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However, the specific aspects of the surrogacy process that gay fathers choose to disclose to their children, and at what age they choose to do, have not been studied. A high level of openness is likewise to be expected in gay father families given the absence of a partner of the opposite-sex with whom to procreate. This openness is unsurprising, given that the parents have to explain the arrival of the baby to family and friends in the absence of a pregnancy. In surrogacy families headed by heterosexual couples, almost all parents are open with their children about their use of a surrogate 6, 17. Gay fathers who started their families using surrogacy need to explain their path to parenthood to their children. Despite the fact that 18,400 infants were born in the United States through gestational surrogacy between 19 (4), the nature of the relationship between children in these families and their egg donor is unknown. Even where there is no relationship between the child and the donor or surrogate, it has been argued that these “birth others” (15) may have a place in the child's family tree (16).
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A relationship between the child and the egg donor may be viewed by intended parents as threatening, given that genetic relatedness is often given primacy in family relationships (14). In gestational surrogacy arrangements, parents may select an egg donor with whom they can have contact in the future (an open-identity donor) or a donor with whom they will have no contact (an anonymous donor), although the possibility of achieving anonymity is increasingly in doubt (13). When contact between gay fathers and surrogates has been found to cease entirely, this has occurred in the Indian context (11), in which socioeconomic and language barriers, as well as agency policies, do not encourage or facilitate contact between parties (12). Relationships between fathers and surrogates have generally been found to be positive, with contact being maintained through occasional emails and/or the exchange of postcards and photographs at birthdays and holidays. However, the amount of contact between children and their surrogate has been found to lessen over time, particularly in the case of previously unknown genetic surrogates (6).Ī small body of research has examined the relationship between gay fathers and their surrogates in Spain, Italy, and the United States 8, 9, 10 both during and immediately after the birth of the child. Studies of surrogacy families conducted in the United Kingdom, where commercial surrogacy is illegal, have found that heterosexual parents can and do form positive relationships with surrogates during pregnancy, which typically continue as the child grows up 6, 7. These concerns have typically been raised in relation to heterosexual parents, specifically mothers, as opposed to fathers in gay father families. Although contact with the surrogate may be beneficial in helping children understand their origins, there have been fears that ongoing contact with the surrogate may undermine the relationship between the parents and the child. The surrogate who carries the pregnancy to term and gives birth has no genetic connection to the child.Ĭoncerns have been expressed regarding the relationship between families created through surrogacy and the surrogate over time (5). However, the most common type of surrogacy in the United States is gestational surrogacy (4), a high-technology procedure in which an embryo is created using the sperm of one of the intended fathers and the egg of a donor and transferred to the surrogate. This can be a relatively low-technology procedure in which conception occurs using the sperm of one of the intended fathers and the egg of the surrogate who carries the child to term (referred to as genetic surrogacy). Gay men may choose to become parents via surrogacy, a process in which a woman bears a child for the intended parent(s). Given recent changes in marriage equality in the United States (2) and physicians’ ethical obligation to treat all persons equally regardless of sexual orientation (3), the number of gay fathers creating families through assisted reproductive technologies is likely to rise. In the United States it is has been estimated that between 2 and 3.7 million children have a lesbian, gay, bisexual, or transgender parent, with approximately 200,000 being raised by same-sex couples (1). Discuss: You can discuss this article with its authors and with other ASRM members at