Book Review: Modern Families - Parents and Children in New Family Forms

Assisted conception services have facilitated the creation of new family forms that did not exist until the late 20th century. Yet it is frequently said that law and policy in this area are based on outdated assumptions about family life and parenting. Susan Golombok's 'Modern Families: Parents and Children in New Family Forms' challenges the assumption that the traditional nuclear family is the best environment in which to raise children. It evaluates empirical data on parenting and children's psychological well-being in 'new family' forms - lesbian or gay families, single-parent families, and families created by IVF or surrogacy - asking whether children's experiences are really so different from those raised in 'traditional' families.

Moving across a range of studies, Golombok evaluates what we know (and what we don't know) about children and parents' well-being. The result is a thought provoking and balanced guide through the data, and the answer to the above question will not come as a surprise to many - children born after various forms of assisted conception are not put at a disadvantage (they may even be at an advantage in early years). However, more importantly in my view, the text challenges the key assumptions that underpin the belief that children are somehow affected by new family forms - and the conclusions are stark: the gender of parents and biological relatedness is not essential for children's psychological well-being, and there is no evidence that assisted conception place children at risk or that family structures and sexual orientation play a fundamental role in a child's personal development.

So what was all the fuss about? Golombok reminds us of the stigmatisation faced by lesbian families, the unease over 'test-tube babies', and the hostility towards surrogacy following the Baby M case. Both in the UK Parliament and the media, children born to these new family forms were being presented at being 'at risk' - the parents' motivations were treated with suspicion and the family structures considered detrimental to a child's well-being. However, while social attitudes around assisted conception have progressed significantly since the 1970s and 80s, there remains this residual idea that the traditional family model is somehow better. This book invites us to reconsider this position and casts an analytical spotlight on two key pillars in fertility law and policy: the importance of the gestational link and the genetic connection between parents and children. Both feature heavily in debates on donor conception and surrogacy.

The removal of donor anonymity in the UK in 2005 was in part due to the argument that donor-conceived children have the right to know their biological origins. As Golombok explains, the view that donor conception can have negative consequences for parenting and children's well-being results from concerns about the impact of secrecy on the family (not telling the child they are donor conceived) and also the absence of a genetic relationship (that the genetic connection matters).

The book highlights research on adoption that has shown knowing one's biological parents can be a benefit to children, and family therapy research has identified how secrecy can create boundaries and cause anxieties. Yet if keeping a child's origins secret can interfere with communication, studies on the matter are not conclusive about whether donor conception causes impaired family functioning, or if impaired family functioning results in poor communication. This, in my view, reflects a broader critique that can be made of empirical data in this field. From the studies included in the text, it is often not clear whether, or how, assisted conception has anything to do with it. It is crucial that any such evaluation does not easily mistake a correlation between ordinary family disharmony and assisted conception with a significant degree of causality.

This danger of misattribution can also be seen in the data on biological linkage. Although it has been observed that an absence of genetic connection to one parent may have implications for identity and the child's relationship with their parents, research on step-parent families has shown that such difficulties can arise from other factors, such as the disruption of a relationship with an existing parent and acquisition of new family members.

On the controversial issue of disclosure of biological origins, Golombok observes that there is no association between the absence of genetic connection and child-adjustment problems in families who have decided not to disclose the use of a gamete donor to their children. This, in my view, weakens the arguments for the state's interest in promoting disclosure (in some families I would imagine it could be quite harmful), but Golombok does also highlight that children are better off being told earlier and that there is some evidence of more positive functioning in disclosing families - but this cannot be assumed to be a direct result of disclosure.

On surrogacy, Golombok presents findings from the UK Longitudinal Study of Assisted Reproduction Families, which first assessed families with children at the age of one. The study revealed that contrary to concerns around surrogacy (e.g. the prejudice, the intended parent's nine-month wait and the need for a positive relationship with the surrogate) intended parents fared better at the early stages of parenthood than those who conceived naturally. Intended parents showed lower levels of stress and depression, greater warmth and attachment-related behaviour, greater enjoyment of parenthood. But they also displayed higher levels of emotional over-involvement, which is not a good thing! When the children reached seven years old there was no difference between surrogate families and natural conception,showing that any benefits of assisted conception level out over time.

Interestingly, Golombok identifies how surrogates and intended parents often get along well after the child's birth, meeting at least once. She also observes how there is no difference between surrogacy and egg donation families, suggesting the gestational link is 'not essential for family functioning'. Both of these observations lend some credence to calls for recognising surrogacy arrangements or reforming the laws on legal motherhood.

Overall, the book highlights the need to treat concerns around assisted conception with caution, preparing to challenge assumptions with empirical findings, but also to identify positive aspects about parenting in 'new families'. It also highlights the need for further research. As Golombok concedes, much of the data are limited and most of the studies are small, tending to focus on preschool and early school-age children. Less is known about adolescents and beyond.

The book therefore offers useful toolkit through which to speak about law and policy in this area with some empirical grounding. However, I have two reservations about such an approach. First, I wonder if the empirical agenda is doomed for failure at the outset due to imperfect data. A high level of causal complexity emerges from the book and, if each family is really so unique, and the factors that influence children's well-being so numerous, interlinked and opaque, then what's the use of evidence-based policymaking? Indeed, it could be dangerous to generalise from data sets.

Second, I have reservations about a model based on the premise that 'parenting' and child welfare are measurable in any meaningful way (other than identifying physical and emotional abuse). Whereas it may be helpful to think about beneficial ways of parenting, at the end of the day, surely it comes down to just not doing a really bad job in the circumstances - whatever they may be. There is a danger that empirical evaluation of parenting can seep into ideas of a 'right' way of doing things, overturning assumptions about the value of a traditional family only to replace them with others.

However, this is a concern I have with the field, rather than the book, which successfully presents the data in an accessible and impartial manner, guiding the reader through the main points and limitations, and allowing everyone to form their own, substantiated opinion on the matter.

Buy Modern Families: Parents and Children in New Family Forms from Amazon UK.