20 Mar The Fertility Doctor’s Secret

Published by The Atlantic

By Sarah Zhang

Updated at 5:23 p.m. ET on March 18, 2019.

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The first Facebook message arrived when Heather Woock was packing for vacation, in August 2017. It was from a stranger claiming to be her half sibling. She assumed the message was some kind of scam; her parents had never told her she might have siblings. But the message contained one detail that spooked her. The sender mentioned a doctor, Donald Cline. Woock knew that name; her mother had gone to Cline for fertility treatments before she was born. Had this person somehow gotten her mother’s medical history?

Her mom said not to worry. So Woock, who is 33 and lives just outside Indianapolis, flew to the West Coast for her vacation. She got a couple more messages from other supposed half siblings while she was away. Their persistence was strange. But then her phone broke, and she spent the next week and a half outdoors in Seattle and Vancouver, blissfully disconnected.

It was only when she got home and replaced her phone that she saw the barrage of messages from even more half siblings. They had found her on Facebook, she realized, after searching for the username linked to her Ancestry.com account. Her husband had given her a DNA test for Christmas because she was interested in genealogy. Her heritage turned out to be exactly what she had thought—Scottish, with English, Irish, and Scandinavian mixed in—and she never bothered to click on the link that would show whether anyone on the site shared her DNA.

Apparently she did have relatives on Ancestry.com—and not just distant cousins. The people now sending her messages said they were Cline’s secret biological children. They said their parents had also been treated by Cline. They said that decades ago, without ever telling his patients, Cline had used his own sperm to impregnate women who came to him for artificial insemination.

According to her DNA, Woock, too, was one of his children.

In the time since Woock’s half siblings got in touch with her, they have broken the news dozens more times. The children Cline fathered with his patients now number at least 50, confirmed by DNA tests from 23andMe or Ancestry.com.* (Several have a twin or other siblings who likely share the same biological father but haven’t been tested.) They keep in touch through a Facebook group. New siblings pop up in waves, timed perversely after holidays like Christmas or Mother’s Day or Father’s Day, when DNA tests are given as well-intentioned gifts.

Like Woock, many of her new siblings learned that they were donor-conceived from a DNA test. (Woock’s parents eventually told her they’d gone to Cline for donor insemination, but they’d had no idea he was the donor.) And in their shock, many also thought the initial messages explaining the situation were part of a scam. But eventually they found news clips laying out that, yes, this doctor deceived his patients, and yes, he used his own sperm, and yes, this is really happening.

At least those finding out now have the benefit of clarity. They won’t have to wander through a thicket of confusion, half-truths, and lies. They won’t have to sit across from Cline, as some of the others did, and listen to him quote Bible verses. They won’t be accused of libel.

Jacoba Ballard was one of the first to piece everything together, and it had taken a long time. She’d known she was donor-conceived since the age of 10, and in 2014, when she was 33, she began looking for half siblings who shared her donor. “I was thinking one, or two at the most,” she says.

In retrospect, finding her first half siblings was too easy. She signed up for an online forum for adoptees and donor-conceived children, and quickly met another woman whose mother had also been treated by Cline. She looked the woman up on Facebook and saw her photos. “I was like, Oh my goodness, I think that is my sister, ” Ballard says. That woman knew another woman whose mother had also gone to Cline, and she had a sister. They all decided to take 23andMe tests. DNA confirmed that they were half sisters and revealed four more matches, bringing the number of half siblings to eight.

A story began to emerge from the DNA, but it contradicted the one Cline had told his patients. He’d said the donors he used were medical residents. He’d said he used each donor for only three successful pregnancies. But 23andMe showed that he’d used one donor at least eight times, and the birth years of the resulting children ranged from 1979 to 1986. Medical residencies last only a few years. What resident would be around to donate sperm for that entire seven-year period?

The answer, Ballard and her half siblings assumed, was in their DNA. No one in the 23andMe database shared enough DNA with them to be their father, but they found dozens of more distant genetic matches. By combing through public records and social-media profiles, and some times simply asking genetic matches about their families, they could build a giant family tree that, they hoped, would eventually lead to their father. Thousands of adoptees and donor-conceived children have used this method to find their biological parents, and forensic genealogists now use it to investigate cold cases like that of the Golden State Killer.

