The role of age of disclosure of biological origins in the psychological wellbeing of adolescents conceived by reproductive donation: a longitudinal study from age 1 to age 14

Abstract

BackgroundThe question of whether children should be told of their biological origins is one of the most controversial issues regarding the birth of children through donated eggs, sperm, embryos or surrogacy.MethodsIn the sixth phase of this longitudinal study when the children were aged 14 years, family relationships and adolescent adjustment were examined in 87 families created through reproductive donation and 54 natural conception families. The quality of family relationships was assessed by standardised interview with mothers and by standardised questionnaires and an observational measure with mothers and adolescents. Adolescent adjustment was assessed using standardised questionnaires. Systematic information on whether and when parents had told children about their biological origins was obtained at earlier phases of the study.ResultsThere were no overall differences between disclosing families and either nondisclosing or natural conception families. However, within the disclosing families, more positive family relationships and higher levels of adolescent wellbeing were found for adolescents who had been told about their biological origins before age 7.ConclusionsThe earlier children born through reproductive donation are told about their biological origins, the more positive are the outcomes in terms of the quality of family relationships and psychological wellbeing at adolescence.

Survey shows that Swedish healthcare professionals have a positive attitude towards surrogacy but the health of the child is a concern

“…In relation to the present study findings, healthcare professionals are obliged to keep up to date on disclosure issues and inform patients about them. Research about disclosure has shown that the most frequent reason for disclosure was to avoid possible harm if the child found out about the surrogacy from other people and wanting to be honest to the child . A longitudinal study of surrogacy in the UK found less positive mother–child interactions when the children were 7 years old and one possible explanation for this finding was the child's increased understanding of surrogacy.…”

Disclosure of donor conception, age of disclosure and the well-being of donor offspring

“…Two studies reported positive effects correlated with earlier age of disclosure. The first study reported more negative feelings at the moment of questioning in the group who had been told after the age of 18 (Jadva et al, 2009) and the second study showed higher levels of psychological well-being in those who learned about their genetic origins before age seven compared to those who were told after age 7 (Ilioi et al, 2016). Taking all these studies together, no clear conclusion about age of disclosure can be drawn.…”

“…A major problem here is that different ages are adopted to define early and late telling. Some studies make distinctions between before 12, between 12 and 17 and after 18 (Hammarberg et al, 2015), others between before 3, between 4 and 6, and between 7 and 14 (Ilioi et al, 2016), and still others before and after 18 (Jadva et al, 2009;Mahlstedt et al, 2010). From a theoretical point of view, these limits may have different implications.…”

“…Third, when all studies on the effects of age of disclosure are brought together, the conclusion seems to be that the effect of age of disclosure is at best small. Three studies demonstrate no difference between children who have been told early versus children who have been told late in life (Paul and Berger, 2007;Mahlstedt et al, 2010;Hammarberg et al, 2015) versus two studies that demonstrate more negative effects of being told late (Jadva et al, 2009;Ilioi et al, 2016). Hammarberg et al (2015) found that recalled age at which they learned about the mode of conception was not associated with the offsprings' current subjective well-being or parental relationship.…”

“…Kovacs et al (2015) also in a unbiased group, found no significant and clinically relevant differences in parent-child relationships and child well-being between the told and not told group. The most recent study by Ilioi et al again shows no overall differences between disclosing families and either nondisclosing or natural conception families (Ilioi et al, 2016). This study looked at the variables relating to quality of parenting, quality of mother-child relationships, global family functioning and adolescent psychological adjustment.…”