The American Interest
Policy, Politics & Culture
Autumn Note: Vial of Tears

Decades on, we’ve only just begun to ask the difficult questions about assisted reproductive technologies.

Published on September 1, 2010

This past May marked the fiftieth anniversary of the FDA’s approval of oral contraceptives. Not for nothing has this influential technology earned the simple honorific “the Pill.” As many of the tributes to this anniversary noted, granting women contraceptive agency enabled them to delay childbearing and pursue higher education, work and long professional careers. But even as the Pill alleviated fear of the unwanted pregnancy that would confine a woman to the home, it also dramatically heightened anxiety about the ticking biological clock. Thus the Pill sparked one revolution that led in turn to another: Infertility born of long-postponed pregnancy found a solution in assisted reproduction technology. The first revolution sped the disconnection of sex and marriage, the second the disconnection of marriage and childrearing. The Pill gave us first the joy of sex without babies, and then, in effect, the freedom and convenience of creating babies without sex.

While we have spent decades coming to terms with the massive effects of the sexual revolution, the fertility industry remains a virtually untrammeled Wild West. Only now, years after sperm, egg and embryo entered the open market, has the first wave of films, books and studies broken to tell the stories of the parents and children who emerged from this process. The combination of medical ingenuity, free-market entrepreneurialism and the profound desire to overcome infertility (whether biological or social) produces the kind of heady drama that attracts filmmakers and writers. And within the constellation of new reproductive options, the intrepid single mother purchasing donor sperm—usually as her biological clock winds down after a storied career in love and work—has captured the most attention. (Roughly half of all sperm sales in the United States are to single women.) Recent books like Louise Sloan’s Knock Yourself Up! (2007), Rachel Lehmann-Haupt’s In Her Own Sweet Time (2009) and the Oprah-approved Three Wishes (2010), co-authored by Carey Goldberg, Beth Jones and Pamela Ferdinand, present the path to hard-won belated motherhood as madcap adventure. This year alone brings three movies featuring A-list actresses that treat artificial insemination with indulgent humor: Jennifer Lopez in The Back-Up Plan; Jennifer Anniston in The Switch, based on a short story, “Baster”, by Jeffrey Eugenides; and Julianne Moore and Annette Bening as a lesbian couple whose teenagers find their donor father in director Lisa Cholodenko’s critically acclaimed The Kids Are Alright.

But this surge in celebration of female reproductive empowerment sits uneasily alongside an intensifying concern about the importance of fatherhood to children and society. While some increasingly question whether fathers are really necessary after all, the assertion of paternal indispensability has been spurred on by President Obama’s two compelling Father’s Day speeches, and by the body of scholarship documenting the unique contribution that residential, biological fathers make to child well-being and cognitive development. When those adorable babies sporting bibs that say “My Daddy’s name is donor” become adolescents and adults, what do they make of their inorganic conception? Are the kids really alright?

To be sure, single mothers (especially of the working professional variety) have received approbation and opprobrium in equal measure since at least as early as the Dan Quayle-“Murphy Brown” face-off in 1992. And doctors had been discretely performing “off the books” artificial insemination decades before the fertility industry, beginning in the early 1980s, rose to its current heights. (The U.S. industry alone brings in $3.3 billion per year, and, at a best educated guess, 30,000–60,000 babies born of donor sperm.) Unsurprisingly, then, recent media coverage has centered on infertile adults and marveled at the expanding choice and control they have in building families in diverse, novel forms. Journalists have evinced considerably less curiosity about the “products of conception”: A child so dearly wanted and planned for would naturally be loved and happy—where’s the story there? But those children are reaching adulthood in increasing numbers and, particularly as they experience parenthood themselves, are raising difficult questions about their unknown genetic heritage. Some have assumed a public role speaking against the industry, state and society that made their unknown fathers nearly impossible to find. Having been so wanted by one’s mother is doubtless a great source of comfort, but it doesn’t dispel these questions. For some, being wanted painfully underscores how deliberately she severed that link—a link not only to a father, but to grandparents, aunts, uncles, cousins and half of one’s ancestors.

Artificial insemination is predicated upon the simple truth that biological connection dearly matters to the mother. It is she who will experience the profundities of pregnancy and birth and see herself in the child who is her own. And yet it also insists that biology doesn’t matter—that DNA is mere genetic material, enabling life but not shaping the essence of who we are. The man who produces that material, one could argue, is no more a father than the doctor who performs the insemination.

