It is well established that parents who conceive children using donor gametes find coming to a disclosure decision a challenging task, yet even those parents who have made a commitment to disclosure are frequently uncertain about the timing, the method, and the outcomes of disclosing (2
). Based on in-depth interviews with 112 disclosing couples who had used egg donation or donor insemination to conceive at least one living child, this report summarizes our findings with respect to disclosure planning and timing as well as the specific strategies and stories parents utilize in conveying the disclosure information to their children. Although we originally anticipated that there might be qualitative differences in the attitudes of DI and ED parents, our finding that these parents voiced similar concerns and feelings about disclosure is supported by recent research by Kirkman in Australia and Golombok in Great Britain. (14
We found that, despite their decision to disclose, parents of children conceived with donor gametes voiced a variety of concerns that have been consistently attributed to gamete donor parents in past research (1
). As we found that both DI and ED parents typically employed one of two disclosure strategies to prepare for and enact disclosure to their children, we postulate that these strategies provide a framework for addressing their concerns and help parents manage their uncertainty while still retaining their commitment to disclosure. We refer to these strategies as “seed-planting” (distinguished by the conviction that early disclosure to the child is of paramount importance) and the “right-time”(characterized by the belief that there is a variably-determined, usually later time, when the child will be most receptive to disclosure). Specifically, we found that both disclosure strategies rationalize the timing of disclosure, normalize the use of donor gametes, and address parents’ fears and concerns about the impact of the information on the child and on the family.
Parents using a seed-planting strategy expressed the desire to normalize their use of donor gametes and to prevent a rupture in the parent-child relationships by disclosing early and often so that the children would “always know” and the information would be “no big deal.” This strategy tacitly argues that if the donor conception is viewed as an integral part of the child’s life history, there can be no time at which this information could significantly alter the child’s relationship with the parents, thus avoiding the possibility of rejection or re-conceptualization. Overall, parents using a seed-planting strategy were more at ease with their disclosure decision and viewed disclosure as an ongoing process that would continue regularly until the parents felt that their children could recall and understand the information. These parents anticipated that their children’s’ responses would influence how the disclosure unfolds and indicated that they viewed the child as a participant in an evolving and interactive family narrative.
On the other hand, parents using the right-time strategy expressed a greater level of uncertainty about their disclosure plans and more concern about how the children would react than did seed-planting parents. Although parents using the right-time strategy also wanted to normalize the use of donor gametes and frame it positively, many viewed disclosure as precarious and potentially harmful if the information was transmitted too soon and without some specific scientific knowledge in place. By waiting until the children were older and understood the difference between private and public information, parents also indicated their concern about the potential for stigma and loss of privacy that could arise from the child’s indiscriminate discussion of the use of donor gametes and infertility.
Parents using the right-time strategy envisioned the years prior to disclosure as a time that enables the establishment of relationships, routines and behaviors that represent stability and normalcy to the child. These routines are believed to not only reinforce trust among immediate and extended family members, but by allowing the child to mature for several years without being influenced or defined by the donor conception, stigmatizing messages from inside or outside the family could also be avoided. Furthermore, that parents using the right-time strategy expressed a concern with getting disclosure “right” may also reflect parents’ fears about judgment or criticism from their children for having used a donor. As a result, right-time parents’ attitudes suggested that the act of disclosure would be more like a performance enacted before the children by the parents, rather than the more interactive process favored by seed-planters. Because this desire for relative confidentiality and concern with preventing a disruption in parent-child relationships is strongly reminiscent of past non-disclosing attitudes that served to protect the family against the threat of social stigma (16
), we conjecture that parents advocating a right-time strategy may represent a transition from past attitudes favoring non-disclosure toward a more current environment encouraging openness. On the other hand, the parental belief in the importance of having children be mature enough to grasp the details of reproduction is supported by the suggestion that children under the age of seven may not be able to comprehend the concept of biological inheritance that would contribute to an understanding of donor conception (22
We found that most parents using the seed-planting strategy began or planned to begin disclosing to their children between the ages of three and four, coinciding with reports of early disclosure from New Zealand and the United Kingdom (7
). Although parents subscribing to the right-time strategy anticipated disclosing to their children around the ages of ten to twelve, disclosure actually took place between the ages of 6 and 7, congruent with Durna’s report of Australian DI parents planning to disclose to children age 8.4 years but actually disclosing to children at age 6.3 years (4
). Finally, we not only found support for the observation that parents almost universally believe that disclosure should be avoided during adolescence (19
), but very few of the parents in our study planned to disclose to post-adolescent or adult children.
