Department of Developmental and Life Span Psychology, Dutch speaking free University of Brussels, 1050 Brussels, Belgium
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Abstract |
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Key words: donor anonymity/donor insemination/donor offspring/lesbian parenthood
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Introduction |
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DI was introduced in Belgium at the start of the 1960s. Since 1990, DI treatment has been offered by a considerable number of academic, public and private hospitals. However, the Centre for Reproductive Medicine of the Free University of Brussels was one of the first institutions to offer this treatment to lesbian couples. The absence of a male parent in the lesbian family structure leaves these couples no choice but to be open with their children about the use of a donor. The fact that this male person is not missing in a heterosexual DI family gives these parents the opportunity to decide whether or not to keep the artificial means of conception secret from their child. Several studies show that most heterosexual couples have no intention of revealing the use of a donor to their children (Brewaeys et al., 1993, 1997
; Cook et al., 1995
; Leiblum and Aviv, 1997
; Gottlieb et al., 2000
). According to these studies, the following aspects appear to deter heterosexual DI parents from telling the truth: the taboo surrounding male infertility, negative attitudes towards childlessness and reproductive technology, fear of harming the child and the relationship between the father and the child, uncertainty about how and when to tell the child, and lack of information to give the child.
Because of the secretive attitude of heterosexual DI couples, only children born into lesbian DI families can be questioned about their experience as donor offspring. This study is one of the first that asks children, who were informed of their donor origin at an early age by both parents and under the right circumstances, how they feel about being donor children. In order to address the recurring ethical question on whether or not DI children should be informed, studies concerning children who have been told of their donor origins need to be carried out. As empirical information about the effects of known donation on the children involved is very sparse, we believe our study can make an innovative and valuable contribution to the DI debate. However, we must be aware of the fact that lesbian DI families and heterosexual DI families are very different with respect to their family structure, i.e. the absence/presence of a father figure. Nevertheless, we must examine the effects of disclosure and privacy on the welfare of the child and the family in order to make clinical recommendations regarding disclosure (Klock, 1997; Shenfield, 1997
). DI parents are currently encouraged to tell their children about their donor origin. This trend is due partly to a similar shift in attitudes towards adoption (Golombok, 1997
; Shenfield and Steele, 1997
). Parents are now encouraged to inform the child at an early age in the case of adoption. In adoptive as well as DI families, a biological connection between the child and one or both parents is missing. In the case of artificial insemination, however, the child is biologically linked to one of the parents, he or she has not been abandoned by his or her biological parents and conception occurred in the context of the recipient's relationship (Golombok, 1998
). Because DI families and adoption families differ in several ways, it can be argued that recommendations regarding disclosure in the case of adoption do not completely apply to DI (Cook et al., 1995
; Klock, 1997
).
Keeping the child's donor origin secret is linked closely to the use of an anonymous donor. Most medical practitioners request complete anonymity. In order to protect the family unit and its members, the social environment of the donor and the social environment of the receiving couple and the offspring need to remain strictly separate. This system also shields the donor from parenthood. In Sweden, on the other hand, an `open' model is being applied (Daniels, 1998). Swedish law imposes the use of identifiable donors. Those who favour this point of view argue that the registration of a donor's identity endorses the value of truthfulness. The donor origin and the identity of the donor must be disclosed to the children involved. They argue that violating the child's right to be given information about his/her descent is simply unethical (Cohen, 1996
). The UK appears to be adopting a middle position by registering non-identifying information about all donors. This information is stored at a national centre and can be made available to the child (Meirow and Schenker, 1997
; Abdalla et al., 1998
).
Although these conflicting attitudes present different opinions on what is best for the child, they all seem to focus on its welfare. However, this `welfare of the child' concept is an extremely vague one. For example, the criteria against which the well-being of the child should be evaluated are unclear (Mumford et al., 1998; Pennings, 1999
). There appears to be universal consensus on the welfare principle, but the practical interpretation of the concept is rather contentious (Brewaeys, 1998
). The debate on the child's best interest will probably continue as long as objective knowledge remains scarce.
