Families working it out: adolescents' views on communicating about donor-assisted conception

Abstract

BACKGROUND

Prompted by legislation in Victoria, Australia, permitting gamete donors to seek identifying details of people conceived from their gametes, this research investigated the views of adolescents from the general population on how parents can best talk to their donor-conceived adolescent children about their conception.

METHODS

Qualitative interviews (six group discussions, n = two to six per group, and one individual interview) lasting c. 50 min with 25 secondary school students.

RESULTS

Naïve adolescents had views largely consistent with those of donor-conceived adults, for example, urging parental honesty, adaptation to individual children, and family cohesion. They identified the social father as the parent while acknowledging the significance of genetic connection to the donor. A minority asserted a preference for non-disclosure; all said that, if disclosed, it should be by parents.

CONCLUSIONS

This small study contributes to increasing understanding of communication within families about donor-assisted conception.

Introduction

Voices missing from the discussion about disclosure of donor-assisted conception are those of young people who do not know that they were conceived with donated sperm. Those voices may be impossible to capture. This paper reports an attempt to approximate them through discussions with adolescents, none identified as knowingly donor-conceived, about how parents could best disclose to their teenage children that a sperm donor contributed to their family formation.

Thousands of people all over the world are created annually by donor insemination (DI), with assistance from clinics or through private arrangements. It is estimated that only a minority of them are aware of the manner of their conception, because most heterosexual couples who used DI have not told their children (Brewaeys, 1996; Durna et al., 1997; Gottlieb et al., 2000; Golombok et al., 2002). Reasons for non-disclosure include a desire to protect the child and the family, shame and embarrassment, not knowing what to say, and simply ‘putting it off’ (Daniels et al., 1995; Brewaeys, 1996; Kirkman, 2003, 2005; Lycett et al., 2005). Controversy and publicity about donor-assisted conception, however, are making parents aware that their children may find out in other ways, such as from another family member or as a result of genetic testing undertaken for medical reasons.

Activism by donor-conceived adults and donor-conception support groups, commentary by counsellors and other professionals, and an increasing body of research have contributed to a growing sense that donor-conceived people, like adoptees, have the right to know about their genetic origins and to have access to information about their gamete donors. The Ethics Committee of the American Society for Reproductive Medicine (2004) recommends that donor-conceived people should be informed by their parents about their conception, emphasizing human rights and the testimony of donor-conceived adults. Parents have been advised to share information with their adult donor-conceived children by presenting an account that focuses on family-building rather than the creation of an individual, as a means of minimizing problems with identity and self-image (Daniels and Meadows, 2006).

Donor-conceived people who discovered their conception as adults, often under adverse circumstances (such as during a family argument or soon after the father's death), report both relief at knowing the truth and resentment at parental untruths; they want to know about or know their donor but tend to identify their social parent as the father (Donor Conception Support Group, 1997; Turner and Coyle, 2000; Hewitt, 2002; Kirkman, 2003; Daniels and Meadows, 2006). Donor-conceived adults who speak publicly claim knowledge of their genetic parentage as their right.

Legislation is slowly making this possible (see Frith, 2001; Lycett et al., 2005; van den Akker, 2006). In Victoria, Australia, for example, anonymous gamete donation is now illegal; two registers are maintained to record all notified births from donor conception in the State as well as information about donors. Identifying information can be released to donor-conceived people from the age of 18 (Infertility Treatment Authority, 2004; Szoke, 2004). The Infertility Treatment Authority, the body established to regulate the provision of assisted reproductive technology in Victoria under the Infertility Treatment Act 1995, administers these central registers. It also maintains two registers to record applications for the voluntary exchange of information between donors and donor-conceived people, their parents (if the donor-conceived person is under 18 years), and biologically related others. The voluntary registers extend assistance to people not covered by the mandatory registers (Infertility Treatment Authority, 2004).