While some researchers report that women tend toward greater openness than men with regard to disclosure (3
), others have found no differences between men and women (7
). We found that, in general, women were more likely to prefer to disclose earlier in the child’s life than do men. In couples using the seed-planting strategy, mothers were more likely to be the parent initiating ad hoc disclosure, perhaps reflecting a greater amount of time spent with younger children. Finally, women considered general, less detailed conversations to be part of the disclosure process while men often thought that only the transmission of the specific details about the donor conception constituted disclosure. Past research citing gender differences was primarily conducted with DI families where it may be difficult to determine if approaches to disclosure differ between spouses because of gender differences or because of differences in the contribution of gametes; for example, Daniels suggests that in DI couples women defer to men’s feelings about disclosure (25
). Noting that approximately a quarter of our study’s parents used a combination of disclosure strategies, we conjecture that when couples were undecided due to differences of opinion, compromise was perhaps reached by combining elements of the strategies where some information was shared early and more detailed information was reserved for “the right time.”
Most parents expressed frustration with the perceived lack of comfortable language and “scripts” available to discuss donor conception with their children, especially as they struggled to find unambiguous terminology with which to refer to the donor, a difficulty also reported by Kirkman in interviews with 32 Australian parents (20
) and by Scheib in a study of 45 American DI families (28
). However, we were able to identify five different origin narratives that were used singly or in combination as the children got older, i.e., “the helper,” “spare parts,” “families are different,” “labor of love,” and “nut and bolts.” There are considerable similarities between these origin stories and the disclosure themes reported by Rumball and Adair in New Zealand DI parents (especially with respect to the “helper,” “spare parts,” and “labor of love” narratives (7
)) as well as overlap with Lycett’s findings on English DI parents with respect to the “spare parts” narrative (19
). These authors also found that parents gradually introduced the donor information, building on the story over time as children were better able to understand (7
We conclude that these disclosure narratives presented the donor conception in a manner that normalized the use of donor gametes, minimized the importance of the actual donor, and protected their legitimacy in their social role as the “real” parents. The ages of the children at the time of disclosure and the parents’ disclosure strategy appeared to be the most meaningful factors for parents in choosing among the disclosure narratives. Because early disclosure was initiated by conveying conceptual information to young children who would not grasp technical details, parents using seed-planting were faced early on with presenting the social implications of having used a donor, such as the donor’s relationship to the child. On the other hand, because right-time disclosure was initiated later when older children were likely to have already established expectations of family roles, these parents chose to focus on conveying the medical details of the conception while minimizing discussion of the donor and emphasizing existing definitions of family.
For example, we found that although both DI and ED parents used or planned to use similar vocabulary and origin stories, DI parents used a “spare parts” narrative more often and ED parents favored the donor version of the “helper” story. This may also reflect DI’s more depersonalized donor selection process where donors are largely anonymous and sperm is provided by commercial sperm banks. The physically innocuous nature of the sperm donation procedure may also make sperm donation seem more like just providing a “spare part,” a theme which later is conveyed to the children.
In contrast, photos of egg donors are widely available and recipients may have the option to meet donors in person. In addition, the fact that the donor and recipient are undergoing simultaneous treatment in the same medical facility calls greater attention to the physical role of the donor, even when the egg donor remains anonymous. As a result, ED parents may favor origin narratives that are more inclusive of the donor because they may be more aware of the donor’s presence and may have spent more time thinking about and imagining the donor. The greater invasiveness and risk involved in egg donation as compared to sperm donation may also make the “helper-donor” story more appropriate for egg rather than sperm donors. Finally, the differences between disclosure narratives of ED and DI parents may not only be based on gender distinctions inherent in the two procedures, but also upon their varied historical contexts.
The “helper-donor” story also serves to reinforce the primacy of the parents’ relationship with the children while also acknowledging that another person was instrumental in creating the family. Hahn and Craft-Rosenberg (18
) found that parents generally desired to place the donor in positive light, and Inhorn and Tober have also described the transaction as the donor providing a “gift” to the parents (29
). Furthermore, recognizing the donor creates the possibility that some relationship may exist between the donor, the parents, and potentially the children. On the other hand, in the “helper-doctor” and “spare parts” narratives, emphasis is placed on the parents’ need for a solution or treatment for their problems having a baby, but the gamete contribution is depersonalized or characterized as a transaction or professional service rather than a gift exchange, and there is no implication of the possibility for an ongoing relationship outside the immediate family.
The “families are different” narrative depends on children being exposed to diverse family configurations, either in their own communities or through books and other media. This story not only demonstrates that the parents’ choice was an active and purposeful one, but it also may serve to reduce a sense of “otherness” for the offspring conceived with donor gametes by fostering a sense of commonality with children and families created in different ways.