As Ballard and her half siblings researched their family tree, one suspiciously familiar name kept coming up: Cline. Finally, a woman who shared some of their DNA told them she had a cousin named Donald Cline who was a doctor in Indianapolis.

Even then, Ballard says, they weren’t sure Cline was their father. Maybe he had a brother or another male relative who’d served as the donor. Four of the eight siblings decided to file complaints with Indiana’s attorney general, saying they suspected that Cline had used his own sperm in patients and asking for an investigation. Ballard contacted a reporter for a local TV station, Fox59, which aired a segment about the unusually high number of kids from one sperm donor but stopped short of naming Cline as that donor.

For months, nothing much happened. Then one of Ballard’s half sisters went for it. She found Cline’s children—those he raised with his wife—and his adult grandchildren on Facebook and sent them a group message. A granddaughter replied, saying she didn’t know anything and couldn’t help.

But then, Ballard says, she got a message from Cline’s son. He had been looking through her Facebook photos and recognized her priest—he said he was Catholic too. He helped broker a meeting between his father and six of the siblings at a restaurant. Cline, who was then in his late 70s, walked in with a cane.

Ballard remembers this first family reunion of sorts as oddly matter-of-fact. Cline admitted to using his own sperm but said the records had been destroyed years ago. He asked each of the siblings what they did and where they lived. He read them Bible verses from a notepad. Ballard saw this as a misguided attempt to comfort her, and she snapped at him: “Don’t try to use my religion.”

Here was her biological father, but he radiated no paternal warmth. Ballard struggled with what it meant, existentially, to have inherited the DNA of a man who would lie to his patients and abuse his position as a doctor. Whatever made him do it, was that inside her, too? She knew the thought wasn’t entirely rational, but she couldn’t shake the feeling that a dark impulse might be lurking deep within her.

And what did make him do it? The half siblings turned the question over in their minds. Was it a religious thing? A sexual one?
“A need to implement this master race or something?” one speculated.

“We’re just this science experiment to him,” another suggested.

“He wanted to have control over, I don’t know, Indiana?”

“He had to maintain his business.”

“Honestly, I don’t know. I have no clue.”

“God complex.”

“Maybe he really thought he was helping people. Maybe he’s that delusional.”

When donald cline opened his clinic in 1979, infertility was a relatively new medical specialty. There were no big sperm banks yet, no catalogs of donors to select by eye color or hobby. Doctors usually found donors themselves, often among medical trainees, who had the advantage of being readily available in hospitals and had reputations as successful young men. (In those days, medical students were nearly all men.)

Sperm donation was shrouded in secrecy from the beginning. In 1884, a doctor named William Pancoast found himself unable to cure a wealthy man in Philadelphia who was struggling with infertility. Not one to give up, Pancoast tried something new. After sedating the man’s wife with chloroform, he injected her with semen from his best-looking medical student. This was the first documented case of successful donor insemination. Pancoast told the husband only afterwards, and the man agreed to never tell his wife. The end justified the means. The healthy baby justified the lie.

By the 1970s, hundreds of doctors were performing donor insemination across the U.S., but secrecy still prevailed. Doctors advised parents not to tell their children. A 1977 survey found that more than half of the doctors did not even keep records, so as to leave no paper trail connecting donor and child. The secrecy sprang in part from uncertainty over who would be the legal father of a donor-conceived child, a question that hadn’t yet been resolved in the laws of many states. But it also came from fear of doing psychological harm. “The child might feel rejected, the sterile husband might feel humiliated, and the wife might be condemned as an adultress,” Kara Swanson, a professor at the Northeastern University School of Law, recounts in her book, Banking on the Body.

When Liz White walked into Donald Cline’s office with her husband in 1981, she carried the weight of all this inside her. She spoke of their infertility troubles with almost no one else. It was only 35 years later—when Cline was in the news—that she and her best friend realized they had both gone to him. He was the fertility specialist in Indianapolis at the time. His patients saw him as a kind, gentle man. His office was decorated with photos of babies he’d helped conceive—a mundane detail that seems unsettling in retrospect.

