The Donor Conception Identity Questionnaire: associations with mental health and searching for and finding donor connections.

OBJECTIVE: To understand how the Donor Conception Identity Questionnaire (DCIQ) correlates with mental health and explore differences in the DCIQ between donor conceived people who were actively searching for donor connections to those who were not and those who had found their donor connections to those who had not. DESIGN: Cross-sectional survey. SETTING: Online survey conducted within United Kingdom. PATIENT(S): A total of 88 donor conceived adults ranging in age from 18 to 70 (mean, 34.27 years; median, 31 years). A total of 39 participants were actively searching for their donor connections, and 49 were not. INTERVENTION(S): Donor conception identity was measured using a questionnaire and scores were correlated with existing measures of mental health. MAIN OUTCOME MEASURE(S): Participants completed the DCIQ and measures of well-being, satisfaction with life, identity, pride, and stigma. RESULT(S): Factor analysis of items from the DCIQ identified four domains: concern and preoccupation; internalized stigma; pride and acceptance; and openness and understanding. The identified factors correlated with scales of psychological and social well-being. Active searchers scored higher than non-active searchers on "concern and preoccupation" and "internalized stigma". Donor conceived individuals who had found their donor connections scored lower on "internalized stigma" and higher on "openness and understanding" compared with those who had not found their donor connections. CONCLUSION(S): The findings of the present study show that scores on the DCIQ correlate with existing measures of psychological and social well-being. Furthermore, donor conceived individuals searching for their donor connections differ from those not actively searching on key domains of the DCIQ. Implications for future avenues of study and support for donor conceived people are discussed.

Direct-to-consumer DNA testing: the perspectives and experiences of donor conceived young adults in the UK.

RESEARCH QUESTION: What meanings do donor conceived young adults give to direct-to-consumer DNA testing, and how does direct-to-consumer DNA testing relate to their lived experiences? DESIGN: Thirty-three young adults participated in in-depth interviews in November 2020 and September 2021 as part of a study of donor conceived people in the UK that focuses on the period of young adulthood. All participants were aged between 18 and 31 years, had been conceived by sperm donation at a time of legal donor anonymity, and were mainly resident in the UK. Interviews were analysed using reflexive thematic analysis. RESULTS: Nineteen participants (58%) had used at least one direct-to-consumer DNA test, and 14 (46%) had not. Three participants (9%) had learned about their donor conception inadvertently through a direct-to-consumer DNA test. Twelve participants (36%) had matched with their donor, someone conceived using the same donor, or both. Four related themes that capture participants' perspectives and experiences of direct-to-consumer DNA testing were identified: ruptures, disclosures, webs and temporalities. CONCLUSIONS: To the authors' knowledge, this is the first study to evidence both active interest and disinterest in direct-to-consumer DNA testing among individuals who are donor conceived. The meanings ascribed to, and uses of, direct-to-consumer DNA testing vary significantly among donor conceived young adults. Findings relating to the relationship between 'informal' and 'formal' information systems, and the absence of guidance and support for those using direct-to-consumer DNA tests, should be considered carefully by practitioners, regulatory bodies and policymakers going forward.

Searching for and making genetic connections: recommendations for practice from donor conceived adults in the UK.

RESEARCH QUESTION: What are the support needs of donor conceived individuals who are searching for or open to matching with genetic connections? DESIGN: A total of 88 donor conceived adults in the UK participated in an online survey open between January and August 2022. Participants were asked about their level of awareness of current resource provision, recommendations for resources to support the process of searching for genetic connections, and recommendations for resources to support with feelings about searching for or being found by genetic connections. RESULTS: Participants were found to have varying levels of awareness of the resources available to them, with 39% describing themselves as aware, 41% as partly aware and 20% as unaware. Their recommendations for practical and emotional resources also varied. The most recommended resources for practical support were DNA testing and changes to UK law. The most recommended resources for emotional support were counselling and peer and other support groups. CONCLUSIONS: The impact of legal and technological changes such as direct-to-consumer DNA testing and the legal transition to identifiable donation may be felt by donor conceived individuals irrespective of their year of birth. The wishes of donor conceived individuals for different support resources should be borne in mind by practitioners, regulatory bodies, and policy makers going forward.

