MESTRADO INTEGRADO EM PSICOLOGIA
PSICOLOGIA DAS ORGANIZAÇÕES, SOCIAL E TRABALHO
Motivations and attitudes of men towards
male gamete donation: donate to whom
and why?
João Carlos Oliveira Areias
M
i
Universidade do Porto
Faculdade de Psicologia e de Ciências da Educação
Motivations and attitudes of men towards male gamete donation: donate to whom and why?
João Carlos Oliveira Areias
Junho 2020
Dissertação apresentada no Mestrado Integrado de Psicologia, área de Psicologia das Organizações, Social e Trabalho, Faculdade de Psicologia e de Ciências da Educação da Universidade do Porto, orientada pelo Professor Doutor Jorge Gato (FPCEUP).
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Avisos Legais
O conteúdo desta dissertação reflete as perspetivas, o trabalho e as interpretações do autor no momento da sua entrega. Esta dissertação pode conter incorreções, tanto concetuais como metodológicas, que podem ter sido identificadas em momento posterior ao da sua entrega. Por conseguinte, qualquer utilização dos seus conteúdos deve ser exercida com cautela.
Ao entregar esta dissertação, o autor declara que a mesma é resultante do seu próprio trabalho, contém contributos originais e são reconhecidas todas as fontes utilizadas, encontrando-se tais fontes devidamente citadas no corpo do texto e identificadas na secção de referências. O autor declara, ainda, que não divulga na presente dissertação quaisquer conteúdos cuja reprodução esteja vedada por direitos de autor ou de propriedade industrial.
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Agradecimentos
Ao Professor Jorge Gato, pela orientação e por todos os ótimos conselhos, ao longo desta grande jornada.
Aos participantes deste estudo, pois sem eles, este estudo não seria possível.
Ao Fernando, por todo o apoio incondicional e por todas as horas que me ouviu falar e desesperar.
À Cátia, por ter sido a melhor companheira e amiga, durante estes 5 anos. Por todas as horas no café a trabalhar arduamente pelos nossos sonhos e por todas as insónias.
À Maria, Margarida, Adriana e Catarina por terem sido incansáveis e por serem as melhores amigas, na vida, que alguém pode ter.
À Catarina, Sofia, Sara, Sara, Nini, Vera, Teresa, Maria Inês e Margarida por todos os momentos no pátio da frente da faculdade. Por todos os desabafos e por todos nós alcançarmos os nossos objetivos.
À minha família, especialmente ao meu avô Manuel, por toda a motivação e por fazerem que o meu sonho profissional tenha sido alcançado.
Ao professor Samuel Lins, e todos os professores/as que contribuíram para a minha formação pessoal e profissional.
À FPCEUP, por todos os momentos, todos os choros, todos os risos e por toda a panóplia de emoções que me fez sentir, ao longo destes 5 anos.
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Resumo
O alargamento da Procriação Medicamente Assistida (PMA) a todas as mulheres e o levantamento do anonimato da doação enfatizou a escassez de dadores, em Portugal. Foram exploradas motivações para doar, atitudes face ao anonimato e atitudes face a doar para
grupos específicos por parte de homens aptos a doar gâmetas, entre os 18 e 40 anos (N = 282). Explorou-se ainda a relação entre estas motivações e atitudes e as caraterísticas
psicológicas e sociodemográficas dos participantes, incluindo a sua orientação sexual. Os participantes reportaram razões altruístas para doar, mostraram atitudes positivas face ao anonimato e maior preferência a doar a mulher inférteis. Porém, no caso de homens heterossexuais, menos educados e mais novos, a motivação para doar para estava mais relacionada com a certificação acerca da própria fertilidade; os últimos tenderam, ainda, a defender que os pais que recorrem a PMA devem divulgar, à criança, as suas origens. Relativamente às variáveis psicológicas, a Conscienciosidade mostrou-se positivamente associada a “saber se sou fértil ou não”. A preocupação empática evidenciou uma associação positiva com “ajudar alguém a ter um filho” e com atitudes positivas face à doação, independentemente da orientação sexual, fertilidade ou estado civil dos recetores. Valores de conservação mostraram-se positivamente associados a “compensação financeira” e “saber se sou fértil ou não”. Uma maior adesão a valores religiosos mostrou-se negativamente associada a “ajudar alguém a ter um filho” e a atitudes positivas face à doação para todas as pessoas. As campanhas de recrutamento de dadores devem considerar as motivações, as atitudes e as características de potenciais dadores; a parentalidade deve ser vista como um direito universal, e a doação deve ser incentivada, independentemente do estatuto de fertilidade dos recetores; informações claras sobre o anonimato da doação poderão também ser fornecidas.
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Abstract
The widening of Assisted Reproduction Technology (ART) to all women and the withdraw of anonymity of the donation emphasized the shortage of donors in Portugal. We looked at motivations to donate, attitudes towards anonymity and attitudes towards donating for specific groups among men able to donate gametes, aged between 18 and 40 years (N = 282). We also explored the relation between these motivations and attitudes and participants’ psychological and sociodemographic characteristics, including sexual orientation. Participants reported mostly altruistic motivations to donate, had positive attitudes towards anonymity, and showed a greater preference to donate to infertile women. Overall, sexual orientation was not associated with participants’ attitudes and motivations. However, heterosexual, less educated and younger men attributed more importance to knowing their fertility as a motivation to donate; the latter also tended to subscribe that parents who resort to ART should disclose to the child his/her origins. Regarding psychological correlates, conscientiousness was positively associated with “knowing one’s fertility”. Empathic Concern was positively associated with “helping someone to have a child” and with positive attitudes to donate independently of recipients’ sexual orientation, fertility or relational status. Conservation values were positively associated with “financial compensation” and “knowing one’s fertility”. Religious values were negatively associated with “helping someone to have a child” and attitudes towards donating to all groups. Recruitment campaigns should take into account specific motivations, attitudes and characteristics of participants and parenthood should be considered as a universal right, encouraging gamete donation regardless of recipients’ fertility diagnosis; clear information about anonymity of the donation should also be provided.
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Introduction
Gamete donation is essential to people incapable of conceiving biologically. In Portugal, 15% to 20% of couples in reproductive age are unable to have children due to infertility issues (Esteves dos Santos, 2019). Same-sex couples may resort to Artificial Reproduction Technology (ARTs), as this is often the only available pathway to parenthood (Goldberg, 2010). There is a great discussion about who can turn to ARTs, as well as moral dilemmas about anonymous donation and the compensation of the donation (Fortescue, 2003; Almeling, 2006). And so, it is imperative that these problems are addressed and solved, for the greater good.
In 1985, Sweden became the first country to allow children conceived through ARTs to know their genetic origins, when they reach age of sufficient maturity (Ekerhovd, Faurskov, & Werner, 2008). Also, in 2012, a Danish revision of infertility treatment laws led to an allowance of anonymous and non-anonymous gamete donation (Bay, Larsen, Kesmodel, & Ingerslev, 2014). In Portugal, since the establishment of the Public Bank of Gametes, in 2011, until 2016, 70 children were born from donated oocyte and sperm. In 2016, the Law n.º17/2016 (Diário da República, 2016), extended public funded ARTs services to all women, regardless of their civil status, sexual orientation or infertility diagnosis (surrogacy is not allowed presently). This way, an increase in the number of children born through ARTs is expected in the next few years and the present work thus focused on donation of male gametes.
