Cover Story

As more children are born using assisted reproductive technologies (ARTs), a major question looms: Should parents tell their children how they were conceived?

In both policy and practice arenas, psychologists are saying, "Yes."

"The feeling is that this is not only the parents' story, but also the child's story," says Jan Elman Stout, PsyD, chair of the Mental Health Professional Group of the American Society for Reproductive Medicine (ASRM). The reasons are both medical and psychological: Children of donor and surrogate technologies risk receiving inaccurate medical advice if they are misinformed of their genetic or biological roots, and such a fundamental secret can create an undercurrent of shame, experts note. For these and related reasons, ASRM's Ethics Committee released a position paper in 2004 advocating disclosure (see www.asrm.org/Media/Ethics/informing_offspring_donation.pdf).

Given the recent development of some ARTs, as well as complications in using children as controls whose parents have not disclosed to them, research in the area is still relatively new. But thus far, telling children appears to be neutral or positive, according to a review article in May's Sexuality, Reproduction and Menopause (Vol. 4, No. 1, pages 17-19) by psychologist Joanna E. Scheib, PhD, and Alice Ruby of The Sperm Bank of California (TSBC). The article also reports on Scheib's and colleagues' research on identity release, in which TSBC children can access their donor's name at age 18. Adult children and donors are mutually curious and may want to meet, Scheib's research finds, but they also want to respect each other's lives and not intrude.

It may be easier to tell children in some cases than others, other research finds. Studies by University of Virginia psychologist Charlotte Patterson, PhD, and others, find that lesbian and single moms are more likely than heterosexual couples to have told their children how they were conceived, undoubtedly because it's clear there is no biological father, Patterson says. Other research shows that some people don't disclose because they want to protect one or more family members, or they're afraid children might reject their own father in favor of their biological one.

No matter what the circumstance, psychologists can offer clients important guidance in deciding about disclosure and in talking to their child, notes Cornell University infertility expert Elizabeth Grill, PsyD.

"There is no definitive answer on the right time to talk to kids," she says. "But in general, younger is better, and parents might want to tell their children before adolescence, when issues of trust and identity take center stage."

--T. DeANGELIS

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