The Pain of Not Being a Biological Father
Most of us, as children assumed that one day we would get married and have a family. As a society we have made the ability to have a family as a entitlement of adulthood. However, of those attempting to become biological parents, one out of six, approximately 17% of the population, experience problems with infertility. Thus approximately 3.5 million couples in the United States are infertile.
Infertility has generally been assumed to be a woman's issue. There seems to be a myth that because pregnancy, birthing, breast feeding and child rearing (to a large extent) are a woman's domain, that fertility too is an issue exclusive to the experience of women. Much of the self-help literature has been geared towards women's experience of infertility. Thus, the perception is that this issue does not really touch the lives of men. Yet, this simply is not the case! The fact of the matter is that of all infertile couples approximately half are due to male infertility, while approximately 30% to 35% of all infertility problems are exclusively male factor in origin. Thus, a great many men are touched by the painful reality of infertility in their lives or in the lives of their partners.
With such little research devoted to the experience of infertility for men, I decided to do research that asked the question: What is the experience of infertility as lived by infertile men? During intensive, in-depth, tape recorded interviews , six infertile men discussed their experiences of infertility and their attempts to come to terms with a life without biological children. The transcribed interviews were then analyzed to find common themes in their experience of infertility. The following themes came from this research study.
- A Sense of Profound Grief and Loss
- A Sense of Powerlessness and Loss of Control
- A Sense of Inadequacy
- A Sense of Betrayal and Isolation
- A Sense of Threat or Foreboding
- A Need For A Positive Reframe of The Situation and of The Self
Sense of Profound Grief and Loss. There was naturally the loss of fertility, but infertility seemed to incorporate a multifaceted loss, and some of these other losses touched a deeper chord for these men than just the loss of fertility. The following were mentioned by the men as different aspects of the loss of fertility that they had to face. They felt a sense of loss in that they would "never be able to father [their] own child". Some expressed that "it's a death", the loss of a "dream child", the loss of a future with that child - of what their life would have been like with them.
The reactions to the loss in the lives of these men varied in length and intensity, although all experienced grief over the losses they had incurred. They used words like the following that depict aspects of grief: "shock", "disbelief", "denial", "devastated", "emotional pain", "anger", "anger at God", a sense of "injustice", "frustration", feeling "numb", and "depressed". Being unable to have a biological child was of major significance within the lives of the men. In reflecting on the intensity of this experience, another man compared his grief of infertility to that of his adopted Grandfather dying:
It was more grief then I had with..with the loss of my adopted grandfather. It was just..grief - physical, emotional grief, that I had lost - I had lost this gift, this ability - fertility - the idea that I would never see, never have a child, a biological child that would have some of my characteristics.
A Sense of Powerlessness and Loss of Control. Up until the time of a diagnosis of infertility, most of the men assumed that they were not only fertile, but that they needed to be responsible for their fertility and thus placed controls upon it. When the controls (contraceptive devices) were volitionally lifted, they assumed that pregnancy would result. This technological control over preventing pregnancy can give a false sense of power and control over achieving pregnancy. When pregnancy did not occur the men became anxious about what the problem might be. Their sense of entitlement or belief in their inherent right to have children exacerbated the experience of feeling out of control and powerless, an experience that resulted in frustration for these men.
Upon finding out of their infertility, they reported experiencing a sense of being out of control; an experience that left them initially somewhat immobilized. The sense of powerlessness or lack of control resulted in some of the men feeling forced to try anything that might help the situation. They felt a desperation that obliged them to try out any advice that would supposedly solve their problem. This included sometimes listening to well-intentioned friends or family members who provided "helpful suggestions". These solutions often implied that the infertile couple could get power and control over fertility if only they really knew what to do or tried a secret trick. Infertility was something that the men felt powerless to change.
However, at some point all of the men began a process of asserting control in their lives, where they actively began to exert some control (e.g. choices regarding the pursuit certain medical treatments or options). These men began to assume control over the areas where they had lost control. This gave them a new sense of empowerment and strength.
A Sense of Inadequacy. A part of each of the men's experience of infertility was this deep sense of personal inadequacy which was woven into each man's sense of his masculine identity. Each participant expressed their experience of inadequacy with words like "failure", "useless", "a dud", "less than average", "inadequate", "not a full man", "not a real man", "less of a man", "unmanly", "feel like garbage", "defective", "not a whole person", "a loser", "sexually inadequate", "questioned my manhood". All of these words describe the men's profound sense of personal inadequacy as a result of their infertility.
The men experienced infertility as taking away their very sense of masculinity. To better express the extent or depth of his feelings of inadequacy to his wife, one man recalled writing to her about the effect that infertility had had on him in this area:
With a lump in my throat I wrote that I felt unmanly, inadequate, and powerless when I compared myself to other men who have children. I told her that I often tried to compensate for my feeling of inferiority by looking and acting like a super jock....I also explained that I felt inadequate sometimes when my performance as a sexual partner was not perfect. And, that I imagine my infertility might have something to do with this.
Another of the men related how he had worked through his feelings of inadequacy through a process of convincing himself of what he still had as a man.
