Acknowledgments
In August 2017, I was walking in Holyrood Park with Tom, an old pal from graduate school. I was recently tenured and Tom was just about to come up (reader: he got it). While walking under the Salisbury Crags, we reflected on our work to that point in our careers. We both agreed that neither of us had a book in us. After our walk, we met up with Jenn—another old pal from grad school—who asked me what I was working on. I told them about a paper I had just started about the ethics of anonymous gamete donation. As the conversation got going—about the nature of parenthood, about why people care about their genetic lineage, about why people donate their gametes—it became clear to me that everything I wanted to say was too big for a single paper. By the end of the evening, I realized I had a book in me. Now it is out of me and in your hands . . . which sounds grosser than I intend.
I am profoundly grateful to the many people who have helped me to write this book. A good portion of my thinking on these matters has been formed in dialogue with the fabulous students I get to teach every year at Carleton College in my “Family Values” first-year seminar. The heart of the book was conceived and written during my yearlong sabbatical as a visitor in the Philosophy Department at the University of Edinburgh with the support of a generous grant from the Bruce Carroll Memorial Fund. I could not have asked for a better setting in which to work on this project. Special thanks go to Guy Fletcher, Philip Cook, and Sarah Chan for inviting me to participate in the Ethics Workshop, the Political Theory Research Group, and the Mason Institute Work-in-Progress group, respectively. Debbie Roberts and, once again, Guy Fletcher were constant companions—philosophical and otherwise—during my time in Edinburgh. I love talking to them about my work and theirs, and I look forward to welcoming them for their sabbatical to Northfield, Minnesota.
I am grateful to audiences at Warwick University and Umeå University as well as to Thomas Lockhart, Kalle Grill, Anca Gheuas, Jason Hanna, and anonymous reviewers for Oxford University Press (OUP) and the Journal of Medicine and Philosophy for providing valuable feedback on draft chapters. Thanks as well to Walter Martin for permission to use a verse from his
song Hey Sister! in chapter 4 and the Journal of Medicine and Philosophy for allowing me to include material from my paper “Well-Being, Gamete Donation, and Genetic Knowledge: The Significant Interest View” in chapter 3. Jason Decker is my go-to philosophy conversation partner and has discussed many of the ideas in this book over many a pint of high quality beer (for him) and low quality beer (for me). Micah Lott and Jenn Lockhart have been fantastic writing partners these past few years and gave characteristically excellent comments on multiple chapters. Ben Richardson read the entire final draft of the manuscript, catching numerous errors and offering very helpful substantive comments along the way.
I also benefited tremendously from two workshops devoted to the manuscript. The first, held at Oxford in May 2017 and organized by Jonathan Parry and Jessica Begon, brought together Liam Shields, Hallvard Lillehammer, Tim Fowler, and Anna Smajdor to offer comments on early drafts of three chapters. The second, held over Zoom in June 2020 and organized by Alice MacLachlan, brought together Alice, Carolyn McLeod, Samantha Brennan, Olivia Schumann, Andrée-Anne Cormier, and Emily Tilton to discuss a complete draft of the book. The final product was greatly improved by their feedback, with substantial parts of chapters 5 and 8 being utterly transformed for the better. The work required to complete the book was supported by the Hewlett Mellon & Dean’s Fellowship at Carleton College.
Susan Golombok, Wes Markofski, Liz Raleigh, and Douglas NeJaime passed along very helpful sources in response to my questions about the sociology and law of new family forms. Kim Decker helped me figure out how to decipher case law references. Kaethe Schwehn provided the hilarious list of common lies parents tell their children in chapter 2. John Appleby, who has considerably more expertise on philosophical issues in reproductive medicine than I do, provided excellent advice, various helpful resources, and a much-needed dose of encouragement at a key moment in the manuscript’s life. Ned Hall generously answered some questions I had about how to think about causal contribution of genetics to phenotypical traits.
A few people deserve more robust “Thanks.” Lisa Fedorak did a fabulous job putting together the index. Lucy Randall and Hannah Doyle at OUP helped a newbie navigate the process of writing a book, patiently answering questions I’ve been asking from the fall of 2017 to literally just a few minutes ago about various aspects of the book publishing process.