The donor-conceived adults who challenge the largely unregulated fertility industry to greater accountability, and who decry anonymous sperm donation as unethical, come together on websites like “Tangled Webs”, “Confessions of a Cryokid”, “Donated Generation”, and “Child of a Stranger.” Others are less incensed, perhaps, but write blogs or join forums on registry sites in search of their donors and half-siblings. These voices are certainly far from monolithic. The culture war has produced a stalemate between advocates of family choice and diversity, on the one hand, and those who champion the special status of the nuclear family on the other. The academe’s sociological research seeks to settle the debate with data and statistics where rhetorical argument appealing to shared principles and common sense fails. Too often, however, it exits the spin cycle with the same alarmism or triumphalism that respectively characterize Right and Left on issues of family and biotechnology.

 

Into this fray come two new works that show us the human faces behind this ethical and political morass. They are modest, intimate works that listen more than speak, ask more than argue. In Single Choice, Many Lives, New-York based independent filmmaker Anne Catherine Hundhausen finds herself newly single at age 36, contemplates donor insemination and chronicles her investigation of choice motherhood and the freewheeling sperm bank industry. My Daddy’s Name is Donor, a survey led by Elizabeth Marquardt, director of the Center for Children and Families at the Institute for American Values, is an unprecedented study of young adults conceived by sperm donation. Together, they offer a kaleidoscope of unsettling portraits: the industry’s insouciant profiteers and hucksters; the single woman startled by the depth of her sudden craving for motherhood but faced with dwindling options; the “genetic orphan” longing for his father; the sperm donor who realizes only with age, and perhaps an unwelcome knock on the door, the weight of decisions made long ago.

Hundhausen opens her film with the infamous Newsweek quote that has rankled women since it appeared in 1986: “Forty-year-old women are more likely to be killed by a terrorist than they are to get married.” Facing down forty herself and seeking advice, she looks to a mixed chorus of her friends, doctors, parents and sister (herself a new mother). They alternately urge her not to wait for Mr. Right but to have a baby alone while she still can; wonder whether she might still get married in time; and confess to finding donor insemination “incredibly creepy.” Ambivalent, she embarks on a cross-country exploration, following single mothers from their perusal of donor profiles, to the travails of pregnancy and parenting alone, to their growing children’s shifting attitudes toward the father they regard as either non-existent or acutely absent. Where the recent run of feature films treat the subject with levity and schmaltz, Hundhausen’s portrayals form a rich, often troubling emotional and ethical landscape.

One of Hundhausen’s subjects is 26-year-old Kathleen LaBounty, whose ongoing search for her donor father has stretched over 600 letters, dozens of failed DNA tests and many years of wondering about the missing, unknowable pieces of herself. Her candid testimony underscores the importance of Marquardt’s work. Her survey makes clear that, among a diverse, fairly representative group of nearly 500 donor-conceived adults, struggles with questions of origin, identity, confusion and loss are common—and are more pronounced among those born to single mothers than to heterosexual or lesbian couples. Compared with equal numbers of people raised by biological or adoptive parents, the donor offspring surveyed were twice as likely to report substance abuse and delinquency. Coupled with free-form responses, the essential nagging questions emerge: Who is my family? Might I have dozens, even hundreds, of half-siblings? Why did my sperm donor not know or care that I exist? Am I angry at my mother for her decision, absent which I wouldn’t be here? Would it betray her to search for my donor? How do I feel about the fact that money (in some cases quite a lot) was exchanged in order to conceive me? Moreover, the donor may not be seen as a father, exactly, but he is clearly more than the “seed provider” or “nice man who helped me have you”: 71 percent of those surveyed agree that “my sperm donor is half of who I am”, and 73 percent agree, “I long to know more about my ethnic or national background.” Strikingly, however, the group still takes a supportive, libertarian view of the fertility industry: 73 percent agree, “Our society should encourage people to donate their sperm or eggs to other people who need them. And even more striking, 20 percent had already done just that (compared with less than 1 percent of those conceived naturally).

Despite the language of altruism that would place assisted reproduction beside adoption (and despite the diverse reasons one might have for participating), “donors” are also “sellers”, the crucial difference being that, in Marquardt’s words, “Adoption functions as an institution, the purpose of which is to find parents for children who need them. Donor conception functions as a market, the purpose of which is to create children for adults who want them.” Where would-be adoptive parents undergo rigorous, even invasive screening, anyone in the United States can purchase sperm, regardless of age, income and physical or mental health. If a particular donor’s sperm is no longer available at the original bank, it may be procured from a previous buyer on the open market with a relatively simple Internet search.

