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For most couples who have used donor eggs or sperm to create their families the decision to tell their child about their genetic origins (disclosure) is often filled with fear and anxiety. These feelings are normal and even parents sure of their decision and committed to telling their children worry. The biggest concern for many is what impact telling will have on their child. Common worries include: How will my child react? Will they be sad, angry or confused? Will they be ostracized by friends or family? Will they feel betrayed?

It helps to put the issue of disclosure in some historical perspective. Using experience collected from adoption, 60-70 years ago secrecy was encouraged to protect both the children and the parents, while today that attitude has changed to one of openness and honesty. Likewise, the use of donor gametes has also been cloaked in secrecy but like adoption, that attitude appears to be changing. Most mental health professionals believe that with few exceptions it is in the best interest of the child to be told they are not genetically related to one of their parents. There are exceptions however and they would be: 1) if the child has a significant learning problem and cannot understand the information; 2) if the child has separated from a parent or if the parents are in the process of divorcing, the child should be told with both parents present when they are emotionally under control and never used as a threat; and 3) if cultural traditions are so restrictive that the child will feel rejected by the community.

Those in favor of disclosing believe that secrets can be problematic and difficult to keep over time. For example, there are many stories of adopted children who accidentally found out about their origins and left them feeling betrayed and mistrustful of their parents. Another argument in favor of disclosure maintains that children can sense there is a secret. They will assume there is something wrong and they will assume it is about them. Scientific advances in the field of genetics may make it difficult to keep genetic origins private especially now when genetics plays such an important role medically and may impact diagnosis and treatment if a child becomes ill. Finally, everyone has right to know about their genetic origins.

The first step in the process of disclosing, and it is a process- a story that will be told many times over many years, is for parents to be aware of their own feelings about using donor gametes. These feelings will color any discussion they have with their child. They have to mourn the loss of their genetic child and have hopefully worked through their doubts, regrets, guilt or shame and are comfortable with creating a family in this non-traditional way. They must also have the ability to separate any unresolved feelings of their childhood traumas from fears about their child being rejected. Discussions should be age-appropriate, honest and instill the child with a positive message about how his/her family was created.

Child development experts recommend the child be told as early as possible. In this way the story becomes part of the child’s reality so that they won’t recall a time when they didn’t know this fact about their history. One way to accomplish this is by reading a book about gamete donation. Children love to hear stories about their beginnings so another is to weave a story about the child that can start out simply with detailed facts added as the child gets older and understands more. Carol Lieber-Wilkins, an infertility therapist and mother by egg donation, suggests parents practice saying the words when the child is an infant. “Parents need to practice doing this when children are non-verbal, so they can get accustomed to the sound of words that are very awkward and uncomfortable to use, like donor or infertility. That way, we can make our mistakes before our kids have a clue.”

At age 3 or 4 children understand that there is a mommy and a daddy and that a baby grows inside the mommy’s body. At this stage terms like tummy and eggs might be better to use than uterus and ovum. It is also at this time when same-sex couples might explain how their child was conceived.

By age 4 or 5 children are questioning how babies are born. This is a perfect opportunity to talk about gamete donation using simple language and only giving them the information they requested. This is also a great time to introduce the concept of the donor as a “helper” or someone special. According to Lieber-Wilkins the term “helper” rather than “donor” seems to be preferred by children and parents alike since it is a term children understand and parents are comfortable saying. Don’t be surprised however if they quickly move on to another topic.

School-aged children 8 or 9 have a greater capacity to understand why parents want and need a child. It is also an appropriate time to discuss the many different ways in which families are created; the concept of genetic connections; and why an egg or sperm donor’s help was needed. It is also important to separate sex from making babies by telling them that the donor did not have sex with their genetic parent. Finally, the child should have the opportunity to ask questions and after a few weeks it is recommended the topic again be brought up again.

Adolescence and the onset of puberty is a time when children are focused on themselves. They are developing a sense of self and establishing some independence from their parents. They will be very interested in any information about themselves however if parents have waited until adolescence to disclose the use of donor gametes their child may react negatively to the news. They may wonder why it has taken so long and it may require a significant adjustment on their part to take in this new information as they establish their identity.