Kim Brownlee generously shared her book proposals with me to serve as a template for my own and then offered extremely helpful feedback on a draft of
my proposal. She also passed on her tremendously useful advice for writing, without which I probably would never have finished the book: “Write every day. Stop when it’s no longer fun.”
Rivka Weinberg read and commented on multiple drafts of multiple chapters. She also provided a model of philosophical writing, in the form of her own book, which gave me something to aspire to. Rivka’s writing makes me think and it makes me laugh, not infrequently at the same time. When trying to figure out how to formulate an idea, I often ask myself the question “WWRW?” (“What Would Rivka Write?”).
Dorothy MacKinnon is an extraordinary copy editor who has saved me countless painful hours of reading my own work and improved my writing along the way. She deserves a prize, which will come in the form of a complimentary book about the ethics of gamete donation.
Alice MacLachlan deserves special mention. Alice and I started talking philosophy in her dorm room at Pearson College in 1996 and haven’t stopped since. Alice’s fingerprints are on every idea in this book (including those she disagrees with). Alice read early drafts. Alice read late drafts. Portions of long text chains about bionormativity, parenting, gender, and genetic relatedness have been imported, whole cloth, into this book. Alice also very kindly let me choose a title for the book that is close to the title of her paper, “Conceiving Differently.” This book would look very different without her contributions.
I also want to thank Dan Hernandez. He didn’t actually do anything. But he has a good streak of being mentioned in the acknowledgments of friends’ books and I don’t want to break it.
I do not want to thank my children. Minutes after learning OUP gave me a contract, I picked up my then five-year-old son from school. On the drive home, I sighed loudly and said “Oh boy.”
“Why did you say “Oh boy?” my son asked.
“Well, I just found out the publisher wants to publish my book, which is exciting. But now it’s hitting me that I really need to write the whole thing and that’s stressful. But I can do it.”
I suggested we start up a chant of “Dad, you can do it! Dad, you can do it!” But, sensing an opportunity to aggravate me, he immediately started chanting, “Dad can’t do it! Dad can’t do it!” Then, in case the knife wasn’t in far enough, he started chanting, “It is too hard! It is too hard!”
As for my eleven-year-old daughter, we had the following exchange about the book this summer:
“Are you still writing your book?”
“Yes I am.”
“Really? I would have given up by now.”
By way of revenge, let me reveal a secret in these pages knowing that my kids are unlikely to read them for many years, if at all. In February 2020, in the depths of Minnesota winter, when it looked like we might all be locked down for a good long time, we decided to buy a Nintendo Switch for the children just in case we found ourselves cooped up together for weeks or even months on end. The plan was to bring out the Switch only if things got desperate (not out of any sense of parenting virtue, but to avoid having to put the genie back in the bottle post-pandemic). The Switch is still sitting in the closet, untouched. The children live in total ignorance of its existence. Until now. THERE WAS A NINTENDO SWITCH IN THE CLOSET CHILDREN! YOU HAD NO IDEA! Also, I love you both very much.
Finally: Emily Carroll. The original draft of this acknowledgment had a loving paragraph right here about all the help and encouragement you’ve provided me while writing the book. I sent it to you. You wrote back with one word: “BORING.” And then you encouraged me to say something about farts. And then you said: “I’m too lowbrow for dedications. I didn’t even put in any in my Doctorate of Nursing Practice Thesis. NONE. I didn’t thank any of you fools.” Well, this fool thanks you.
The
Central Question
Here is a picture of my parents:
The author’s parents
What does it mean to you when I say, “These are my parents”? What would you want to know in order to figure out whether they are, in fact, my parents? Whether they are my genetic progenitors? Whether the woman on the right gestated me? Whether they raised me?
We all know that the relationships captured by these questions—the genetic relationship, the gestational relationship, and the social relationship— can come apart. Some children’s social parents are also their genetic parents, though they were gestated by someone to whom they bear no genetic relation. Some children’s social parents are neither their genetic nor their gestational parents. Some children are genetically related to, and gestated by, one of their social parents but not the other. And some children were gestated by one social parent, but are genetically related only to the other.
This book is about the ethics of intentionally creating children for whom the social and the genetic relationship are separate, either altogether or in part. This is what happens when children are created via donor conception. In donor conception, someone “donates”1 their gametes—either sperm or eggs—to a person, or people, who want children but require genetic material from other people.
