Family Communication About the Donor Conception: A Multi-Perspective Qualitative Study With Lesbian Parents and Their Children

Legal age limits in accessing donor information: experiences of donor-conceived people, parents, sperm donors and counsellors

RESEARCH QUESTION

What are the lived experiences of donor-conceived people, parents, sperm donors and counsellors related to legal age limits on accessing donor information in the Netherlands?

DESIGN

A phenomenological study was carried out that included 20 donor-conceived individuals, 15 parents, 6 sperm donors and 5 counsellors. Data were collected through online qualitative in-depth interviews and focus groups. The data were analysed using Dahlberg's Reflective Lifeworld Approach.

RESULTS

The results show how: (i) age limits create challenges related to dependency, autonomy and loyalty to parents; (ii) donor information can be important for identity development, which looks different at different ages; (iii) inaccessible information can lead to unfair loss and may be perceived as negative; (iv) relational stability provides a good foundation for dealing with the (in)accessibility of donor information; (v) procedural barriers and age limits increase the inaccessibility of donor information; and (vi) comprehensive counselling is desired for donor-conceived individuals, parents and donors.

CONCLUSIONS

This study shows that legal age limits on accessing donor information can lead to several negative consequences. The age limits focus on one individual, which is not appropriate for questions about ancestry that always pertain to a relational network. Counselling should be tailored to the child's needs, and the child's family should be involved. Furthermore, the donor should receive independent counselling.

Children's Exploration of Their Surrogacy Origins in Gay Two-Father Families: Longitudinal Associations With Child Attachment Security and Parental Scaffolding During Discussions About Conception

Evidence is lacking about the factors that are pivotal in enhancing the exploration of surrogacy origins in children of gay fathers during middle childhood. The present study examined the separate and combined influences of child attachment security and parental scaffolding (i.e., fathers' attempts to accept, encourage, and emotionally support their children's expression of thoughts and feelings) during discussions about conception on children's exploration of their surrogacy origins in 30 Italian children born to gay fathers through gestational surrogacy. Within each family, both father-child dyads (n = 60) participated in a 5-minute videotaped conversation regarding an aspect of the child's conception when children were mean aged 8.3 years (t1). At this time, children were also administered the Security Scale Questionnaire to evaluate their attachment security. Approximately 18 months later (t2; M age = 9.9 years), children were interviewed about their surrogacy origins. Linear mixed models (LMMs) for longitudinal data indicated that, with higher levels of parental scaffolding, only children who perceived greater attachment security reported greater exploration of their surrogacy origins. The findings are the first to underscore the importance of conversations about surrogacy within the context of parent-child attachment relationships, as well as the importance of fathers sensitively supporting their children as they explore their origins during middle childhood. In doing so, it is expected that fathers will likely facilitate their children's positive integration of their surrogacy conception into a coherent sense of identity during adolescence.

The perspectives of adolescents conceived using surrogacy, egg or sperm donation

STUDY QUESTION

What are the perspectives of adolescents conceived using surrogacy, egg or sperm donation regarding their conception and the third party involved?

SUMMARY ANSWER

The majority of adolescents described feeling indifferent about their conception, and yet simultaneously reported an interest in the third party involved, or were in contact with them.

WHAT IS KNOWN ALREADY

There is an assumption that children conceived through reproductive donation will feel negatively about their origins in adolescence. However, little is known about the views of adolescents who have been conceived through different types of reproductive donation.

STUDY DESIGN, SIZE, DURATION

Forty-four adolescents, all of whom had been told about their conception in childhood, participated in a semi-structured interview as part of the sixth phase of a longitudinal, multi-method, multi-informant study of assisted reproduction families in the UK.

PARTICIPANTS/MATERIALS, SETTING, METHODS

All adolescents were aged 14 years, had been conceived using surrogacy (n = 22), egg donation (n = 13) or sperm donation (n = 9) to heterosexual couples, and varied in terms of their information about, and contact with, the third party involved in their conception. Semi-structured interviews were conducted in participants' homes. Interviews were analysed qualitatively to determine adolescents' perceptions of their conception, and their thoughts and feelings about the surrogate or donor involved.

MAIN RESULTS AND THE ROLE OF CHANCE

Adolescents were found to feel positive (n = 7), indifferent (n = 32) or ambivalent (n = 5) about their conception. Amongst adolescents not in contact with the surrogate or donor, most were interested (n = 16) in the surrogate or donor, and others were ambivalent (n = 4), or not interested (n = 6) in them. Adolescents in contact with the surrogate or donor expressed positive (n = 14), ambivalent (n = 1) or negative (n = 1) feelings about them.

LIMITATIONS, REASONS FOR CAUTION

Of 56 adolescents invited to take part in the study, 47 consented to take part, giving a response rate of 84%. It was not possible to obtain information from adolescents who do not know about their conception.