A unique feature of Victorian legislation is that donors are permitted to request identifying information about people conceived from their gametes. If donor conceived people are younger than 18, the Infertility Treatment Authority seeks consent from their parents. Consent would be sought directly from a donor-conceived adult who is over the age of 18; the first people affected by this law turned 18 in July 2006. It is the responsibility of the Infertility Treatment Authority to notify donor-conceived people that their donor seeks information about them and to ask permission to release it. The Infertility Treatment Authority letter could be the first disclosure. Publicity generated by the Infertility Treatment Authority is designed to ensure that parents can consider whether they want to tell their children before there is any chance of receiving such a letter.

Drawing from work in adoption (e.g. Triseliotis, 2000), many researchers and counsellors advise parents that the best time to tell children that they have been donor-conceived is when they are very young (see Kirkman, 2005). Research appears to support this advice (Scheib et al., 2005) and books have been published to help parents talk with children about donor conception (e.g. McWhinnie, 1996). More recently, the UK Donor Conception Network produced booklets for parents of children from birth to adulthood (Montuschi, 2006a–d).

The Victorian legislation has profound ramifications for parents who did not tell their children before adolescence. Research on communication about sexuality between parents and adolescents has confirmed that parents find it a difficult topic to discuss with their children (Kirkman et al., 2002, 2005). It is even more so when they have to reveal the circumstances of their adolescent's conception at a time when the very idea of sperm donation is likely to cause embarrassment and distress (Kirkman, 2004).

As far as we can ascertain, no research has been done on how ‘naïve’ adolescents would advise on parental disclosure to their age group. We continue to learn from donor-conceived adults who have reflected on their circumstances, but it would also be valuable to have insights about those for whom disclosure is still only a future possibility. It is not ethical to ask donor-conceived people who do not know about their donor conception how they would like to be told about it. Instead, we consulted young people who are not identified as being donor-conceived.

The aim of this research was to investigate the views of adolescents from the general population on how parents can best talk to their donor-conceived adolescent children about their conception. It was designed to inform the development of specialist resources for parents and a public information campaign in Victoria, Australia, in recognition of the ramifications of legislation.

Method

We chose group discussions for this investigation as the most appropriate means of describing and understanding attitudes, interpretations, and beliefs among specified populations about a particular topic (Rice and Ezzy, 1999). Because we expected this to be a new topic for most of our participants, we thought that lively discussion among peers would yield more information than individual interviews. We also thought that it would constitute a less intimidating environment to deal with such a sensitive topic.

Participants

Young people in the final five years of secondary school (aged 14–18) were selected from two co-educational schools. Because of the sensitivity of the topic, we sought written permission from parents of all students in each year, describing the topic and its significance. Parents were told that only a small number of students in their child's class would be invited to participate so that non-participation was not evidently because of parents' refusal. Should a parent not wish a donor-conceived child to participate, refusal would be unlikely to arouse comment. Students were given the opportunity to decline to participate once their parents had given permission. Of those whose parents gave permission, about five to 10 students from each class were invited by school staff to each discussion. The selection was based largely on student availability at the chosen time.

Six group discussions, lasting about 50 min, were held with a total of 24 students (10 girls, 14 boys) in years eight to 11; numbers in the groups ranged from two to six. In addition, one boy in year 12 was interviewed because no other student was available in the approach to final examinations. No financial or other incentives were given to participants.

Procedure

Discussions were held in school meeting rooms, undisturbed by other school activities. They were facilitated by the first author, assisted by a male researcher who acted as note-taker. Discussions were audio-recorded, with the permission of participants, and transcribed.

