Donor conception and psychosocial support provisions across jurisdictions - what's out there?

As demand for donor conception (DC) rises the landscape is becoming increasingly complex. DC-linking now occurs through various means, including direct-to-consumer DNA testing, which may reveal DC where this has not been disclosed and make those genetically related known to each other, including earlier than is possible through identity-release provisions in many jurisdictions. Early contact between donors and recipient parents, as well as same-donor siblings is becoming more common. Large sibling groups within and across jurisdictions are increasingly being identified and there is also growing reliance on imported gametes and online donor recruitment platforms. These developments can be associated with challenges for donor-conceived people (DCP), parents, donors and their families, and have led to calls for more accessible and responsive psycho-social support services. This paper maps the DC context in ten Western countries, including the availability of psychosocial support and counselling. Given the growing complexity of DC and its lifelong impact on all involved, we pay particular attention to post-donation counselling support related to disclosure, long-term psychosocial wellbeing, and DC-linking. We identify key challenges in existing DC provisions and support systems and propose improvements that support DCP, donors, parents, siblings, and their families in managing the longer-term implications of DC.