Parent psychological adjustment, donor conception and disclosure: a follow-up over 10 years.

STUDY QUESTION: What is the relationship between parent psychological adjustment, type of gamete donation (donor insemination, egg donation) and parents' disclosure of their use of donated gametes to their children. SUMMARY ANSWER: Disclosure of donor origins to the child was not always associated with optimal levels of psychological adjustment, especially for fathers in donor insemination families. WHAT IS KNOWN ALREADY: Cross-sectional analyses have found mothers and fathers who conceived a child using donated sperm or eggs to be psychologically well-adjusted, with few differences emerging between parents in gamete donation families and parents in families in which parents conceived naturally. The relationship between mothers' and fathers' psychological well-being, type of gamete donation (donor insemination, egg donation) and parents' disclosure decisions has not yet been examined. STUDY DESIGN, SIZE, DURATION: In this follow-up study, data were obtained from mothers and fathers in donor insemination and egg donation families at 5 time points; when the children in the families were aged 1, 2, 3, 7 and 10. In the first phase of the study, 50 donor insemination families and 51 egg donation families with a 1-year-old child participated. By age 10, the study included 34 families with a child conceived by donor insemination and 30 families with a child conceived by egg donation, representing 68 and 58% of the original sample, respectively. PARTICIPANTS/MATERIALS, SETTING, METHODS: Families were recruited through nine fertility clinics in the UK. Standardized questionnaires assessing depression, stress and anxiety were administered to mothers and fathers in donor insemination and egg donation families. MAIN RESULTS AND THE ROLE OF CHANCE: Mothers and fathers in both donor insemination and egg donation families were found to be psychologically well-adjusted; for the vast majority of parents' levels of depression, anxiety and parenting stress were found to be within the normal range at all 5 time points. Disclosure of the child's donor origins to the child was not always associated with optimal levels of parental psychological adjustment. For example, disclosure was associated with lower levels of psychological well-being for certain groups in particular (such as fathers in donor insemination families), at certain times (when children are in middle childhood and have a more sophisticated understanding of their donor origins). LIMITATIONS, REASONS FOR CAUTION: Owing to small sample sizes, the value of this study lies not in its generalizability, but in its potential to point future research in new directions. WIDER IMPLICATIONS OF THE FINDINGS: Donor insemination and egg donation families are a heterogeneous group, and future research should endeavour to obtain data from fathers as well as mothers. Support and guidance in terms of disclosure and family functioning might be most beneficial for parents (and especially fathers) in donor insemination families, particularly as the child grows older. The more that is known about the process of disclosure over time, from the perspective of the different members of the family, the better supported parents and their children can be.The first three phases of this study were supported by funding from the Wellcome Trust. The final two phases of this study were supported by grant number RO1HD051621 from the National Institute of Child Health and Human Developmen

"I am your mother and your father!": In vitro derived gametes and the ethics of solo reproduction

In this paper, we will discuss the prospect of human reproduction achieved with gametes originating from only one person. According to statements by a minority of scientists working on the generation of gametes in vitro, it may become possible to create eggs from men’s non-reproductive cells and sperm from women’s. This would enable, at least in principle, the creation of an embryo from cells obtained from only one individual: ‘solo reproduction’. We will consider what might motivate people to reproduce in this way, and the implications that solo reproduction might have for ethics and policy. We suggest that such an innovation is unlikely to revolutionise reproduction and parenting. Indeed, in some respects it is less revolutionary than in vitro fertilisation as a whole. Furthermore, we show that solo reproduction with in vitro created gametes is not necessarily any more ethically problematic than gamete donation—and probably less so. Where appropriate, we draw parallels with the debate surrounding reproductive cloning. We note that solo reproduction may serve to perpetuate reductive geneticised accounts of reproduction, and that this may indeed be ethically questionable. However, in this it is not unique among other technologies of assisted reproduction, many of which focus on genetic transmission. It is for this reason that a ban on solo reproduction might be inconsistent with continuing to permit other kinds of reproduction that also bear the potential to strengthen attachment to a geneticised account of reproduction. Our claim is that there are at least as good reasons to pursue research towards enabling solo reproduction, and eventually to introduce solo reproduction as an option for fertility treatment, as there are to do so for other infertility related purposes

Transition to parenthood and quality of parenting among gay, lesbian and heterosexual couples who conceived through assisted reproduction

Little research has focused on the emotions felt during pregnancy and early parenthood as well as the initial quality of parenting displayed by first-time parents who conceived using assisted reproduction technologies (surrogacy, donor insemination, and in vitro fertilization). Research on primary and secondary caregivers in gay, lesbian, and heterosexual families is especially sparse. The current study examined 35 gay-father families, 58 lesbian-mother families and 41 heterosexual-parent families with their infants. Families were assessed at home when their infants were 4 months old (±14 days), and each parent participated in an audio-recorded standardized semi-structured interview in which we explored parental feelings during pregnancy, feelings about the parental role, perceived parental competence, the enjoyment of parenthood, expressed warmth and emotional over-involvement of parents. 13 Heterosexual parents reported less positive feelings in early pregnancy than lesbian parents, while gay parents reported less positive feelings at the end of pregnancy than lesbian mothers and more positive feelings about parenthood during the first post-partum weeks than heterosexual parents. There was no interaction between family type and caregiver role on reported feelings, or on perceived competence, enjoyment, warmth, and involvement. The present findings elucidate the transition to parenthood among first-time parents conceiving through assisted reproductive technologies, and especially contribute to our knowledge about gay fathers who became parents through surrogacy