...it may be just a whole journey of convincing myself intellectually, that this is the case....Convincing myself that it isn't necessary for me to be fertile in order for me to be a complete person. I'm still a husband and a father [through adoption]. I perform just as well at work. I am just as capable in all other areas of my life.
A Sense of Betrayal and Isolation. The experience of infertility also incorporated a sense of betrayal and isolation. In living with infertility, these men felt betrayed by their families, friends and medical professionals. Some of the men reported that extended family did not accept the reality of the impact of their infertility; they felt others sometimes belittled the impact that infertility had on their lives. Sometimes the men felt family members would deepen the wound of infertility, in assuming to know what the men might be experiencing or by trying to give advice. For these men, these experiences elicited feelings of frustration, anger, a sense of isolation, and betrayal.
It was not uncommon for these men to feel betrayed and isolated even from their spouse. Some felt their spouse had unjustly blamed them for not giving them children, even though infertility was never something within their control. At times each of the men found it difficult to talk to their wives about their experiences. For some this was because they felt they were personally at fault, while for others their wives became a symbolic reminder of the reality of their own infertility.
Because the experience was very personal and touched feelings of inadequacy, these men also felt inhibited to share their experience and were reluctant to risk the possibly of not being understood. When they did disclose their secret, if they perceived that the listener ignored the issue or devalued the importance of it, they again felt betrayed. This betrayal of trust would elicit fear of future hurt and thus each man was inclined to distance himself from others as a means of self protection, thereby increasing his sense of isolation. The isolation was also a part of the men's attempts to avoid any more pain; they withdrew to escape from the pain they were experiencing. One man admitted, "We isolated ourselves from a lot of people."
However, this emotional isolation did not last forever. After some period of time, the isolation between husband and wife was overcome. These couples began to see infertility as a shared experience. Many stated that they became closer as a couple through their experience. The deep sense of isolation ended as many found support through others who were also dealing with infertility.
A Sense of Threat or Foreboding. Within these men's stories of their experience of infertility was a sense of foreboding or threat. Upon the diagnosis of infertility, these men not only had to deal with the losses that it brought, but also sensed a threat to their futures. They were unsure as to what kind of impact infertility might have upon the rest of their lives; something that elicited anxiety and fear. At some level, each man recognized that infertility threatened the very essence of all that they had held as secure; their future family, their marriage, and their personal identity. Not knowing for sure what the full impact of infertility might be, they felt helpless against this sense of an impeding doom. Questions that were raised by the experience included: How much would infertility destroy their futures? Would it destroy their marriages? Would it permanently wound how they felt about themselves?
These questions invoked anxiety and fear for these men.
Although infertility brought with it a number of fears or threats for these men to cope with, it is important to note that each also felt a strong need to overcome these perceived threats that they felt had been placed before them. All of the men talked about different ways in which they coped. This coping was necessary for the men in order to eventually overcome the threatening aspects of their experience of infertility.
A Need For A Positive Reframe of The Situation and of The Self. Apparent within the stories of these infertile men was a desire or momentum towards taking this negative situation and gleaning positive meanings out of it. For each of the men in the study there seemed to be a need to find new and positive meanings (or purposes) to what originally seemed meaningless and painful. Within their stories, there emerged two main areas of positive reframe - (1) their situation and (2) their sense of self or identity.
In expressing some of the "good" that they felt had come from their experience of infertility, the men stated that infertility had given them "more compassion"; "the ability to empathize with others who are experiencing loss"; more caring; "not so judgmental". They also stated that "it's broadened [their] thinking in a lot of areas" and felt that their experience had made them "more sensitive to other people's needs", problems or issues.
Some of the men felt that their infertility helped them to reprioritize their life goals and change their values. Some mentioned that infertility allowed them to dialogue in a more meaningful way with their family and friends. When the men moved past feeling personally isolated from their wives, they began to risk sharing their inner feelings and experiences. As they shared their fears and their pain, this sharing tended to bring the couples closer together.
For example, one man shared how the experience of infertility eventually made him feel closer to his partner, "...I could never have imagined that an area that had kept us so distant from each other, infertility, and in such pain, could make us feel so close."
Not only did the men feel a need to make sense out of their infertility, but they also had a need to redefine their sense of self. With the loss of fertility, these men felt that they had lost part of themselves. Many went through a process whereby they reevaluated and redefined their worth as individuals.
Most of the men felt a need to redefine their sense of masculinity. One man shared how he felt that his "...maleness had been attacked..." and felt that if he had had a better self image and sense of what it meant to be a man that the impact of infertility would have been less.
Although these men may have reconstructed more positive self images and can see positive aspects of this difficult life experience, they in no way implied that they now think of their infertility only as a positive experience. A number of the men stated that they had come to the realization that infertility would be with them for the rest of their lives. Although they may have come to terms with their losses and even identified some gains, they recognized that in some sense they may never be able to close the book on the impact infertility has had on their lives. One of the men expressed it well when he said,
I think that the biggest thing that we've had to work through as a couple and me as a person, is just learning to live with it. Because it changes everything. Being infertile changes everything.