Solo Fathers and Mothers: An Exploration of Well-Being, Social Support and Social Approval.

Research has begun to explore the experiences of single mothers by choice who choose to start a family alone and do so using donated gametes. However, very little is known about the experiences of single fathers by choice, and even less is known about how their experiences might compare to mothers in the same position. This exploratory study of single mothers (n = 19) and fathers (n = 17) by choice examined mental health and social support among mothers who used sperm donation, and fathers who used egg donation and surrogacy, to become parents. Data relating to their reasoning for pursuing solo parenthood, mental health, and social support were analyzed quantitatively. To further explore fathers' experiences of being a solo parent, a thematic analysis was conducted exploring their descriptions of social responses to their family type. Regarding parental mental health, no statistically significant differences were found between mothers and fathers, and both groups of parents had sought out supportive networks, both before becoming a parent, and as a single parent. Fathers' responses indicated that they received both supportive and negative reactions, although they generally perceived the majority of interactions to be positive. However, frequent references made by members of the public, or by the media, to their family type being new or different served to reproduce social scripts about normative family types. The study findings, despite the small sample size, contribute to a new understanding of the well-being and experiences of both mothers and fathers who choose to start their family and parent alone.

"I guess the trans identity goes with other minority identities": An intersectional exploration of the experiences of trans and non-binary parents living in the UK.

Background: Research on trans and non-binary parents has identified challenges in integrating parenting and gender identities, and in navigating stigmatizing environments. Studies have also highlighted the unique experience of transmasculine pregnancy and its violation of cisheteronormative ideals, yet little is known about either the experiences of trans and non-binary parents who have used diverse routes to parenthood or their experiences beyond the transition to parenthood. Research on the way in which gender intersects with other identity categories to shape the experiences of trans and non-binary parents is also lacking. Aims: This study aimed to explore the experiences of trans and non-binary parents in the UK within different parenting spaces both during and after the transition to parenthood, using an intersectional framework. Methods: Eleven semi-structured interviews were conducted with trans and non-binary parents and analyzed according to the principles of thematic analysis. Results: Three main themes were identified, reflecting participants' experiences within the "highly normative world" of parenting, and the strategies of "being a pragmatic parent" and "being a pioneering parent" used to navigate this. Discussion: The findings of this study highlight the usefulness of an intersectional approach for research on this topic. Findings also evidence a need for inclusive, and queer, parenting spaces for trans and non-binary parents, so that parents and children can enjoy the benefits of trans parenting.

Children with Trans Parents: Parent-Child Relationship Quality and Psychological Well-being.

Objective. Families with trans parents are an increasingly visible family form, yet little is known about parenting and child outcomes in these families. This exploratory study offers the first quantitative assessment of parent-child relationship quality and child socio-emotional and behavioral adjustment in families with a self-identified trans parent with school-aged children. Design. A sample of 35 families (37 trans parents, 13 partners, and 25 children aged 8-18 years) was recruited primarily through social media. Parents, children, and teachers were administered a range of standardized interview and questionnaire assessments of parent-child relationship quality, quality of parenting, psychological adjustment, and gender-related minority stress. Results. Parents and children had good quality relationships, as assessed by both parents and children, and children showed good psychological adjustment. Child age at the time the parent communicated their gender identity to the child was unrelated to child outcomes. Conclusions. Parents and children in trans parent families had good quality relationships and children showed good psychological adjustment. The findings of this exploratory study challenge commonly held concerns about the potentially negative effects on children of growing up with a trans parent.

Single mothers by choice: Parenting and child adjustment in middle childhood.