Each year, tens of thousands of children are conceived with donated sperm or eggs.2 By some estimates, there are over 1 million donor-conceived people in the United States and many more the world over. Anonymous gamete donation—where the identity of the donor is never intended to be made available to the donor-conceived person—is prohibited in places like the UK and Sweden. In these countries, donor-conceived people may learn the identity of their donor when they turn 18. In other countries, such as the United States and Canada, anonymous gamete donation is not only allowed, but also widely practiced.3 The children created from anonymously donated gametes may never know who one of their genetic parents is.4
Is this a problem? If so, why? And if not, why not? These questions are profoundly important to the millions of people who are part of the donor conception community. This community includes not just donor-conceived
1 This term is not entirely apt for reasons I’ll come to soon.
2 Most commonly donated sperm, less commonly donated eggs, and even less commonly donated sperm and eggs, i.e. “double donation.”
3 For a helpful table that shows the current rules surrounding gamete donation in various countries, see Ariana Eunjung Cha, “Her 44 Siblings Were Conceived with One Donor’s Sperm: Here’s How It Was Possible,” Washington Post, September 12, 2018, https://www.washingtonpost.com/ graphics/2018/health/44-donor-siblings-and-counting/.
4 Or parents in the case of double donation.
people, but also their parents, gamete donors, and an entire segment of the fertility industry that acquires and provides donated gametes to intended parents, often for profit.
But the ethical significance of conceiving children with donated gametes extends well beyond the donor conception community. You cannot think about the ethics of donor conception without confronting questions that matter to everyone: What is the significance of genetic relatedness? What makes someone a parent? What obligations do parents have to their children?
These questions matter to you even if your family situation—as a child or a parent—is utterly stereotypical, conforming to the “traditional” conception of the family as consisting of a mother, a father, and children that are genetic offspring. Everyone has views—however implicit—about what it means to be a parent, about the nature of family-relatedness, about what kinds of things parents should (and should not) do for their children. You might well go through life without ever thinking about, let alone forming views on, the pros and cons of using flatwound strings on an electric guitar. But it is impossible to navigate our world, given the kinds of creatures we are, without having some views about the nature of parents and families, even if they never come to the surface for critical scrutiny. The practice of donor conception provides a vivid occasion to think about the nature of the relationships that are a central part of everybody’s life.
1. What this book is and isn’t about
Donor conception has changed a lot in the past 60 years or so. Back in the “bad old days,” donor conception was something of an ad hoc affair: a couple (and it was always a heterosexual couple) who could not conceive on their own would find a doctor who would secure donor gametes for insemination. Sometimes those gametes came from the doctor himself.5 Sometimes it was from a friend
5 And, indeed, this still happens with shocking frequency. The big difference these days is that the doctors are doing something entirely deceptive and illegal since the intended parents believe the gametes are coming from a donor they have chosen. See CBC News, “Fertility Doctor Implanted Own Sperm in Clients 11 Times, Lawsuit Alleges,” April 5, 2018, https://www.cbc.ca/news/canada/ottawa/ fertility-doctor-own-sperm-11-times-1.4606814; Jacqueline Mroz, “Their Mothers Chose Donor Sperm: The Doctors Used Their Own,” New York Times, August 21, 2019, https://www.nytimes.com/ 2019/08/21/health/sperm-donors-fraud-doctors.html; Christopher F. Schuetze, “Dutch Fertility Doctor Swapped Donors’ Sperm with His, Lawsuit Claims,” New York Times, May 15, 2017, https:// www.nytimes.com/2017/05/15/world/europe/dutch-fertility-doctor-swapped-donors-sperm-withhis-lawsuit-claims.html
or acquaintance. The intended parents basically had no choices when it came to who their donor was and little or no descriptive information about him6 what he looked like, his level of education, his medical history, etc. Donor conception was essentially “off the books.” The law didn’t recognize the possibility of someone donating gametes but having no legal rights or responsibilities with respect to the resulting child, and so records were either not kept in the first place or not kept for very long. The donor was assured anonymity in the sense that it was simply understood that his identity would never be discovered.