Negotiating daughterhood and strangerhood: retrospective accounts of serial migration

Most considerations of daughtering and mothering take for granted that the subjectivities of mothers and daughters are negotiated in contexts of physical proximity throughout daughters’ childhoods. Yet many mothers and daughters spend periods separated from each other, sometimes across national borders. Globally, an increasing number of children experience life in transnational families. This paper examines the retrospective narratives of four women who were serial migrants as children (whose parents migrated before they did) . It focuses on their accounts of the reunion with their mothers and how these fit with the ways in which they construct their mother-daughter relationships. We take a psychosocial approach by using a psychoanalytically-informed reading of these narratives to acknowledge the complexities of the attachments produced in the context of migration and to attend to the multi-layered psychodynamics of the resulting relationships. The paper argues that serial migration positioned many of the daughters in a conflictual emotional landscape from which they had to negotiate ‘strangerhood’ in the context of sadness at leaving people to whom they were attached in order to join their mothers (or parents). As a result, many were resistant to being positioned as daughters, doing daughtering and being mothered in their new homes

Cohort profile: the avon longitudinal study of parents and children: ALSPAC mothers cohort

The Avon Longitudinal Study of Children and Parents (ALSPAC) was established to understand how genetic and environmental characteristics influence health and development in parents and children. All pregnant women resident in a defined area in the South West of England, with an expected date of delivery between 1st April 1991 and 31st December 1992, were eligible and 13 761 women (contributing 13 867 pregnancies) were recruited. These women have been followed over the last 19–22 years and have completed up to 20 questionnaires, have had detailed data abstracted from their medical records and have information on any cancer diagnoses and deaths through record linkage. A follow-up assessment was completed 17–18 years postnatal at which anthropometry, blood pressure, fat, lean and bone mass and carotid intima media thickness were assessed, and a fasting blood sample taken. The second follow-up clinic, which additionally measures cognitive function, physical capability, physical activity (with accelerometer) and wrist bone architecture, is underway and two further assessments with similar measurements will take place over the next 5 years. There is a detailed biobank that includes DNA, with genome-wide data available on >10 000, stored serum and plasma taken repeatedly since pregnancy and other samples; a wide range of data on completed biospecimen assays are available. Details of how to access these data are provided in this cohort profile

LEADING COMMENT: Children of lesbian mothers: From the 1970s to the new millennium

In both the popular and academic media, lesbian and gay parenting is the issue of the moment. Recent examples include the case of two gay men fathering twins with a surrogate mother in the US; the results of a study of gay fathers by Gill Dunne at the London School of Economics (Guardian, January 12, 2000); and comments from Dame Elizabeth Butler-Sloss, President of the Family Court, on the appropriateness of lesbian women and gay men as adoptive or foster parents (Guardian, October 16, 1999). These examples show that current debates focus on gay fathers, assisted reproduction and fostering/adoption. Does this mean that the concerns first raised in child custody disputes in the 1970's - that children raised in lesbian mother families would be at risk for psychological problems and atypical gender development – have been laid to rest? Psychological problems Concerns about the psychological well-being of children of lesbian mothers were based on the widely accepted view that some childhood experiences carry a risk of psychiatric disorder. This is predominately an argument about social acceptance; because lesbianism is not socially acceptable, the children of lesbian mothers will experience social disapproval. Thus, they will be likely to experience teasing and bullying by peers, which in turn may cause them to become socially withdrawn. Ultimately, it has been argued, the child will be unable to form and maintain friendships, an ability that has been shown to be important for self-esteem and psychological well-being in later life

Stories of Sameness and Difference: The Views and Experiences of Children and Adolescents with a trans* Parent

Scholarly attention has recently been given to the ways in which gender and parenting identities intersect, yet little is known about how children and adolescents with a trans* parent experience family life and relationships. This article reports data from a qualitative study in the UK based on interviews with 29 children and adolescents aged 5–18, all of whom have at least one parent who is trans*. Drawing upon theories of symbolic interactionism, the study investigated children and adolescents’ meaning-making and experiences of family life and relationships in the context of their parent’s gender identity. Data were analyzed using a theoretically informed thematic approach, which resulted in the identification of four main themes. Overall, findings suggest that parental gender identity does not adversely impact upon how children and adolescents perceive their relationship with their parent, but may be otherwise relevant to their experiences both within and outside of the home. Findings are discussed in relation to theories of family display (Finch, 2007) and discourse dependence (Galvin, 2006), suggesting that combining and extending these perspectives might be useful for understanding the perspectives of children and adolescents in different contexts of family diversity

