And you have certainly offered no evidence that this study represents “poorly executed social science.”

Would you like to try again?

This is a transcript of the talk the mother has with her daughter the day before they are going to meet the dad/sperm donor for the first time.

Mom: I wanna talk to you about going to meet Ben in Boston. Do you think that something might happen with mommy and Ben? Because he’s marrying another lady, who’s a very nice lady and he loves her a lot.  

Daughter: So he’s gonna break up with you?

Mom: He’s not with me silly. Remember?

Daughter: So you already broke up?

Mom: Ok sweetie, so is he in our lives? 

Daughter: No.

Mom: So how could we break up if he’s not in our lives?

Daughter: ‘Cause you’re married.

Mom: We’re not married. Why would you think that we would be married?

Daughter: Because you got the sperm!

Mom: How did mommy get the sperm?

Daughter: Google.

Mom: Google, that’s good. 

Yesterday I watched the movie “Rise of the Planet of the Apes”. After being three feet away from a black back gorilla in Uganda earlier this year I now have to watch everything with big apes – real or computer animated, doesn’t matter. Unexpectedly I found a story that reminded me of something familiar, perhaps even with a lesson to be learned. Let me give you an introduction to the first 30 minutes of the movie.

A young genius scientist comes up with what he believes is the cure for Alzheimer’s. He tests his medicine on chimps and one of them shows outstanding growth of intelligence due to the healing effects the medicine has on its brain. But one day the chimp goes on a rampage for no obvious reason and security at the laboratory shoots it to death. The incident scares off investors of the project and the scientist is told to put all his apes to sleep. But he finds out that the reason the female chimp became so aggressive was because she tried to protect her newborn. The scientist takes the baby chimp home and raises it as his own child. He very quickly understands that the little one is extraordinarily intelligent and that it has genetically inherited this from his mother.

For the coming years the chimp, Caesar, is raised in the most loving home, with a lot of compassion and understanding – kind of the perfect home environment it seems. But as the chimp grows older he feels that he doesn’t fit in. He is a very troubled youngster and one day he confronts the scientist, through sign language, and asks him where he comes from. “Who is Caesar?” he signs. The scientist first says “I am your father”, but sensing Caesar’s dissatisfaction with the answer, takes him to his lab and shows him the laboratory to tell him about his mother. The monkey is perplexed by hearing about his conception story and is left with a lot of questions, an emptiness, a sense of not belonging that eventually turns into anger. The scientist “dad” is also troubled but insists that “he belongs with me, with us”. But it is too late. New technology with honorable intentions, and an upbringing full of love has nevertheless created an angry activist, a revolutionary that seeks justice and vengeance for having been stripped of family, freedom and dignity…

After they published their critique, I responded in this piece at BioNews and on this blog to what I felt were unfair statements by them. And while I believe we continue to have some differences of opinion, I respect their work and expertise and feel that certainly if there is going to be a way forward on regulation in the US that Wendy Kramer is and will be a leader of that movement here.

Anonymous Sperm Donor, whoever you are, you’ll go further and achieve more in this debate if you’ll find better ways to express your concerns. Sometimes when I’ve overstepped the line of civility I’ve recognized it and apologized. Maybe you’d like to consider a better way to talk about Wendy Kramer and the DSR and offer her an apology too (and by the way, Eric Blyth really is a professor…why on earth give  him grief for saying so?)