In 2018 the Portuguese Constitutional Court imposed the end of anonymity in all ART’s, concerning sperm, oocytes and embryo donors (Dias Cordeiro, 2018). The new law on ART’s hampered the importation of gametes, since gametes have to be imported from a country where it is allowed for people born from ART’s to know their genetic origin (Novais, 2019). Following this, the Law n.º48/2019 (Diário da República, 2019) protected, from the end of anonymity, gametes donated before May 7th 2018 and donations used before the same day.
It is considered that the scarcity of donors comes from the lack of sensibilization campaigns close to populations who are more propitious to donate (Lusa, 2016). To address this problem, the Portuguese Association of Fertility organized a campaign for sperm and oocyte donation in 104 Portuguese universities (Lusa, 2016). To answer to the demand of gametes and to diminish the importation of reproductive cells from public centers, in January 2017 two new centers of gamete harvest were inaugurated. Currently, there are four public
2 and fifteen private centers where people can donate gametes (Silva, Freitas, Baía, Samorinha, Machado, & Silva, 2019).
The issue of anonymity (or the lack of it) arises from a social debate weighing the rights and duties of the child who will be born and the rights of the donor. If, on one hand, the child has the right to know its genetic origins, its antecessors and its story, on the other hand, the donor has no duty to create any type of affectional bond with the child (Ekerhovd et al., 2008)
Since gamete donation is considered an altruistic donation (Almeling, 2006; Ekerhovd et al., 2008; Fortescue, 2003; Hedrih & Hedrih, 2012; Thijssen, Provoost, Vandormael, Dhont, Pennings, & Ombelet, 2017; Van der Broeck, Vandermeeren, Vanderschueren, Enzlin, Demyttenaere, & D’Hooghe, 2013), the lack of anonymity may increase the insufficiency of donors, as the goal would be to be involved in the process but, at the same time, to keep some distance after the donation (Fortescue, 2003).
Associated with ART’s, another ethical debate exists, regarding the recruitment of donors to Public Banks: the financial compensation. In Portugal, each donation of masculine gametes is rewarded with €42.13, and the donor is freed from paying any user taxes in the National Health Service (Serviço Nacional de Saúde, 2020). However, not all public systems reward gamete donation. In France, the donation is anonymous and free, and the donor must already be a parent. (Kalampalikis, Fieulaine, Doumergue, & Deschamps, 2013).
The study of male gamete donation in Portugal is thus a timely and necessary one. First, access to ART’s has been widened to all women, regardless of their marital status and sexual orientation. Second, the recent end of anonymity may be a factor that can influence the motivation to donate. Finally, there is a shortage of gametes. Our goal in this work was to investigate motivations and attitudes towards gamete donation in Portugal, as well as which characteristics of potential donors are associated to these processes.
Motivations and attitudes toward gamete donation
Three big motivations to donate gametes have been highlighted in literature: (i) altruism, (ii) financial compensation, and (iii) verification of one’s own fertility (Ekerhovd et al., 2008; Hedrih & Hedrih, 2012)
Altruism concerns the willingness to help others, without any personal benefit. In the case of gamete donation, this relates to the desire to help a couple without children to fulfill
3 the dream of having a child (Ekerhovd et al., 2008; Hedrih & Hedrih, 2012; Thijssen et al., 2017; Van der Broeck et al., 2013). Altruism has been associated to a depreciation of financial compensation for the donation, with donors stating they would still donate if the compensation was non-existent (Ekerhovd et al., 2008; Hedrih & Hedrih, 2012; Thijssen et al., 2017). However, other studies showed that most of the potential donors would stop donating if the compensation was non-existent (Van der Broeck et al., 2013). Financial compensation is thus another motivation to donate gametes (Bay et al., 2014; Hedrih & Hedrih, 2012; Thijssen et al., 2017; Van der Broeck et al, 2013). A third motivation relates to the verification of one’s own fertility (Hedrih & Hedrih, 2012; Thijssen et al., 2017; Van der Broeck et al., 2013). Studies showed that individuals presented curiosity and willingness to pass on their “good genes” and the need to confirm if their gametes are able to conceive a child (Thijssen et al., 2017), though the latter was only found among young people (Thijssen at al., 2017). One of our goals, in this study, was to explore possible differences between these three motivations, in our participants.
Different attitudes related to male gamete donation have been identified, such as attitudes towards potential receivers of the donation, towards the relationship with the descendant of the donation, towards the anonymity of the donation, and towards social aspects of the process (Hedrih & Hedrih, 2012; Thijssen et al., 2017). Given our goals, we will highlight attitudes towards anonymity and attitudes towards donation to lesbian couples versus other family configurations.
As said, the debate about anonymity of the donation extends across many countries, besides Portugal. A study from Belgium, investigated motivations and attitudes of candidate sperm donors. Half of the participants stated they would like to know how many children were conceived from their sperm. Only a quarter would have liked to have information about the family and the children who were conceived. Most of the participants stated parents should have the decision whether or not to inform the child about their genetic origin and half of them believed parents should be honest with the children. The majority of men indicated they would be willing to provide information about themselves to the children but only 26% of the participants would be willing to donate if their name was disclosed (Thijssen et al., 2017). Another study, among Danish donors, aimed to study motivations and attitudes towards gamete donation. Half of the participants stated they would no longer donate if it was not possible to assure anonymity, while a minority stated they would continue donating or were uncertain. The majority of donors stated they would reveal all non-identifying information about themselves, they would have liked to know the number of children
4 conceived from their sperm and would accept that the children could know their identity (Bay et al., 2014).
These studies show a relatively positive view on donation non-anonymity, even if men tend to back out of donating if their name is disclosed. This way, we expected this same pattern attitudes towards non-anonymity to happen in Portugal.
Another controversial topic about the parties involved in ART’s relates to the receivers of the donation. Overall, positive attitudes towards donation to single women and/or lesbian couples have been reported (Bay et al., 2014; Ekerhovd et al., 2008; Thijssen et al., 2017), however, negative attitudes toward lesbian and gay parented families continue to be reported (e.g., Crawford & Solliday, 1996; Gato & Fontaine, 2013, 2016). College students in the USA considered gay couples to be less emotionally and less apt to be parents, when compared to heterosexual couples (Crawford & Solliday, 1996). In Portugal, Gato and Fontaine (2013) highlighted the existence of apprehension from university students toward adoption of same-sex couples when it came to the normative sexual and gender development of children. This apprehension was especially presented when a boy was adopted by a lesbian couple than when a girl was adopted by a gay couple (Gato & Fontaine, 2013). Later, the same authors (2016) confirmed that men express more negative attitudes toward same-sex families than women, among a sample of undergraduate students from helping professions. Participants also considered that the sexual orientation of the couple only impacted the psychosexual development in the case of a boy adopted by two men. Regarding the evaluation of parental competences, male participants stated that lesbian and gay couples were less stable and less suitable to be parents and were more likely to harm the child, when compared with heterosexual couples (Gato & Fontaine, 2016, 2017).
In what concerns the impact of the sexual orientation of the potential donors themselves, Freeman and colleagues (2016) verified that gay and bisexual men showed an open mind when it came to anonymity and were more willing to contact children conceived with their sperm than heterosexual men.
