I work in tech for my day job so I have access to various new AI models and, from time to time, I test out how they view surrogacy by doing some research or asking a question. I recently re-did this current website using AI and I had to repeatedly explain the website was for people born through surrogacy and fight against the bias towards making the site about intended parents, surrogates, etc. AI continually presented me with AI generated photos of families holding a new baby or fake articles about the joy of being a surrogate. When it finally clicked, the AI exclaimed something to the effect of “what a niche site to build!” I sighed and thought to myself, “don’t rub it in”.

In any case, in a recent deep dive, I found a research article listed that caught my attention: New-Onset Mental Illness Among Gestational Carriers from 2025. It pulls research from Ontario, Canada comparing outcomes across non–gestational carriers with unassisted conception, non–gestational carriers who conceived by in vitro fertilization, gestational carriers. This is a complicated way of saying they compared across people who conceived their own child naturally, those who needed help conceiving their own child, and those who were gestational surrogates. I recommend reading the research directly and I won’t spend time summarizing that beyond sharing the following specifics and outcomes:

Gestational carriers appear more likely to be diagnosed with mental illness during and after pregnancy. Because gestational carriers may be more likely to be diagnosed with new-onset mental illness, mental health screening and the provision of counseling and support during and after pregnancy may be particularly important in this group.

The findings of additional analysis 1 suggest that some gestational carriers may experience grief from relinquishing the newborn, such as that described after adoption¹⁴ or removal of the child into foster care¹⁵—something that needs detailed study.

The Guardian has an article titled “Surrogates at greater risk of new mental illness than women carrying own babies, study finds” if you prefer a more synthesized, easy to read summary.

It’s astounding to me that this is so under-researched and that the research doesn’t extend to the resulting children. Of course, people are affected by carrying a child, birthing it, and giving it away. It’s why psychological screenings are done and it’s been a longstanding point of removing folks from the prospective pool if they don’t seem they can handle it. The main research I’ve found on the impacts of surrogacy over time on the children comes from Prof. Susan Golombok, who I have been in contact with. Her book, We Are Family: what really matters for parents and children, sits on my shelf a few feet from me. I’ve dared to open it a handful of times only to close it soon after in a heap of disappointment. The start of her research comes from a powerful place of wanting to support lesbian moms in custody battles:

It showed a photograph of three women and their three children underneath the headline, ‘Out of the closet into the courts: why could one of these women lose custody of her child?’ I flipped open the magazine and began to read. The journalist, Eleanor Stephens, described how, almost without exception, lesbian mothers fighting custody battles against their former husbands were losing the right to live with their children, in stark contrast to the experiences of heterosexual mothers who were practically always awarded custody in those cases. At the time the article was published, not a single lesbian woman had been awarded custody of her children by a UK court.”

I’m queer and found it devastating to read even this first page of the Preface to the book. She nobly took on this overall cause and, in the process, eventually landed in the world of surrogacy to study the impacts on children to try to give a research backed stamp of approval. This is a complex, sensitive topic in a complex world. There is a world of difference between a mom who comes out as a lesbian after having children with an ex-husband and a husband and wife using a surrogate. Again, I’ll repeat: surrogacy isn’t a gay issue. Susan Golombok studies are longitudinal, beginning in 2000, and follow 42 families and their children at ages 1, 2, 3, 7, 10, and 14. By age 7, only 32 families remained from what I can tell. To complicate the research more, traditional and gestational were combined with 21 of the children (66%) by traditional surrogacy and 11 (34%) by gestational surrogacy. I’m born via traditional surrogacy and I would greatly argue for not merging these two. Below is a nice Claude-powered summary of the research, which I read many years ago now:

The most comprehensive study on children born through surrogacy comes from Professor Susan Golombok at the University of Cambridge, who followed families from infancy into early adulthood. Here is what the research found at each stage. The single most consistent finding across all ages is that early, honest disclosure of a child’s origins is the strongest protective factor for long-term mental health.