Typical donor conception looks very different today. It usually involves as least two transactions.7 When it comes to conceiving with donated sperm, a sperm bank first acquires sperm from a donor (in the United States, for example, donors are paid; in Canada they are not). Second, that sperm is sold to (an) intended parent(s) who can either use the sperm themselves without a fertility clinic8 or do in vitro fertilization through a fertility clinic. According to Naomi Cahn, there are currently more than 150 sperm banks in the United States and “they can ship frozen sperm anywhere.”9 A vial of sperm can cost as little as $350.
Egg donation is a different kettle of fish. As Cahn notes:
Buying donor eggs is more difficult, and more expensive. Until recently, there were relatively few egg brokers, and eggs had to be fresh. With new technology allowing for the successful freezing of eggs, and with increasing demand, there are growing numbers of egg sellers. But, unlike sperm, donor eggs require the use of a fertility clinic and a cycle of in vitro fertilization.10
Intended parents have a lot of options when it comes to choosing a donor. They can filter donors by race, education level, eye color, hair color, or hobbies. The California Cryobank allows you to choose donors on the basis of their resemblance to celebrities like Ben Affleck or Brett Favre.11
6 And it was always a “him.” Egg donation only became possible in the 1980s.
7 Naomi R. Cahn, The New Kinship: Constructing Donor-Conceived Families (New York: NYU Press, 2013), 44.
8 By using what is known as the Turkey Baster Method. CoParents, “Artificial Insemination: The Turkey Baster Method,” accessed August 2, 2020, https://www.coparents.com/blog/the-turkeybaster-method-what-is-it-and-how-to-perform-it/.
9 Cahn, The New Kinship, 19.
10 Cahn, The New Kinship, 19.
11 From Cahn: “Through the trademarked ‘CCB Donor Look-a-Likes’ program, prospective purchasers can click on a link that will take them to photos of two or three celebrities whom the staff has decided are the closest matches to the donor.” Cahn, The New Kinship, 52.
Offering intended parents these kinds of choices raises serious questions about donor conception: Is it ethical for people to buy and sell gametes in the first place? What kind of medical screening should be in place for potential donors? How many offspring should it be permissible to create from one donor? To what extent should intended parents have a say about the genetic features of the donor they choose? What does it even mean for donated gametes to have a “race,” and how does the practice of “racing” gametes connect to, and further entrench, problematic notions of race, kinship, and relatedness?12
These are all important questions. But I don’t address them in this book. Instead, my focus is on what I will call the central question that confronts many people who plan to conceive with donated gametes, namely: Should they use an anonymous donor or not?
Of course, calling this the central question presumes that conceiving children with donated gametes is permissible in the first place. Not everyone thinks it is. Anti-natalists think that all procreation is impermissible and so will object to donor conception just because it is a form of procreation. I do not take on anti-natalist arguments at all in this book.13
But there are others who, while not opposed to procreation in general, are opposed to donor conception because of how it relates (problematically in their view) to parental responsibility14 or healthy identity-determination.15 I do discuss those views in this book. But I do not attempt to first show that donor conception is permissible and only then turn to the central question. Rather, my responses to these kinds of views emerge in my answers to the central question.
My project, then, begins in medias res: it proceeds from the fact that donor conception is, and will continue to be, widely practiced. And it turns an
12 Camisha A. Russell, The Assisted Reproduction of Race (Bloomington: Indiana University Press, 2018).
13 There is a distinction between what we might call “in-principle anti-natalists” and “in-practice anti-natalists.” In-principle anti-natalists, like David Benatar and Seana Shiffrin, object to procreation as such because of its intrinsic structural features (though Shiffrin’s brand of anti-natalism is less demanding, I think, than Benatar’s). In-practice anti-natalists object to procreation given contingent facts about the world (such as, for instance, the fact that there are many existing children that need parents). See Tina Rulli, “Preferring a Genetically-Related Child,” Journal of Moral Philosophy 13, no. 6 (2016): 669–98; David Benatar, Better Never to Have Been: The Harm of Coming into Existence (Oxford: Oxford University Press, 2008); Seana Valentine Shiffrin, “Wrongful Life, Procreative Responsibility, and the Significance of Harm,” Legal Theory 5, no. 2 (1999): 117–48.
14 Rivka Weinberg, The Risk of a Lifetime: How, When, and Why Procreation May Be Permissible (New York: Oxford University Press, 2016), chapter 2.
