When research challenges belief: Surrogacy families in the political crossfire

When the Surrogacy Arrangements Act came into force in the UK in 1985, it banned commercial surrogacy and made it illegal to advertise for surrogates. At the time, the government assumed that, without a financial incentive, surrogacy would fade away. Instead, the opposite happened: the number of children born through surrogacy slowly, but steadily, increased.

By 1997, a few controversial cases, together with concern about the level of expenses being paid by intended parents to surrogates, led the government to establish the Surrogacy Review Committee. Its task was to consider payments to surrogates and the wider regulation of surrogacy arrangements.

The committee comprised Professor Margaret Brazier, a lawyer, Professor Alastair Campbell, a medical ethicist, and me, Professor Susan Golombok, a psychologist. As we examined the ethical, social and psychological questions surrounding surrogacy, one issue became impossible to ignore: although there were many strongly held opinions about the harms surrogacy was said to cause, there was almost no empirical evidence on the outcomes for intended parents, children, or surrogates.

Although too late for the review, we began a series of studies at the Centre for Child Adolescent and Family Research at the University of Cambridge to fill the gap in knowledge, including a 20-year longitudinal study based on a representative sample of families formed through surrogacy, made possible by the involvement of the UK Office of National Statistics. The work was funded by the Wellcome Trust and the US National Institutes of Health, with findings published in leading peer-reviewed journals.

I won't repeat all of those the findings here, except to say that they were reassuring, and did not support the dire predictions often made about psychological harm to intended parents, their children, or surrogates. This does not mean surrogacy is simple, or that every experience is trouble-free, but it does mean that public debate should be guided by evidence rather than assumption.

In 2017, the government asked the Law Commission of England and Wales and the Scottish Law Commission to review surrogacy law. By then, surrogacy had become an established route to parenthood in the UK for people unable to carry a pregnancy themselves, yet the legal framework had fallen badly out of date. In 2023, the Law Commissions published a report and draft legislation proposing that intended parents should become the child's legal parents at birth, and that a Surrogacy Register be created so that people born through surrogacy could trace their origins (see BioNews 1185a and 1185b). Our research formed part of the evidence considered during these deliberations.

Since then, however, there has been a marked shift in the way research on the psychological consequences of surrogacy is used in public debate. Instead of informing discussion, evidence has increasingly been ignored, misrepresented, or selectively quoted. This has occurred in the context of a growing backlash against surrogacy, including from politically and religiously motivated groups opposed to surrogacy and assisted reproduction more broadly.

A clear example appeared in the Heritage Foundation's Project 2025 report, published in 2023, which advocated a return to the 'traditional family' and supported restrictions on assisted reproduction, including surrogacy and gamete donation. The report claimed gamete donation is harmful to children – a claim not supported by empirical research, including work by my team and other researchers.

The pattern continued in 2024, when a Vatican report cited the experience of a single person born through surrogacy, who attributed lifelong mental health problems to being relinquished by her biological mother, as evidence that surrogacy causes psychological harm. Personal accounts deserve to be heard with respect, but one case cannot prove general psychological harm. Most strikingly, the report made no mention of our 20-year study of a representative sample of UK surrogacy families.

In 2025, matters became even more troubling when a United Nations report gave a seriously misleading account of our findings. It highlighted one negative result when the children were aged seven, while omitting many positive or neutral findings from repeated, in-depth assessments from infancy through adulthood. By selectively focusing on one isolated result and ignoring the broader pattern, the report created a false impression that children born through surrogacy are psychologically disturbed (see BioNews 1306).

The same report also relied on a flawed argument about children's attachment. It implied that because a baby is born to a surrogate and then goes to the intended parents, the child's capacity to form secure attachments is undermined from the outset. But attachment does not form at birth, it develops over time and depends on the quality and consistency of early caregiving relationships. This is a basic finding in developmental psychology. To suggest otherwise is inaccurate and lends scientific language to an ideological position.

I was also struck by the sources cited to support these claims. One of the two academics referenced was a philosopher rather than an attachment specialist, despite the existence of many experts in the attachment field. His own publication abstract acknowledged that 'there seems to be little evidence of harmful consequences of surrogacy,' yet he proposed two alternative strategies to argue that surrogacy is harmful: that separation from the gestational mother is inherently damaging, and that a surrogate's lower level of attachment to the fetus may place the child at risk. Neither proposition is supported by robust scientific evidence.

This is not to suggest surrogacy research is beyond criticism – no area of research is. Our longitudinal study had a necessarily modest sample size because it began when relatively few surrogacy families with one-year-old children were available to recruit. Some attrition over two decades was inevitable. It is also important to recognise that our work was conducted in the UK, where surrogacy operates within a regulated system. These are proper limitations to acknowledge, and they should inform how the findings are interpreted.

But there is an important difference between recognising limitations and distorting evidence. The former is good scholarship; the latter is advocacy masquerading as scholarship. Misrepresentation does a disservice not only to research, but also to the people most directly involved: surrogates who feel proud to help others create a family; intended parents who have navigated a difficult path to parenthood, and children, most of whom grow up in loving families and often maintain warm, valued relationships with the surrogate.

No scientific study is perfect, and subsequent studies often address the earlier limitations. What is disturbing in the current debate is not serious disagreement, but the determination of some opponents of surrogacy to dismiss or misrepresent evidence that does not fit their beliefs. Even a limited body of carefully gathered data provides a sounder basis for public policy than an abundance of conviction unsupported by facts.