White and her husband had been trying to conceive for two and a half years by the time they sought Cline’s help. They’d already seen another doctor, who’d attempted insemination with frozen donor sperm. When that didn’t work, the doctor recommended Cline, who used fresh sperm, which at the time had higher success rates. Cline said he would find a medical resident whose appearance and blood type matched White’s husband’s. He also said not to tell anyone, not even their future child, about the sperm donation.

White is 66 now, and when I met her this past fall, she greeted me at the door of her home barefoot and with her white hair pulled into a neat updo. Her house, in Zionsville, a town just outside of Indianapolis, was meticulously ordered, and her words were meticulously chosen. She told me Cline had inseminated her 15 times over five months. “I went October, November, December of ’81; January of ’82, and February,” she said, nodding her head as she ticked off the dates. She went to his office on the three days she was ovulating each month. Ovulation cycles cannot be changed for convenience’s sake, so she went in even on weekends. She remembers lying there alone in a gown, the clinic otherwise empty, and now she wonders what he was doing when he went next door to get the sample.

Until very recently in human history, reproduction always required an act of sexual intimacy. We elide this fact now, with consent forms and dense clinical language and gynecological tools that look brutishly utilitarian. But artificial insemination still requires an exchange of bodily fluids that can be procured only through sexual stimulation. (Consider: the stereotypical drawer of porn magazines at the fertility doctor’s office.) To have your doctor masturbate in his office and then to have that same doctor sit between your legs, injecting his sperm inside you—the edifice separating the clinical and the sexual breaks down completely.

It’s impossible to say exactly what went on inside Cline’s mind then. (I went to his house to interview him, but he said his lawyers had advised him not to talk. His attorneys did not respond to a request for comment.) Some of his donor children told me their mothers did not think of Cline’s actions as sexual when they found out the truth. Some mothers did not think about it much at all.

But White replayed the sequence of events in her mind. She thought of him masturbating in his office. She is a clinical social worker, and she slipped into clinical language to describe what she thought: “A man’s mind following ejaculation—there’s a lot of dopamine, a lot of serotonin and norepinephrine. All of those are mood enhancers that bring about wonderful feelings for them.” She continued: “We came in for a medical procedure.”

More than three decades later, she now says, “I feel like I was raped 15 times.”

In those same three decades, the mores around sex, assisted reproduction, and medical authority have changed, too. When the news about Cline came out, the medical community denounced his actions. “It was a breach of trust between a physician and his patient. One could say immoral,” says Robert Colver, an Indiana fertility specialist who knew Cline. “All of us were shocked.”

Would it have been as shocking 30 years ago? In 1987, a national survey of fertility doctors found that 2 percent had used their own sperm in patients. On one hand, it was clearly not the norm. On the other, it couldn’t have been so beyond the pale if it was presented as an option in a multiple-choice survey. The survey did not ask, however, whether the patients in those cases were aware that their doctor was also their sperm donor.

I asked Colver, who has been practicing since the 1980s, how such a deception could even occur to a doctor. He had trouble answering, but he noted that procuring sperm was a much more tedious and time-sensitive process back then. Cline has said he inseminated within the hour to maximize a sample’s viability. That would have meant coordinating the schedule of the sperm donor with the appointment of the ovulating patient several days a month, every month. Cline was a top fertility doctor in Indianapolis; he had a lot of patients.

Based on the birth dates of his youngest known donor children, Cline stopped using his own sperm in the late 1980s, when sperm banks became more common. (The whole industry started relying on frozen sperm then, because doctors had discovered that HIV could be transmitted through fresh sperm.) When Cline later got into legal trouble, his friends and family members wrote letters to the judge about how difficult it must have been for him to disappoint patients when a donor couldn’t be found. A friend whose wife was a patient of Cline’s—but did not have children through donor insemination—wrote:

Dr. Cline’s always put his patients first. Empathetic and full of compassion, he sought ways to help families through this most tender period when both husband and wife feel helpless … We can also empathize with the couple waiting expectantly because the time is right, and can understand the devastation that would wash upon them if there would be no viable sperm donor at that critical moment.