Adoptive gay father families: parent-child relationships and children's psychological adjustment

Findings are presented on a U.K. study of 41 gay father families, 40 lesbian mother families, and 49 heterosexual parent families with an adopted child aged 3–9 years. Standardized interview and observational and questionnaire measures of parental well-being, quality of parent–child relationships, child adjustment, and child sex-typed behavior were administered to parents, children, and teachers. The findings indicated more positive parental well-being and parenting in gay father families compared to heterosexual parent families. Child externalizing problems were greater among children in heterosexual families. Family process variables, particularly parenting stress, rather than family type were found to be predictive of child externalizing problems. The findings contribute to theoretical understanding of the role of parental gender and parental sexual orientation in child development

A longitudinal study of the experiences and psychological well-being of Indian surrogates

Study question: What is the psychological well-being of Indian surrogates during and after the surrogacy pregnancy? Summary answer: Surrogates were similar to a matched group of expectant mothers on anxiety and stress. However, they scored higher on depression during and after pregnancy. What is known already: The recent ban on trans-national commercial surrogacy in India has led to urgent policy discussions regarding surrogacy. Whilst previous studies have reported the motivations and experiences of Indian surrogates no studies have systematically examined the psychological well-being of Indian surrogates, especially from a longitudinal perspective. Previous research has shown that Indian surrogates are motivated by financial payment and may face criticism from their family and community due to negative social stigma attached to surrogacy. Indian surrogates often recruited by agencies and mainly live together in a “surrogacy house.” Study design, size, duration: A longitudinal study was conducted comparing surrogates to a matched group of expectant mothers over two time points: (a) during pregnancy (Phase1: 50 surrogates, 70 expectant mothers) and (b) 4–6 months after delivery (Phase 2: 45 surrogates, 49 expectant mothers). The Surrogates were recruited from a fertility clinic in Mumbai and the matched comparison group was recruited from four public hospitals in Mumbai and Delhi. Data collection was completed over 2 years. Participants/materials, setting, methods: Surrogates and expectant mothers were aged between 23 and 36 years. All participants were from a low socio-economic background and had left school before 12–13 years of age. In-depth faceto-face semi-structured interviews and a psychological questionnaire assessing anxiety, stress and depression were administered in Hindi to both groups. Interviews took place in a private setting. Audio recordings of surrogate interviews were later translated and transcribed into English. Main results and the role of chance: Stress and anxiety levels did not significantly differ between the two groups for both phases of the study. For depression, surrogates were found to be significantly more depressed than expectant mothers at phase 1 (p = 0.012) and phase 2 (p = 0.017). Within the surrogacy group, stress and depression did not change during and after pregnancy. However, a non-significant trend was found showing that anxiety decreased after delivery (p = 0.086). No participants reported being coerced into surrogacy, however nearly all kept it a secret from their wider family and community and hence did not face criticism. Surrogates lived at the surrogate house for different durations. During pregnancy, 66% (N = 33/50) reported their experiences of the surrogate house as positive, 24% (N = 12/50) as negative and 10% (N = 5/50) as neutral. After delivery, most surrogates (66%, N = 30/45) reported their experiences of surrogacy to be positive, with the remainder viewing it as neutral (28%) or negative (4%). In addition, most (66%, N = 30/45) reported that they had felt “socially supported and loved” during the surrogacy arrangement by friends in the surrogate hostel, clinic staff or family. Most surrogates did not meet the intending parents (49%, N = 22/45) or the resultant child (75%, N = 34/45). Limitations, reasons for caution: Since the surrogates were recruited from only one clinic, the findings may not be representative of all Indian surrogates. Some were lost to follow-up which may have produced sampling bias. Wider implications of the findings: This is the first study to examine the psychological well-being of surrogates in India. This research is of relevance to current policy discussions in India regarding legislation on surrogacy. Moreover, the findings are of relevance to clinicians, counselors and other professionals involved in surrogacy. Trial registration number: N/A

Children with Trans Parents: Parent–Child Relationship Quality and Psychological Well-being

Objective: Families with trans parents are an increasingly visible family form, yet little is known about parenting and child outcomes in these families. This exploratory study offers the first quantitative assessment of parent–child relationship quality and child socio-emotional and behavioral adjustment in families with a self-identified trans parent with school-aged children. Design. A sample of 35 families (37 trans parents, 13 partners, and 25 children aged 8–18 years) was recruited primarily through social media. Parents, children, and teachers were administered a range of standardized interview and questionnaire assessments of parent–child relationship quality, quality of parenting, psychological adjustment, and gender-related minority stress. Results. Parents and children had good quality relationships, as assessed by both parents and children, and children showed good psychological adjustment. Child age at the time the parent communicated their gender identity to the child was unrelated to child outcomes. Conclusions. Parents and children in trans parent families had good quality relationships and children showed good psychological adjustment. The findings of this exploratory study challenge commonly held concerns about the potentially negative effects on children of growing up with a trans parent