15 J. David Velleman, “The Gift of Life,” Philosophy & Public Affairs 36, no. 3 (2008): 245–66; J. David Velleman, “Family History,” Philosophical Papers 34, no. 3 (2005): 357–78.
interrogative eye on how it should proceed with respect to the issue of donor anonymity.
2. Getting clear on terms
My answer to the central question is this: intended parents who plan to conceive with donated gametes should, generally speaking, use a donor whose identity will be made available to the resulting child. This is, roughly, because doing so puts their child in a good position to satisfy the child’s likely future interest in knowing who their donor is. I say more about how this argument unfolds later in the chapter. For now, though, I want to explain how I’ll be using five key terms that appear throughout the book: “donor,” “genetic knowledge,” “anonymous donor,” “open donor,” and “known donor.”
2.1. Donor
Before discussing the different kinds of gamete donors, I want to highlight how inapt the term “donor” is to describe many people who provide gametes to others. As we’ve already seen, many donors (like those in the United States) are paid for their services. When someone is compensated for providing some good, we don’t usually say they’ve donated it. There are interesting and important questions about why gamete providers are usually called “donors” rather than, for example, “sellers.”16 Nonetheless, I stick with the language of “donors” for two reasons.
First, there really are gamete donors, people who provide gametes for no compensation. I could distinguish these (genuine) donors from the sellers. Alternatively, I could use the term “gamete providers,” but I worry that this would make people think of sperm and egg clinics rather than the people providing their gametes. This leads me to my second reason for sticking with the term “donor”: it is so widespread that I fear using any other term will just invite confusion, particularly given that basically all my sources use the term. So: “donor” it is.
16 Cahn remarks that the “donor world is characterized by a vocabulary that serves as a cultural clue (and cue) to our interpretation and understanding of these new families.” Cahn, The New Kinship, 7.
2.2. Genetic knowledge
People who carry the BRCA 1 or 2 gene mutation are highly susceptible to developing breast cancer. Suppose you learn that you have the mutation. You have learned something about your genetic makeup. It makes a lot of sense to call the kind of knowledge you have acquired “genetic knowledge.” Someone who has his entire genome sequenced (and is in a position to understand the results) has a lot of genetic knowledge.
This is not how I will use the term “genetic knowledge.” When I talk about “genetic knowledge” I mean to refer to knowledge of who one’s genetic progenitors are. In other words, the person who is seeking genetic knowledge, as I shall use the term, wants to know who her genetic parents are. Now, what it means to know who someone is—i.e. their identity—is a thornier issue than it appears. Knowing a person’s name isn’t enough. And sometimes, neither is knowing a lot about a person or even being acquainted with them (“I just had a great conversation with someone, but I don’t know who he is!”). Conversely, you can know who someone is without knowing much of anything about them or without ever having met them.
My guess is that the variety of ways we talk about “knowing who someone is” is not amenable to a unified account. But for my purposes we can rely on an intuitive conception of what it means for a donor-conceived person to know who her donor is. Someone who knows her donor only by the donor number does not know who her donor is (even if she has a decent amount of information about the donor). Contrariwise, someone who knows her donor’s name and has enough information to fairly reliably pick him out or track him down knows who her donor is. This person could, as it were, point to the donor were he in front of her and say, “That’s him.” This person has genetic knowledge as I shall be using the term.
Notice that my conception of having genetic knowledge falls short of another way we might understand what it means to know who one’s genetic parents are: having a relationship with them or, more minimally, being acquainted with them.17 Someone could have genetic knowledge as I use the term without ever meeting their donor.
17 This is the kind of genetic knowledge that really matters for Velleman. Velleman, “Family History.”
So we have three senses of “genetic knowledge” on the table (with my usage in boldface):18
1. Medical genetic knowledge: knowledge of one’s genome, particular genetic traits, etc. (in the language of genomics).
2. Progenitor genetic knowledge: knowledge of who one’s genetic progenitors are.
3. Relationship genetic knowledge: being in a relationship with one’s genetic parents.
My focus in this book is on the second kind of genetic knowledge. I will argue that intended parents should put their donor-conceived child in a position to acquire genetic knowledge. In other words, they should put their child in a position to know who their genetic progenitor is.