Students were told about the Victorian law and the possibility of donor-conceived people being contacted if their sperm donor were seeking information about them. Discussion was initiated with a scenario about a family with a teenage donor-conceived member, saying that the parents had heard publicity about the possibility that the donor could seek information about the child. Their son did not know he was donor-conceived. Participants were asked, “What do you think the parents should do now?” Discussion was not formally structured and participants could talk about what mattered to them. In several cases, other scenarios with variations to the family structure were used but the conversation was often maintained without them. We chose this unstructured method because we were interested in seeing which aspects of the situation attracted young people's attention. In this way, their responses are likely to reflect what one might expect of unaware donor-conceived adolescents, most of whom can be expected to be equally naïve about the topic.

The sensitivity of the topic meant that we took care not to ask participants how they would respond to being told about being donor-conceived nor to ask any personal questions. All discussion was directed to the scenarios, to the feelings and actions of hypothetical adolescents, and to advice to parents.

Details of scenarios and prompts are available from the first author.

The project was approved by the Human Research Ethics Committee of the Department of Human Services, Victoria, and registered with the University of Melbourne Human Research Ethics Committee.

Analysis

Discussions were analysed using the four systematic steps appropriate for focus groups (e.g. Hawe et al., 1990/2003, ch. 9): organizing the data (transcription, integrating notes written during the discussion); shaping (identifying and categorizing themes and patterns); summarizing (identifying the full range of views expressed); and explaining. Analysis was an iterative process that involved multiple reading of transcripts and discussion of emerging themes and patterns among researchers.

Results and discussion

The focus groups yielded information about seven key topics and revealed the complex meaning to adolescents of donor-assisted conception. The topics are: whether or not parents should tell their children; the age at which it was best to be told; communicating about donor conception; adolescent responses to being told; continuing communication; the dad and the donor; and support for young people after disclosure. A few important themes underscored the key topics: parents need to know their children and adapt their communication accordingly; parents' attitudes to using donor-assisted conception will be significant to the family and its adolescent members; donor conception is a matter for the family as a whole; and individual differences in personality and circumstances mean that a simple recipe for communication cannot be propounded.

No differences were evident among year groups. Students from one school appeared to defer more to parents than students from the other school, although the conclusions reached were similar.

Discussion in each group tended to begin with revealing the initial shock, to an adolescent, of the unfamiliar idea of donor-assisted conception:

“It's totally bizarre, there's no doubt about it.” “Not really. It's just a sperm.” …“Well, it is something you comment about because it's something that's not normal. Like it's not the normal way to be conceived.” (Girls, Year 11)

As the ramifications were explored, the participants demonstrated subtle and sensitive insights:

“Who you are is more your upbringing.” “Yeah, and it's your personality and your experiences.” “But physically it is half of who you are.” (Girls and boy, Year 11)

On the whole, the views expressed by the participating adolescents were consistent with what has been said by donor-conceived people. The outstanding difference was that a few students endorsed the desirability of ignorance. Although they were not asked to reflect on what it might be like for them to be donor-conceived, a minority of participants volunteered that they would prefer their parents not to tell them if they had been conceived with donor sperm.

To tell or not to tell

At least one member of three of the groups (from Years 8, 9, and 11) maintained that they would prefer not to be told about being donor-conceived:

“I'd rather, for my own emotional well-being – like, if there's no one to, you know, send me a letter saying, ‘Oh yeah, I was your sperm donor’ or whatever, you're better off just living life as you are. I mean, if you're happy I don't think you need to know.” (Girl, Year 8)

“I'd prefer that my parents didn't tell me.” “You're naïve.” “Yes, I am naïve. But also I respect my parents so much and I really love them, and if they told me that, it would change the way you think about them.” “I think the whole problem with it depends on who the child is, and depends on the situation of the family.” “They said that they'd all prefer to be told now. I wouldn't.” (Boys, Year 9)

The majority argued that there was a risk of finding out in other ways. If there were no letter from the Infertility Treatment Authority about the donor requesting information, it could be because of a biological anomaly such as eye colour, genetic testing, or third-party intervention:

“[Parents] shouldn't have the expectation that their children will never find out. … It's going to vary. It is going to be different. So you can't just ignore it when you're trying to make the decision.” (Boy, Year 11)

