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How 'family' is being redefined for the modern world

Gee Roberts, a 23-year-old medical student in Exeter, England, is planning her wedding. Her mum and dad will be there, of course, and another important guest: Suzanne, her surrogate, the woman who gave birth to her in 1998.

"She's a really important person in my life, and she's a really important part of my family," says Roberts, who was one of the first few hundred babies to be born via modern surrogacy in the UK. When outsiders are confused about her parentage, she draws them a little family tree. To her, it's simple: "[There's] my mum, and then I've got my surrogate, and they're different people."

Surrogacy, which involves a woman carrying a child for another person or couple, is banned in its commercial form in Britain, but allowed as a non-profit arrangement. According to the organisation that facilitated Roberts' surrogacy, demand now far outstrips the number of willing surrogates. Data also shows the number of people using fertility treatments with surrogates has jumped by as much as 22% in a year. Some, like Roberts' parents, come to it after struggling with infertility. For others, such as gay couples, it is one of the few routes to parenthood, alongside adoption.

Like every new family form that emerged in recent decades, surrogacy has caused much controversy – including over the potential psychological impact on the children born of it. That discomfort around new types of family is partly linked to a sense of uncertainty. Whether created with the help of new technologies or thanks to social change, these families often face the accusation that they are risking the wellbeing of future generations. After all, if no one has ever conceived or raised a child this way before, then how can we possibly predict the consequences?

In reality, we know far more about new family forms than is often assumed. For a start, many once-pioneering families now span several generations, and have vital lessons to share. In addition, while each family is different, researchers have uncovered certain patterns which appear to apply to all families – including, possibly, ones currently unknown.

As a result, we have a surprisingly detailed picture of families that were once seen as niche, but that are going to define the 21st Century. After all, unconventional parenthood is on the rise. Same-sex couples make up an increasingly large share of adoptive parents, and the use of donor eggs and sperm is increasing as older couples and single people choose parenthood, to name just two growing trends. As diverse as these families are, many grapple with similar questions, such as how to tell the children about their origin, or how to best manage relationships with third parties, be they surrogates or donors. Thanks to decades of research, many of those questions can now be answered.

"It's very ingrained in our society that the traditional family is the best environment for raising children," says Susan Golombok, a psychologist and former director of the Centre for Family Research at the University of Cambridge. She is the author of a book on new family forms, called We Are Family: What Really Matters for Parents and Children.

Golombok's research began in the 1970s, with a study of lesbian mothers and their children. At the time, lesbian mothers routinely lost custody of their children, even in cases where welfare workers gave glowing reports of their parenting, because the courts ruled that their same-sex relationships would cause the children mental and emotional harm. In fact, when Golombok began her work, no openly lesbian mother had ever been granted custody of her children by a UK court. Some mothers were even ordered to sleep apart from their female partners whenever the children visited.

Later, Golombok and her colleagues researched gay fathers, trans parents and their children, families with children conceived via egg or sperm donation, or surrogacy. What they found, disproved "the assumptions that people had made about the impact on children of families that don’t fit the traditional nuclear model".

In study after study, good relationships between parent and child, with warm, responsive parenting, and open communication, were shown to be more important for the children's wellbeing than the gender, sexual orientation, number and genetic relatedness of the parents, and the way the children are conceived – all once thought to be major factors in their emotional and psychological development. The research, together with campaigns from the families themselves, transformed custody cases and led to landmark legal change, such as the UK's decision in 2002 (later in Scotland, in 2007) to let same-sex couples jointly adopt.

"We've now had huge amounts of research on all different kinds of new family forms that have come to the same conclusion, that what really matters for children is the quality of family relationships, as opposed to the composition of their family," says Golombok.

Golombok expects this to be the case in still-novel family forms, such as those with children created with the eggs and sperm of three people, or at some distant point, with eggs and sperm derived from human stem cells. The way the eggs and sperm are obtained, or the number of genetic parents, probably won't matter that much for the children's wellbeing, in her view.

However, researchers did find a persistent threat to new family forms, one that can harm the mental health of children: social prejudice.

A dad's story: "Living a lie"

"When my dad came out when I was in middle school, I did not know any other families who had openly gay parents," Dana Arnaboldi says, remembering her childhood in Massachusetts in the 1980s. "So a challenge for me was feeling a bit isolated or nervous about people's reactions."

Her father, Allan Arnaboldi, recalls feeling fearful. His ex-wife, Dana's mother, was accepting. But society was not. He worried that coming out as a gay father might get him fired from his job as a primary school teacher, make it difficult to find or keep housing, and hurt Dana's social life and friendships.