We expected heterosexual men to show more negative attitudes towards donating to lesbian couples and/or to single lesbian women than to heterosexual couples and/or single heterosexual women. No differences were expected in the case of gay and bisexual men. Furthermore, we expected that heterosexual men showed more negative attitudes toward non-anonymity donation than non-heterosexual men.
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Correlates of attitudes towards gamete donation
Numerous variables can influence motivations and attitudes of individuals towards gamete donation. In this study, besides the sexual orientation of the donors and of the recipients of the donation, we investigated the role of potential donors’ characteristics such as personality traits (White, Poulsen, & Hyde, 2017), empathy (Verhaert & Van den Poel, 2011), social values (Ryckman, Gold, Reubsaet, & van den Borne, 2009), and religious values (Rubio, 2015) on motivations and attitudes towards gamete donation.
Personality Traits
Conscientiousness is described as a tendency for people to be hardworking, purposeful and disciplined, instead of easy going, unambitious and weak-willed (McCrae & Costa, 2008). It has also been identified as particularly relevant in giving behaviors. For instance, people with high levels of conscientiousness have more tendency to volunteer time (White et al., 2017). Furthermore, a study which aimed to explore the relationship between motivation for body donation port-mortem and personality traits highlighted conscientiousness as a major motivation for body donation (Bolt, Eisinga, Venbrux, Kuks, & Gerrits, 2011).
Openness to Experience describes imaginative, curious and exploratory tendencies rather than rigid, practical and traditional tendencies (McCrae & Costa, 2008). People with high levels of openness are not the passive recipients of a panoply of experiences they are unable to project; they actively seek new experiences. However, closed individuals are likely to be traditional and repetitive and oblige their functions to escape from stress (McCrae & Costa, 1997). Facing this, we intended to explore the relation between Conscientiousness, Openness to Experience and attitudes and motivations to donate gametes.
Empathy
Decety and Jackson (2004) defined empathy as a sense of similarity between the feelings of the self and the feelings of others. It has been established that empathy is an antecedent of different helping behaviors (Batson, 1987). Empathy can also have an effect in the perception of benefits of the decision to donate organs, affecting how motivated are individuals by motivators to donate for themselves or for others (Cohen & Hoffner, 2013). People with high levels of empathic concern are donors in various contexts, focusing on
6 alleviating the suffering of others in need and seem to be rather other-oriented and compassionate towards others (Verhaert & Van den Poel, 2011). Given this, we intended to explore the relation between empathic concern and motivations and attitudes towards gamete donation.
Values
Schwartz (1992) defined values as criteria which individuals use to select and justify actions and to evaluate events and people (including the self). The theory proposed an organization of 10 types of motivational values, being Power, Achievement, Hedonism,
Stimulation, Self- Direction, Universalism, Benevolence, Tradition, Conformity and Security (Schwartz, 1992).
A study conducted by Ryckman and collaborators (2009) aimed to identify which personal values were associated with the intent to register as an organ donor. It was discovered that individuals who showed higher levels of social conformity, but lower levels of hedonism expressed a greater intent to register as organ donors. The study also highlighted how personal values could play an important role in health education campaigns, seeking the increase of the supply of donor organs available for transplantation.
Conservation values express the need to conserve the status quo (e.g., family security, social order) and the security it provides in relationships with others, traditions and institutions (Schwartz, 1992, 1994). Hence, we intended to explore the relation between conservation values and motivations and attitudes towards gamete donation.
Religious Values
Although the Catholic Church exerted for a long time an influence on the Portuguese society, nowadays “Portugal is, in a modern way, simultaneously a secularized, religious and catholic country” (Dix, 2010, p. 25). Catholicism tends to reject all alternative forms of family formation, based on arguments about the nature of sex, marriage and the family, as well as arguments about the dignity of the embryo, the rights of the child and the resources used to improve biological reproduction (Rubio, 2015). We thus aimed to explore the relation between religious values and motivations and attitudes towards gamete donation.
Summarizing, the goal of study was, firstly, to explore the differences between motivations to donate, attitudes towards anonymity and attitudes towards donating for
7 specific groups, secondly, to explore these differences as function of the sexual orientation of the participants and, lastly, the relation between motivations to donate, attitudes towards anonymity, attitudes towards donating for specific groups and participants’ psychological characteristics.
1. Method
1.1. Participants
Our sample was composed of 282 male participants, ranging from 18 to 40 years of age. As showed in Table 1, most participants were heterosexual. Almost all of the participants described their “race”/ethnicity as white or Caucasian. The majority of the participants reported to live in the North of Portugal. Slightly less than half of the participants lived in a major city and the remainder in a small city/town/rural area. Most participants had or were attending a higher education degree (the majority in Social Sciences). Participants showed a middle tendency in political orientation. Regarding professional status, more than half of the participants were employed and the remainder were either unemployed or students. Participants who were employed reported mainly a permanent employment link. Additionally, more than half of the participants reported a monthly income of 1000€ or less. Most of the participants were single, claimed they did not have children, and had never donated sperm before.
To calculate the adequacy of our sample size, the G*Power Software (version 3.1.9.7) was used (Faul, Erdfelder, Lang, & Buchner, 2007). A power analysis, with an alpha = .05 and power = .95, revealed that the projected minimum sample size needed to detect an effect size of f = .15 is n = 129 (for a Repeated Measures Analysis of Variance).
1.2. Procedure
Data were collected through a questionnaire, which was released online via social networks (Facebook and Instagram), from December 2019 to March 2020. Inclusion criteria for the study were to be a male able to donate sperm, with an age between 18 and 40 years. To this end, a Facebook page was created for the study, where participants could read about the aim of the research and find a hyperlink to the questionnaire. Fourteen assisted
8 reproduction clinics (three public and 11 private) were contacted in order to advertise the research. Only three clinics contacted us back, reporting they could not help in advertising the study. The study was also advertised among LGBT associations, since one of the goals of the investigation was to explore the influence of the sexual orientation of the participants on their motivations to donate gametes, their attitudes toward anonymity of the donation and their attitudes toward donating for specific groups. Besides this, 100 printed questionnaires in closed envelopes were also personally distributed among the research team members’ social contacts. Of these 100 questionnaires, 17 were returned. This low return rate relates to the COVID-19 pandemic and the lockdown measures decreed by the Portuguese government in March 18th 2020, that prevented social exchanges between researchers and potential participants after this period.
Both versions of the questionnaires (paper and on-line) had an informed consent, in which participants could read the goals of the study and be aware of their right to confidentiality and anonymity, by checking boxes at the start of the questionnaire. Contact details for the principal researcher were provided so participants could reach out, in case of doubts or questions. Participants could give up on filling the questionnaire at any moment, without any consequence. Completing the questionnaire took no longer than 20 minutes and participation had no direct benefits to the participants.
