Long-term study reveals “psychological resilience” in donor-conceived offspring of lesbian families

The psychological adjustment of donor-conceived offspring of lesbian parents over two decades: differences by donor type and contact with the donor (Carone, 2025)

Carone, N., Koh, A. S., Bos, H. M. W., Rothblum, E. D., & Gartrell, N. K. (2025). The psychological adjustment of donor-conceived offspring of lesbian parents over two decades: differences by donor type and contact with the donor. Reproductive BioMedicine Online. https://doi.org/10.1016/j.rbmo.2025.105020

Geographic Region: United States

Research Question: How stable is psychological adjustment in donor-conceived offspring of lesbian parents over 21 years, focusing on differences by donor type (anonymous, known, open-identity) across four developmental stages (childhood, adolescence, emerging adulthood, and established adulthood) and the impact of donor contact during established adulthood.

Design: Data drawn from Waves 4, 5, 6, and 7 of the U.S. National Longitudinal Lesbian Family Study (a longitudinal cohort study), with assessments at ages 10, 17, 25, and 30-33 years. Donor type was determined by parental reports at Wave 4. At Waves 4 & 5 (ages 10 & 17), parents completed Child Behavior Checklist (CBCL) - 113-item standardized assessment. At Waves 6 & 7 (ages 25 & 30-33), offspring completed Adult Self-Report (ASR) - 120-item assessment. Both measures evaluated internalizing behaviors, externalizing behaviors, and total problem behaviors. At Wave 7 (ages 30-33), researchers compared those who had contacted the donor (n=38) versus those who had not (n=32).

Sample: 70 donor-conceived offspring (51% cisgender female, 71% heterosexual, 90% White, 91% college degree or higher) of whom 34% had anonymous donors, 34% had known donors, and 31% had open identity donors. 90% of the original 84 families recruited in Wave 1 of the study were retained by Wave 7.

Key Findings

• The study found no significant differences between cismale and cisfemale offspring across any psychological measures.

• Anxiety, depression, and withdrawal behaviors stayed consistently low across all four time points for everyone in the study, regardless of what type of donor their parents used.

• Acting-out behaviors like aggression and rule-breaking followed a predictable pattern: they decreased during the teenage years, increased somewhat during the college/early career years (ages 17-25), then decreased again as people entered their thirties. This pattern was the same regardless of donor type and reflects normal developmental changes.

• Psychological well-being scores were virtually identical between those who had contacted their sperm donor by their thirties and those who had not.

Limitations:

• The U.S. National Longitudinal Lesbian Family Study was limited by its predominantly White, cisgender sample, which restricts generalizability to more diverse populations. The research spans decades during which societal attitudes and technologies evolved significantly, potentially affecting data comparability across time points. The study does not explore nuanced aspects of donor and interactions due to relatively small sample sizes and may not reflect the full range of donor-conceived experiences.

• For this particular article, potential moderators such as socioeconomic status, family functioning, and parent-offspring relationship quality were not examined.

• The tools used to collect data (CBCL and ASR) are primarily problem-focused rather than strength-focused. They excel at identifying areas of difficulty and symptomatology but don't directly measure positive aspects of well-being like life satisfaction, resilience, or flourishing. They assess the absence of problems more than the presence of positive functioning. The measures may also pathologize normal neurodivergent presentations or miss the experiences of neurodivergent DCPs who have learned to mask their differences (h/t to D for raising this point).

Applications

• The stability of psychological adjustment across donor types highlights the fundamental role of family relationships in shaping offspring well-being and underscores the importance of fostering supportive family environments, regardless of the specific donor arrangements.

• Donor-conceived adolescents may benefit from guidance and support in integrating the unique aspects of their family structure and their conception into their broader sense of identity.

• In emerging adulthood, donor-conceived people often begin contemplating their future parenthood, and this process may involve reflecting on how their own nontraditional family background shapes their plans for having children and how they might explain their donor conception to their future children. These individuals may require support during this critical transitional phase.

My Hot Take

Carone et al. state: These findings underscore that donor-conceived offspring’s psychological adjustment is not inherently compromised, regardless of how they navigate their relationships with their genetic origins. In this context, the minimal impact of donor type on behavioral outcomes challenges prevailing assumptions that knowledge of, or contact with, a donor directly influences psychological well-being (Shenfield, 2002).