Participants also argued for the child's right to know, although this was mediated in some groups by a sense of the parents' right to judge when and how knowledge would be communicated:

“It's stuff that does affect her, so it is kind of her right to know. But again, when she should find out is up to the parents.” (Boy, Year 12)

Whether because of the chance of discovery or because they thought it was the child's right to know, participants on the whole concluded that children needed to be told by their parents:

“I'd hate to be the child that found out in a letter that, you know, my dad didn't have enough sperm to produce me so they had to use some [donor sperm].” “You'd probably disrespect them more if they didn't tell you themselves and they let a letter tell you.” (Girls, Year 10)

It was also suggested that secrecy implied shame, which was inappropriate in some (but not all) participants' eyes:

“I think not telling them sort of makes them – because we talk about losing respect and things like that – not telling them is sort of like, what's the word I'm looking for, being ashamed of it, and they shouldn't be.” (Girl, Year 10)

After considering the possibility of telling children individually, there appeared to be consensus that donor conception was a matter for the family as a whole:

“I think for it to all work … it has to be the family together. It can't be parents versus children. It has to be –” “A unit.” “I think it's not only affecting the children, either. It's also affecting the parents in making the choice to tell their children, and their children's reaction to them. So I think it has to be a whole family thing.” (Girls and boy, Year 10)

The ideal age for donor-conceived people to learn about their conception

The discussions with students were based on the need to tell adolescents because of the law in Victoria. They often found it hard to imagine what it would be like to grow up knowing about it. Their ideal ages ranged from ‘very young’ to ‘when they have their own children’, although the majority moved towards having it known from a young age. Throughout the conversations they emphasized that parents needed to draw on their knowledge of their children if they want to communicate with them:

“I think … it would be easier to tell kids younger … because at that age—” “They're more accepting.” (Girl and boy, Year 11)

“I don't know what's the right age to be able to tell your kids that sort of thing. Because I guess in some ways you couldn't tell them when they were, like, 5 or 6 because they wouldn't understand.” (Girl, Year 10)

“I'm not sure about age but I'm sure older would be better.” “Maybe when they're older and they've got a family of their own, they can see how much they love their own kids and know how much, how desperately, they wanted them.” (Boys, Year 9)

The discussion encompassed the ability to understand (implying that it was better for children to be older) and the need not to be shocked by having one's assumed genetic connection with a parent overturned (hence better to be told younger). There were some who maintained that it would be difficult at any age:

“When you're still told it would be like, ‘I've been deceived’. … And teenagers would say, ‘Why couldn't you tell me when I'm older?’. Older people would say, ‘Why couldn't you tell me when I'm younger?’”(Boy, Year 9)

“I think, no matter what age it is, it's going to be really hard to hear.” (Girl, Year 9)

When there are donor-conceived siblings of different ages, or where not all children in a family are donor-conceived, participants tended to conclude that they should all be told together:

“I think if one sibling knows then the other one has to as well.” “I think it would be easier to take it, like, together.” “Exactly. Because … it would feel like they weren't, you know, completely alone or anything if that did happen, you know. And if it was all together as a family I think it would just be much better.” (Girls and boy, Year 10)

Communicating about using donor-assisted conception

Preparation for the initial telling includes choosing the occasion and finding the words to say. It was repeatedly said that the fundamental requirement was that parents should know their children and adapt their approach accordingly:

“Try and make sure you know how your kid's going to react beforehand and prepare for it.” “Know your kid.” (Girls, Year 8)

Adolescents can appreciate that it might be difficult for parents to know how to talk about donor-assisted conception:

“There's no easy way to say it.” (Boy, Year 9)

Although participants agreed on the need to plan the occasion for first telling, there was no consensus on how formal the event should be, and awareness of advantages and disadvantages of formality and informality. That depended, as does so much else, on the family dynamics and the preferences of individual members:

“I imagine that they would probably try and set it up to be somewhat more, like, formal. They wouldn't just give it as a passing remark. Although that might help. Like, if it's formal, if you put too much pressure on it, then it might seem a bit too contrived.” (Boy, Year 12)

“The less of a big thing it's made, as an event, the less it will be seen to be a huge thing.” (Girl, Year 11)

No script emerged for parents to use in talking to their adolescent children. The most important components of what they should say were expressed as honesty and reassurance of parental love:

“I can't really imagine another way of saying it other than being straightforward and saying, you know, ‘I'm infertile so we had to use this donation’.” … .“It should be honest and straightforward, and the reasons should be outlined, and as much information as you can give them would be good.” (Girls, Year 11)

“Just say that they are their parents: … ‘We are your mum and dad and we always will be’. And, like, making sure that the child understands that this is not going to change the relationship that they've had for the past 18 years.” (Boy, Year 12)

“Kind of reassure him … that they actually are the parents so, like, not to feel any different: ‘Because we still are, as we always were, your parents, and this is just another factor’.” (Girl, Year 10)

Parental honesty, it was argued by these secondary school students, should extend to the reasons for not having told before and an explanation for choosing to tell now:

“Make it clear that the reason they've decided to tell them is because they love them and they want them to know the truth.” (Boy, Year 9)

Underlying all aspects of communication was an appreciation by these young people that parental attitudes will have a profound influence on how their children respond. The best preparation for parents, therefore, was to have come to terms with their use of donor-assisted conception, if necessary with external support such as counselling. At the same time, it was understood that the children could perceive matters differently from parents, who must respect the differences:

“I think the parents should go to counselling or something. Because the dad probably has a reason and that's probably because of the insecurity, thinking, probably, ‘I don't want my kid going off with some other guy’.” (Girl, Year 8)

“[Parents should] see you're not given a negative view on it or, you know, an overly positive view. It's just kind of like, ‘That's the way it is’. I think when parents are telling them it shouldn't be in the hush-hush way because then it does sound like there's something wrong with it or it's a bad thing. And if the kid grows up and views it as a bad thing that's their choice.” “I think the way it's presented is incredibly important, no matter what the age. If it's presented as ‘This is a really taboo topic’, then they'll think of it as a really taboo topic.” (Girls, Year 11)

“It really is, I think, much more important that the children have the control of the conversation and it's not just being, ‘Well, this is what, you know, the truth is; deal with it’. … Because it's not really about, you know, the parent enforcing how they're going to recover from it all.” (Girl, Year 10)

Adolescent responses to being told that they were donor-conceived

Participants imagined that adolescents would respond to learning about their donor conception in a variety of ways, including shock, anger, confusion, acceptance, and curiosity. They suggested that the response will depend, to some extent, on the quality of existing family relationships and communication patterns. It was also said that differences in circumstances – such as family structure, personality, age, maturity – would contribute to differences in responses:

“Be prepared for, ‘Oh, my god, I hate you! How could you not have told me?’ And they probably don't mean it.” “Yeah. It's the overwhelmingness.” (Girls, Year 8)

“It really depends on the temperament of the child.” (Boy, Year 8)

“It depends on the people, the relationship between the parents, and all that sort of stuff.” (Boy, Year 9)

“I would imagine that the child would have more curiosity on the subject. Like how it actually happened. Unless they completely oppose the idea where they just create a wall, they would probably want to have a bit more of a dialogue on that. Why did they choose to use that method? And was it impossible to use any other methods? Like, how did they go about it.” (Boy, Year 12)

“All these situations are very different. We've got the single mum and sort of happy family and then we've got this one who's got a son from the first husband, a daughter from the second one; they're all very different. And I think they handle it in different situations.” (Girl, Year 8)

It was envisaged that there would be change over time in the adolescent's response; this was generally seen as from distress to acceptance:

“The big deal is that you thought your dad was … the one who's conceived you and then suddenly you found out that he wasn't. You'd feel like kind of a gap from that relationship. But then once you'd thought it through, then it would actually come back to you and you'd realize that they've been your dad your whole life and they still are.” (Girl, Year 8)

Participants suggested that parents might need and even expect reassurance from their children but should be prepared that their children might not be able to reassure them:

“The parents would be, you know, absolutely scared that this meant that their child would stop loving them the same way. So, whether they would actually get reassurance, as I'm pretty sure you wouldn't give it straight away, the parents would definitely want it.” (Boy, Year 9)

Continuing communication after the first telling

Participants were clear that, once parents had begun discussion with their adolescent children about being donor-conceived, further exchanges should be left up to the children to initiate. Parents ought to make it clear that they were happy to talk about it and answer questions, but leave it at that:

“I think the children should feel comfortable to be able to ask their parents more about it and I don't think the parents should necessarily hassle their kids to talk about it.” “From then on I think it's all up to the kids. Because if they want to know more about it, then the feeling has to be that they can ask whatever they want.” (Boy and Girl, Year 10)

Parents might want to ask their children to keep DI a secret, perhaps for their own protection, but this was perceived as likely to be harmful rather than helpful:

“I think that's a terrible thing to put on a child after she's found out. ‘Oh, we'll give you this but you can't tell anyone else’. I think it's a really unfair demand that the parents are making. Because after all it's her life, essentially.” (Girl, Year 10)

The dad and the donor

The virtual introduction of another man into the family was a challenging thought for many participants across all groups. There was lively discussion about language, parenthood, and the role of the donor as a person. Although participants tended to use the term ‘real father’ for the donor when they began to discuss the subject, they acknowledged ‘Dad’ as the real father. It was clearly difficult for them to know what words to use for such a novel idea. Some maintained the ‘fact’ of genetic antecedence as defining a ‘real’ father, although consensus was achieved in all discussions that a parent was the one who raised and loved the child. Ultimately, according to these adolescents, it was up to the donor-conceived person to decide what words and relationships she or he preferred, although once again parental attitudes and example were seen as extremely important:

“He is essentially the biological father.” (Boy, Year 9)

“You don't have to biological to be a father.” (Boy, Year 8)

I think you'd probably call him ‘donor’, so it's like you still think that the man that you live with is your father. … This guy isn't the father that you want to become attached to. You still want to stay with the other one.” (Boy, Year 8)

“I would openly ask the children, you know, ‘What would you prefer?’ you know, ‘How would you want to look at this person as?’ you know. ‘What kind of connection is there?’” (Girl, Year 10)

“Families would have to work it out.” (Boy, Year 8)

Most participants thought a donor-conceived person would be curious about the donor; some thought that it would be important to meet him. A few could not imagine such a circumstance and had no idea what an adolescent's attitude would be. They were also aware that there would be circumstances under which no information would be forthcoming, and in this parents would need to provide support. In one group, participants thought that parents should exercise control over whether or not the child could seek out the donor, based on their knowledge of the child. Once again, underpinning the whole approach to the donor was the significance of strong relationships with their parents:

“I think the most important thing is that they've got their really open, compassionate relationship with their parents. That should be of the utmost importance.” (Girl, Year 10)

“If I was a donor child, I wouldn't really want to know the donor. I just wouldn't want to think about it. I just wouldn't want to know, really.” (Boy, Year 9)

“I think I should know about them. Like, what they like, what they do, what they do for living, where they live, what they do in the spare time, what their favourite colour is.” (Girl, Year 8)

“I do think that it's a really healthy, healthy move that they can know each other, yeah, as acquaintances, and kind of recognize the connection that they have. With the biological.” (Girl, Year 10)

Support for adolescents after learning about being donor-conceived

Although participants suggested that adolescents might need help and support, some thought that parents were the ideal resources whereas others thought they lay outside the family. The latter group suggested that adolescents might want this support to be confidential, without the need to report to their parents that they have seen a counsellor or called a help line. Apart from the group that gave authority to the parents, it was argued that adolescents need to be able to make choices and to have them respected by their parents.