If his friends saw this as an exculpatory explanation, those angry with Cline saw something uglier. They saw not selflessness but selfishness. They saw a doctor who cared more about his professional success than his patients’ well-being. They saw a man too comfortable in his power. If he truly believed he was doing nothing wrong, why did he deceive his patients?

Colver was more measured. He said he understood the reluctance to disappoint a patient. “Is it sad that month to say, ‘Unfortunately, Mrs. Jones, [the donor] couldn’t come because of an emergency. So sorry, we’re going to have to wait until next month’?” Of course it is. But consider the alternative: “To tell Mrs. Jones versus 30 years later having it come out like this. There’s really no comparison between the two.”

Liz white carries around a photo of herself in 1982, beaming in a hospital bed with a baby boy in her arms. She named him Matthew, “gift from God,” because she thought of the sperm donation as a gift then. She is 30 in the photo. “That’s how young I was,” she told me, which I took to mean: I know you see an old woman now, but I was young and vulnerable and alone with the man.

Matt figured it out before his mom did. After four of the half siblings filed their complaints with the Indiana attorney general, the Fox59 reporter, Angela Ganote, asked the local prosecutor about Cline. Her inquiry led to a criminal investigation. In September 2016, Ganote broke the news that Cline had been charged with two counts of felony obstruction of justice, and Matt—along with the rest of the public—learned what Cline had done.

Matt already knew he was donor-conceived. Back in high-school biology class, he’d realized that his blood type didn’t match his parents’. They sat him down and told him about the sperm donor, and no one really thought too hard about how Cline had promised that the donor’s blood type would match Matt’s father’s. White remembers feeling bad for his dad then, but the revelation provoked no deep identity crisis. His mother would sometimes point out a building when they drove down 86th Street in Indianapolis: “That’s where I got pregnant with you.” She thought of it as a joyous place. After Matt saw Cline in the news, he looked up the address. It was Cline’s old office. A DNA test confirmed what he already knew deep down. The resemblance between Matt and a young Cline is uncanny. They could be the same person.

Over the next year, Matt and his newfound half siblings watched the criminal case against Cline unfold. He wasn’t charged with rape. He wasn’t charged with battery with bodily waste—Indiana considers that a crime only if it’s done “in a rude, insolent, or angry manner.” He wasn’t charged with criminal deception—any records were long gone. In fact, Cline wasn’t charged for anything he did almost four decades ago. No law in Indiana—or in most other states, for that matter—specifically forbids a doctor from using his own sperm in his patients.

Prosecutors charged Cline with two counts of obstruction of justice: He had received letters from the attorney general’s office notifying him of the investigation, and had written back at least twice saying he’d never used his own sperm and that any woman who said otherwise was “guilty of slander and/or libel.” This was easy to disprove. Investigators showed up at Cline’s house with a search warrant for his DNA. They swabbed his mouth, and that was that.

In the 1980s, before anyone dreamed up mail-in DNA tests and internet genealogy sites, Cline must have thought no one would ever find out. As he faced the consequences now, he seemed to believe that he could make the whole mess go away by denying it with the full force of his being. Tim DeLaney, the prosecutor in this case, told me he saw the original wrong as a transgression by a person in power. When Cline was accused, DeLaney said, “he went to that same position of power and basically said, ‘I’m a doctor. These people are lying. They have defamed me.’ It wasn’t the reaction of a scared, powerless person. It was the reaction of a person used to being powerful.”

What particularly galled some of the siblings was how Cline used his faith as deflection. By all accounts, he is a very religious man—for his sentencing, several elders from his evangelical church wrote letters attesting to his character. After the restaurant meeting, Cline called Ballard to say her digging up the past was destroying his marriage: His wife considered his actions adultery. In the call, which Ballard recorded, Cline told her he regretted what he’d done—though he admitted to using his own sperm only nine or 10 times—and quoted Jeremiah 1:5, in which God lays out his plan for the prophet: “Before I formed you in your mother’s womb, I knew you.” Again, Ballard felt he was using her faith to try to manipulate her.