"I also did not know any other gay fathers for a while, so I was in conflict about not being like straight fathers or feeling different from other gay men who were not fathers; that was kind of like living a lie within each group or keeping ourselves separate," he writes in an email.

Eventually, Allan and Dana Arnaboldi took part in a photo exhibition on diverse families in the 1990s, called Love Makes a Family: Portraits of LGBTQ People and their Families. When the exhibition came to the school where he taught, a small number of families protested. But there was also an outflowing of support. "I think it also helped some other gay and lesbian teachers in the school system to come out and for gay parents of some of my students to speak with me more comfortably," he says.

When the whole culture is telling you that you can't possibly do a good job, that's a pretty heavy message - Nanette Gartrell

 

That sense of parenting against the odds is typical of new family forms, researchers say. "When the whole culture is telling you that you can't possibly do a good job at this, that's a pretty heavy message," says Nanette Gartrell, a psychiatrist and principal investigator at the National Longitudinal Lesbian Family Study in the US.

In the 1980s, Gartrell and her colleagues began studying a group of lesbian mothers who conceived children via sperm donation. At the time, it was believed that "these parents could not possibly create a healthy environment for these children, that the children would be psychologically damaged". Some had been rejected by their own parents for deciding to have children. 36 years on, almost all of them and their children are still part of the long-term study.

Gartrell and her team found that social stigma shaped the mothers' experiences, but also, that they managed to buffer the impact on the children's mental health.

"They had a desire to show the world that they could be good parents, and that their children could do well," she says. "It took a tremendous amount of work to deal with the homophobia and stereotypes that they encountered at every stage of their child's growth and development."

When the children were 10 years old, they scored as well or better than their peers on standardised tests measuring their psychological wellbeing. However, 43% had experienced homophobia for having lesbian mothers. They had higher levels of anxiety and depression than the rest. Yet the study also identified protective factors. Children who attended schools that included LGBTQ+ issues in the curriculum, and whose mothers were active in the lesbian community, fared better than the others in terms of their mental health. Talking to the children about ways to respond to negative comments, was also found to be beneficial.

Close relationships can buffer the impact of bullying, research shows

 

At the age of 17, the adolescents had good mental health, were academically successful, enjoyed close friendships and family bonds, and rated their happiness highly. However, half the children again reported having experienced hostility for having lesbian mothers, which hurt their mental health. Yet, having close relationships with their mothers cancelled that negative impact.

Gartrell believes these families' solutions, such as finding peer support, and rehearsing responses to negative comments, would be useful for any child being marginalised, whatever the reason.

Into the open: "The common thread is love"

"We sought out a place to raise our children that would be inclusive and welcoming of two women raising children," says Robin Jurs. She and her partner, Barbara Allen, raised their two children in Northampton, Massachusetts, in the 1980s and 1990s. Their strategies were similar to those used by the women in the study: finding a friendly environment, and helping their children when they faced negativity.

"There was the time some other child told our daughter that she did not have a 'real family' because she did not have a dad," Jurs recalls. They talked to the teacher, who decided to hold a lesson in which the students would interview different families, including theirs. "We were able to naturally address being a family without a dad while pointing out to the students that there are many forms of family."

Barbara Allen remembers the ordinary joy of family life. "When the kids were growing up, I felt grateful that I was spending a Friday night folding little socks," she writes in an email. "I was proud that my shopping cart was full of their favourite foods, I loved giving and getting hugs, and at times I was simply the chauffeur. And of course, as with any family, much much more."

Nabowire DeVore-Stokes, a dance artist who was featured in the Love Makes a Family exhibition as a child, echoes that sentiment. Looking at the photo of her family, she feels that "it’s great that it can be an example of what families look like. Our family dynamic is different now but there are many people that shape our family and the common thread is love, which I think is one thing that has stayed constant before and now in our family."

When asked to look back on 25 years of parenting, the mothers in the longitudinal study said that one of their best moments was seeing their children appreciate diversity. As Gartrell concludes: "Their kids were incredibly proud to be raised by mothers whom they saw as leaders, in this first generation of lesbian-parent families."

We were one of the first gay couples to adopt kids in the United States – Jon Cooper

 

Golombok and her team found a similar pattern across other new family forms, of parents trying hard to support their children. Gay fathers of adopted children, for example, showed more parental warmth and were more responsive to their children, than heterosexual adoptive parents.