There are connections between the three kinds of genetic knowledge I’ve identified. Someone might want progenitor genetic knowledge or relationship genetic knowledge as a means of gaining valuable medical genetic knowledge. Or someone might want medical genetic knowledge as a means of gaining progenitor genetic knowledge, which, in turn, they might want in order to gain relationship genetic knowledge.
In light of these possible connections, you might think this: a plausible account of why intended parents should put their child in a position to acquire progenitor genetic knowledge will appeal to the value of having medical genetic knowledge or relationship genetic knowledge (or both). But that’s just not true. Donor-conceived people’s interest in acquiring progenitor genetic knowledge (when they have such an interest—not all do) usually goes well beyond an interest in having medical genetic knowledge, but usually falls short of an interest in relationship genetic knowledge. What they usually
18 There is a fourth kind of genetic knowledge, what I will call ancestral genetic knowledge, i.e. knowledge of one’s genetic ancestors. I say a little more about it, and why I will not be talking about it, presently. My three categories of genetic knowledge basically come from Vardit Ravitsky, “Knowing Where You Come From: The Rights of Donor-Conceived Individuals and the Meaning of Genetic Relatedness,” Minnesota Journal of Law, Science & Technology 11 (2010): 665. She refers to them as different “aspects” of the right to know one’s genetic origins: the medical aspect, the identity aspect, and the relational aspect (668). My categories depart a little from Ravitsky’s. Her “aspects” encompass the kind of knowledge being sought along with the reason for seeking it (e.g. “The identity aspect points towards the right to personal information about the donor as a person (narrative information) that would assist offspring in overcoming identity issues” (668, boldface added), whereas mine only include the former. Ravitsky also identifies a fourth aspect of the right to know, which she calls the “parental disclosure” aspect, which “relates to the right to know the truth about the circumstances of one’s conception” (668).
want to know is who their donor is for reasons that will then answer the question “Who am I?”19
This is why I do not argue that intended parents should put their child in a position to acquire relationship genetic knowledge. And it is also why I set aside purely medical or health-related rationales for why intended parents should use an open donor.20 Appeals to the value of these other kinds of genetic knowledge simply don’t reflect the experiences of most donorconceived people, either by not going far enough (medical genetic knowledge) or going too far (relationship genetic knowledge).
So my focus throughout is on progenitor genetic knowledge where, once again, that denotes knowledge of who their genetic parents are. This might strike some as a limited form of genetic knowledge, leaving out what we might call ancestral genetic knowledge, i.e. knowledge of one’s genetic lineage going back generations. My focus on progenitor genetic knowledge does not include whatever interest in ancestral genetic knowledge people might have.
There are two reasons for this. First, I think the primary locus of interest for donor-conceived people is knowing who their donor is (even though such knowledge may be a means to acquiring ancestral genetic knowledge). The second reason I focus on progenitor genetic knowledge is that I think there is a strong case for taking seriously a donor-conceived person’s interest in acquiring such knowledge. This is because the interest is rationally grounded. I argue in chapters 4 and 5 that it is responsive to something genuinely valuable and not merely a function of living in a bionormative society, i.e. a society that highly valorizes—and often misunderstands—the nature of genetic ties. I am less convinced that the same is true, generally speaking, of people’s interest in ancestral genetic knowledge. I will not try to defend that claim here. And, indeed, some of what I say in defense of the interest in acquiring progenitor genetic knowledge can be applied, wholly or in part, in defense of an interest in ancestral genetic knowledge. But I will not make that case, focusing instead on progenitor genetic knowledge.
From here on, I am just going to refer to progenitor genetic knowledge as “genetic knowledge.” I grant that shortening it in this way could be misleading, since talk of “genetic knowledge” naturally brings to mind medical genetic knowledge. But I’m sticking with the term “genetic knowledge” for
19 Just what counts as an answer to that question and why having progenitor genetic knowledge can help answer it is the topic of chapter 4.
20 I say more about why I’m setting aside the appeal to medical reasons below (p. 15).
what I’m interested in. The alternatives are either too clunky or no less ambiguous.21 So, I will use “genetic knowledge” to mean “knowledge of who your genetic progenitors are.” Don’t forget!