Cline was ultimately fined $500 and given a year of probation. He lost his medical license, but he’d been retired since 2009. If he hadn’t replied to the attorney general’s letters—which he had been under no obligation to do—he might have gotten off entirely. (Several of the donor-conceived children and their mothers have also filed civil lawsuits against Cline.)

DeLaney knows that some of the half siblings were angry that he only charged Cline with obstruction of justice, but he didn’t think he could prove any other crime in court. He still thinks about the case often. “It’s by far the most philosophically interesting of any case I ever had,” he said. Cline violated the trust of his patients, but did he also wrong their children, who wouldn’t exist if not for Cline’s deception?
For Matt White, watching all this play out awoke a sense of purpose. He’d dealt with infertility himself; his own two kids were conceived through sperm donation—the modern version, with online catalogs and donors’ baby photos. That gave him a sense of what his mother had gone through to have him. He understood why she felt violated.

I met White, now 36, at a bakery in Indianapolis last November, the morning after the first storm of the season had shellacked the roads in ice. The day before, he and his mother and several of his half siblings had had a meeting with the president pro tempore of the Indiana Senate, Rodric Bray. The senator had introduced a fertility-fraud bill inspired by Cline’s case the previous session, but it had died without a vote. Now the siblings were trying to revive the bill, which would make it illegal for doctors to use reproductive material improperly, and White had become the group’s unofficial leader. It helped that his office was two blocks from the statehouse. He could pop over for meetings.

White knows that many people may see Cline’s case as a one-off, just the strange behavior of a lone doctor out in Indiana. But a handful of other doctors have also been accused of secretly using their own sperm—in Connecticut, Virginia, Idaho, Vermont, and Canada. CeCe Moore, a genealogist who has helped adoptees and donor-conceived children find family, told me she’s come across enough cases of fertility doctors using their own sperm that “when I see these large groups of half siblings, it’s actually the first thing I think about now.” Many of the sibling groups have chosen to stay private, and their reactions run the gamut. Some siblings “think very highly of their donor father, his ‘contributions’ to their mothers,” Moore said. “Some are horrified by it.”

White was among those horrified, obviously. His mother contacted Jody Madeira, a law professor at Indiana University at Bloomington who has studied bioethics and reproductive medicine. Madeira took an interest in the case and helped write the fertility-fraud bill. “When you talk to people about the Cline case, it’s a physiological reaction of disgust, the sense that it’s deeply, morally wrong,” she says. “Is it legally wrong? It should be.”

Many of the children Cline fathered still live in Indianapolis, and they find themselves accidentally running into his family. At the bakery where we met, White pointed straight ahead. Cline, he said, “lives down the street over there. I live down the street over there, and my mom lives in town here.” Cline’s daughter-in-law is an ob-gyn at the practice White’s wife goes to. He thinks he saw Cline’s daughter, a nurse who worked in Cline’s practice, at Subway once. He got sick to his stomach and walked out. His mom saw the same daughter at a nail salon; she was getting a pedicure and couldn’t get up to walk away.

The donor children have begun cataloging the ways their own paths have crossed, too. White went to Purdue at the same time as one of his half brothers. One sibling sold another a wagon at a garage sale. Two of them lived on the same street. Two had kids on the same softball team. They’re worried that their children are getting old enough to date soon. “Did you not consider we all live in a relatively close area?” one sister said she has wondered about Cline. “Did you really think … that we wouldn’t meet? That we wouldn’t maybe date? That we wouldn’t have kids who might date? Did you never consider that?” Cline now looms over their kids’ every innocent crush, their every prom date.

Cline has admitted to using his own sperm about 50 times, which is about the number of children who have been identified through DNA. More may be out there, though—DNA testing is common but nowhere near ubiquitous. During the time I corresponded with his donor children, every few weeks one of them would tell me that another sibling had been found. In the fall, they started sending letters to Indiana legislators urging them to support the fertility-fraud bill. (It was introduced in the general assembly, and seemed to be gaining momentum.) In early January, White texted me to say he had sealed a batch of letters to legislators the night before, only to find two more siblings. He was going to add a note on the envelopes.

white’s updates about new siblings always seemed to come with a mix of anger and sadness: anger at the growing scope of Cline’s misdeeds, sadness for each additional family being turned upside down by a decades-old secret. But each new half sibling has dealt with the revelation in his or her own way.