WIDER IMPLICATIONS OF THE FINDINGS

The findings contradict the assumption that children conceived through reproductive donation will feel negatively about their origins in adolescence and suggest that it may be helpful to draw a distinction between adolescents' feelings about their conception in general, and their feelings about the surrogate or donor in particular.

STUDY FUNDING/COMPETING INTEREST(S)

This study was funded by the Wellcome Trust [097857/Z/11/Z]. The authors have no conflicts of interest to declare.

'Is blood thicker than water?' Donor conceived offspring's subjective experiences of the donor: a systematic narrative review

The aim of this study was to provide a systematic narrative review of the published research articles on donor conceived offspring's subjective experiences of their donor. A systematic search of electronic databases (PsycINFO and PubMed) provided 29 published quantitative and qualitative studies matching the inclusion criteria. The analysis of the studies outcomes led to the identification of four main themes: (i) views/representations of the donor; (ii) desire to contact the donor (in terms of desire to meet the donor, reasons for wanting to contact the donor, type and frequency of contact); (iii) reactions to discovering the donor's identity and contacting the donor; (iv) identity issues. The findings revealed that genetic ties do matter to donor conceived people, especially during adolescence or adulthood. Many donor conceived people were interested in contacting the donor and all of them needed to make meaning of the role of the donor, as well as to integrate it into their family life and self-concept. Besides curiosity and medical reasons, many people reported wanting to contact the donor to see what he/she looked like, and to have access to their own ancestry and genetic history.

'What Does Donor Mean to a Four-Year-Old?': Initial Insights into Young Children's Perspectives in Solo Mother Families

This study reports on the questions, thoughts and feelings of children aged 4-9 conceived by donor insemination to single mothers. Fifty-one mothers and 47 children from the same families were each administered a semi-structured interview. Mothers generally reported that while children either lack understanding, or have not yet been told, about their donor conception, they may be thinking and talking about the absence of a father. Most children did not mention either donor conception or father absence and reported positive feelings about their families and friendships. Possible explanations for the discrepancy between mothers' and children's reports are discussed.

Children's thoughts and feelings about their donor and security of attachment to their solo mothers in middle childhood

STUDY QUESTION

What is the relationship between children's thoughts and feelings about their donor and their security of attachment to their solo mothers in middle childhood?

SUMMARY ANSWER

Children with higher levels of secure–autonomous attachment to their mothers were more likely to have positive perceptions of the donor, and those with higher levels of insecure–disorganized attachment to their mothers were more likely to perceive him negatively.

WHAT IS KNOWN ALREADY

There is limited understanding of the factors that contribute to children's thoughts and feelings about their donor in solo mother families. In adolescence, an association was found between adolescents’ curiosity about donor conception and their security of attachment to their mothers.

STUDY DESIGN, SIZE, DURATION

19 children were administered the Friends and Family Interview and Donor Conception Interview between December 2015 and March 2016 as part of the second phase of a longitudinal, multi-method, multi-informant study of solo mother families.

PARTICIPANTS/MATERIALS, SETTING, METHODS

All children were aged between 7 and 13 years and had been conceived by donor insemination to solo mothers. Interviews were conducted in participants’ homes. The Friends and Family Interview was rated according to a standardized coding scheme designed to measure security of attachment in terms of secure–autonomous, insecure–dismissing, insecure–preoccupied and insecure–disorganized attachment patterns. Quantitative analyses of the Donor Conception Interview yielded two factors: interest in the donor and perceptions of the donor. Qualitative analyses of the Donor Conception Interview were conducted using qualitative content analysis and thematic analysis.

MAIN RESULTS AND THE ROLE OF CHANCE

Statistically significant associations were found between the perception of the donor scale and the secure–autonomous and insecure–disorganized attachment ratings. Children with higher levels of secure–autonomous attachment to their mothers were more likely to have positive perceptions of the donor (r = 0.549, P = 0.015), and those with higher levels of insecure–disorganized attachment to their mothers were more likely to perceive him negatively (r = −0.632, P = 0.004). Children's narratives about the donor depicted him as a stranger (n = 8), a biological father (n = 4), a social parent (n = 3), or in ambivalent terms (n = 4).

LIMITATIONS, REASONS FOR CAUTION

Findings are limited by the wide age range of children within a small overall sample size. Participants were those willing and able to take part in research on donor conception families. The statistical significance of correlation coefficients was not corrected for multiple comparisons.

WIDER IMPLICATIONS OF THE FINDINGS

Findings highlight the importance of situating children's ideas about the donor within family contexts. It is recommended that those working with donor conception families consider this when advising parents about whether, what and how to tell children about donor conception.

STUDY FUNDING/COMPETING INTEREST(S)

This study was funded by the Wellcome Trust [097857/Z/11/Z]. The authors have no conflicts of interest to declare.