Along the way, many families redefined what it means to be traditional.

"Rob and I were one of the first gay couples to adopt kids in the United States. Although that's fairly routine nowadays, as are alternative paths to gay parenthood like surrogacy and IVF, four decades ago it was pretty groundbreaking," writes Jon Cooper in an email.

The Coopers adopted five children, all of whom are now adults. One of them is getting married later this year. "Luckily, we raised our growing family in a progressive town on Long Island with a very welcoming local community. We encountered only positive reactions from our neighbours," Jon Cooper recalls.

Their family form has now become much more mainstream. In the US, 24% of female same-sex couples, and 8% of male same-sex couples, are raising children. In the UK, about 17% of adoptions are now by same-sex couples.

And yet, old prejudices continue to re-erupt. In the UK in the 1980s, a children's book about a little girl raised by her dad and his male partner, called Jenny Lives with Eric and Martin, caused a public outcry and led to a law that effectively stopped schools from mentioning same-sex relationships. The law has since been repealed. But as recently as 2019, a children's book featuring two male penguins raising a chick, prompted groups of parents to besiege British primary schools, again demanding that same-sex relationships not be mentioned at all.

For Dana Arnaboldi, changing attitudes and laws have transformed her experience: "When I was in high school and my dad had recently come out, not many of my friends knew he was gay. It would never occur to me now to hide that fact from anyone." She now has two children, who "are growing up around all kinds of families, and I don't think they have any expectations about what a family 'should' look like".

The first wedding her daughter attended as a baby was that of her grandfather, Allan, to his partner Mitch, in 2006, three years after Massachusetts legalised same-sex marriage.

Allan Arnaboldi says one of his granddaughters had an experience with a friend that reminded him how far the world had come. The friend, a girl, said she was transgender. When the granddaughter asked what that meant, the friend said she was born a boy but felt that she was really a girl, and therefore lived as a girl. "Our granddaughter was nonplussed and continued conversing about something totally unrelated as if it was just a new bit of information, but no reason to reject this girl's friendship," he says.

It was not just gay and lesbian parents who were encouraged to live a lie. Mothers and fathers who conceived with the help of a sperm donor, due to the husband's infertility, were also advised to hide that fact – even from their own children. It was thought that this would avoid confusing them.

The result, however, was at times disastrous. Some children sensed that there was a secret. Others eventually found out by accident. In recent years, outraged donor-conceived people have been pushing for the right to know about their heritage, and thereby access vital information such as their medical history, and number of half-siblings.

The earlier parents begin to talk to their children about their origin, the better – Susan Golombok

Now, the advice is the opposite: openness.

"What we found from our research is that the earlier parents begin to talk to their children about their origin, where they came from, how they were conceived, the better," says Golombok. Some parents in her team's study started in babyhood, with books and stories, and later answered questions as they arose. The children were sometimes curious, but not confused or upset. "The children who are distressed about it are those who find out later on, as teenagers or as adults."

In the UK, the law was changed so that if a person donated sperm, eggs or embryos after April 2005, people conceived from the donation have the right to find out their donor's identity at the age of 18. That first cohort of full-disclosure, no-anonymity children is about to come of age, and whether they will exercise that right or not, it marks a new chapter.

People born through surrogacy, they're not lied to. They just get on with their lives, because that’s how they were born, and it's fine – Gee Roberts

 

Gee Roberts has always known about her origins. Throughout her childhood, her parents arranged meet-ups with Suzanne, her surrogate. They explained that she was her "tum mum", who carried her in her tummy. Roberts doesn't use that term herself now, since she doesn't see Suzanne as her mother, but the explanation with the tummy made sense to her.

In primary school, when asked to draw a picture of her mum and dad, she added in Suzanne, too. At the same time, she has always felt secure about her own place in the family, and the fact that her parents are the people who raised her. "I have always been where I was meant to be. I was meant to be the child of my parents, and that's where I am," she says. "I was born because my parents wanted me."

In 2019, Roberts visited the United Nations in Geneva as part of a campaign to protect the rights of donor-conceived and surrogacy-born people, and gave a speech about her family's positive experience with surrogacy. She was struck by the pain and trauma of donor-conceived people who were lied to, and the contrast to her own community of surrogacy-born children, who tend to know how they came into the world.

"It's much harder for parents to pretend it hasn’t happened," she says of surrogacy. "And I think that means people have to be open from the beginning."

