Problematizing donor conception and drawing the right conclusions from the evidence
2021; Elsevier BV; Volume: 115; Issue: 5 Linguagem: Inglês
10.1016/j.fertnstert.2021.02.012
ISSN1556-5653
Autores Tópico(s)Assisted Reproductive Technology and Twin Pregnancy
ResumoFrom the very start of sperm donation, psychological studies have shown that donor-conceived children were doing well. This stands in sharp contrast to the message given by a very vocal but small group of donor-conceived persons whose frustration and anger create the impression that we are dealing with a very problematic and contentious practice. The obvious conclusion is that they cannot be taken as representative of the total population of donor-conceived persons. The present study is part of a series of publications emanating from the National Longitudinal Lesbian Family Study (1Carone N. Gartrell N.K. Rothblum E.D. Koh A.S. Bos H.M.W. The stability of psychological adjustment among donor-conceived offspring in the U.S. National Longitudinal Lesbian Family Study from childhood to adulthood: differences by donor type.Fertil Steril. 2021; 115: 1302-1311Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar). The study has two strong merits: its longitudinal perspective and its unbiased sample. Almost all studies on attitudes of donor-conceived persons are based on highly biased samples, recruited from support networks and websites created to enable contact between donors, donor offspring, and donor siblings. Despite the concern that children conceived with donor gametes would be at risk of psychological difficulties, all studies performed in unbiased samples showed no differences with naturally-conceived families (2Golombok S. Ilioi E. Blake L. Roman G. Jadva V. A longitudinal study of families formed through reproductive donation: parent-adolescent relationships and adolescent adjustment at age 14.Dev Psychol. 2017; 53: 1966-1977Crossref PubMed Scopus (27) Google Scholar). Although these studies were crucial to getting us to the point where we are now, one starts wondering how long we will keep looking for problems. It is almost as if we cannot or do not want to believe that the kids are all right. Being donor-conceived, and surely having an anonymous donor, must entail serious psychosocial issues, must it not? By assuming problems in donor-conceived families, this research indirectly and regardless of the intentions, presents genetic families as preferable and unproblematic. This is unfair to all families created through gamete donation or adoption. Empirical studies, including the one by Carone et al. (1Carone N. Gartrell N.K. Rothblum E.D. Koh A.S. Bos H.M.W. The stability of psychological adjustment among donor-conceived offspring in the U.S. National Longitudinal Lesbian Family Study from childhood to adulthood: differences by donor type.Fertil Steril. 2021; 115: 1302-1311Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar), are supposed to help clinics, policy makers, and current and future parents to make informed decisions about treatments, policies, and regulation. However, legislation and regulation in gamete donation are based on psychological theories that are highly resistant to empirical findings. When a theoretical claim is not confirmed or even contradicted by empirical findings, one expects researchers either to drop or modify the claim and/or to start looking for alternative explanations. Take the issue of disclosing donor conception to the offspring and the harmful effects of secrecy. It has been argued that family secrets have an adverse effect on family relationships and, thus, on the child. Not a single study has shown that not informing the child about the mode of conception (considered by many as the ultimate secret) results in empirically measurable psychological harm to the offspring (3Pennings G. Disclosure of donor conception, age of disclosure and the well-being of donor offspring.Hum Reprod. 2017; 32: 969-973Crossref PubMed Scopus (25) Google Scholar). Still, psychologists and counselors keep repeating over and over again that telling and telling early is better for the child. While drawing conclusions or making recommendations, the researchers ignored their own findings. The investigators of this study should be applauded for breaking this trend: they pointed out that their study did not confirm the assumed link between adoption and gamete donation regarding the effects of not knowing or not being able to access one's genetic origins. Although already important in itself, the conclusion should go even further: one should question the existence of the supposedly underlying psychological mechanism (the so-called "genealogical bewilderment") (4Leighton K. Addressing the harms of not knowing one's heredity: lessons from genealogical bewilderment.Adoption Culture. 2012; 3: 63-107Crossref Google Scholar). That mechanism may be little more than an argument to promote a certain ideology, that is, the view that in a "real" family, parents and children are related genetically. The most important finding from this study is that donor type (anonymous, identifiable, or known) is irrelevant for the psychological adjustment of adult donor offspring. This finding suggests that a multitrack system of donor types not only should be allowed but may even be recommended. In the absence of negative consequences for the offspring, the possible advantages for the parents (e.g., feeling more secure in their role) may tip the balance. Moreover, this study (and other studies) showed that it is not necessary for donor offspring to access their genetic origins or to contact the donor for healthy development. There is plenty of literature that demonstrates that in the last decade an increasing number of donor offspring became curious about the donor and considered contacting him. That reaction is perfectly normal and expected in a society that stresses the importance of genetics for all aspects of a person's life. This reaction, however, does not prove that these people need the genetic knowledge in the sense that they would not be able to perform a task that is essential for a person's well-being without it, such as identity building. The present study confirms this. The group with an anonymous donor did not differ from the other groups in terms of psychological adjustment and two-thirds of the 25-year-olds with an open identity donor had not contacted him. How can this be explained if knowledge of one's genetic origins is necessary to construct an identity? Why were not more psychosocial problems connected with identity development detected in those groups? In a similar study in donor-conceived persons with different donor types performed in the Netherlands by some of the same researchers, they came to the conclusion that "their studies failed to support the premise based on kinship theory that children without complete genealogical information will be psychologically harmed" (5Bos H. van Rijn-van Gelderen L. Gartrell N. Self-esteem and problem behavior in Dutch adolescents conceived through sperm donation in planned lesbian parent families.J Lesbian Studies. 2020; 24: 41-55Crossref PubMed Scopus (2) Google Scholar). It seems also that the theories about the relationship between knowledge of one's genetic origins and identity should be reviewed. Despite the reassuring empirical evidence on the psychological and social development of families with children conceived with donor gametes, the whole practice is problematized. Certain elements of the practice, such as donor anonymity, are presented as a violation of a fundamental human right of the offspring based on the claim that anonymity harms the child. Rights are social constructions intended to protect important interests. This and other studies prove that the presumed right to know one's genetic origins does not promote an important interest. People can still defend such rights based on other arguments, such as beliefs about the superiority of genetic families or natural reproduction. The latter beliefs are, however, clearly ideological convictions largely independent of scientific findings. The psychological studies are relevant only for those who believe that our normative system of rules and regulations should be consistent with scientific findings. The stability of psychological adjustment among donor-conceived offspring in the U.S. National Longitudinal Lesbian Family Study from childhood to adulthood: differences by donor typeFertility and SterilityVol. 115Issue 5PreviewTo study differences by sperm donor type in the psychological adjustment of the U.S. National Longitudinal Lesbian Family Study (NLLFS) offspring across three time periods from childhood to adulthood. Full-Text PDF
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