The aim of this study is to investigate the child's concept of the donor. The fact that all these children know about their DI origin allows us to gather information about how these children perceive their donor. Is the donor just an anonymous sperm cell or is he a person about whom they want to know more? Because mothers and children are both used as informants, their attitudes towards the status of the donor are compared.
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Materials and methods |
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For the descriptive part of the follow-up study, in-depth topic interviews were used both for the parents and for the children. The content of the interview with the child on the donor concept was as follows: birth story, attitudes towards the status of the donor and conversations with their mothers about donor characteristics and related topics. The interview with the parents included questions about the birth story and the donor status. In order to give a structured summary of the children's and mothers' answers, a categorization procedure was used.
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Results |
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Donor status
After they had told their birth story, we asked them whether or not they wanted to know more about the donor. Because we wanted to ensure the children were well-aware of the fact that in Belgium no information about the donors is available, we explained to them that Belgian clinics only work with anonymous donors. Summarizing their answers yielded three points of view concerning the status of the donor: those who were in favour of identity registration, those who wanted non-identifying information to be available and those for whom the donor could remain anonymous. Anonymity is used to indicate that these children want no information at all. About half of these children (n = 22; 54%) preferred donor anonymity at this point in their life. The remaining 19 children (46%) wanted to know more about the donor. The majority of the latter group (n = 11; 27%) were interested in the donor's identity. The remaining eight children (19%) of this group were happy with non-identifying information (Table II).
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Family differences
In 14 families (58%), two or more siblings participated in the study. In half of these families (n = 7) siblings held different views about the status of the donor. Differences were found between sisters, brothers and between siblings of the opposite sex. These results reveal that the needs of one child may be very different from those of another, even if they live in the same household. Some children have their own opinion about these issues, independent of their siblings' attitudes.
Conversations about donor characteristics
We asked these children if they ever talked about the donor with their mothers. Twenty-six children (63%) said they never discussed these things with their mothers. Most of these children noted that they had no need for such conversations. Two children pointed out that conversations about the donor were useless since their mothers had no information to give them.
The remaining 15 children (37%) reported that they had talked about the donor with their mothers on several occasions. Eleven children had conversations with their mothers about certain characteristics of the donor (physical appearance, personality, etc.). Several of these children speculated and made jokes about the donor's physical appearance or asked their mothers if the donor looked like them. Five children had had conversations about the use of an anonymous donor. Three boys had asked their mothers for the donor's identity. (Table IV).
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To find out how these mothers perceived the donor, we asked them if the story about `the seeds' they initially told their children reflected their own perception of the donor. We also asked them whether thoughts about the donor crossed their minds and whether they talked about this family issue with their partner (Table V). In 54% of the families (n = 13), the parents hardly talked or thought about the donor. It was something they had come to terms with a long time ago. Some of the mothers felt there was no difference between a donation of spermatazoa and a donation of blood. Only a little piece of a human being was involved. In the remaining 11 families (46%), this subject had arisen occasionally. As a result of certain characteristics of their children, in almost all of these families remarks were made about the donor's physical appearance (height, etc.) or personality. Several mothers made jokes about it. They sometimes said to each other that their children had inherited all their annoying characteristics from the donor. In ~50% of these families, especially those in which one of the children appeared to have some health problems, mothers wondered about the donor's medical history. One mother wondered if the clinic would be able to trace the donor in case of a life-threatening disease like leukaemia. Two mothers regretted not being able to thank the donor for his help.
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A comparison between parents and children
Donor status
A comparison of the attitudes of the mothers, as shown in Table VII (n = 43; two mothers were left out because of their indecisiveness) and the children (n = 41) towards the status of the donor reveals that their opinions differed significantly (P = 0.0352; Fisher's exact test, two-tailed). Children more often wanted information to be available than mothers. They preferred non-identifying (20%) as well as identifying information (26%) to be registered more often than their mothers (2 and 19% respectively).