1.3.Measures
Sociodemographic data. Participants answered a sociodemographic questionnaire,
which included questions about age, gender (male or other), sexual orientation (heterosexual, bisexual, gay or other), “race” and/or ethnicity (open question), region of residence (North, South, Center, Greater Porto, Greater Lisbon, Madeira, Azores), place of residence (major city, small city, town or rural area), education level (4th grade, 6th grade, 9th grade, 12th grade, graduation, masters or doctorate) and area of study (whenever applicable), political orientation (from 0 = left wing to 10 = right wing), marital status (married/non-marital partnership, single, separate, divorced or widower), parental status (having children or not), professional status (full-time job, part-time job, unemployed, or student), job (whenever applicable), and type of contract (temporary, permanent, not applicable), monthly income (up to 500€, between 501€ and 1000€, between 1001€ and 1500€, between 1501€ and 2000€,
9 between 2001€ and 2500€ or above 2501€) and if participants ever donated sperm (yes or no).
Motivation to donate, attitudes toward anonymity and attitudes toward donating for specific groups. To measure motivations to donate, attitudes towards anonymity and
attitudes towards donating for specific groups, we used an experimental scale (Areias & Gato, 2019), adapted from Thorn, Katzork, and Daniels (2008). This scale was divided in three groups of questions: motivation to donate (3 items, e.g., “Financial compensation”), with a Likert-type scale from 1 (Unimportant) to 6 (Very Important); attitudes towards anonymity (3 items, e.g., “Parents should disclose DI conception with the child”), with a Likert-type scale from 1 (Totally Disagree) to 6 (Totally Agree); and attitudes towards donating for specific groups (6 items, e.g., “Lesbian woman without fertility issues”), with a Likert-type scale from 1 (Not Willing) to 6 (Very Willing). Items were averaged, with higher scores indicating greater importance/agreement/willingness. For each subscale, items were treated individually as in the original study (Thorn et al., 2008).
Personality traits. We used a brief version of the NEO-PI-R scale (Costa & McCrae,
1992), the Portuguese version of the NEO-FFI (Magalhães, Salgueira, Gonzalez, Costa, Costa, Costa, & Lima, 2014). Given our research aims, we chose the Conscientiousness (12 items, e.g., “I try to perform all the tasks assigned to me conscientiously”) and Openness to Experience (12 items, e.g., “I don’t like to waste my time daydreaming”) subscales. A 5-point Likert-type scale from 1 (Totally Disagree) to 5 (Totally Agree) was used. Items were averaged, with higher scores indicating greater levels of the measured dimension. The internal consistency values (Cronbach’s alphas) presented acceptable values for Openness to Experience (α = .62) and good values for Consciousness (α = .76).
Empathy. To measure empathy, we used the Portuguese version of Interpersonal
Reactivity Index (Davis, 1983; Limpo, Alves, & Castro, 2010). Considering our research goals we only used the Empathic Concern subscale (6 items, e.g. “Sometimes I don’t feel very sorry for other people when they are having problems”). A 5-point Likert scale from 0 (Does not describe me) to 4 (Describes me very well) measured each item. Items were averaged, with higher scores indicating greater levels of empathic concern. The subscale presented a good internal consistency value (α = .75).
Social Values. Social values were measured using the Portuguese version of the
Schwartz’s Values Scale (Schwartz, 1992; Granjo & Peixoto, 2013). In this study, only the Conservation values were included (6 items, e.g. “He believes that people should do what
10 they’re told. He thinks people should follow rules at all times, even when no-one is watching”). These are divided in three categories: Tradition, Conformity and Security, with two items each category. In the present study, the overall subscale of Conservation values was used. Each item was measured with a Likert scale from 1 (Not like me at all) to 6 (Very
much like me). Items were averaged, with higher scores indicating greater levels of empathic
concern. The subscale presented a good internal consistency value (α = .74).
1.4. Data analysis procedure
All statistical procedures were conducted using the SPSS 26. Repeated Measures Analyses of Variance (RM ANOVAs) were run to assess within-subjects differences in motivations to donate, attitudes toward anonymity and attitudes towards donating for specific groups. Given the unbalanced number of participants in each group, Mann-Whitney tests were run to assess differences in (i) motivations to donate, (ii) attitudes towards anonymity, and (iii) attitudes towards donating for specific groups, as function of sexual orientation (gay and bisexual men were assembled in one group and heterosexual men in another; two asexual men, and two men who described their sexual orientation as “other” were excluded from the analyses).
In order to inspect the association between (i) motivations to donate, attitudes toward anonymity, attitudes towards donating for specific groups, (ii) sociodemographic characteristics, and (iii) psychological characteristics (Conscientiousness, Openness to Experience, Empathic Concern, Conservative Values, and Religious Values) Pearson’s r correlations were run.
2. Results
First, we analyzed the distribution of the continuous variables used in the study. All values were withing the normality range for both skewness 2.09 to 0.95) and kurtosis (-1.47 to 4.14) (Kline, 2011). Next, we report results regarding: (i) within-subjects differences in motivations to donate, attitudes towards anonymity, and attitudes towards donating for specific groups, (ii) differences in motivations to donate, attitudes towards anonymity and attitudes towards donating for specific groups as function of participants’ sexual orientation, (iii) relation between motivations to donate, attitudes towards anonymity and attitudes
11 towards donating for specific groups and participants’ sociodemographic and psychological characteristics.
2.1. Within-subjects differences in motivations to donate, attitudes towards anonymity and attitudes towards donating for specific groups
Within-subject differences were assessed for motivations to donate, attitudes towards anonymity and attitudes towards donating to specific groups. According to Table 2, motivations to donate were primarily related to altruistic reasons. This way, helping someone to have a child significantly differed from both knowing one’s fertility and financial compensation (difference with a medium-large effect size).As for attitudes towards anonymity, willingness to be contacted by the child when they reached 18 years was the less subscribed attitude, differing significantly from the other two, which were endorsed to a greater extent (Table 3) (difference with a medium effect size).
Regarding attitudes towards donating for specific groups, heterosexual women with fertility problems was the group associated with the most positive attitude, differing from lesbian couples, heterosexual women without fertility problems, and lesbian women with fertility problems. Donating to a lesbian woman without fertility problems differed from donating to a different-sex couple, a heterosexual woman with fertility problems and a lesbian woman with fertility problems. In its turn, donating to a different-sex couple differed from donating to a heterosexual woman with fertility problem and from heterosexual woman without fertility problems. Donating to a heterosexual woman without fertility problems differed from donating to a lesbian woman with fertility problems (Table 4). In sum, participants held more positive attitudes towards donating to groups with fertility problems (difference with a medium effect size).
2.2. Differences in motivations to donate, attitudes towards anonymity and attitudes towards donating for specific groups as function of sexual orientation
According to Table 5, differences as function of sexual orientation were only found in the motivation “Knowing one’s fertility”, with heterosexual men giving more importance to this motivation than non-heterosexual men.
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2.3. Association between motivations to donate, attitudes towards anonymity
and attitudes towards donating for specific groups, and participants’
sociodemographic and psychological characteristics
Regarding sociodemographic characteristics, age was negatively correlated with the motivation “knowing one’s fertility” and with the attitude “parents should disclose DI conception with the child”. Education levels were also negatively correlated with the motivation “knowing one’s fertility”. Monthly income of participants was negatively correlated with financial compensation (Table 6).
As showed in Table 7, Conscientiousness was positively correlated with knowing one’s fertility. Empathic Concern was positively correlated with helping someone to have a child and with positive attitudes towards donating to most groups (lesbian woman without fertility problems, different-sex couple, lesbian couple, heterosexual woman without fertility problems, and lesbian woman with fertility problems). Conservative values were positively correlated with financial compensation and knowing one’s fertility. Lastly, religious values were negatively correlated with helping someone to have a child and to attitudes towards donating to all groups.
