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What children understand about family-building and when they understand it

Developmental Tasks for Children Conceived Through Third-Party Assistance

Important tasks for all children conceived through donor egg, sperm, or embryos include the need to integrate their growing understanding of donor conception into their evolving sense of:

-Personal identity;
-How people grow, develop, and become who they are;
-What makes a family; and
-The meaning and significance of the donor

A Child's Developmental Stages

Three to Five
At ages three to five, children have a built-in enthusiasm for learning about the world around them, including where babies come from. Although children at this age won't be able to fully understand the concept, this can be a good time to introduce donor conception so that your child becomes familiar with the language and vocabulary you choose to use and begins to understand basic concepts, such as how loved and wanted they were and that there was help involved.

Five to Seven
At ages five to seven, there is an increased complexity in thinking and children can begin to tell the difference between fantasy and reality. Whereas at younger ages, some parents create their own “fairy tale” versions of the story of embryo donation, by this age, it may be important to use more accurate language and vocabulary in talking about “egg, sperm, embryo, and uterus.” At this stage, children may begin comparing how people and things are the same or different.

For children in single-parent or same-sex families, there may be more questions and comparisons about one's own family composition with that of other families. It is at this age that a more authentic understanding about donor conception will begin and, with it, typically more questions and curiosity. The questions at this stage may be more simplistic, such as “What did she look like?” or “Was she nice?”

Eight and Nine
A big leap in brain development happens in children around the age of eight or nine that leads to an increased understanding of the world and relationships between things. One result of this change is that at this age donor-conceived children are likely to be able to understand donor conception and genetics in more sophisticated ways.

The questions children ask at this age may reflect this (i.e. “Would I be different if I came from a different egg or embryo?”). At this stage, donor-conceived children may experience and absorb more fully the meaning of donor conception in terms of not being genetically connected to one or both parents. This can result in feelings of sadness as one realizes that one is not genetically connected to a much-loved parent.

It is important to note that for boys in particular, this thinking can be fairly simplistic and literal, leading some to conceptualize the donor in terms of a parent. This is not because they would equate the role of the donor with the significance of the emotional relationship they have with the person who loves, cares for, nurtures, and parents them. Rather, it is more a product of their concrete thinking. They simply don't know any other place to fit their new understanding of the significance of the donor's contribution. This typically changes as boys mature and take on the more complex thinking that is characteristic of later adolescence.

Ten to Eleven
At ages ten to eleven, girls make a leap in physical and social development, typically leaving boys behind. Cognitively, too, they are ahead of boys and, therefore, are more likely to be asking questions about donor conception. Parents may notice an increased tendency for their children to seek privacy and time alone, as well as a tendency to challenge parents instead of cooperate as they might have done one or two years earlier.

Self-consciousness also develops at this age, along with a reluctance to talk outside the family about anything that makes them different or sets them apart. Boys seem more sensitive than girls about being seen as different. Depending on the child and how the topic has been handled, there may be a renewed interested in the topic of donor conception with some donor-conceived children (primarily girls) desiring contact with other donor-conceived children and other children (often boys) being completed disinterested in such discussions.

As a parent of a child conceived through third party-assistance, it is easy to be particularly sensitive to challenges to parental status and authority that can happen in adolescence. Many parents who have used donor assistance live in fear of the phrase “You're not my real parent anyway...” While this sentiment may be relatively uncommon, it is expressed by some donor-conceived children, sometimes not until adolescence but sometimes earlier.

This comment may occur in a moment of frustration and anger when a child uses the first weapon that comes to mind to hurt the parent (i.e. “I don't have to listen to you, you're not my real parent anyway”). At other times, it may be an expression of sadness as a child more fully absorbs the meaning of donor conception and that he/she is not genetically connected to a much loved parent (i.e. “I wish you were my donor mother”).

In the case of this being expressed while angry, the best response is to help our children distinguish between family building issues and regular developmental issues. When we respond: “You know that if you have questions about how our family was created, we are always available to talk about it. However, right now you need to get back in your room and clean it (or whatever the conflict was about), which is what I asked you to do.”

First, last, and always we are the parenting parents. When our children see that the angry outburst did not result in him or her getting what she wanted, she will never use it again. Welcome the opportunity to once more reassure your child that you are a family like all others—and with differences.

Britta Dinsmore earned her doctorate in counseling psychology from the University of Oregon in 1998. She has been licensed as a psychologist in the State of Oregon since 1999 and maintains a private practice as well as serves as a psychological consultant to Oregon Reproductive Medicine.

Dr. Dinsmore provides individual and couples counseling for patients experiencing fertility challenges, assisted family-building decisions, and pregnancy loss. Additionally, Dr. Dinsmore provides psychological evaluations of egg donor and gestational carrier candidates. A particular area of interest and expertise for Dr. Dinsmore is contact between parties involved in third-party assistance.

Dr. Dinsmore is a member of the American Society for Reproductive Medicine's Mental Health Professional's Group and also has served as a mental health advisor to PVED. Currently, Dr. Dinsmore serves on PVED's executive board as the organization's Director of Mental Health. Dr. Dinsmore is also the mother of a ten-year-old son conceived through egg donation.

Dr. Dinsmore may be reached via brittadinsmore@comcast.net or her website, www.brittadinsmore.com


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