As for the men who make regular deposits at the bank, their pay is pegged to demand. The bank maintains a minimum threshold of donor desirability (short men, for instance, need not apply), but those blessed with superior looks and education sell considerably more, at higher prices (around $650 per vial) and are compensated accordingly. There are waiting lists for the most popular, who, like participants in California Cryobank’s “celebrity look-alike” feature, can make upwards of $1,200 per month. And higher-end packages may include the donor’s baby photos, personal essay, audio interview, handwriting analysis and Myers-Briggs temperament test.

While such detailed information can help a woman choose and feel connected to her donor, it is at best a snapshot, particularly with regard to his past and future health. Banks perform a modicum of screening for drug abuse, HIV and other diseases, and hold frozen sperm in quarantine per FDA regulations, but additional medical tests and records, or long-term tracking for genetic disease after the donor leaves the program, are unrealistic, as Claus Rodgaard, managing director of Cryos New York, admits uncomfortably. Likewise, he says, further background checks to verify a donor’s claimed education, employment or medical history, or to maintain detailed registries, are “unfeasible.” Such efforts would increase operating costs, raise prices and decrease competitiveness. With a touch of sarcasm, he adds, “Sure, if people wanted to pay $2,000 per straw, we could ask [donors] more questions, or do more testing.” For the donor-conceived child who contracts diabetes, cystic fibrosis or polycystic ovarian syndrome, the incomplete medical history afforded by heavily protected donor anonymity is a serious handicap. 

 

The fertility industry is broadening the path to parenthood in affluent societies worldwide, and the United States is the clear laggard in confronting the ethical questions it raises. Amid legislative and broader public debate, countries including Britain, Sweden, Norway, New Zealand and parts of Australia have banned anonymous donation, enabling the child to seek out her father when grown; Canada has made it illegal to pay donors of eggs or sperm; France has limited the number of children that a single donor may produce to five; and Italy and Ireland have limited access to married couples. Why has the United States, with the largest (though as yet unquantifiable) donor conceived population in the world, been so reluctant to follow suit in law and in public conversation?

The simplest answer, perhaps, is that when the “pursuit of happiness” is taken to be an unalienable right, we tend to insist on a minimum of obstructions on our chosen path to that happiness. For most Americans, after all, the assertion of rights is the keenest expression of shared moral identity. Perhaps, too, Americans’ stubborn optimism resists disappointments and trade-offs in life’s course and fuels a bullishness about progress, a drive to throw off the shackles of human limitation. When the limitation is infertility, and the goal a healthy baby of one’s own, any interference seems downright unjust. Indeed, 76 percent of Marquardt’s respondents agree that “every person has a right to a child.” In contrast to our more circumspect European cousins, many Americans call for expanded access to assisted reproduction.

Against this powerful impulse to uphold and further the right of adults to found a family whenever and however they choose, how should we consider the rights of the voiceless child? Should the idea that a child ought to know and be cared for by the man and woman who created him be expressed in the exalted language of human rights? David Blankenhorn, a signatory to My Daddy’s Name is Donor, thinks that Americans increasingly tend to

 

treat each specific right as if it stands alone . . . disconnected from any overarching anthropology or system of values that alone permit us to adjudicate rights in conflict and also to understand rights in relationship to duties, obligations, and other human goods that cannot easily be expressed in terms of rights. The obvious danger in this . . . is that each right, in its isolated supremacy, tends to get expressed in absolutist, totalizing terms. I fear that we in the United States, trained as we are in what we call our “bill” of rights, are particularly prone to this temptation.1

 

Indeed, the conflict between the desires of choice mothers and those of their donor-conceived children seems to some extent irreducible. Increased support for the single woman’s choice means lessened regard for the child’s need for his father, a need he or she can only fully articulate in adulthood as a loss.

 

For all the newness and rapid growth of assisted reproduction, humans have a long history of instrumentalizing the child. From the patrimonial preservation of lineage, to state-sponsored natalism to raise up warriors or workers, to the contemporary gamete market that promises deep-pocketed parents the genes to bestow intelligence and beauty, the child is understood as made or acquired rather than given. As Marquardt puts it, “The religious injunction that the child is a gift is something of a corrective to the impulse to control life, long before reproductive technology was available.”2 Perhaps, too, the biblical command to “be fruitful and multiply” is instructive: Where fashionable evolutionary psychology sees the desire to pass on one’s genes as the driver of human life, and so would render the Bible’s injunction superfluous, it overlooks the countervailing, equally powerful urge to delay or reject parenthood.