• Infancy to Age 3: No psychological difficulties were observed, and parent–child relationships were warm and healthy. Surrogacy children were indistinguishable from naturally conceived children at this stage.
• Age 7: Children born through surrogacy showed a temporary spike in adjustment difficulties, including anxiety and behavioral problems. Researchers believe this reflects the age at which children begin to cognitively understand what their origins mean.
• Age 10: The difficulties seen at age 7 had largely resolved, and surrogacy children were again comparable to their peers. By this point, around 91% of children had been told about their origins and most had a positive understanding of them.
• Age 14: Psychological adjustment remained similar to naturally conceived children, with only minor differences. Surprisingly, mother–adolescent relationships in surrogacy families were actually more positive than in families formed through egg or sperm donation.
• Early Adulthood: Young adults born through surrogacy showed no significant psychological problems overall. Those who had been told about their origins before age 7 reported better relationships with their mothers and stronger well-being.

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I have many problems with her research, including mixing in gestational with traditional, the limited sample size impacting validity, and the research ending after age 20. I’m 33 and 11 years ago at age 22, I went to a surrogacy conference in San Francisco to be interviewed about my experiences with surrogacy. While at that conference, some agencies there pitched their services to me, including one in Mexico who openly “bragged” that I wouldn’t have to interact with my surrogate at all if I didn’t want to. I went to the conference feeling vulnerable but curious to share this part of myself to help give insight into my experience to help future kids and I left feeling shaken and uneasy. Most of the questions I got after the panel were basically questions asking for reassurance and approval. You can hear it in how I was intro-ed: “She is a delightful young woman so if you have any concerns that anything weird would come out with having a surrogate baby, she can tell you she’s really normal”. I look back on that and feel borderline used as almost propaganda. I don’t think anyone intended that but I know now as an adult what it’s like when you fit a narrative someone is trying to push and how fast tracked you can suddenly be to be a mouthpiece for that side. At 22, I was still in a state of fear around coming out to folks about being born through surrogacy and I hadn’t come close to wrapping my head around the deep, traumatic impact being born through surrogacy had on me.

I learned from some adoptees and another surrogate born pal about the concept of “coming out of the fog” (FOG: Fear, Obligation, Guilt) to describe the journey an adoptee has from societal and likely familial denial of the trauma of adoption to recognizing the deep impact and loss adoption has. The eight phases start from “adoption is just a fact” and march along into drowning in complexity/loss before ending on a final phase of deciding how to move forward with healing. From what I’ve heard and read, coming out of the fog isn’t a guarantee and it often requires events happening and/or a level of safety to do so. At 20, let alone at 22, I was no where close to feeling the full effects and, mind you, I was adopted by the mom who raised me but not in the truest definition. Surrogacy throws more complexity into the picture, partially since there’s not a strong societal surrogacy narrative to begin with, and because it allows for a connection with my dad/biological father. The nuances are numerous and I don’t have the capacity to expand on them all today. I do think looking enough like my parents (a key decision point for which surrogate they worked with and something you can pick/choose) hid further my origins and added an easy layer of collective gaslighting onto my existence. Even recently, I was on a call for work and had my mom say hi when one of my coworkers commented “how much we look alike”. I wince inside when I hear that.

None of this research is enough. We need more from all sides, including for surrogates themselves but, my god, especially for those of us born this way. For now, I will continue to try to have this site be a beacon and a space for anyone who wants to share their story about being born through surrogacy. I only hope to find more of us and to grow the small group chat I’m in with a few of us. It may not add up to research but it can add up to nuance and expand the conversation rather than flattening it into a few statistical analysis on whether any of us lost our minds at 10 years old. I almost wish I were in the study. At 13, I sliced marks into my arm with a dull knife thirteen times within a few months after meeting my birthmom. I also had straight As, was a great soccer player, had friends, etc. Would that count as a psychological difficulty? I understand the role and need for research yet I worry the lack of incentives for this research to be done by an increasingly venture capital backed industry (the fertility industry) will cause any research that does land to be too little, too late.