I began counseling couples going through the International adoption process. Even though domestic adoptions were becoming more open in the US, international adoptions were still inherently closed. When international adoptions declined drastically in the mid-2000s to improve child trafficking regulations, I switched gears. I learned about third-party reproduction counseling from my fertility doctor, and I began screening anonymous egg donors. Early on, the young women I screened didn’t give much thought to what it really meant to donate their eggs. I remember one young lady comparing it to donating a kidney. I knew more education was needed in the field.
I started to feel conflicted about my professional life. As the adoption field became more open, the third-party reproductive field remained fiercely protective of genetic secrets. I knew the psychological challenges of anonymous egg and sperm donation on a child. The closed adoption system was repeating itself, but worse. I knew that children should have access to their genetic information but there were no regulations requiring donation facilities to keep the information on file for a lifetime.
I couldn’t remain neutral anymore. How would these children find out their genetic information if they wanted to someday? There were major gaps in psychological preparation for intended parents. Intended parents had questions that agencies weren’t answering. Parents were seeking more than simple answers.
In session, I covered details that other professionals weren’t, like epigenetics and how infertility grief affects parenting across the life span. One counseling session was not enough time to prepare couples for the journey. I recommended joint counseling sessions with known donors to discuss roles and intentions and to anticipate the child’s needs. There came a point when I couldn’t be neutral anymore.
The turning point came when an angry client called and threatened me. I was on a road trip with my family in Oregon in 2015, when my cell phone rang. It was a client I had seen the week prior. He and his wife came to me for couples counseling to prepare to secretly use an acquaintance as an egg donor. I remembered his wife so well. She was suffering when she came to my office, deeply grieving. I felt for her. I saw her brokenness and felt her heartache. I felt the resistance in the room but who could blame them? Their dreams were broken and now they had to face the psychological complexity of egg donation.
I knew they wanted to just brush this under the rug and move on. It would’ve been much easier for me to avoid the hard topics, but my job was to counsel them according to ASRM guidelines. My heart pounded as I informed them of the ASRM’s recommendation to disclose the truth to the child. As the husband’s tension rose, I chose my words more carefully. I knew he was protecting his wife’s feelings, and I wanted to be tender too. It was uncomfortable, but it was my job to be neutral yet compassionate.
It was also my recommendation that their donor come to a counseling session with them to discuss their relationship moving forward. Do they all agree on disclosure? Has the donor shared the secret with anyone? How would they communicate if the secret got out? What would they do if the child wanted contact with the donor? What would the relationship with the donor be like?
The couple declined this meeting and we moved on. I sent a psychological report to their doctor and noted that the couple declined a joint session but had met the counseling requirements of the ASRM. My personal recommendation upset the doctor’s office manager, and she wanted me to rewrite the report without the negatives. I explained I did not put anything in the report that would disqualify them for the procedure according to the ASRM guidelines. I simply felt it was best for known donors and couples to talk through what their relationship would look like for the child’s sake.
That’s when the office manager contradicted the couple and told me they were using an anonymous donor. I’d like to think it wasn’t a direct attempt to lie to me. I’d like to think she meant that the known donor wanted to remain anonymous but that was impossible. The couple already knew their donor. They were friends on social media, so by definition it was not anonymous. I refused to change my report, so the office manager threw it in the trash and told the couple to see a different counselor. That’s when the husband called me and accused me of not providing the proper counseling. He threatened to report me if I did not refund his fee for counseling. He felt that I shoved “my agenda” down his throat during our session.
I was ready to quit counseling for third-party donation that day. I was sickened by what I saw happening. I had already been bullied by egg donation agencies to pass unqualified donors and lost business because I wouldn’t rubber stamp the psychological evaluations. As I expected, the angry client’s doctor’s office never sent another one of their patients to counseling with me. I knew so much more than they did, but they didn’t want to hear it.
I knew that life was long and I may have to answer to the unborn children someday. I felt a deep responsibility to them because I was one of them. I was a child with a mysterious identity to figure out. I lived through the confusion, the grief, and the silence. I fell silent again, muted and unheard in this field.
As disgusted as I was by the phone call that day, something stirred in me, and I knew I couldn’t go back to doing what I was doing before. Not the same way. That angry client showed me that I wasn’t okay with the way anonymous donation was being conducted. Science may change the way we conceive babies, but it can’t change the role DNA has on human identity development.
After decades of research, the adoption field understands why children should have access to their genetic information if they want it. It’s time for the third-party reproduction field to require more education and implement industry standards to reflect our knowledge of human development. If they would not listen, then I would go straight to those parents and ask the questions. It was time for me to do it. I might lose all my business, but I counseled differently starting that day. I started telling clients when they called for an appointment that I was on the side of openness before they even stepped in my office. I lost 80% of my business the following year, but slowly I began seeing more known donors, same-sex couples, and other couples that were open to being open. It was liberating.
Since then, I’ve counseled many couples using known (family members or friends) or open/ID release donors. The adoption community understands that openness is possible and healthy for the child. We can learn a lot from the adoption community’s approach to open adoption. I have interviewed hundreds of donors over the years and many of them were willing to be identified. We can’t let fear stop us from what is doing best for the children being born.