This honesty, Roberts believes, has had big emotional benefits: "People born through surrogacy, they're not lied to, they don’t feel betrayed by their parents, or that anyone's been deceitful. They just get on with their lives, because that’s how they were born, and it's fine."

Research on surrogacy-born children is still limited, but what has been carried out so far backs the idea of a generation accepting of their origins, at least in the UK and US. In UK surrogacy families, the children had positive relationships with their mothers, and felt good about their surrogate and their birth. In most cases, the families and the surrogate stayed in touch over time, and the surrogates generally fared well. A study of gay fathers in the US found that the dads talked to their children about their origins early on, and had a good relationship with the surrogate. The children had good relationships with their parents, and high levels of psychological wellbeing.

However, there have also been cases of traumatic surrogacies.

A tale of two surrogacies

Kim Cotton, now a grandmother of seven living in a village near Cambridge, was the UK's first surrogate. She already had two children of her own when she agreed to carry a baby for a couple living abroad, conceived via artificial insemination. She never met the intended parents. "It was done anonymously," she says. "And that to me, now, is quite abhorrent, really. That's my regret, the only regret I really have."

She gave birth to the baby girl in a London hospital on a cold January day in 1985. News of the surrogacy threw the country into a frenzy. Cotton had to be smuggled out of the hospital, hiding on the floor of a car, with a blanket thrown over her, to escape the crush of reporters. Journalists accused her of renting out her womb and selling her child. A ban on commercial surrogacy was rushed through.

She never saw Baby Cotton, as she still calls her, again.

"I didn't dare cuddle her too long in the hospital, because she looked like one of mine," she recalls, her voice tinged with sadness. "It was very difficult, really."

Her story has a twist, however. Cotton went on to found a non-profit surrogacy organisation, called COTS (Childlessness Overcome Through Surrogacy), in the hope of supporting others. A few years later, she became a surrogate again, with twins, via IVF.

This time, it was for friends, and she and the intended mother attended scans together. The parents were there at the birth: "The joy in the delivery room… it was fabulous." To this day, they remain in touch. Cotton describes her relationship with the twins as aunty-like: "They are not genetically mine, but there is a bond." She wishes she could have built such a relationship with Baby Cotton, too.

All of the surrogates wanted to meet the intending parents – Nishtha Lamba

 

In the UK, an effort is underway to reform the law and create a clear process for surrogacy. But in some other countries, where surrogacy was previously unregulated, the law has been tightened.

Nishtha Lamba, a senior lecturer in psychology at Middlesex University Dubai, studied the psychological welfare of Indian surrogates, at a time when India was a hub for international surrogacy. The women named financial necessity as their main motivation. But, in a striking parallel to Cotton's experience, they nevertheless hoped for at least a basic relationship with the families they helped create around the world.

"All of them wanted to meet the intending parents," Lamba says. They wanted to know the baby was going to a good home. However, almost half of the women Lamba interviewed never met the intended parents at all: not before, during or after the birth. Over 70% of them never even met the child, who was taken away straight after birth.

"I wanted to see the baby just once as I would never get this moment again in life," one of them told Lamba. "I just saw the hands and legs of the baby."

When Lamba interviewed them, months after the birth, some were still hoping that the parents would get in touch.

Beyond "the traditional way"

New family forms can raise complex questions about the relationships that define us. But even in the past, society learned to adapt to such change. In fact, the family has always been fluid, much more so than is often assumed, according to a report on the history of diverse families by Patricia Thane, a visiting professor in history at Birkbeck College in London.

For a start, people died younger, and men died younger than women, leaving many widows to raise their children alone. "There were as many single-mother families in the later 19th Century, as there were in the later 20th Century," she says. Older people in the past might have no surviving children, or the children might have moved away to find work, and it was harder to keep in touch. Now, technology makes it much easier for generations to maintain contact over a lifetime.

As our own society's idea of family continues to evolve, those with an unusual origin story may find surprising advantages. Gee Roberts, for example, sees it as an asset as she deals with people from all walks of life in her medical career: "So many families now are not just made up of a mum and a dad, in the traditional way. And I'm probably someone that people can be quite open with about that."

Once, when she was working in a hospital, she overheard a nervous discussion among the staff. A child had been born via surrogacy. The two dads were waiting to take the baby home. There was some uncertainty over how to proceed.

Roberts went to see the fathers, and, like an envoy from the future, handled the situation with ease: "We got to the surrogacy part, and they explained, and I said,  'yeah, I was born through surrogacy as well'.  And we had a brilliant conversation."

Sophie Hardach