Article
‘It's a bit too much fathering this seed’: the meaning-making of the sperm donor in Italian lesbian mother families

https://doi.org/10.1016/j.rbmo.2016.06.007Get rights and content

Highlights

  • We explored how Italian lesbian mother families deal with third-party reproduction.

  • No mother considered the sperm donor as the father of her child.

  • The sperm donor was experienced as an entity, as a medical process, and as a person.

  • Images of the donor as a ghost, as a place, and as a kind man lie beneath meanings.

  • Genetic and non-genetic mothers constructed shared meanings of the donor.

Abstract

How do female-partnered mothers deal with the third-party involved in their reproductive arrangement? The aim of this study is to identify the meaning-making of the sperm donor, exploring different patterns between genetic and non-genetic mothers, as well as between open-identity and anonymous donation. Semi-structured interviews were conducted with 24 Italian female-partnered mothers, who at the time of data collection had at least one donor-conceived child. Interpretative Phenomenological Analysis was performed to identify emergent themes. None of the mothers considered the donor as the father of their child. Three patterns of thoughts and feelings recurred: ‘donor as an entity’, ‘donor as a medical process’, ‘donor as a person’. Genetic and non-genetic mothers constructed shared meanings regarding the donor. Mothers who opted for anonymous donors were more likely to describe the donor as an entity and as a medical process compared with mothers who opted for open-identity donors. Different images of the donor lay beneath each meaning: respectively, donor as a ghost, donor as a place, donor as a kind man. Findings offer important insights for healthcare providers working in fertility clinics. They further suggest the most appropriate terms for third-party reproduction and specific psychological counselling needs of prospective female-partnered mothers.

Introduction

The citizenship status of Italian gay men and lesbian women is limited compared with most other democracies in terms of both individual and family rights. Despite the legal vacuum and the homophobic stigma (Baiocco et al, 2015, Lingiardi et al, 2016), an increasing number of gay men and lesbian women are becoming parents (Baiocco, Laghi, 2013, Baiocco et al, 2014). When lesbian women decide to have children within their current relationship, they have to turn to third-party reproduction offering a spectrum of possibilities regarding both donor arrangement (from open-identity to anonymous) and degrees of familiarity with the donor (from family members to strangers living in other countries).

In addition to using a known donor drawn from their social or family networks, such as friend, non-genetic mother's relative or new acquaintance (Goldberg and Allen, 2013), unknown donors drawn from sperm banks are also possible (Nordqvist, 2012). In the latter case, depending on the legislation in force, donors can either remain anonymous or specify that their identity will be available to recipients or resultant offspring when the child reaches sixteen or eighteen years. Exploring the differences between lesbian women with clinical and non-clinical donor conception processes in dealing with spermatazoa, Nordqvist (2011a) noted that clinical donor recruitment facilitated the anonymisation of the donor and enabled female-partnered mothers to feel themselves to be sole parents of the child. Dempsey (2010) interviewed twenty female-partnered mothers pointing out that they did not consider the genetic father as an equivalent parent and thus his minimal involvement was the ideal parenting arrangement for them. Similarly, according to Almack (2006), pursuing a known donor brought along the risk that he could demand more involvement than had been previously agreed and sue for children's custody.

In Italy assisted reproduction is regulated under the Law 40/2004 ‘Norms concerning medically assisted procreation’, that is one of the most restrictive in Europe. Article 4 states that the use of donated gametes and embryos, as well as surrogate motherhood, are strictly forbidden. For this reason, a growing number of individuals, including lesbian women and gay men, are now seeking reproductive assistance abroad (de Wert et al., 2014). In doing so, they engage in the so-called ‘cross-border reproductive care’ (Pennings et al., 2008). Ferraretti et al. (2010) reported that ‘reproductive emigration’ quadrupled (from 1066 in 2003 to 4173 in 2005) after the Italian Law 40/2004 was enacted.

Within this scenario, ‘transnational donation’ (Pennings and Gürtin, 2012) specifically indicates the pursuit of treatments involving the use of donor gametes. The existing literature delineates several factors contribuiting towards intended parents undergoing reproductive treatments abroad. Some of the factors are the high cost of treatments, the lack or low quality of specific services, the mistrust in local medical services and the long waiting lists (Hudson et al, 2011, Shenfield et al, 2010). However, for Italian prospective female-partnered mothers it is the strictness of the legal context that makes transnational donation an inescapable reality, a sort of ‘reproductive exile’ (Inhorn and Patrizio, 2009).

Since 2006, Danish legislation (Law 923/2006) has granted same-sex couples and singles access to assisted reproduction, permitting conception with both anonymous and open-identity sperm donors. In Belgium, as of July 2007, assisted reproduction has been accessible to both heterosexual and same-sex couples, however only anonymous sperm donation is allowed (Law 6 July 2007). Parents, as well as children and doctors, can only access information concerning the donor's health conditions and physical characteristics. Anonymous sperm donation is further permitted to both heterosexual and same-sex couples by Spanish (Law 14/2006) and Greek legislation (Law 3305/2005) and the donor's identity is revealed only in the presence of very serious problems for the health and life of the child. In all of these countries, both genetic and non-genetic mothers are recorded on the birth certificate and the donor has no parental rights to the child.

