I spent this past weekend at a wonderful conference in Boston. Lots of very smart people thinking about ART and many things related to ART. One of the recurrent topics was the importance of anonymity those who provide gametes for third-party reproduction. (I know that this seems a very clunky way to put it–why not just say “sperm donors” and be done with it? There are reasons, as regular readers (of my now irregular blog) will know. For one thing, there’s the word “donor”–which is perhaps not the best word to use for people who are paid. For another, there are overlapping issues for egg providers, and it may be that the overlapping issues are converging. I cannot discuss all this here, but suffice it to say that I choose the clunky language deliberately.)
Anyway, one of the things that interested me was that many different questions were raised and there seemed to be some real disagreement in how to think about these questions. Since I’ve spent a lot of time thinking about anonymity in the past, I thought it might be time to revisit (and maybe reorganize?) my own thoughts on the subject. This could take a couple of posts, but I think it’s worth it.
So first off, there’s what one even means by anonymity. Anonymity is related to secret-keeping. An anonymous donor (in the philanthropic context) is one whose identity is kept secret. But when you think about third-party reproduction, you can think of different levels of secret-keeping.
For instance, heterosexual couples might keep the very fact that they used a third-party gamete provider secret. They might pretend that the child is genetically related to both of the parents (here I mean social and legal parents), when in fact this is not the case. And even here I can divide levels of secrecy further. The couple might keep the use of third-party gametes completely secret, not even telling the child, or they might keep it secret from the public at large while acknowledging use within some smaller private sphere.
I don’t think there’s any general public entitlement to know who has used third-party gametes. I’m not one who would favor stamping birth certificates, say. (Shades of Bastard Out of Carolina!) Thus, secret-keeping in that context is fine by me.
But I think differently about secrecy within the family. There’s a long and not very happy history of family secret keeping around adoption. I’m thinking here of children who were adopted but who do not discover this fact until late in their lives. I think there’s something to be learned from this: Not telling a child they are adopted amounts (in my view) to lying to the child. And it’s a lie about something fairly important. Thus, it will very often lead to feelings of betrayal, which cannot possibly be a good thing. (I suspect it also leads to a good deal of internal stress, as the prospect that the child will learn the truth must loom large at many moments.)
I think the same is true as to the use of third-party gametes. If you don’t tell a child that they are not genetically related to both of their parents, the child (of heterosexual parents, anyway) will often assume the contrary–that they are. And if they learn that this isn’t true, they’ll (rightly) feel lied to. Further, it seems to me that the odds are very good that they will learn this sooner or later. And it seems to me that as medical science becomes more and more entwined with genetics, the odds that they will learn the truth are increasing. Perhaps it is possible that a child will live its entire life never knowing the truth and maybe, were that to happen, it would be okay. But surely truth is better than the gamble that they won’t find out? Particularly when you add in the cost of the (constant?) worry that the child will find out?
You’ll notice that I referred to heterosexual parents above. That’s because lesbian and gay parents as well as single parents are distinctly different. While they may very well be users of third-party gametes, they have little choice but to be honest about that. Obviously the missing gametes came from somewhere outside the couple. Thus, these families have no opportunity to lie or conceal. And in fact, these families have in many ways paved the way for heterosexual families. Their need to talk to children about their origins has diminished the stigma and broadened understanding.
All of which leads me to my first conclusion, which can also serve as my stopping point for today: While families may be entitled to keep their use of third-party gametes private vis-à-vis the world in general, they should not keep this information from the children so conceived. That’s important because it means that the children will inevitably wonder about where those gametes came from–and that would be the next thing to think about when it comes to anonymity.