3. Discussion
The main goal of this study was to highlight what drives men to donate gametes, specifically, their motivations to donate, their attitudes toward anonymity and towards donating for specific groups, considering their sexual orientation, and what psychological traits and sociodemographic characteristics were associated with the these motivations and attitudes. Differences were found between motivations to donate and “helping someone to have a child” was the most reported motivation, denoting an altruistic stance towards gamete donation. Differences were also found in attitudes toward anonymity, with men showing positive attitudes towards the disclosure of DI conception to the child and the disclosure of non-identifying information about themselves; willingness to be contacted by the child when they reached majority (18 years old) was the least reported attitude. Concerning attitudes towards donating for specific groups, differences were also found, with men reporting more positive attitudes to donate to a heterosexual woman with fertility problems and less positive attitudes to donate to a heterosexual woman without fertility problems. Taking into account
13 the sexual orientation of the participants, no differences were found between non-heterosexual and non-heterosexual men in their motivations and attitudes, except in the motivation to know one’s fertility, with heterosexual men assigning more importance to this motivation than non-heterosexual men.
Regarding sociodemographic characteristics, younger participants subscribed more the motivation “knowing one’s fertility” and believed “parents should disclose DI conception with the child”, than their older peers. Less educated participants subscribed more the motivation “knowing one’s fertility”, than their more educated counterparts. Concerning the participants’ psychological characteristics, Conscientiousness was positively associated with knowing one’s fertility. Empathic concern was positively associated with helping someone to have a child and a positive attitude towards donating to most groups. Conservation values were positively related with financial compensation and knowing one’s fertility status, Finally, participants who attributed more importance to religious values were less motivated to help someone to have a child and less willing to donate to all types of recipients. For clarity reasons, we opted to discuss results per dependent variable, i.e., i) motivations to donate, ii) attitudes towards anonymity, and iii) attitudes towards donating for specific groups.
3.1. Motivations to donate
Consistent with the literature, altruistic motivation seemed to be the most important reason to donate gametes, valuing the desire to help a childless couple to have a child (Ekerhovd et al., 2008; Hedrih & Hedrih, 2012; Thijssen et al., 2017; Van der Broeck et al., 2013) and depreciating the financial compensation for the donating (Ekerhovd et al., 2008; Hedrih & Hedrih, 2012; Thijssen et al., 2017). Motivations to donate were not associated with participants’ sexual orientation, except in the case of the motivation “knowing one’s fertility”, with heterosexual men giving more importance to this motivation than non-heterosexual men. Non-non-heterosexual men’s devaluation of their fertility status may be associated with the fact that they anticipate stigma upon parenthood (Gato, Leal, Coimbra, & Tasker, 2020). Further, many non-heterosexual men seem to be unfamiliar with alternative paths to parenting (Patterson & Riskind, 2010) and some still envisage parenting as a feminine role (Gato & Fontaine, 2017; Pelka, 2009). Nevertheless, future investigation should investigate further the genesis of these differences.
14 Age was negatively associated with the motivation “knowing one’s fertility”, with younger men giving more importance to this motivation. According to Thijssen and collaborators (2017), this association is to be expected, since younger and childless men have not yet confirmed their fertility status. Further, less educated men also valued more this motivation. Considering “knowing one’s fertility” an individualistic motivation to donate, these results bring to the discussion differences between collectivist and individualistic values. Triandis (1995) described collectivist people as driven by in-group rules and duties, prioritizing the goals of the group and emphasizing the connectivity with others, while individualistic people are more driven by their own needs, preferences and rights, prioritizing their personal goals. In our study, this relation may have translated into men with lower levels of education being more individualistic, hence the negative relation between “knowing one’s fertility” and education levels. Although no evidence was found regarding this relation, future investigation should explore the link between these concepts.
Considering psychological characteristics of participants, men with higher levels of Conscientiousness gave more importance to the knowledge of their fertility status. This positive association may come from the fact that people with high levels of conscientiousness are hardworking, purposeful and disciplined (McCrae & Costa, 2008) so, these people would give importance to a motivation to donate which is both based in the curiosity and willingness to pass on their “good genes” and in the need to confirm one’s fertility (Thijssen et al., 2017), in order to prove their purpose and usefulness to society and themselves.
Similarly, men with higher levels of Conservation values also gave more importance to the knowledge of their fertility status. This is not surprising if we take into account that more conservative individuals value social order and give more importance to traditional institutions (Schwartz, 1992, 1994), such as the heteronormative family, in which children generally have a genetic link with their parents.
People with high levels of empathic concern are donors in various contexts, compassionate towards others and seem to be other-oriented, focusing on alleviating the suffering of others in need (Verhaert & Van den Poel, 2011), hence the positive association between empathic concern and the motivation to help others to have a child, found in this study. Conversely, religious values were negatively correlated with the latter motivation. Even though Portugal is nowadays a secular country, Catholic values still seem to exert a
15 certain influence (Dix, 2010). In our study, the negative association between adherence to religious values and helping someone to have a child may be due to the fact that Catholicism tends to reject alternative family configurations, including the pursuit of pregnancy through ART (Rubio, 2015).
3.2. Attitudes towards anonymity
Willingness to be contacted by the child was the less subscribed attitude and differed from “parents should disclose DI conception with the child” and “the institution where DI was realized can provide information about me to the child, since that information does not identify me”. This result is in accordance with research that has found that men tend to give up donation if their name is to be disclosed (Bay et al., 2014; Thijssen et al., 2017). Nevertheless, a relatively positive view regarding the non-anonymity of the donation was noticeable, since all the participants positively endorsed attitudes toward disclosure of the DI conception and release of donor’s identity. No differences in attitudes towards anonymity were found as function of sexual orientation, contradicting the findings of Freeman and collaborators (2016), according to which gay and bisexual men showed a more open mind when it came to anonymity and were more willing to contact children conceived with their sperm, than their heterosexual peers.
Concerning sociodemographic characteristics, age was negatively associated with the attitude “parents should disclose DI conception with the child”, meaning younger participants subscribed more to this attitude. According to Riggs and Russell (2011), men with ages under 26 preferred identity release legislation and so, this preference for identity release may be mirrored in opinion that parents should disclose DI conception with the child. No psychological characteristics were associated with attitudes towards anonymity, perhaps due to the choice of psychological correlates in this study. Future investigation should include other aspects, such as neuroticism or agreeableness.
3.3. Attitudes towards donating for specific groups
Regarding attitudes towards donating for specific groups, a positive tendency to donate to all the groups was noticeable, consistent with results from other studies (Bay et al., 2014; Ekerhovd et al., 2008; Thijssen et al., 2017). Nevertheless, donating for a heterosexual
16 woman with fertility problems was the group with the most positive attitude. This may come from the altruistic motivation to donate reported by participants. In fact, altruism is based on the desire to help someone to have a child (Ekerhovd et al., 2008; Hedrih & Hedrih, 2012; Thijssen et al., 2017; Van der Broeck et al., 2013) and infertile women may have been perceived, a priori, as those who are in greater disadvantage. From another angle, the preference for donating to groups with fertility problems, may reflect that the spirit of the Law nº17/2016 (Diário da República, 2016), which extended public funded ARTs to all women (independently of their sexual orientation, relational status, and fertility status) may not have been internalized by the participants of this study and access to ART may still be seen mostly as a prerogative of infertile women. Interestingly, non-heterosexual and heterosexual men do not seem to think differently about this issue.