The same Christmas Heather Woock got her DNA test, she’d made her father a book tracing his genealogy, all the way up to Scottish royalty. Losing the genetic connection with her father meant losing the story she had literally written about who she was and how she came to be. It’s this identity crisis—more than Cline’s inexplicable actions—that she’s still working through. The hardest part, she says, is “processing that my parents outright lied to me throughout my childhood.”

Kylene Gott, a 38-year-old teacher from Indianapolis, was in the car with her mom when she revealed that Cline was her biological father. Her mother’s response: “Well, good.” Well, good? “If it was going to be anyone, I’m glad it’s him.” Gott says her mom later talked about having seen pictures of Cline’s kids on the wall and how pretty they were, and how intelligent. She had wanted kids like that. But her response upset Gott, who believed her origin story explained the dislocation she’d felt her whole life in jobs and in social situations. “I haven’t really known who I am; that’s why I haven’t been able to figure out what I’m supposed to do in the world,” she says. She was thrilled to have new half siblings, and she dissected their lives for similarities, from favorite McDonald’s orders to the bouquets in their wedding photos.

Another woman in Indianapolis, whom I’ll call Amy, told me her mother was strangely calm when she heard about Cline. (Some of the donor children asked me not to use their real names, because they hadn’t told everyone in their lives about their paternity.) Her mom’s reaction was especially unnerving because Amy thought Cline was supposed to have used her father’s sperm, not a donor’s, and this deception struck her as even more grotesque. A few weeks after we spoke, Amy emailed to say we had to talk. She had confronted her mother, who revealed that she’d always known it was a donor, if not Cline himself. When Amy was conceived, her parents had promised never to tell—a promise her mom had kept even though Amy’s father died years ago. Amy wishes she’d never learned the truth. “Ignorance is bliss,” she told me, wistfully drawing out the last word.

A man I’ll call Tyler, who is a construction manager in Washington, D.C., told me that his mother, too, said she’d thought Cline had used her husband’s sperm. But, oddly, she didn’t seem angry at Cline so much as angry at being found out. She made Tyler swear never to tell his dad. “You and I gotta take it to the grave,” she said. Tyler now wonders whether she knew all along that the sperm came from a donor, even if she didn’t know that donor was Cline. He still hasn’t talked with his dad about it.

Joseph (not his real name) has a twin brother, but they look nothing alike. “I’m taller than him. He outweighs me by 30 pounds,” he says. They have different personalities, too. When Joseph took a DNA test in 2017 and discovered his paternity, he and his twin briefly wondered whether they had different fathers, because Cline had told their mother he’d mixed a donor’s sperm with her husband’s. But no: They both had Cline’s DNA. True to their different personalities, they reacted in opposite ways. Joseph has been very involved with the Facebook group, while his twin wants nothing to do with it. Strangest of all, Joseph met a half brother who looks exactly like him—much more so than his actual twin.

They are just a few of the many people forging connections after the initial shock of a DNA surprise. Adoptees have reunited with their birth families. Donor-conceived children have found their biological fathers. And half siblings have met one another, creating new iterations of family entirely different from the traditional family unit their parents were seeking when they went to a fertility doctor.

In June of last year, on Father’s Day weekend, the siblings gathered in Indiana for their second annual picnic. They’d been getting together in smaller groups, for holidays, girls’ nights, lunches, and meetings with state legislators. But this was the big shebang. Tyler flew in for the day from Washington. Spouses and children came too. Matt rented out a picnic pavilion, and brought name tags because many of the siblings were meeting for the first time. Their numbers had almost tripled since the previous year.

Everyone pitched in a little. One sibling brought a birthday cake, which was becoming a tradition. Kylene brought chips and salsa. Amy made pasta salad. Heather thought to bring much-needed packs of bottled water. Matt brought chicken wings, and he sweated over the grill cooking them. It was a hot day. Their kids ran through sprinklers. They climbed trees and got sticky with sap. From afar, it must have looked like any family reunion.

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