Notably, when a genetic lesbian mother returns to Italy after the conception, she is treated as a single mother to all intents and purposes, even if she has a female partner. The non-genetic mother does not have any kind of parental rights to the future child, including access to second-parent adoption, and thus is particularly vulnerable to legal issues. If genetic and non-genetic mothers separate, the non-genetic mother will have neither legal nor genetic grounds to support a custody claim as a father would. Consequently, differences in genetic participation may increase uncertainty in equal parental legitimacy for both individual parents and the couple. Moreover, these feelings may well be echoed by others (Mitchell and Green, 2007).

How do female-partnered mothers deal with the third-party reproduction involved in their reproductive arrangement? It is often assumed that female-partnered mothers may have fewer difficulties with the involvement of the sperm donor than heterosexual counterparts, since they know from the start that they will need him to conceive a child (Indekeu et al, 2014a, Indekeu et al, 2014b, Wyverkens et al, 2014). Their status as a donor conception family is ‘socially visible’ (Wyverkens et al., 2015) and thus they do not have to be concerned with the concept of the child having both a father and a donor (Scheib et al., 2003). However, Haimes and Weiner (2000) argued that experiences and definitions of the donor as ‘father’ or as ‘not father’ should be considered within the broader social context in which societal ideas about ‘fatherhood’ develop, as this may have an impact on the non-genetic mother's position. Goldberg and Scheib (2015) highlighted that, as intra-familial donation is relatively uncommon, the genetic asymmetry in lesbian mother families may lead the couple to minimise the significance of genetics, so that the mother-child relationship is seen as socially and intentionally constructed (Grace and Daniels, 2007).

Studies found that female-partnered mothers often expressed the desire that children bear some resemblance to them and make an effort to match the donor's traits with their own, usually those of the genetically unrelated mother (Nordqvist, 2010, Scheib et al, 2003). Non-genetic mothers interviewed by Raes et al. (2014) described their genetic unrelatedness to the child in terms of coming ‘third in line’ (p. 464), experiencing an additional challenge to their equality as parents. It follows that non-genetic mothers might experience the donor differently than genetic mothers, perceiving him as a threat to their validity as parent. Furthermore, patterns similar to both of these have been found in heterosexual two-parent families (Becker et al, 2005, Grace et al, 2008, Indekeu et al, 2014b, Wyverkens et al, 2015).

Based on her clinical observations, Ehrensaft (2000) noted that the necessity of a ‘birth other’ to conceive due to the absence of a male partner may expose lesbian mothers, especially the non-genetic ones, to their worst fears. That is, the fear that the donor appears as the ‘unwelcome father’ or as the ‘evil other’ (Ehrensaft, 2008) who comes to claim the child as his own. As a consequence, they tended to see contact with the donor as a potential intrusion into their family life due to his genetic link with the child (Donovan and Wilson, 2008) and therefore opted for an anonymous donor (Touroni and Coyle, 2002).

Wyverkens et al. (2014) found that female-partnered mothers who conceived via anonymous donation questioned the donor as an exclusive concept. Indekeu et al. (2014a) noted that the emerging emotional bond between the non-genetic parent and the child and the increasing acknowledgement of the conceptual value of the donor as a person for the child ‘resulted in a more relaxed approach to the contribution of the donor such that he became more accepted and integrated in their family narrative’ (p. 275). Another possible reaction is that mothers ‘minimize the intervention of the donor by picturing him as an anonymous sperm cell with no parental responsibilities whilst also representing him as the bearer of some of their children's features’ (Vanfraussen et al., 2001, p. 2024). An anonymous donor is ‘out of sight, out of mind’ (Nordqvist, 2010) and may thus be erased or undervalued. In contrast, female-partnered mothers pursuing open-identity donor insemination may describe the donor's status as that of an ‘uncle’ or as ‘acting like a father’ (Nordqvist, 2012, Tasker, Granville, 2011).

Although there is a growing body of qualitative studies conducted with female-partnered mothers through donor insemination, most of them were from North America (Goldberg and Scheib, 2015), the United Kingdom (Almack, 2006, Donovan, Wilson, 2008, Haimes, Weiner, 2000, Nordqvist, 2010, Nordqvist, 2011a, Nordqvist, 2012), Australia (Dempsey, 2010), Belgium (Raes et al, 2014, Van Parys et al, 2014, Wyverkens et al, 2014), Sweden and Ireland (Ryan-Flood, 2005). In all of these studies, participants have sought donor conception within their country of residence and, as such, have not entered into transnational donation. Additionally, in all of these countries the non-genetic mother is well recognized, both socially and legally, in her parental role.