Empathic concern was positively associated with donating for most groups of recipients. This positive attitude for donating for specific groups derives from the fact that people with high levels of empathic concern focus on alleviating the suffering of others and are rather compassionate towards others (Verhaert & Van den Poel, 2011). Contrarily to empathic concern, however, adherence to religious values was negatively associated to donating for all the groups. As mentioned above, this negative association may stem from the influence Catholic views about the family (Rubio, 2015).
3.4. Limitations, future directions, and implications for practice
Like any other study, this one was not without limitations. More than half of our sample was highly educated and hence not representative of the Portuguese population. Regarding this, 56% of the participants had completed or were completing a university degree; however, in 2019, only 19.6% of the Portuguese population had achieved this educational level (PORDATA, 2020). Additionally, the imbalance concerning the number of heterosexual and non-heterosexual men, may have compromised results and prevented us from drawing conclusions as function of this variable. The small magnitude of effects (except in the RM ANOVAs) also imposed a concern, limiting the generalization of results.
Given prevailing negative attitudes towards same-sex parented families (e.g., Gato & Fontaine, 2013, 2016, 2017), future investigation should explore the relation between views of lesbian and gay parenthood and motivation/attitudes to donate to same-sex couples, as well as the impact of stigma directed at sexual minorities, by exploring attitudes towards
17 homosexuality, in general, and how these attitudes correlate with attitudes towards donating for lesbian and gay parents. It should also be noted that there is no evidence that psychosocial development of children of same-sex couples is, in any way, undermined (Patterson, 1992), and so, future campaigns, aimed to recruit gamete donors, should also disseminate this fact.
Despite the limitations, our findings have implications for practice. By highlighting motivations, attitudes and characteristics of possible candidate donors, results of this study may be informative for future sensibilization campaigns, since it is considered that the lack of donors comes from the scarcity of these campaigns (Lusa, 2016). Based on these results, it could be argued that campaigns should target specific motivations, attitudes and characteristics of the participants. As Ferguson, Atsma, de Kort, and Veldhuizen (2012) reported in the context of blood donation, emphasizing positive feelings associated with donation may increase donation rates, thus the same could be applied in the context of gamete donation. For example, in this study, the most reported motivation to donate was to help someone have a child, i.e., an altruistic motivation, and so it may be pertinent in a campaign to highlight the altruistic character of a donation.
This study also contributes to the view that the withdraw of the anonymity of donation, which took place in Portugal in 2018, may not affect the number of possible donors, thus showing the positive trend towards non-anonymity reported by other studies (Bay et al., 2014; Thijssen et al., 2017). However, given the pattern of disengagement with the anonymity of the donation when the information disclosed is too personal or in cases where there is the possibility of contact with the child the issue of anonymity should be further debated and clarified. Future recruitment campaigns should therefore stress that, upon release of anonymity, there is no obligation or commitment of any kind on the part of the donor towards the child. Likewise, it is crucial to emphasize that parenthood is a universal right, encouraging the donation of gametes to any person or couple, regardless of their diagnosis of fertility and sexual orientation.
18
4. Conclusion
The present work has contributed to the emergent field of investigation on gamete donations, by investigating motivations to donate, attitudes towards anonymity and attitudes towards donating for specific groups, from the perspective of potential donors. Motivations and attitudes differed from each other but did not differ as function of sexual orientation. Groups with fertility problems were slightly more favored than others. Hopefully, results of this study may be used to help design more effective campaigns to attract male donors.
19
5. References
Almeling, R. (2006). ‘Why do you want to be a donor?’: gender and the production of altruism in egg and sperm donation. New Genetics & Society, 25(2), 143-157. doi:10.1080/14636770600855184.
Batson, C. D. (1987). Prosocial motivation: Is it ever truly altruistic? In L. Berkowitz (Ed.), Advances in experimental social psychology, Vol. 20 (p. 65–122). Academic Press. https://doi.org/10.1016/S0065-2601(08)60412-8
Bay, B., Larsen, P. B., Kesmodel, U. S., & Ingerslev, H. J. (2014). Danish sperm donors across three decades: motivations and attitudes. Fertility & Sterility, 101(1), 252-257.e251. doi:10.1016/j.fertnstert.2013.09.013.
Bolt, S., Eisinga, R., Venbrux, E., Kuks, J. B., & Gerrits, P. O. (2011). Personality and motivation for body donation. Annals of Anatomy-Anatomischer Anzeiger, 193(2), 112-117. https://doi.org/10.1016/j.aanat.2011.01.005
Crawford, I., & Solliday, E. (1996). The attitudes of undergraduate college students toward gay parenting. Journal of Homosexuality, 30(4), 63-77. doi:10.1300/J082v30n04_04 Cohen, E. L., & Hoffner, C. (2013). Gifts of giving: The role of empathy and perceived
benefits to others and self in young adults’ decisions to become organ donors. Journal
of Health Psychology, 18(1), 128-138. doi:10.1177/1359105311433910.
Costa, P. T., & McCrae, R. R. (1992). Normal personality assessment in clinical practice: The NEO Personality Inventory. Psychological assessment, 4(1), 5.
Davis, M. H. (1983). Measuring individual differences in empathy: Evidence for a multidimensional approach. Journal of Personality and Social Psychology, 44, 113-126.
Decety, J., & Jackson, P. L. (2004). The functional architecture of human empathy.
Behavioral and Cognitive Neuroscience Reviews, 3, 71-100.
Decreto Lei nº 17/2016 de 4 de abril do Ministério da Educação. Diário da República: I série, Nº 65 (2016). Acedido a 6 nov. 2019. Disponível em: www.dre.pt
Dias Cordeiro, A. (2018, abril 26). Procriação Medicamente Assistida: filhos vão poder saber quem foram os dadores. Público. Disponível em: https://www.publico.pt/ Dix, S. (2010). As esferas seculares e religiosas na sociedade portuguesa [The secular and
20 Ekerhovd, E., Faurskov, A., & Werner, C. (2008). Swedish Sperm Donors Are Driven by Altruism, but Shortage of Sperm Donors Leads to Reproductive Travelling. Upsala
Journal of Medical Sciences, 113(3), 305-313. doi:10.3109/2000-1967-241.
Esteves dos Santos, S. (2019, abril 16). Infertilidade atinge 15% dos casais em idade reprodutiva. Atlas da Saúde. Disponível em: https://www.atlasdasaude.pt/
Faul, F., Erdfelder, E., Lang, A.-G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior
Research Methods, 39, 175-191.
