The more complex the situation, the more important it is to simplify. What Children Need to Know and Why Because these issues are identity issues that cannot and will not be changed, children need to know the truth about their adoption, about their conception through surrogacy or using donor gametes. These issues, which are central to who they are genetically, are different from and far more significant than mechanical issues surrounding their conception and birth such as a failure of birth control, a medical problem which resulted in a cesarean rather than vaginal delivery, the use of hormonal therapy in order to sustain a pregnancy, or the placing of father's sperm into mother's uterus via catheter rather than through sexual intercourse. Secrets are unhealthy in intimate relationships. The existence of significant secrets are nearly always felt on a subconscious level and are most often toxic to family systems.
Secrets are almost universally impossible to keep.
Clinicians have reported extensively on the damage to self esteem and to relationships which has occurred when adoptees have stumbled across the facts of their adoptive status or had it revealed late in childhood or beyond. Such revelations nearly always resulted in feelings of betrayal by and anger with parents that were all but impossible to heal completely. Families formed via various forms of surrogacy, donor insemination, donor oocytes or donated embryos are, genetically, adoption-expanded families. Parents who choose not to tell their children about such origins risk great damage to their relationships with their children later when their children discover the truth that has been hidden from them. Secrets are usually based in and caused by feelings of shame.