Findings are presented of the second phase of a longitudinal study of families created by single mothers by choice. Forty-four single heterosexual mothers were compared with 37 partnered heterosexual mothers, all with a donor-conceived child aged around 8-10 years. Standardized interview, observational, and questionnaire measures of maternal wellbeing, mother-child relationships and child adjustment were administered to mothers, children, and teachers. There were no differences in maternal mental health, the quality of mother-child relationships or children's emotional and behavioral problems between family types. However, higher levels of parenting stress and higher levels of children's prior adjustment difficulties were each associated with children's adjustment difficulties in middle childhood irrespective of family type. The findings suggest that the presence of two parents-or of a male parent-is not essential for children to flourish, and add to the growing body of evidence that family structure is less influential in children's adjustment than the quality of family relationships. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

'What Does Donor Mean to a Four-Year-Old?': Initial Insights into Young Children's Perspectives in Solo Mother Families.

This study reports on the questions, thoughts and feelings of children aged 4-9 conceived by donor insemination to single mothers. Fifty-one mothers and 47 children from the same families were each administered a semi-structured interview. Mothers generally reported that while children either lack understanding, or have not yet been told, about their donor conception, they may be thinking and talking about the absence of a father. Most children did not mention either donor conception or father absence and reported positive feelings about their families and friendships. Possible explanations for the discrepancy between mothers' and children's reports are discussed.

Disclosure of donor conception in the era of non-anonymity: safeguarding and promoting the interests of donor-conceived individuals?

This article responds to a debate article published in Human Reproduction earlier this year. In that article, the authors suggested that parents should be encouraged to disclose the use of donor gametes to their children given rapid and widespread advances in genetic testing and sequencing. However, there is an urgent need to engage with the assertion that in this context, telling children about their donor conception both safeguards and promotes their interests, particularly if such disclosure is motivated by parents' anxieties about accidental discovery. Disclosure that is motivated by the notion of non-anonymity may also encourage parents to share misinformation about donors and encourage their children to have unrealistic expectations. Fertility professionals must remain mindful of these outcomes when discussing disclosure and the future implications of increasing access to genetic information with both prospective and current parents. It is strongly advised that future discussions about the end of donor anonymity are not conflated with the debate on disclosure.

Disclosure of sperm donation: a comparison between solo mother and two-parent families with identifiable donors.

Disclosure of donor conception to children was compared between solo mother and two-parent families with children aged 4-8 years conceived since the removal of donor anonymity in the UK. Semi-structured interviews were conducted with 31 heterosexual solo mothers and 47 heterosexual mothers with partners to investigate their decisions and experiences about identifiable donation and disclosure to their children. No significant difference was found in the proportion of mothers in each family type who had told their children about their donor conception (solo mothers 54.8%; partnered mothers 36.2%). Of those who had not told, a significantly higher proportion of solo mothers than partnered mothers intended to disclose (P < 0.05). Partnered mothers were more likely than solo mothers to feel neutral, ambivalent or negative about having used an identifiable donor (P < 0.05), and were less likely to consider children's knowledge of their genetic origins as extremely important (P < 0.05). These findings are relevant to provision of counselling services as it cannot be assumed that parents will tell their children about their origins or their entitlement to request the identity of their donor at the age of 18 years. Further qualitative research would increase understanding of solo mothers' attitudes towards disclosure.

Single mothers by choice: Mother-child relationships and children's psychological adjustment.

Fifty-one solo mother families were compared with 52 two-parent families all with a 4-9-year-old child conceived by donor insemination. Standardized interview, observational and questionnaire measures of maternal wellbeing, mother-child relationships and child adjustment were administered to mothers, children and teachers. There were no differences in parenting quality between family types apart from lower mother-child conflict in solo mother families. Neither were there differences in child adjustment. Perceived financial difficulties, child's gender, and parenting stress were associated with children's adjustment problems in both family types. The findings suggest that solo motherhood, in itself, does not result in psychological problems for children. (PsycINFO Database Record