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119 SIX Deciding Whether to Tell Children about Donor Insemination An Unresolved Question in the United States Gay Becker As many as one in eight married couples in the United States experience difficulty conceiving a child, leading more than one million women a year to seek infertility treatment (SART, 1998). Although inadequacies associated with sperm are causal or contributory to almost half of all infertility, there has been little if any effective treatment for male infertility until the 1990s. As a result, the artificial insemination of women with the sperm of donors who are usually anonymous has been widely practiced in many countries for almost half a century. It is estimated that as many as thirty thousand children a year have been conceived in this manner in the United States alone (Shenfield & Steele, 1997), resulting in the birth of as many as one million offspring since the 1950s. When male infertility is discovered and couples subsequently decide to use donor sperm to conceive a pregnancy, issues of biological continuity and stigma arise that affect the decision-making process about disclosure. Great significance is attached to genetic, or blood, relationships in the United States (Duster, 1990; Nelkin & Lindee, 1995; Schneider, 1980), where public approval for donor insemination (DI) is lower than for adoption or for other reproductive technologies that do not have third-party involvement (Klock, 1993). Moreover, there is apparently more stigma attached to male than to female infertility. The experience of stigma is de- fined as a negative sense of social difference from others that is so far outside the socially defined norm that it discredits and devalues the individual (Goffman, 1963). It has been found that men who have been identified as having an infertility factor experience greater stigma than men who do not and that the stigma attached to male infertility is much greater than that attached to female infertility (Nachtigall, Becker, & Wozny, 1992). Other research 120 GENDER AND BODY POLITICS has shown that higher guilt and blame levels are found among men who are themselves the infertile partner, when compared with men with infertile partners (van Balen & Trimbos-Kemper, 1994). Furthermore, there is less openness about infertility status in the case of male infertility (van Balen, Trimbos-Kemper, & Verdurmen, 1996). Based on research with couples who used donor insemination in Great Britain, Snowden, Mitchell, and Snowden (1983) suggested that the underlying impetus for nondisclosure is protection of the infertile husband’s feelings, as it avoids the risk of having the husband’s potency, virility, or masculinity come under suspicion. They also observed that infertility is often ascribed to women, regardless of its actual source, to protect men from the stigma of infertility. The stigma attached to male infertility thus reflects cultural attitudes about masculinity and male sexuality. Sexuality, conceptualized as part of gender (Butler, 1993; Grosz,1994; Ortner, 1996), is a moral domain (Foucault, 1986), and, as Howell (1997) notes, certain kinds of behavior are singled out for moral debates more than others, sexuality being one such arena. In a study of Great Britain’s Warnock Report, Haimes (1993) found that assumptions about gender were embedded in the report itself and affirmed in committee members’ interviews: semen donation was associated with “deviant” sexuality, while egg donation was associated with altruism. These characterizations symbolize deep-seated gender assumptions about what is natural—assumptions that became embedded in policy and lived out in practice. Following Douglas ’s (1966) observations about women’s bodies as the site of symbolic transgressions of social boundaries, it can be argued that the use of male donors to achieve a pregnancy in a woman’s body is a transgression of cultural rules about how children should be conceived. This practice challenges patriarchal concepts of what is natural for women and men and indicates the perceived threat to common understandings of the family, including sexuality within marriage, that the use of third parties engenders. Such societal views about women’s bodies and “appropriate” male and female sexuality are, therefore, central to decisions parents make about disclosure. Parents who use DI may view the decision not to disclose as one that protects them from the negative reactions of society, family, and friends, and it protects the child from being looked upon as different from others (Nachtigall, 1993). Although parents who decide not to disclose to their children often cite the principle of confidentiality (expressed as the social right to privacy, personal autonomy, and freedom from unwanted intrusion...

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