“It depends on the kids, but let the kids know that that option is there but they obviously aren't forced to use it. And so, like, if there was a counsellor, for example, give them all the details of the counsellor, like the number and all that stuff, and say, ‘If you would like to use this resource, please use it; we will not think any less of you because you're not coming to us. We respect that you want to talk to someone else about it’.” “Or the other view on that is if you tell them about counselling, it might make them get really scared and think this is a really big issue.” … “They might start thinking, ‘Why is this such a big problem? I don't need to see a counsellor, I'm fine’, you know. And they might start to make them think this is a bigger issue than really it is.” (Girls, Year 10)

The complexity of the situation was recognized, including the difficult choices parents need to make and — for all that their parents know them well — the unpredictability of adolescents' responses.

Conclusion

Being asked to respond to the novel issue of how parents could best manage knowledge of donor conception in their families elicited thoughtful, wide-ranging responses from the young people who participated in this study. Although varied and sometimes conflicting views were expressed there were common themes, such as the need for parents to be honest, the role of individual differences and human complexity, and the significance of strong parental and family relationships.

A majority of participants urged parents not to keep donor conception a secret, although it should be recognized that not all participants endorsed this view. Nevertheless, even those young people who would rather not know said that, if there were any chance of finding out, they want their parents to tell them rather than anyone else.

Once parents have decided to tell, they need to judge, using their knowledge of their adolescent and the family dynamics, how best to do so; there is no single ‘correct’ way. Our participants recognized that parents' own attitudes to the use of donor sperm will influence how their children perceive it; parents, therefore, need to have come to terms with having used DI.

The young people in our study imagined that some adolescents could have adverse reactions to being told that they were donor-conceived, arising from the confusing ramifications of the discovery. However, this was not presented as a reason for secrecy but as something the parents needed to anticipate and manage sympathetically, as they would for other crises of adolescence.

Participants asserted that parents must reassure their children that they love them no matter what their genetic connection, and make it clear that their dad is still their dad, a view that was supported in their discussion of the distinction between a biological father and a parent.

It was a majority opinion that parents should adapt to the preferences of their children in relation to the donor, such as what to call him and whether to meet him, even if these differ from parental preferences. Given that adolescents might need continuing information and support, our participants thought that parents could make it easy for them to seek informed help and advice outside the family, possibly confidentially. They were also aware that parents themselves might need help in dealing with disclosure.

We set out to investigate what naïve adolescents would say about learning that one is donor-conceived, as a way of gaining insight into the circumstances of adolescents whose parents have maintained the secret thus far. The results of this study are generally consistent with what we know from donor-conceived adults, who are universally reported as saying that it is their right to know. The outstanding difference is that some participants maintained that they would prefer never to be told. This might seem to compound the dilemma of parents wondering whether or not to tell. However, it could be used to reassure parents who worry that their children might not understand a decision to avoid or delay telling. Once parents recognize that there is an increasing risk of discovery (setting aside arguments about rights), and that it is wise to tell their children before they learn from another — perhaps less benign — source, they can expect that there will be a good chance that their children will appreciate that their parents wanted to protect them or found it a difficult subject to discuss.

A key strength of this study is that it captures the responses of adolescents, albeit a small selection, who were not known to be donor conceived. Their thoughtful discussions contribute to the growing understanding of parents, counsellors, and policy-makers in how best to manage communication in families formed by DI.

Acknowledgements

We gratefully acknowledge the valuable contribution of the students who participated in the discussions and the schools that facilitated their participation. Paul Myers assisted M.K. to facilitate the focus groups. The research was funded by the Department of Human Services, Victoria.

References