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Discussion |
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The thoughts and/or questions about the donor that the mothers had at various times illustrate that their donor concept is susceptible to change. By attributing physical characteristics, medical aspects or traits to the donor or by seeing him as a helpful person, he ceases to be a non-person (an anonymous sperm cell) and becomes a person. Reducing the donor to an anonymous sperm cell becomes more difficult for some mothers as their children mature. Unlike babies, these children have a unique physical appearance and personality. Also, the analysis of the conversations between parents and children about donor characteristics and the analysis of these mother's birth story reveals that several mothers' donor concepts are far from clear-cut. They try to minimize the intervention of the donor by picturing him as an anonymous sperm cell with no parental responsibilities whilst also representing him as the bearer of some of their children's features. These results also illustrate that calling upon heredity to explain the presence of certain good and bad traits in a person is a process that takes place unnoticed. In addition, the fact that all these mothers wanted the same donor for all their children seems to suggest that the presence of a biological connection is more important to them than they are aware.
In several families, mothers and children held different views concerning the status of the donor. More children than mothers were in favour of the registration of non-identifying as well as identifying information. This difference may be due to the fact that the mothers and the children do not approach the donor issue from the same angle. As all the children were 7 years old, they understood that the donor is the man from whom they descend. Their answers reflected the awareness that he is the man from whom they have inherited certain characteristics (Solomon et al., 1996
). Children in their middle childhood years become increasingly aware of biology as an underlying characteristic of family relations (Newman et al., 1993
). School-age children also begin to express greater curiosity about their origins (Brodzinsky et al., 1995
). The mothers, on the other hand, emphasized the fact that they, as a couple, had chosen to become parents; the child is the result of this shared wish. Only their family structure made the biological assistance of the donor inevitable. To the mothers, the donor is only a means to an end. As mentioned above, conversations about donor characteristics did occur in several families. Talking about the donor had probably made this man more real because aspects such as physical appearance and personality were mentioned frequently. The more real and personal the donor becomes, the more of a threat he represents for the completeness and naturalness of the DI family (Pennings, 1997
). However, an open, non-defensive style of communication may be important to these children's well-being, since this communication style has proven to be more conducive to healthy identity development in case of adoption (Brodzinsky et al., 1995
). Communication problems may arise in families where mothers prefer donor anonymity whilst their children want to know more about the donor. These children may refrain from discussing donor issues openly with their parents once they become fully aware of their mothers' attitudes towards the donor. For some of these children, this may already be the case since the majority of the children said they never talked about donor characteristics with their mothers.
In the lively debate on the status of the donor, the well-being and the needs of the child have always been emphasized. However, given the position of the child, its welfare cannot be separated from the well-being of the parents (Pennings, 1997); the child's psychological well-being is connected with that of the parents (Cook et al., 1995
; Golombok, 1997
). Allowing parents to choose what seems best for themselves and for the child will probably lead to a good outcome for all family members (Shenfield and Steele, 1997
). Our results suggest that among DI children in general and among members of the same family unit, opinions differ on the status of the donor. This suggests that the legal requirement of either anonymity or identification will never work for all the people involved. A flexible system seems to be necessary in order to meet the needs of each family (Pennings, 1997
). Each individual family should have the opportunity to choose the donor type that fits their particular family concept (Brewaeys, 1998
). As several mothers stated, patients should not be forced into one choice by a central authority. The choice prospective parents make should fulfil their own needs and the needs of the child-to-be. As we mentioned earlier, the results of this study suggest that some children feel the need to know more about the donor. This possibility cannot be ignored when choosing a certain donor type at the time of insemination.
Because this article is part of a follow-up study that also explores the quality of family relations, we will be able to investigate whether the demand for information is in some way linked to this variable. These results will be presented elsewhere.
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Acknowledgements |
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Notes |
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References |
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Submitted on December 11, 2000; accepted on May 16, 2001.