Counselling lesbian couples: requests for donor insemination on social grounds

Lesbian couples' views about and experiences of not being able to choose their sperm donor

In this qualitative study, we explore how lesbian recipients view and experience the selection of their anonymous sperm donor. The study was conducted in Belgium, where fertility centres follow a legal protocol that severely restricts personal choice in donor selection. While previous studies have shown that recipients want greater control and input in the selection of their sperm donor, this was not a main concern for most women in the present study. They generally acknowledged their lack of control on the selection outcome and accepted this as part and parcel of an anonymous donation policy that provides an opportunity to have a child. They actively and passively downplayed initial concerns about the donor selection procedure and felt they did not have or need a right to further control over the donor selection. In adopting this 'subordinate' position, they felt they should trust the hospital, which they hoped would fulfil rather high screening standards. Those who did want more choice were nuanced and careful about their motivations: they focused on selecting traits that would facilitate normal child development or increase family coherence. The findings shed light on how these patients perceive their position in this third-party reproduction setting.

Motives and decisions for and against having children among nonheterosexuals and the impact of experiences of discrimination, internalized stigma, and social acceptance

Same-sex parents are increasingly a topic of public discourse. A growing number of homosexuals openly speak about their desire to have children or are already living together in different family constellations. The current study examined the decisions for or against having children and the motivations behind those decisions among nonheterosexuals living in Germany. A sample of 1,283 nonheterosexuals participated by means of an online survey. As some nonheterosexual individuals do not identify themselves with a male or female gender identity, a third category, "gender different," was generated. Motives for (not) having children, perceptions of social acceptance, experiences of discrimination in relation to one's sexual orientation, and levels of internalized stigma were taken into account regarding their influence on the decision about parenthood. Most respondents (80%) reported that they did not have children. However, among this group, 43% stated that they had decided to have children later in their lives, 24% were undecided, and 11% had already decided against having children. The most important influences on the decision of whether to have children were respondents' age and their desire for emotional stabilization. Negative experiences as a result of sexual orientation and internalized stigma had no impact on the decisions regarding parenthood.

Lesbian mothers and their children: the third wave

Research regarding lesbian mothers and their children has gone through a transformation in the last forty years. The first wave of research examined lesbians who had become parents while in heterosexual relationships. The second wave examined women who became parents within the context of lesbian relationships. Both of these waves focused on family functioning and child outcome, using heterosexual-headed families as comparison groups. The third wave of research, which is now underway, is focusing on the unique challenges faced by these families, and how lesbian mothers are creating and raising their families on their own terms. This article explores the research as it has evolved over the years and the direction in which it is headed.

Lesbian intra-partner oocyte donation: A possible shake-upin the Garden of Eden?

Treatment of same-sex couples using infertility therapies has become more acceptable over the years, but remains controversial. In December 2005, two law changes came into force in the UK that impact same-sex couples. Firstly, the Civil Partnership Act 2004 acknowledged legal relationships between same-sex couples; and secondly, the Adoption and Children Act 2002 allowed same-sex couples to adopt. In view of these law changes, it is timely to consider procreation in same-sex couples and, particularly, the possibility of intra-partner oocyte donation within a lesbian relationship. Such treatment would require one female partner to provide the oocyte and the other female partner to act as embryo recipient. The embryo(s) could be created using IVF with registered anonymous donor sperm. The novelty of allowing a lesbian couple to cause a pregnancy in this way could allow the recipient to give birth to a baby that was genetically related to her partner. If society finds this acceptable, intra-partner oocyte donation using donor sperm for IVF could successfully provide a family for lesbian couples, offering an alternative to individual donor insemination. The ethical aspects of the treatment are discussed.

Perinatal Mental Health in Lesbian Mothers: A Review of Potential Risk and Protective Factors

Postpartum depression and other perinatal mental illnesses are common complications of childbirth. The majority of research on these conditions has been conducted in heterosexual women; however, increasing numbers of women are choosing to parent in the context of lesbian relationships. Although many of the fundamental aspects of the transition to parenthood are shared between lesbian and heterosexual mothers, lesbian mothers may differ from heterosexual parents on a number of variables that have been previously associated with perinatal mental health. Lesbian mothers may be more likely than their heterosexual peers to lack social support, particularly from their families of origin, and may be exposed to additional stress due to homophobic discrimination. However, the likelihood that lesbian pregnancies will be planned, together with the relatively equal division of child-care labour observed in lesbian couples, may offer protection from perinatal depression. The study of perinatal mental health in lesbian mothers is warranted, both to ensure that the mental health needs of this largely invisible population are being met, and to further illuminate the role of psychosocial stress in perinatal mental health in all women.

Spare embryos: 3000 reasons to rethink the significance of genetic relatedness

IVF laws in Victoria, Australia provide that human embryos must not remain in storage in excess of 5 years. Studies reviewing the fate of surplus human embryos reveal that close to 90% of couples choose to discard their excess embryos and that hundreds of embryos are disposed of annually. It has been argued that human embryos are a valuable resource and that there is a need to consider educational programmes to encourage couples to donate spare embryos to other infertile couples, rather than discard them. Surveys show that one reason that so few embryos are donated is that couples attach great significance to genetic parenthood. Advances in reproductive technology may necessitate a review of biological definitions of family and the importance of genetic relatedness. It can be argued that it is unreasonable to conclude that genetic ties are so significant that embryos should be discarded rather than donated and raised by non-genetically related parents. It is suggested that education programmes should encourage reflection on people's beliefs about the importance of genetic relatedness with regard to what makes a family. Open embryo donation or directed embryo donation programmes might cause couples to change their minds, or alleviate their anxiety about donating embryos to others.

Should requests for donor insemination on social grounds be expanded to transsexuals?

Donor insemination may provide an answer to transsexuals with female partners who have a wish for a child. Although the follow-up on children born in the context of these families is non-existent and the follow-up on transsexuals after sex reassignment surgery (SRS) is limited, fertility centres might consider accepting the requests of transsexuals with a female partner. Between 1997 and 2001, nine couples presented themselves at the Centre for Reproductive Medicine of the Dutch-speaking Brussels Free University, of whom five couples were accepted. Nevertheless, some caution is called for because transsexualism is socially not accepted. Moreover, transsexualism is still considered to be psychiatric condition. The following recommendations should be taken in consideration. Treatment should be limited to female-to-male transsexuals with a female partner. A multidisciplinary team of specialists should carry out the diagnosis for gender identity. Developmental problems of the gender-disordered child might interfere with socio-economic, psychological and emotional stability in adulthood. The period of sex reassignment should be nearly completed.