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Differing opinions

About 12 years ago, I was undertaking a donor implications counselling session with a couple who needed donated eggs.  It wasn’t too long after RTAC had altered guidelines for practice regarding third party reproduction in Australia, and as a result, clinics were no longer providing anonymously donated eggs, sperm and embryos.  Counselling focused clearly  on the idea that openness about donation could be beneficial for donor conceived children, than we encouraged families not to keep it a secret from their child that they had been donor conceived.   Even today, this can still be a challenging concept for some families, but at that stage it was still really quite a new way to consider donor conception.  This particular session was more than just challenging though, as it is one of only 2 times in my 20 years as a psychologist that I have felt physically threatened by a client. 1 minute we were calmly discussing the intention of this couple to become parents, and the next minute, the potential father had crossed the room with his fist raised and a pretty clear threat to physically assault me unless I stopped talking about open donation.  In that moment, I was pretty angry, but also pretty shaken. I was doing my job and trying to represent the literature around donor disclosure, as I understood it. I was trying to follow the counselling guidelines at the time, as presented by my professional association (ANZICA).  I was genuinely trying to present information that I believed would help that couple and their eventual child manage a successful donor conception.  And as a result I had been threatened and bullied in a way I have rarely experienced.  Afterwards, I spent considerable time wondering whether what I had said was offensive or wrong, but at the end of the day I knew I not said anything different to any other donor session.  Still, my confidence in providing an opinion, based on more than just personal belief, but also research literature and professional treatment guidelines, was disturbed and for some time I was somewhat hesitant in assertively stating what I believed to be right.

I finally got some relief from stress associated with that incident about 18 months ago when I was sitting in a professional development workshop for fertility counsellors, listening to a presentation by two eloquent and unpresuming young women.  They were both in their late 20s and had both been donor conceived.  Neither had discovered that they were donor conceived in particularly positive or affirming ways (and one of them had only found out about her donor conception a couple of years previously).  Both of them firmly delivered the same clear message.  They wished that they had known they were donor conceived when they were young, and that the information had been presented to them clearly and calmly, with opportunity for them to openly ask questions (and received answers) about the circumstances surrounding their conception.  They asked the counsellors present to advise donor recipient parents to be open, to disclose the donor conception to the child, and to tell them early.  It was one of the most powerful presentations I have ever attended and I was incredibly grateful to these 2 women for telling their stories.  I frequently refer to them now when I undertake donor counselling sessions.  When I travelled recently on my Fellowship I became keenly aware that open donation is still not the norm in most countries, and the idea that donor conceived children should receive information about their donation and the donor is still not the message being communicated everywhere.  However, I did also notice that there is increasing interest in the idea, and an increasing awareness of the benefits of donor disclosure.  It has been an interesting journey swimming against the tide of “hiding” donor conception, and some still defensively oppose the idea.

This week I experienced another incident that reminded me of that counselling session 12 years ago, but this time the “attack” came online.  I expressed an opinion about the 55 year old UK woman who recently had triplets, and indicated that there should be treatment limits regarding the maximum age at which a person should be assisted to becoming a parent.  I expressed an opinion that being delivered to a significantly older parent might present challenges to a child.  I received a comment to the blog which initially appeared to provide the opportunity for an interesting discussion on the topic, but this unfortunately quickly deteriorated into a series of comments which seem to make a great deal of assumptions about myself and my opinions.  This distressed me greatly, and again left me wondering about whether I have said something that is inappropriate.  I would like to apologise to anyone who was offended by my opinion, as offence was certainly not my intention, and I do understand that we all address our fertility at different times and in different ways.  There are many many reasons that parenthood is delayed, and very often it is not choice.

However I still believe that I have a right to make statements based on my professional knowledge and experience.  I have not been able to find clear evidence about the impact for children whose parents were in their mid to late 50s at time of delivery, and I suspect this is because the technology that permits this is so new.  I can however make some assumptions about the impact of ageing parents on young children based on other evidence.  I don’t see it as a massive stretch to assume that most children would benefit from having healthy active parents as they reach their teens and twenties.  I do understand that we are ageing better, but we haven’t quite mastered immortality yet (and in fact, I genuinely hope we never do).

I do firmly take the view that just because we can, doesn’t mean we always should. There are many advances that science would allow, but ethical questions hold us back.  Do I believe that the litmus test for becoming a parent should be the person’s biological limits – no I don’t.  If this were my belief I would struggle to support any type of fertility treatment, regardless of infertility diagnosis, gender or sexuality.  However, I do absolutely think that we need to have considered discussions, based on evidence, about what is best for children (even those who haven’t been born yet) and set some standards for what treatment is permitted, and which treatment is withheld.    Perhaps the standards will change over time (just like they have with anonymous donor conception). Another reality that became extremely clear to me during my research that even when standards are set, some will ignore them.  Regardless, I still do think the standards should be there.

I am well aware that anyone trying to provide a point will find some research somewhere that provides their argument, but I will put this here regardless.  On the issue of older parents,  I note a paper published this week which discusses the potential benefits of parenting when older, (although I am unable to ascertain if this applies to significantly older parents (in their mid-late 50s at time of baby’s birth) as the oldest age group included in the study is identified as being 45+ years).  You can find the paper at http://onlinelibrary.wiley.com/enhanced/doi/10.1111/j.1728-4457.2016.00105.x/

Interestingly, many localities still make it extremely difficult for same sex couple to have their families with the help of third party reproduction, but another study published this week argues clearly in support of same sex parenting, reporting very clearly that households with same sex parents demonstrate no negative impacts on parenting. That article can be found at http://journals.lww.com/jrnldbp/Fulltext/2016/04000/Same_Sex_and_Different_Sex_Parent_Households_and.1.aspx

I will curious to hear if anyone else expresses (or is confident enough to express) an opinion on the subject, and I am really sad to find out (firsthand) that expressing an opinion really can lead to such aggressive responses, rather than respectful discussion.  More importantly,  I will be curious to watch the emerging evidence about the benefits and negative impacts of very late parenting on families.  I wonder if I will have a chance one day to listen to the opinion of a young person talk about what the experience of growing up with very old parents was like for them.  I hope they prove me and my opinions wrong.

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