Donors: curious connections in donor conception

This is an important book in the field of studying reproduction and health, and a timely response to the social changes following the policy shift that abolished the anonymity of gamete donors. Many scholars have been looking at relevant issues, mostly in relation to donor-recipient people, yet less attention has been paid to donors and their families. Petra Nordqvist and Leah Gilman examine gamete donors’ experiences from a relational perspective.

Donors: Curious Connections in Donor Conception aims to explore the effects of changes in the legal, social, cultural, and technological context at this specific historical moment on people who have been or are considering becoming gamete (sperm or ovum) donors and how they make sense of the connections with the donor-conceived children and the families. The shift from donor anonymity to traceability in the UK, which began in 2005, signifies a great transition from secrecy to openness in terms of the identity of people who donate sperm and ova. This regulatory change is the response to donor-conceived people’s campaign for openness and the right for them to contact donors after they reach the age of 18 (p. 16). It has resulted in a new protocol for clinical practice in reproductive medicine and reflects wider sociocultural changes. By depicting donors’ lived experiences, Donors explains “the broader shift in donor conception practices and cultures” as the consent donor policy enacted and, at the same time, the emerging use of the Internet and social media to perform informal donation (p. 211). Thus, Donors examins both people who participate in donations in clinics, and those who donate informally, who are already acquainted with recipient parents. By looking at various donations, Donors captures how people perceive donation differently through investigating donors’ experiences as well as their relationships and their personal lives.

With the expansion of reproductive gamete donation in the UK and worldwide, increasing research interests have been addressed around recipients, including recipient parents and donor-conceived children. However, there is a shortage of scholarly literature on the donor families and their relationships, especially research conducted via qualitative approaches, which can give a more in-depth understanding of how donation decisions shape donors’ lives and those with whom they share connections. Methodologically, Petra Nordqvist and Leah Gilman explore gamete donors’ experiences from a relational perspective and employ the personal life approach in sociology,¹ to explore how social policies impact on people’s perceptions of connectedness. Donors sees gamete donation as a reflection of practices and relatedness negotiations, as well as a response to shifting social and political agendas.

In the Introduction, the authors begin with the story of a sperm donor, Zak, to bring out the pressing questions: What does it mean to be a donor? (p. 1) How does that affect the donor, and their families and other relevant relationships in their lives? (p. 2) Chapter 1 begins by describing the historical context of the legal changes in terms of the birth of “identity-release policies” in the UK. This research, on which Donors is based, applied qualitative sociological methods by conducting 52 interviews with both sperm and ovum donors, 23 donor relatives, and medical professionals and counsellors helping the donation process from 2017 to 2021 (p. 11, p. 233). By tacitly focusing on 10 stories selected from the interviews, Chapter 2 elaborates on the meanings of different donations in terms of anonymity or openness of identity from lived experiences, rather than static categories often defined inside clinics and labelled on the donors. Donors suggests replacing typologies of donations with a more dynamic concept of “pathways”: identity-release pathways, known donors, and anonymous. While “most of the donors are linked closely to one donation pathway; some did not neatly follow any one of the particular pathways” (p. 57). Therefore, breaking down the typologies can facilitate the understanding of donation experiences and perceptions.

Chapter 3 concentrates on how legal changes impacted the meanings of being a donor, which are also embedded in the sociocultural context, as people make sense of their “local moral worlds”² by referring to the social and cultural norms. Donors explores the tension between an individual’s empowerment and relationality in the context of current legislation that limits initiating contact to donor-conceived offspring only. Nordqvist and Gilman also consider the concept “making parents” suggested by Thompson³ and examine the morals of “good donors” to argue that “sperm and egg donation is framed as an action that both ‘makes parents’ and ‘makes people’” (p. 12). Chapter 4 delves into “the negotiation process” with both recipient families and donors’ families by looking at the moral aspect of donation practices. Donors developed a neutral and responsive position in relation to the role they played, which is that they are expected to be available for potential contacts but also to know their place.

The concept of “negotiated relationships”⁴ is a way to understand that interpersonal connections are not merely decided by a single framework, for example, the biogenetic link. Rather, relatedness and kinship are created and reproduced through constant negotiation. Chapter 5 goes deeper into the sensory affinities of the connections with recipients and their families from the donors’ perspective. Instead of looking at the donor-recipient connection through rose-tinted spectacles, the authors examine the multidimensional sensations of being a donor and recipient by proposing that “affinities can be moving, magical, exhilarating, and joyous, but also, by the same token, profoundly ruinous, detrimental, and even devastating” (p. 144). Chapter 6 turns to the impacts on donors’ relationships with others by focusing particularly on their families, which successfully tells the other side of the story in gamete donation by illustrating how donors and their families live and understanding where they come from and the way they connect (p. 29).

In conclusion, the book’s findings are, first, the use of the relational approach to explore donors and their lifeworld, in which Nordqvist and Gilman argue that donation is shaped by the inter-relationships with others in their personal everyday lives. Second, this book suggests employing the concept of “affinities” as a research lens rather than the assumed genetic framework to understand people’s interpersonal connections. Third, the authors review the impacts of the current policy on donor openness through empirical data collection and analysis to suggest that the policy might be trapped by the pitfall of interpreting donation as a binary – either secrecy or openness. Lastly, Donors suggests that UK governance and policies should depend not only on the premise of donor-conceived people's experiences but also on those of the donors.

The aim of this book is to provide a conceptual tool to re-examine the current circumstance, that is, a relational approach that delves into the connections of the donors and their families as well as donor-conceived children and their families. Donors not only successfully captures the donors' experiences, perceptions, and feelings within broader cultural and legal changes, but also balances the analysis on different gender roles in reproduction: sperm and ovum donation, recipient mothers and fathers, and same-sex couples, which gives a diverse and vivid picture of the donation landscape in the UK. Although Donors exclusively looks at gamete donation in the UK context, it also brings insights to lawmakers and reproductive practitioners in other countries, considering its careful examination of the distinctive legal transition of donor policies and its in-depth elaboration on the lived experiences of people who have been making families and helping others make families under this legal circumstance. This is an important and timely book that reviews UK donor policies and depicts the lived experiences of donors and their significant others, who negotiated, contemplated, and acted on the decision of gamete donation.

Acknowledgements

I am grateful to Professor Sarah Franklin and Dr Marcin Smietana for helpful comments on early drafts and to Cambridge Trust & the Ministry of Education Taiwan for offering Taiwan Cambridge Scholarship.