This individual and collective urge fuels the widening gap between nature and culture that leaves women facing difficult choices in a society organized with scant regard for female fertility.3 The demands of career and the vagaries of the mating market require educated women to map out motherhood with a foresight and deliberation that most of their own mothers could not have imagined. What woman even one generation removed could have envisioned herself shopping for sperm, choosing the father of her child by clicking “add to cart”? Hundhausen, like many would-be choice moms, assumed that marriage and motherhood lay in her future—until the time to say “not yet” ran out. The cultural shifts and structural pressures that have sharply increased the numbers of both single mothers and childless women are too numerous to rehearse, but one cannot ignore the resounding, plaintive question Hundhausen’s film presents with such understated power: “How did I get here?”

One hears in the accounts of single mothers by choice less vexation with the workplace than with the dating marketplace. The soul mate model of marriage has moved it from the launching pad to the capstone of adult life. The elevation of romantic love, coupled with wariness about the financial and emotional wreckage of divorce, has so heightened expectations of marriage that it now has even less status as a prerequisite for motherhood. While many choice moms hope to marry after the birth, they also report feeling liberated by being able to say to the men they’ve spent more than a decade dating: “We don’t have to wait for you anymore.” While artificial insemination is often associated with female procrastination and overweening careerism, surely the ranks of men who are ambivalent about or disinterested in fatherhood are a significant reason why women turn, with some mix of resignation and relief, to anonymous sperm donation. Younger women, anticipating the potential disarray of failed relationships or shared custody post-divorce, may even choose to forgo the search for a husband and head straight for the sperm bank. Hundhausen profiles a 27-year-old woman who describes with open bitterness the “glorified sperm donors” she knew who impregnated multiple women and took only a passing interest in their children, and the heroic single mothers who held families together. She never sought a husband, having planned since youth to go it alone.

It is safe to say, however, that most women do not share this grim determination, and continue to hold fairly traditional aspirations for marriage and family. It is perhaps surprising, then, that books like Sylvia Ann Hewlett’s Creating a Life: Professional Women and the Quest for Children (2002) and Lori Gottlieb’s Marry Him: The Case for Settling for Mr. Good Enough (2010), which serve to remind women to face the uncomfortable reality of declining fertility as they chart their life course, have met with considerable backlash. Gottlieb, herself a choice mom, underestimated the challenges of single parenthood and regrets her long years of rejecting men who would have been suitable fathers. The books suffer from a certain solipsism, but their argument is not so controversial on its face, and it certainly doesn’t approach the strident scaremongering of which they were widely accused. Forceful rejoinders appeared in Linda Hirschman’s Get to Work: A Feminist Manifesto (2006) and Liza Mundy’s Everything Conceivable: How Assisted Reproduction Is Changing the World (2007), which celebrate women’s increased options and freedom from husbands and fathers.

There is something in the ferocity of this debate over the timing and conditions of pregnancy—after children arrive, the “mommy wars” get even more heated—that suggests that something deeper is at stake. The fight for gender parity, having achieved many of its goals, pushes into the realm of gender sameness, seeking to offset or outwit the biological realities that uniquely constrain women. This becomes particularly urgent with regard to reproduction, which yokes a woman to her body differently than does disease or disability in men and women alike. As one of Hundhausen’s subjects describes giving birth, “At that point your body is no longer yours. It has one primary purpose, which is to be a channel through which another human being is entering the world.”

Indeed, the experience of pregnancy and early motherhood is ego-shattering in a way that doesn’t sit well with feminist notions of female dignity and autonomy. (Apparently, the early feminist slogan “Our Bodies, Ourselves” applies to female sexuality but not maternity.) Hence the emphasis on its drudgery and silence about its exhilaration, or about how deep the craving for it may strike. Katie Roiphe, a useful contrarian and longtime fly in the feminist ointment, called attention to this “minor dishonesty” in an August 2009 Slate piece that, thanks to a mischievous subtitle, lit a brushfire of controversy: “My Newborn Is Like a Narcotic: Why won’t feminists admit the pleasure of infants?” Like Hundhausen and her subjects, who describe the startling intensity of the longing for and experience of pregnancy, Roiphe describes the tyranny of the body during early motherhood as something akin to addiction:

 

There is an opium-den quality to maternity leave. The high of a love that obliterates everything. . . . [P]art of the allure of maternity leave is precisely this: You give up everything you are and care about. . . . You are the vague, slow, exhausted animal nursing its young. Anything graceful, original, sharp, intelligent about you is gone. And it is that sacrifice of the self, that total denial of the outside world, that uncompromising violence done to your everyday life, that is this period’s appeal.

