Should Children Be Told They Are 'Test-Tube' Babies?

Some people may pine for the good old days when parents could tell children that the stork delivered them. Today that discussion is much more complex, thanks to "assisted reproductive technology."

The first "test-tube" baby was conceived in 1976. She was the product of an egg from her mother and sperm from her father, but conceived in the lab, not in her mother's body.

Then, during the 1980s, sperm from men other than the father and eggs from women other than the mother became available for in vitro fertilization.

Since then, thousands of children in the United States have been conceived with such high-tech methods, or what today is called "assisted reproductive technology" (ART). Indeed, in 2007, 57,564 American children were so conceived, according to the Centers for Disease Control and Prevention.

Moreover, the ART combinations today can be astounding, experts say. A child may have three parents instead of two. A child may live in a family with two biological mothers—one the egg mother and one the womb mother. A child may have myriad half siblings from an egg donor or sperm donor, for example, or a twin born in a different womb or at another time.

Not surprisingly, ART has ushered in a wealth of psychodynamic issues, and perhaps none is more crucial than the question: Should ART children be told how they were conceived?

Some psychiatrists, psychoanalysts, and psychologists with an interest in the subject think that they should. They explained why at the American Psychoanalytic Association meeting in New York City in January and in interviews with Psychiatric News.

The Danger of Leakage

"If a child is not informed of his or her biological origins, there may be the unconscious transmission or leakage of such information in families that decide to not tell," Diane Ehrensaft, Ph.D., reported. In addition to being an Oakland, Calif., clinical psychologist who works with adults and children impacted by ART, Ehrensaft has written a book on the subject—Mommies, Daddies, Donors, Surrogates.

ART children who are not told how they were conceived may also have attachment difficulties, Ehrensaft believes, because both the secret and the discomfort that often accompany not telling can still be transmitted to the child either unconsciously or in subtle innuendoes. A recent British study found that ART children who were not told were more likely to have a conduct disorder than ART children who had been told, raising the question of whether something in the process of not telling disrupted the youngsters' relationship with their parents.

Not telling ART children the truth may also prompt them to distrust adults in general, said Anna Balas, M.D., a New York psychiatrist and psychoanalyst who has worked with some ART children.

"ART children should be told the truth, not just for their benefit but for that of their parents," New York psychiatrist Ann Maloney, M.D., asserted. "To carry a secret through your whole life takes a ton of psychodynamic energy." John Ross, Ph.D., agreed. Ross is a psychologist and psychoanalyst. Maloney and Ross are also married and have two daughters conceived via ART.Previous Section