2.3. Anonymous, known, and open donors
Anonymous donors wish to remain unknown—at least at the time of donation—to any of their resulting genetic children.22 As a result, they donate on the condition that their identities and identifying-information will not be shared with any resulting children without their consent. Here is how NW Cryobank explains things in their FAQ for sperm donors:
After becoming a qualified sperm donor, you will be issued a donor number and you will only be identified by this number to anyone outside of the donor department. When you retire from the program, it is important that you do not forget your sperm donor number in case you should have questions or any other reason to contact us in the future.
We are obligated by mutual agreements to maintain the anonymity and privacy of all parties, including the donor, recipient, and all offspring resulting from anonymous donor insemination. However, if given mutual consent by the sperm donor and adult offspring, we will attempt to facilitate anonymous contact.23
Even if a donor is anonymous, a lot of information is often made available for intended parents—or indeed anyone—to peruse online. This information may include childhood photos, basic facts about appearance (height, eye color, hair color and texture), ethnicity, educational attainment (including areas of study), and a donor “essay” where they respond to prompts like
21 “Biological knowledge,” for example, is no less clear. In fact, it is less clear since the genetic relationship is not the only biological relationship present in procreation. A child born of a gestational surrogate might want to know who the surrogate was. This is a kind of biological knowledge. Alternatively, a child who results from an embryo with donated mitochondria might want to know who donated the mitochondria. This is also a kind of biological knowledge. I say a little below about what, if anything, my views about gamete donation mean for these other forms of non-traditional family-making (pp. 25–28).
22 My description of anonymous donation, open donation, and known donation in the following pages captures the overwhelming majority of gamete donation.
23 NW Cryobank, “Frequently Asked Questions about Using Donor Sperm,” accessed May 19, 2020, https://www.nwcryobank.com/donor-sperm-faqs/
“Why do you want to be a donor?” and “What is your philosophy of life?”24 You might also be able to see the Staff Impression of the donor’s personality and appearance (e.g. “Lips: Medium fullness to upper lip, full lower lip”). Once someone has selected a donor, even more information might become available. But if the donor is anonymous, no identifying information is made available.
It is important to note that “anonymous donor” is a normative category: someone is an anonymous donor in virtue of an understanding with the clinic that their identity ought to remain a secret. This means that even if a donor’s identity is discovered, he is still an anonymous donor inasmuch as he donated with the understanding that his identity would not be made available to the resulting child or be easily discoverable.25
Known donors are known to the intended parents and vice versa from the beginning of the donation process. This is usually because they are a close friend or relative (a brother or a sister, for example) of the intended parents.26 The child that results from a known donor’s gametes usually knows who the donor is and that that person is their donor from a young age.
Open donors typically donate to clinics, which sell the donor’s gametes to intended parents, with no input from the donor. Open donors do not know who the intended parents are and vice versa. What makes these donors open is that they agree to have their identities revealed to any child that results from their gametes at the child’s request when they turn 18 (or before if there is mutual agreement on the matter).27
24 Donor 254Z: “As Rocky Balboa says, ‘It’s not about how hard you hit. It’s about how hard you can get hit and keep moving forward, that’s how winning is done.’ ” “Donor Profile,” NW Cryobank, accessed January 12, 2021, https://www.nwcryobank.com/donor/.
25 This last caveat might make some wonder whether there really is such a thing as an anonymous donor in this age of cheap genetic kits and the internet. Perhaps we have reached the end of anonymity when it comes to gamete donation. I discuss this below (p. 12).
26 Having said that, there has been a considerable rise in the number of people using known donors that are known to them only through the process of trying to find a donor without the aid of clinics altogether. On the rise of donors who are “going direct to customers,” see Nellie Bowles, “The Sperm Kings Have a Problem: Too Much Demand,” New York Times, January 8, 2021, https://www.nytimes. com/2021/01/08/business/sperm-donors-facebook-groups.html.