Ferguson, E., Atsma, F., de Kort, W., & Veldhuizen, I. (2012). Exploring the pattern of blood donor beliefs in first-time, novice, and experienced donors: Differentiating reluctant altruism, pure altruism, impure altruism, and warm glow. Transfusion, 52, 343–355. https://doi.org/10.1111/j.1537-2995.2011.03279.x
Freeman, T., Jadva, V., Tranfield, E., & Golombok, S. (2016). Online sperm donation: a survey of the demographic characteristics, motivations, preferences and experiences of sperm donors on a connection website. Human Reproduction, 31(9), 2082-2089. doi:10.1093/humrep/dew166
Fortescue, E. (2003). Gamete donation - where is the evidence that there are benefits in removing the anonymity of donors? A patients viewpoint. Reproductive BioMedicine
Online (Reproductive Healthcare Limited), 7(2), 139-144.
doi:10.1016/S1472-6483(10)61743-9.
Gato, J., & Fontaine, A. M. (2013). Anticipation of the sexual and gender development of children adopted by same-sex couples. International Journal of Psychology, 48(3), 244-253. doi:10.1080/00207594.2011.645484
Gato, J., & Fontaine, A. M. (2016). Attitudes toward adoption by same-sex couples: Effects of gender of the participant, sexual orientation of the couple, and gender of the child.
Journal of GLBT Family Studies, 12(1), 46-67. doi:10.1080/1550428X.2015.1049771
Gato, J., & Fontaine, A. (2017). Predicting attitudes toward lesbian and gay parent families among portuguese students from helping professions. International Journal of Sexual
Health, 29(2), 187-201. doi:10.1080/19317611.2016.1268232
Gato, J., Leal, D., Coimbra, S., & Tasker, F. (2020). Anticipating Parenthood Among Lesbian, Gay, Bisexual, and Heterosexual Young Adults Without Children in Portugal: Predictors and Profiles. Frontiers in Psychology, 11. doi:10.3389/fpsyg.2020.01058
21 Goldberg, A. E. (2010). Division 44: Contemporary perspectives on lesbian, gay, and bisexual psychology; Lesbian and gay parents and their children: Research on the family life cycle. Washington, DC: American Psychological Association. doi:10.1037/12055-000
Granjo, M., & Peixoto, F. (2013). Contributo para o estudo da Escala de Valores Humanos de Schwartz em professores. Laboratório de Psicologia, 11(1), 3-17.
Hedrih, A., & Hedrih, V. (2012). Attitudes and motives of potential sperm donors in Serbia.
Stavovi i motivi potencijalnih davalaca sperme u Srbiji., 69(1), 49-57.
doi:10.2298/VSP1201049H.
Herek, G. M. (2002). Gender gaps in public opinion about lesbians and gay men. Public
Opinion Quarterly, 66(1), 40-66. doi:10.1086/338409
Kalampalikis, N., Haas, V., Fieulaine, N., Doumergue, M., & Deschamps, G. (2013). Giving or giving back: New psychosocial insights from sperm donors in France. Psychology, Health & Medicine, 18(1), 1-9. doi:10.1080/13548506.2012.668195
Kimmel, M. S. (1994). Masculinity as homophobia: Fear, shame, and silence in the construction of gender identity. In H. Brod & M. Kaufman (Eds.), Theorizing
masculinties (pp. 119–141). Thousand Oaks, CA: Sage.
Kite, M. E., &Deaux, K. (1987). Gender belief systems: Homosexuality and implicit inversion theory. Psychology of Women Quarterly, 11,83–96.
Kline, R. B. (2011). Methodology in the Social Sciences. Principles and practice of
structural equation modeling (3rd ed.). Guilford Press.
Lei nº 48/2019 de 8 de julho da Assembleia da República. Diário da República: I série, Nº 128 (2019). Acedido a 20 jan. 2020. Disponível em. www.dre.pt
Limpo, T., Alves, R. A., & Catro, S. L. (2010). Medir a empatia: Adaptação portuguesa do Índice de Reactividade Interpessoal. Laboratório de Psicologia, 8(2), 171-184. Lusa (2016, maio 1). Banco Público de Gâmetas fez nascer 70 crianças em cinco anos.
Público. Disponível em: https://www.publico.pt/
Magalhães, E., Salgueira, A., Gonzalez, A. J., Costa, J. J., Costa, M. J., Costa, P., & Lima, M. P. D. (2014). NEO-FFI: Psychometric properties of a short personality inventory in Portuguese context. Psicologia: Reflexão e Crítica, 27(4), 642-657.
McCrae, R. R., & Costa, P. T., Jr. (1997). Conceptions and correlates of openness to experience. In R. Hogan, J. A. Johnson, & S. R. Briggs (Eds.), Handbook of
22 McCrae, R. R., & Costa, P. T., Jr. (2008). Empirical and theoretical status of the Five-Factor Model of personality traits. In G. Boyle, G. Matthews, & D. Saklofske (Eds.), Sage
Handbook of personality theory and assessment (Vol. 1, pp. 273-294). Los Angeles:
Sage.
Patterson, C. J. (1992). Children of lesbian and gay parents. Child Development, 63,1025– 1042
Patterson, C. J., & Riskind, R. G. (2010). To be a parent: Issues in family formation among gay and lesbian adults. Journal of GLBT Family Studies, 6(3), 326-340. doi: 10.1080/1550428X.2010.490902
Pelka, S. (2009). Sharing motherhood: Maternal jealousy among lesbian co-mothers.
Journal of Homosexuality, 56(2), 195-217. doi: 10.1080/00918360802623164
PORDATA, 2020. Resident population aged 15 and over by level of highest educational qualifications obtained (%).
http://www.pordata.pt/en/Portugal/Resident+population+aged+15+and+over+by+lev el+of+highest+educational+qualifications+obtained+(percentage)-884
Rubio, J. H. (2015). Family Ties: A Catholic Response to Donor-Conceived Families. Christian Bioethics, 21(2), 181–198. doi:10.1093/cb/cbv003
Ryckman, R. M., Gold, J. A., Reubsaet, A., & van den Borne, B. (2009). Value priorities and intention to register for posthumous organ donation in Dutch adolescents. The
Journal of Social Psychology, 149(2), 213-227. doi:10.3200/SOCP.149.2.213-228
Schwartz, S. H. (1992). Universals in the content and structure of values: Theoretical advances and empirical tests in 20 countries. In M. P. Zanna (Ed.), Advances in
Experimental Social Psychology (Vol. 25, pp. 1-65). Orlando: Academic Press.
Schwartz, S.H. (1994). Beyond individualism/collectivism: New dimensions of values. In U. Kim, H.C. Triandis, C. Kagitcibasi, S.C. Choi e G. Yoon (Eds.), Individualism and
Collectivism: Theory Application and Methods. Newbury Park, CA: Sage.
Serviço Nacional de Saúde (2020, February 19th). Banco Público de Gâmetas [Web page]. Retrieved from: https://www.sns.gov.pt/cidadao/banco-publico-de-gametas-2/
Silva, S., Freitas, C., Baía, I., Samorinha, C., Machado, H., & Silva, S. (2019). Doação de gametas: questões sociais e éticas (não) respondidas em Portugal. Cadernos de Saúde
Pública, 35(2). doi:10.1590/0102-311x00122918
Thijssen, A., Provoost, V., Vandormael, E., Dhont, N., Pennings, G., & Ombelet, W. (2017). Motivations and attitudes of candidate sperm donors in Belgium. Fertility & Sterility,
23 Thorn, P., Katzorke, T., & Daniels, K. (2008). Semen donors in Germany: A study exploring motivations and attitudes. Human Reproduction, 23(11), 2415-2415. doi:10.1093/humrep/den279
Triandis, H. C. (1995). Individualism and collectivism. Boulder, CO: Westview.