 

Despite having uttered the word “feminist” only once in the piece, Roiphe came under attack for the suggestion that a protean female self built up over more than a decade of higher education and professional achievement could so instantly be subsumed by something as banal and universal as maternity. Her critics bristled at the assumed generalization, as if she had disparaged women who fail to respond with precisely the same self-abandonment—or who resent having done so rather than luxuriating in it as Roiphe did.

Hundhausen deftly teases out this discomfiting, sudden assertion of the body’s demands, as her various subjects describe not only their unbidden, acute hyperawareness of babies, but their swift slide from careful, rational planning and the happy anticipation of control over everything from the donor’s eye color and alma mater to the future child’s diet and religion. A querulous tone creeps into their interviews as they note the hormonal fluctuations and exhaustion that leave them disoriented and longing for a supportive partner, or the paralyzing fear when labor comes to one lying alone in bed at four in the morning, and to another in the eleventh hour of labor before an emergency C-section. After the child is born, they describe an uneasy or even wistful feeling of connection to the donor, borne of curiosity as the child develops surprising, unfamiliar traits or physical characteristics. One mother featured discovers in her son’s autism a more tragic, immutable link to his donor father: Of the six half-siblings she located, two have autism and two have a related sensory disorder, for which donors cannot yet be tested.

While virtually no choice mom rues her decision, she faces abundant, unique challenges that helpful, well-intentioned doctors and sperm bank marketers couldn’t have prepared her for. A New York Times profile of several Manhattan women unsuccessfully or inconclusively pursuing artificial insemination captures the minutiae of unforeseen challenges:

 

Whether it’s a matter of trying to get a photo taken of you with your child or finding a way to shower without worrying that you won’t hear your baby cry or accommodating a difficult work schedule, being a single parent can require compromises and jury-rigging that might awe a person with a partner. It is a measure of how deep the pull toward motherhood can be.4

That deep pull toward motherhood is what complicates our new, cherished belief that intentionality and love are all that make a family. The central question encircling deliberative, delayed parenthood and assisted reproduction seems to be how and whether our bodies matter, and through them our biological connections to past and future. The single mother who conceives at the clinic with her feet in stirrups and bears the child of a man she has never seen and will likely never meet and the child fatherless from the point of conception both face this question with some inevitable tension, and even in direct opposition.

 

What, if anything, can be done to mitigate this tension? The authors of My Daddy’s Name is Donor are among a growing cohort calling for an end to anonymous donation—regardless of the near-certain consequence of a significant drop in available donor sperm. Relatedly, while it could significantly contribute to that drop, many critics argue that the number of offspring born of a single donor be limited to a number he might reasonably be able to meet and know if his grown children seek him out. And despite the financial costs involved, the industry’s integrity is also suspect without provision of counseling to both donors and would-be parents, to deepen understanding of the full implications of the decision, including the donor-conceived person’s atypical experience. More fundamentally, however, the “gold standard” studies necessary to get a more accurate and incisive picture of the industry would falter on the sheer lack of transparency and record-keeping at sperm banks and fertility clinics; the dearth of reliable information must be redressed.

Such studies and restrictions would go a long way to restore some balance in the fertility industry between adult desire and children’s needs. But better supported research into the experience of donor offspring cannot resolve the larger questions. Even if it were scientifically proven that donor children achieve relatively satisfactory outcomes over their lifetimes, we need not only to measure their objective well-being using the typical metrics, but also to listen to their voices and hear their stories. Our abiding sympathy for the pain of infertility and the desire to have children of one’s own yields a certain deafness to the donor-conceived population.

To be sure, many of them are or will ultimately be “alright.” But the relevant question isn’t whether more suffer than not, but whether any suffer at all, and whether what suffering there is implicates our unqualified support for unbridled reproductive freedom of exchange. We deeply wish it were true that these children fare well, that they are “just fine” in all the various scenarios adults have planned to maximize their own happiness. We want to believe that all these formations are equal and the same in the love and support they provide the children. And we want to believe that assisted reproduction is just another stage in our progressive transcendence of the body’s limitations. Yet biology stubbornly reasserts its role in our personhood and lived experience. Those limitations are persistent, but furnish a richness to our lives, as limits properly conceived always do—though we may never stop yearning to be free of them.

1Blankenhorn, “The Rights of Children and the Redefinition of Parenthood”, presentation to the Danish Institute for Human Rights, June 2, 2005. 2“Who did I come from? The children of donor dads grow up”, MercatorNet, May 30, 2010. 3See Dorothea Israel Wolfson, “In the Family Way”, The American Interest (July/August 2009). 4Jennifer Egan, “Wanted: A Few Good Sperm”, New York Times, March 19, 2006.

Noelle Daly is assistant editor of The American Interest.