In learning more about their own conception, some donor-conceived people have been shocked by the lack of transparency in the industry that created them. They have been disturbed to find, in some cases, that they have dozens of half siblings from the same donor, that doctors have secretly impregnated patients with their own sperm, or that donors have lied about themselves to sperm banks—all at least partially because donation was anonymous. Now donor-conceived people like Adams are questioning the need for any secrecy at all. In a forthcoming book called Uprooted, Peter Boni, who learned he was donor-conceived at age 49, lays out a “Donor-Conceived Bill of Rights” that demands, first and foremost, the end of anonymous donations and includes access to a donor’s medical records, limits on the number of offspring per donor, and consequences for outright fertility fraud. “Can you point to any federal law,” Boni asked me rhetorically, “that protects the rights of the donor-conceived child?”

Indeed, the agreements around sperm donations were originally forged among donors, parents, and doctors. Fast-forward a few decades and the children—now adults—are trying to change a fertility industry that sees them as neither its customers nor its patients, even though it is directly responsible for their existence. The issues raised might apply to both sperm and egg donation alike, though historically, the focus has been on sperm donation because it’s much more common. As donor-conceived people advocate for new rights today, they are also forcing society to confront a more fundamental question, one left perhaps inadequately answered all those years ago: How much do biological ties really matter?