Should You Tell Donor-Conceived Children Their Biologic Identity?

Alternative family building is helping many people realize their dream of parenthood. However, it is also creating a dilemma about how much of a child’s biological background should parents reveal.

What will have a bigger impact: secrecy or disclosure?

Alternative family building and the “modern” family

Modern medicine is evolving the idea of “family.” Thanks to decades of advancements in reproductive science, infertile married couples, single women and same sex couples can all raise children of their own; formerly accepted ideas of family are giving way to include more diverse family units.

Such families are possible thanks to alternative family building. Unlike in vitro fertilization (IVF) and other assisted fertility procedures that use the parents’ own genetic material, alternative family building requires a third party egg, sperm, embryo donor, and/or surrogate mother.

While these procedures are opening doors for many families, they are not without obstacles. How will knowledge of his or her genetic history affect the child? Should parents disclose the method of conception or keep it a secret? Should the child know the identity and medical history of the donor?

As doctors of fertility science, we watch couples struggling with these questions every day. While it’s our greatest joy to see the dream of family realized, it is also our responsibility to ensure that prospective families understand the possible impact of alternative family building on their child.

The disclosure dilemma has no right or wrong answer, so it is important that parents consider and discuss all options and make the decision that is right for their child. Each family, after all, is unique.

To help guide these decisions, we have compiled a list of considerations for parents deciding what information to disclose to their child.

Should you keep it a secret?

Since most donors choose to remain anonymous, it’s highly likely that your child’s origin will remain confidential. Of course, in certain situations – such as ethnic alteration, same-sex couples, friend or family donors and use of a surrogate mother – secrecy is not an option. Exceptions aside, it is certainly possible to keep the method of conception private.

So, why opt for nondisclosure? Here are a few common reasons:

Social stigma

Some parents fear that revealing a child’s genetic identity risks social stigmatization within the community. Religion, economic status and political views are often rooted in a person’s historical and biological context; parents may fear their child’s differences could mean social rejection.

Normality

Although the meaning of “family” is evolving, alternative families are still in the minority. Some couples keep silent to preserve appearances and avoid difficult issues. Male and female infertility, for example, is often (albeit falsely) considered an affliction that should not be discussed. Couples may decide to keep certain details secret, perhaps revealing when a child is at an age to better understand.

Family

Occasionally, parents simply want to avoid issues that may arise within the family if they elected to disclose the child’s origin. They prefer to keep the peace by preventing excessive stress and conflict; some are fearful that their child may gravitate towards his or her biological parents and/or community.

Should you disclose?

While there are a myriad of reasons why parents choose not to reveal their child’s genetic origin, some argue that keeping this information secret is unhealthy and unproductive for the child and parents.

Let’s explore a few common reasons parents decide to disclose a child’s biological background:

Emotional risk

No matter the reasons for nondisclosure, there is the simple fact that the family would, in a sense, “live a lie” by hiding a child’s genetic history. Social researchers note that protecting a secret can often create tension between partners because it means that their lives must function around confidentiality.

Even if a parent is simply trying to keep the peace, the repercussions of a child finding out their origin late in life – intentionally or not – could be devastating. Consequently, for many parents, it is more important to have an honest and open family relationship.

Preserving heritage

Some parents decide to disclose their child’s genetic history so that they can celebrate and preserve the child’s heritage. Willingness to embrace and explore where the child came from can help families peacefully coexist and create a nurturing environment.

Medical history

From a practical standpoint, parents might wish to reveal a donor’s medical history so that the child is aware of any risks or inheritable conditions.

Note that it is not a good time to explain your child’s genetic past if:

• The child has a developmental disorder that will hinder her or him from understanding
• The child is going through a stressful time and will associate the information with that particular anxiety
• The family is undergoing conflict, like divorce; the information should not be revealed in a moment of anger

Identity angst

A big part of growing up is learning who you are, and sometimes, accepting who you are.  For some people, either of these situations can be a struggle. This struggle can be compounded, for some children and adults, by the knowledge that they were the product of donor sperm or donor egg.

While the American Society of Reproductive Medicine’s (ASRM) Ethics Committee notes that disclosure does not have as big of a negative impact as once feared, many of their conclusions were based on what we know about adopted children.

In its opinion, ASRM did not address the findings from a 2010 study released by The Commission on Parenthood’s Future found that individuals who knew they were the product of donor sperm were more likely to have depression, delinquency, substance abuse and a feeling of isolation compared to children raised by their biological parents.

Compared to adopted children, individuals who are the product of donor sperm were substantially more saddened by observing other children in the company of their biological fathers.

Needless to say, some of these offspring will feel like there is a hole in their lives, whether or not they are aware that they were the product of donor egg or sperm. However, those who do know that they were conceived via a donor have something upon which to fixate their angst. It is noteworthy that many children will try to locate their biologic parent through organizations like Donor Sibling Registry.

For the reasons above, some parents will opt for donors who say they would allow for future contact from a family, or a child, should they desire it in the future. Not all donors will allow such contact, and those who say they will, might change their minds in the future.

We say none of this to discourage full disclosure, but to increase the awareness of challenges that may arise. It is possible that by knowing the challenges facing young adults, issues can be addressed by parents before they become problems. By knowing potential problems, the risks of feeling isolated might be mitigated or reversed.

Deciding what is important

While there is significant division when it comes to beliefs about whether or not to tell a child about his or her genetic history, it is essential to remember that genetics are not what make a parent. A loving and secure relationship is what truly matters to your child.

So, when deciding what to tell your child, think about what is important to you. Is it trust and openness? Normality? Awareness and education?

In the end, a willingness to nurture, teach, protect, guide and love – not DNA – will decide how you welcome a child into your family.