The “labor of love” narratives primarily addressed parents’ motivations for using a donor and appeared to be positioned defensively, assuming or pre-empting a negative response by the children to disclosure. Parents employing the right-time strategy frequently invoked the labor-of love story in conjunction with a logistical explanation of the donor conception. This suggests that in some cases they were motivated by the hope that if the child knows how badly they were wanted they would have a greater appreciation and acceptance of the parents’ decision to use a donor.
Finally, the “nuts and bolts” narrative, primarily employed by parents using or planning to use the right-time strategy, serves to convey scientific and medical details of the donor conception without addressing the possible social implications. Similar to the “spare parts” narrative, it highlights the procedural aspects of using donor gametes without overtly challenging the existing definition or experience of family that has already been presented to the children.
We found that the majority of DI and ED parents in this study had disclosed (32%) or planned to (45%) disclose to their children. Although these rates are higher than in most past studies on DI families (2
), they are comparable to more recent studies of DI and ED families in Great Britain and Australia (7
). The average age of the first-born donor-conceived child was a little over 5 years with both parents in their mid-to-late forties, primarily Caucasian, married, highly educated, and affluent – a demographic composition comparable to those reported in other recent studies on gamete donation families (10
). Although a large number of gamete donor parents were interviewed, we acknowledge that our findings cannot help but be influenced by the self-selected nature of our study population and the fact that they reside in the affluent and politically and culturally liberal environment of Northern California.
There has been speculation that parents who plan to disclose but do not disclose early in their children’s lives may ultimately not disclose at all. Several studies have found that most parents who planned to disclose to their children had not yet done so by the time the children approached age eight (1
) and that disclosing becomes more infrequent as children age (4
). As most of the donor-conceived children in this and other studies are relatively young, reports on final disclosure stances from non-longitudinal studies are likely to be inconclusive. The few longitudinal studies which have included children approaching adolescence found that most parents have not disclosed to their children (9
). We cannot predict if the parents in this study who planned to disclose will follow through with their plan. However, we found no differences between how those who have disclosed and those who intend to disclose described their strategies for and their feelings about disclosure and their current or former uncertainties about the outcomes, with the one exception that many who had disclosed experienced relief.
We found that no parents regretted disclosing and most reported either a neutral or positive response from their children, congruent with other studies where parent’s disclosure outcomes are available (4
). Many parents in our study expressed relief after disclosure, which we attribute to the absence of negative responses from the children. Although essentially all disclosing parents cited honesty as at least partial motivation for disclosing, those choosing the seed-planting strategy were able to act in concert with this belief early on, whereas those using the right-time strategy spent a number of years living somewhat at odds with their values. This tension is one that may contribute to right-time parents’ greater uncertainty and discomfort prior to disclosing. Indeed, not only was the apprehension expressed by pre-disclosure parents far greater than those who had disclosed, but parents’ fears about disclosure having a negative impact, at least initially, appear to be exaggerated.
Although couples may not follow the advice of counselors regarding disclosure (3
), our findings support the long-standing observation that parents desire peer and professional help with disclosure (1
) if only to help them formulate their own views. As it has been speculated that the general lack of assistance, and specifically the lack of disclosure "scripts" may be a deterrent for parents in carrying through with the disclosure (1
), it seems clear that if disclosure of donor gametes is to become more widespread, parents will require greater support services to assist them in this process. Although Hunter and Lycett in Great Britain (17
) and Rumball and Adair in New Zealand (7
) reported wide use of written materials including “My Story” (44
) and other similar books published in Europe and Australia, parents in this study, particularly those using the right-time strategy, generally expressed frustration at what they perceived to be a lack of resources and support to help them explain donor conception to their children. Whether this reflects a level of ambivalence, initiative, or motivation on the part of these parents or rather represents a lack of availability or guidance, it appears that many of these affluent and highly educated American men and women were not accessing or utilizing existing materials to assist them with disclosure. We did find that couples using a seed-planting strategy were more likely to embrace ideas and techniques commonly studied and used in adoption literature, which in turn may have contributed to their expressing a greater feeling of confidence than those using the right-time strategy.
Finally, we found support for the observation that disclosure is seen as an ongoing process by parents once it has been initiated (7
). As such, we strongly agree with the suggestion that if there is indeed a shift toward greater openness in parents using third party reproduction, there will be an increasing need for support services to assist parents in this process not only initially, but continuing long after their children are born (1
). Our belief is that support that parents will find most effective will be based on evidence from the experiences of other donor gamete families and will require continued research on the long-term experience of disclosing donor conception to children.