With a few exceptions (Haimes, Weiner, 2000, Ryan-Flood, 2005), it should be noted that much of the previous research investigated the experiences of female-partnered mothers with anonymous or known donors (i.e., a male friend, a male partner of a female friend), paying little attention to unknown open-identity donors. In addition, the data were constrained by the limitations of conducting couple interviews (Nordqvist, 2012, Raes et al, 2014, Wyverkens et al, 2014), and, when individual interviews were carried out, they usually addressed the genetic mother (Frith et al., 2012). For example, Donovan and Wilson (2008) interviewed only two non-genetic mothers separately in a sample of twelve female-partnered mothers. Consequently, considering both genetic and non-genetic mothers' thoughts and feelings would give a more complete understanding of how female-partnered mothers construct meanings regarding their sperm donor (Almack, 2006).

The aim of this paper is to identify female-partnered mothers' thoughts, feelings and images of the donor, and explore whether different patterns emerge in genetic and non-genetic mothers, as well as in cases of open-identity and anonymous donation. Given that in Italy the law doesn't allow female-partnered mothers the same parental rights, it is reasonable to expect that non-genetic mothers see the donor as a threat to their parenting and family integrity (Donovan, Wilson, 2008, Nordqvist, 2012). Since the research is rooted in the scenario of transnational donation, a secondary aim of the paper is to elucidate the impact of such legislation upon mothers' narratives.

Seeking to provide greater insight into the complexities of mothers' narratives, this study is informed by social constructionism (Schwandt, 2000) and intersectionality (Cole, 2009) theoretical frameworks. Ehrensaft's (2000) clinical observations with female-partnered mothers via assisted reproduction are also considered. In keeping with previous qualitative studies on the same topic (Goldberg et al, 2012, Wyverkens et al, 2015), social constructionism sheds light on how female-partnered mothers' personal interpretations of their sperm donor are influenced by their relationship with the partner and the child, as well as by the broader, dominant, Italian heteronormative discourses (Carone et al, 2016, Lingiardi et al, 2016) regarding same-sex parenthood and access to assisted reproduction. This study further draws on the intersectionality paradigm (Cole, 2009), as it accounts for how women's multiple identities may intersect to influence their thoughts, feelings and images of the donor at two or more axes of experience – here, being the genetic or the non-genetic mother, pursuing an anonymous or an open-identity donor, and transnational donation. In doing so, intersectionality places lived experiences at the centre of analysis. In fact, as noted by Ryan-Flood (2005), assisted reproduction in lesbian mother families cannot be understood independent of the context within which it occurs. Consistent with the authors' theoretical perspective, Ehrensaft's work (2000) will be used to explain how mothers' sharing of thoughts, feelings and fantasies about the donor simultaneously informs the tensions that accompany such family building and expands on children's understanding of their donor-conceived origins.

Section snippets

Participants

Participants were recruited using snowball sampling within Rainbow Families, the main Italian association that brings together lesbian mothers and gay fathers who plan to have children, and ordinary supporters. Data were obtained from 24 Italian female-partnered mothers who pursued transnational sperm donation. While six couples chose an anonymous donor, the other six couples chose an open-identity donor. None of them used intra-partner oocyte donation and friend's or relative's spermatozoa.

Results

IPA identified one super-ordinate theme: none of the mothers (n = 24) considered the donor as the father of her child. Subsequently, three different patterns (master-themes) recurred within the interviews, covering negative and positive thoughts and feelings towards the donor. The first of these patterns was the ‘donor as a figure’, which included his erasure, as well as his emotional and cognitive denial. The second pattern was the ‘donor as a medical process’, which included the association

Discussion

This study complements the literature in the research field on same-sex parenting by investigating how Italian female-partnered mothers think about, feel and imagine the sperm donor involved in their children's conception.

Starting from a common and transversal super-ordinate theme that described the donor as lacking a father role in the child's life, IPA highlighted, in some mothers, the gradual construction of the donor into the family scene through three different patterns of thoughts and

Acknowledgements

We are grateful to all the lesbian mother families who have taken part in this study. We also would like to thank Susan Golombok and the three anonymous reviewers for their helpful comments. Finally, many thanks to Anja McConnachie for correction of the English language.

Vittorio Lingiardi, psychiatrist and psychoanalyst, is Full Professor of Dynamic Psychology at the Faculty of Medicine and Psychology, Sapienza University of Rome. He has published more than 60 international papers, and presided over several research projects in Italy. With Nancy McWilliams, he is the Steering Committee of the new edition of the Psychodynamic Diagnostic Manual. With the paper ‘Psychoanalytic attitudes towards homosexuality: An empirical research’ he won the 2004 Ralph Roughton

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    Vittorio Lingiardi, psychiatrist and psychoanalyst, is Full Professor of Dynamic Psychology at the Faculty of Medicine and Psychology, Sapienza University of Rome. He has published more than 60 international papers, and presided over several research projects in Italy. With Nancy McWilliams, he is the Steering Committee of the new edition of the Psychodynamic Diagnostic Manual. With the paper ‘Psychoanalytic attitudes towards homosexuality: An empirical research’ he won the 2004 Ralph Roughton APA Paper Award. Among others, his current research interests are focused on same-sex parenting and assisted reproduction, sexuality and the mental health of LGBT communities.

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