27 These kinds of donors are sometimes called “identity-release” donors, although some clinics make a distinction between identity-release donors, who are willing to have their identity released, and open donors who have “agreed to a minimum of one communication with any offspring once he or she turns 18.” California Cryobank, “Donor Types,” accessed January 12, 2021, https://www. cryobank.com/how-it-works/donor-types/
3. The central question and the end of anonymity
With these explanations of keys terms in hand, we can make my central claim sharper: intended parents should use an open donor because doing so puts their child in a good position to satisfy the child’s likely future interest in progenitor genetic knowledge. But for reasons I’ve just explained, I’ll be sticking with the simpler formulation, which drops “progenitor”, throughout: parents should use an open donor because doing so puts their resulting child in a good position to satisfy the child’s likely future interest in having genetic knowledge 28
Some might wonder if, given various advances in genetic testing, anonymous donation is more or less a thing of the past. Remember that “anonymous donor” is a normative category. It picks out donors that reasonably expect their identities to remain unknown to their genetic offspring. But in this age of cheap genetic kits and the internet, can anyone reasonably expect that? Newspapers are rife with articles and advice columns about people who have used a commercially available genetic testing kit and discovered their genetic origins are not at all what they thought they were.29 The databases of genetic information being compiled by companies such as 23andMe are getting to the point where, “60% of the searches for individuals of European descent will result in a third-cousin or close match, which theoretically allows their identification using demographic identifiers.” In the “near future” these kinds of searches “could implicate nearly any U.S. individual of European descent.”30 So, we may be approaching the point where no one can reasonably expect their identity to remain secret and so no one is an anonymous donor.31
That might lead some people to think that there’s just no point in thinking about the ethics of anonymous versus open donation. But that’s not true for
28 This thesis makes a claim about using an open donor, not a known donor. That might seem strange since using a known donor puts a child in an even better position to acquire genetic knowledge. I explain why my thesis is about open donors below and then again in chapter 8, (pp. 25–28).
29 See, for example, Amy Dickinson, “Perspective: Ask Amy: DNA Testing Reveals Shocking Results,” Washington Post, February 13, 2018, https://www.washingtonpost.com/lifestyle/style/askamy-dna-testing-reveals-shocking-results/2018/02/13/54097586-076a-11e8-b48c-b07fea957bd5_ story.html; Jacqueline Mroz, “A Mother Learns the Identity of Her Child’s Grandmother: A Sperm Bank Threatens to Sue,” New York Times, February 16, 2019, https://www.nytimes.com/2019/02/ 16/health/sperm-donation-dna-testing.html; Dani Shapiro, Inheritance: A Memoir of Genealogy, Paternity, and Love (New York: Anchor, 2020).
30 Yaniv Erlich et al., “Identity Inference of Genomic Data Using Long-Range Familial Searches,” Science 362, no. 6415 (November 9, 2018): 690–94.
31 Susan Dominus, “Sperm Donors Can’t Stay Secret Anymore: Here’s What That Means,” New York Times, June 26, 2019, https://www.nytimes.com/2019/06/26/magazine/sperm-donor-questions. html
at least the following three reasons. First, even if anonymity could soon be a thing of the past, we’re not there yet. There are, then, pressing questions to ask about people who are currently planning to conceive with donated gametes and whose children might be part of a cohort that cannot, as a matter of fact, be confident that they will be able to identity their donor.
Second, even if anonymity becomes a thing of the past, there is a moral difference between parents actively putting their child in a position to acquire genetic knowledge (from someone who is willing to be identified) versus leaving it to the child to track down the information (from a donor who would rather have remained anonymous). If there are good reasons for a donor-conceived person to have access to genetic knowledge, then leaving it to them to track it down (from someone who didn’t volunteer to be identified) when their parents could have easily made it available puts the burden on the wrong person.
But are there good reasons for a donor-conceived person to have access to genetic knowledge? This question brings us to the third and most important reason the end of anonymity doesn’t render my project irrelevant: pointing out that anonymity is on the way out doesn’t shed any moral light. That is, it doesn’t tell us whether the infeasibility of anonymous donation should be welcomed or lamented. If it should be lamented, then we should consider whether there are policies that could protect or strengthen anonymity (where anonymous donation is still allowed). And perhaps the places where anonymous donation is not permitted should change course! On the other hand, if the end of anonymity is to be welcomed, then we should work toward policies that put the burden of making genetic knowledge available on intended parents and not on their children.
But asking whether we should welcome or lament the end of anonymity matters apart from possible practical ramifications. This is because the question demands that we scrutinize some of our most basic commitments about the nature of families and the ties that bind. As I said earlier, looking closely at the ethics of using an anonymous donor versus an open donor promises to shed light on issues that matter to us all.
4. Framing the issue
Not all intended parents can choose whether to use an anonymous or open donor. As we’ve already seen, some countries don’t permit anonymous