The 23-year-old Shenfield article cited is not a study but an exploration of the ethical and legal aspects of the debate surrounding whether donor-conceived people have a right to be informed about their genetic origins. The pro argument states that this is fundamentally about the right to self-determination and informed decision-making about one's own life, including the option to gain access to information about one’s genetic origins. Carone seems to suggest that because their clinical measures don't show differences in psychological adjustment, the underlying rights argument could be invalidated. If people adapt well to having information withheld, does this justify withholding it (i.e., continuing to allow anonymous donation)? Are rights contingent on psychological benefits?

Carone et al also state: … The overall positive adjustment of established adults of lesbian parents from ages 10 to 30–33 likely reflects the resilience developed by this cohort and the adaptive strategies that lesbian-parent families developed to cope with the long history of stigmatization associated with their family structure.

Yet later they acknowledge a very crucial limitation: Experiences related to race, ethnicity, and gender identity can significantly shape family dynamics, access to support systems, and experiences of stigma, all of which are relevant to psychological adjustment in donor-conceived families. In predominantly White, cisgender samples, there may be greater societal acceptance of non-traditional family forms or more access to resources that buffer against minority stress, potentially leading to more favorable psychological outcomes. Therefore, the relatively low levels of behavioral problems observed in this study might, at least in part, reflect the social privilege and stability afforded to this specific demographic group.

Carone et al. state: Findings underscore the psychological resilience of donor-conceived offspring of lesbian parents, irrespective of donor type or contact.

The study did not use data collection tools that measure resilience. The study is conflating the absence of clinical problems with the presence of resilience—these are fundamentally different constructs.

My Soapbox: A crucial missing piece in donor conception research is an examination of how parents approach the issue with their children. Studies often measure whether disclosure happened and when, but not how parents handled these conversations: Did they encourage or shut down their child's curiosity? Did they proactively provide access to donor information or withhold it? Did parents initiate on behalf of their children or wait for their children to initiate? How did the parents' own feelings about the donor's role get transmitted to their children? If the all of families in this study generally had open, supportive communication that validated their children's curiosity and autonomy around genetic origins, could that explain the general lack of “problematic behaviors” across donor types? Until we understand how family communication and actions shape donor-conceived people's relationship with their genetic origins, we're only skimming the surface of what really matters for identity development and wellbeing across the lifespan.​​​​​​​​​​​​​​​​

I'm also concerned this particular article reinforces the "angry DCP" trope—the harmful stereotype that donor-conceived people who express any questioning, discomfort, or negative feelings about their origins must be maladjusted or psychologically damaged. A person can be thriving, grateful for their family, psychologically healthy, AND still want to know their genetic history or be curious about their genetic relatives (or advocate for change in the industry). By measuring only psychological adjustment and concluding that donor type "doesn't matter", the study inadvertently reinforces the narrative that DCPs who seek access to genetic information or genetic relatives are somehow problematic or ungrateful. This framing dismisses legitimate curiosity and identity needs as pathological, when they're actually normal human experiences. The study's conclusions could easily be misused to argue: "See? DCPs are fine without genetic information and access, so their concerns aren't valid"—completely missing that healthy, well-adjusted people can still have unmet needs around identity and genetic connection.

Funding Source: Not explicitly stated

Lead Author: Nicola Carone is a psychoanalytic psychotherapist and Associate Professor of Dynamic Psychology at the University of Rome Tor Vergata, who specializes in research on parenting and attachment in diverse family structures, including LGBTQ+ parents and assisted reproduction families. He joined the National Longitudinal Lesbian Family Study team in 2020. No personal connection to donor conception is mentioned in the available information.

Regulatory Context

• There are no comprehensive federal laws regulating gamete donation or donor conception in the U.S. The process is largely self-regulated by the fertility industry.

• The Food and Drug Administration (FDA) does have some oversight, primarily related to screening and testing of donors for infectious diseases.

• The American Society for Reproductive Medicine (ASRM) provides ethical guidelines and recommendations for donation practices. However, these are not legally binding.

• There are no legal limits on compensation for donors. A 2011 court ruling (Kamakahi v. ASRM) determined that price caps on donor compensation violate antitrust laws.

• ASRM recommends a minimum age of 21 for gamete donors, but this is not legally mandated.

• The U.S. does not have laws prohibiting anonymous donation.

• Some states have enacted their own laws regarding aspects of assisted reproduction, and parentage, but these vary widely.

Related Studies

Early disclosure and family identity may influence donor sibling relationship dynamics

Adult offspring of lesbian parents report satisfaction with donor contact levels

Adult offspring of lesbian parents reflect on having been donor conceived