It’s important that parents understand what normal child development is so they don’t assume that all the issues and conflicts that are bound to arise in childhood stem from the use of donor gametes. This has the potential to cloud the parent’s judgment if everything is filtered through the “non-genetic” point of view. One psychologist describes a scenario in which a 12-year-old girl is angry and says, "I wish you weren't my mom. You're not a cool mom." This child’s reaction is not because her mom is the non-genetic mom. It's because that's how she's feeling about her mom on that particular day.

Once a child is told about the use of donor gametes the information is theirs to share with others however, they may need some help determining what details are appropriate to share and with whom. It is important for parents to stress that they are proud of the way their child came to be and will respect and support their decision. Parents should also prepare their child for the fact that not everyone they tell will understand or agree with using donor gametes but they will be there to help them work through any problems that arise.

It would be impossible to tackle all the issues about disclosure but these are some final comments/ suggestions by experts in the field:

• Always recognize and acknowledge your children’s feelings
• Confusion, sadness and pain are normal responses to this information since the child may experience a sense of loss at the lack of genetic connection to both parents
• Physicians need to know a child’s genetic history
• Telling early avoids the betrayal children may experience if they find out when they’re older
• Encourage discussion
• Speak to a counselor if you are not telling your child because you fear rejection
• Learning goes on at the emotional level as well- be aware of your tone of voice and facial expression when discussing donor conception with your child
• Selectively share this information with people you can trust
• Although parents cannot protect their children from all the hurts they will experience in life they can help them work through them as a family

Books for Reading with Children:
Before You Were Born… Book Series from XY and Me Books (Janice Grimes) http://www.xyandme.com

My Story / Our Story Series from the Infertility Research Trust http://www.dcnetwork.org/ (link through Online Bookshop)
http://www.infertilitynetwork.org/html/store.asp

Tell Your Child Series – Rozanne Nathalie http://www.tellyourchild.com and
http://www.beaverspondpress.com

Let Me Explain: A Story About Donor Insemination. Jane T. Schnitter and Joanne Bowring. Perspectives Press, 1995.

Mommy Did I Grow in Your Tummy? Where Some Babies Come. Elaine Gordon. E. M. Greenberg Press, 1992.

Books recommended by ASRM:
http://www.asrm.org/Professionals/PG-SIG-Affiliated_Soc/MHPG/mhpgbooks.html

For more information on this topic visit the following websites:
Resolve:
http://www.resolve.org/site/PageServer?pagename=cop_tainf_ttyc

American Fertility Association:
http://theafa.org/secure/nobarriers/pubs/AIA_Infocus_Third_Party_104.pdf
http://www.theafa.org/faqs/afa_talktoovumdonorchildren.html

Donor Conception Network:
http://www.donor-conception-network.org/telltalkpubs.htm

http://www.donormoms.org

Harvard Medical School for Mental Health and Media:
http://www.artparenting.org/index.html

References:
Demby G and Mendell P. Talking with Children about Ovum Donation. AFA Fact Sheet. Available at: http://www.theafa.org/faqs/afa_talktoovumdonorchildren.html

Hanafin H. Talking to Kids about ART. Available at: http://www.artparenting.org/talking/transcripts_kids.html

Pruett K. ART Children: Developmental Issues across the Lifespan. Paper presented at American Society for Reproductive Medicine Thirty-Sixth Annual Postgraduate Program, Children of the ARTs: Psychosocial Challenges to Redefining Family; October 11-12, 2003; San Antonio, Texas.

Singer E. Talking with Children Conceived Through Donor Insemination,
IVF with Egg Donor or Surrogacy. The Center for Adoption Support and Education, Inc
Available at: http://adoptionsupport.org/pub/docs/donor.pdf

Stolberg S. Quyandry on Donor Eggs: What to Tell the Children. New York Times January 18, 1998. Available at: http://query.nytimes.com/gst/fullpage.html?res=9D01E4DB1538F93BA25752C0A96E958260&
sec=&spon=&pagewanted=print

Weinshel M. Where did I come from? Answering kids' questions about donor eggs or sperm. NYU Child Study Center. Available at: http://www.aboutourkids.org/aboutour/articles/alternate_conception.html