P-480 Demographic and family-based predictors of Dutch societal attitudes towards surrogacy

Abstract

Abstract Study question What factors shape societal attitudes toward surrogacy in a representative sample of the adult population? Summary answer Participants’ demographic factors (education, sexuality, ethnicity, religiosity) and factors related to surrogacy families (parental composition, social bond oocyte donor) predict attitudes toward surrogacy. What is known already Attitudes toward surrogacy families frequently have a negative influence on the well-being of these families. Counselling will help surrogacy families cope with negative reactions. Current debates regarding legislation on surrogacy show diverse attitudes towards surrogacy. Previous studies hint at attitudes toward surrogacy being influenced by demographic factors such as age, education, sexual preference, ethnicity, urbanization and religiosity, and factors of surrogacy families such as parental composition (cisgender different-sex parents, same-sex parents and transgender parents) and social or genetic bonds between the surrogate, oocyte donor and parents. Study design, size, duration This vignette study included a representative sample of 1075 adults from the Dutch population, who filled out a questionnaire in June 2023. The vignettes used were descriptions of a surrogacy family and gave context to the questionnaire. Vignettes varied the following aspects; sexuality and gender of parents, and social and genetic bonds between the parents, the surrogate, and the oocyte donor. Participants were asked about their attitudes on four randomly assigned vignettes. Participants/materials, setting, methods Demographic information of the participants was collected via questionnaires. We designed vignettes accompanied by a questionnaire to measure attitudes (α between .81 and .91). Multilevel regression analysis was performed with attitudes as the dependent variable and demographic factors (age, education, sexual preference, ethnicity, urbanization and religiosity) and aspects of surrogacy families (parental composition, genetic and social bonds with the surrogate and oocyte donors) as predictors. Main results and the role of chance Attitudes are influenced by most studied demographic factors. People were more likely to have positive attitudes when they were either higher educated, identified themselves as non-heterosexual, had a Dutch background, or were less religious. Age and urbanization did not predict attitudes. Factors related to the parental composition of a surrogacy family predicted attitudes. A cisgender man and a cisgender woman were judged more positively compared to two cisgender men or when a transgender person was involved. Oocyte donation from a friend or sister was judged more negatively compared to an oocyte from the oocyte bank (without a social bond to the parents). Attitudes were more negative when oocyte donation took place than when oocytes of an intended mother were utilized (p values range between .007 and < .001). There was no difference between the presence and absence of social and genetic bonds between parents and surrogates. There were no differences in the presence or absence of a genetic bond between parents and oocyte donors. No differences were found between a surrogate using her own oocytes compared to donated oocytes. Limitations, reasons for caution The study was limited to one European country. Furthermore, all participants participated in monthly questionnaires. Although a representative sample of the Dutch population was used, willingness to participate monthly in questionnaire studies might influence generalizability. Wider implications of the findings Based on our findings, it will be possible to inform cisgender different-sex, same-sex and transgender parents of the societal reactions they might encounter and counsel them on how to best deal with these reactions. The attitude towards known oocyte donors warrants us to initiate more investigation. Trial registration number not applicable