Van den Broeck, U., Vandermeeren, M., Vanderschueren, D., Enzlin, P., Demyttenaere, K., & D'Hooghe, T. (2013). A systematic review of sperm donors: demographic characteristics, attitudes, motives and experiences of the process of sperm donation.
Human Reproduction Update, 19(1), 37-51. doi:10.1093/humupd/dms039.
Novais, V. (2019, Agosto 28). Mais do que duplicou o número de mulheres à espera de dadores para poderem ser mães. Observador. Disponível em: www.observador.pt Van den Broeck, U., Vandermeeren, M., Vanderschueren, D., Enzlin, P., Demyttenaere, K.,
& D'Hooghe, T. (2013). A systematic review of sperm donors: demographic characteristics, attitudes, motives and experiences of the process of sperm donation. Human Reproduction Update, 19(1), 37-51. doi:10.1093/humupd/dms039
Verhaert, G. A., & Van den Poel, D. (2011). Empathy as added value in predicting donation behavior. Journal of Business Research, 64(12), 1288-1295. doi:10.1016/j.jbusres.2010.12.024
White, K. M., Poulsen, B. E., & Hyde, M. K. (2017). Identity and Personality Influences on Donating Money, Time, and Blood. Nonprofit and Voluntary Sector Quarterly, 46(2), 372-394. doi: 10.1177/0899764016654280.
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6. Supplementary Material
Table 1. Sociodemographic Variables
M SD Age* 26.68 6.81 Education Levels 4.82 0.89 Political Orientation** 5.81 2.43 Monthly Income*** 2.27 1.26 n % Sexual Orientation Heterosexual 192 68.10 Bisexual 27 9.60 Gay 59 20.90 Asexual 2 0.70 Other 2 0.70 “Race”/Ethnicity White/Caucasian 263 93.26 Other 19 6.74 Region of Residence North 92 32.60 South 14 5.00 Center 42 14.90 Greater Porto 55 19.50 Greater Lisbon 63 22.30 Madeira 5 1.80 Azores 5 1.80 Other 6 2.10 Place of Residence Major city 121 42.90
Small city, town or rural area 161 57.10
Marital Status
Married/Civil Union 68 24.10
25 Professional Status Employed 163 57.80 Unemployed/Students 119 42.20 Type of Contract**** Temporary 41 25.30 Permanent 98 60.50 N/A 23 14.20 Area of Study***** Agricultural Sciences 5 3.20
Engineering and Technology 23 14.60
Humanities and Arts 21 13.30
Medical and Health Sciences 27 17.10
Natural Sciences 14 8.90 Social Sciences 67 42.40 Other 1 0.50 Parental Status Yes 33 11.70 No 249 88.30
Have you ever donated sperm?
Yes 6 2.10 No 276 97.90 *. Valid n = 280 **. Valid n = 281 ***. Valid n = 271 ****. Valid n = 162 *****. Valid n = 158
26
Table 2. Differences in Motivations to Donate
Table 3. Differences in Attitudes toward Anonymity
Attitudes toward Anonymity M (SE) F(2, 562) p Ƞ2
Parents should disclose DI conception with the child
4.24a (0.10)
29.26 < .001 .09 The institution where DI was realized can
provide information about me to the child, since that information does not identify me
3.95a (0.11)
I would be willing to be contacted by the child when they reached majority (18 years old)
3.30b (0.12)
Note. Marginal means are reported and values in parentheses represent standard errors. Significant mean differences using the Bonferroni correction for multiple comparisons are denoted by differing superscript letters.
Table 4. Differences in Attitudes towards Donating for Specific Groups
Motivations to Donate M (SE) F(2, 562) p Ƞ2
Financial Compensation 3.75b (0.10)
36.98 < .001 .12 Knowing one’s fertility 4.03b (0.11)
Helping someone to have a child 4.85a (0.08)
Note. Marginal means are reported and values in parentheses represent standard errors. Significant mean differences using the Bonferroni correction for multiple comparisons are denoted by differing superscript letters.
Attitudes towards Donating for Specific Groups
M
(SE) F(3.46, 973.22) p Ƞ
2
Lesbian woman without fertility problems
4.80c
27
Table 5. Differences in motivations to donate, attitudes towards anonymity and attitudes
towards donating for specific groups as function of sexual orientation
M (SD) U p Non-heterosexual n = 86 Heterosexual n = 192 Motivations to Donate Financial Compensation 3.71 (1.69) 3.76 (1.75) 8099.50 .797 Knowing one’s fertility 3.63 (1.80) 4.22 (1.79) 6701.00 .010 Helping someone to have a
child 4.74 (1.47) 4.91 (1.37) 7862.00 .500
Attitudes towards Anonymity Parents should disclose DI
conception with the child 4.26 (1.53) 4.23 (1.66) 8277.50 .971 The institution where DI
was realized can provide information about me to the child, since that information does not identify me
3.95 (1.83) 3.96 (1.84) 8214.00 .945 Different-sex couple 5.06
b (0.09) Heterosexual woman with
fertility problems 5.33a (0.07) Lesbian couple 4.89 b,c (0.10) Heterosexual woman without
fertility problems
4.67c (0.11) Lesbian woman with
fertility problems
4.97a,b,c (0.10)
Note. Marginal means are reported and values in parentheses represent standard errors. Significant mean differences using the Bonferroni correction for multiple comparisons are denoted by differing superscript letters.
28 I would be willing to be
contacted by the child when they reached majority (18 years old)
3.59 (1.91) 3.21 (1.94) 9219.00 .112
Attitudes towards Donating for Specific Groups Lesbian woman without
fertility problems 5.07 (1.49) 4.66 (1.79) 9071.50 .147 Different-sex couple 5.15 (1.39) 5.01 (1.51) 8419.00 .766 Heterosexual woman with
fertility problems 5.28 (1.28) 5.33 (1.14) 8183.50 .890
Lesbian couple 5.14 (1.41) 4.76 (1.70) 9091.00 .138
Heterosexual woman
without fertility problem 4.72 (1.74) 4.63 (1.79) 8384.00 .822 Lesbian woman with
fertility problems 5.21 (1.36) 4.83 (1.68) 9103.00 .127 Note. Mean and standard deviation values were presented for a better understanding of the differences.
29
Table 6. Correlations between Motivations to Donate, Attitudes towards Anonymity, Attitudes towards Donating for Specific Groups and
Sociodemographic Variables Age Education Level Monthly Income Motivations to Donate Financial Compensation -.08 -.01 -.12*
Knowing one’s fertility -.15* -.21** -.04
Helping someone to have a child .02 -.09 -.07
Attitudes toward Anonymity
Parents should disclose DI conception with the child -.15* -.08 -.03
The institution where DI was realized can provide information about me to the child, since that information
does not identify me -.12 -.01 -.00
I would be willing to be contacted by the child when they reached majority (18 years old) -.09 -.11 .04 Attitudes towards Donating for Specific Groups
Lesbian woman without fertility problems -.00 .01 -.02
Different-sex couple -.01 .06 .01
Heterosexual woman with fertility problems -.03 -.01 -.11
Lesbian couple -.08 -.00 -.00
Heterosexual woman without fertility problems .09 .04 .04
