Discovering your presumed father is not your biological father: Psychiatric ramifications of independently uncovered non-paternity events resulting from direct-to-consumer DNA testing

The past three decades have seen a rise in the popularity of commercial direct-to-consumer (DTC) DNA test kits (e.g., Ancestry, 23andme, MyHeritage). An estimated 30 million people worldwide have taken such tests in a recreational setting as of 2020 (Georgiadis, 2020).

These DNA test kits offer consumers information relating to their health and ancestry. Furthermore, these tests provide an option to find relatives by genetic markers from the pool of other consumers who tested their DNA.

In recent years, many stories have emerged in popular media about consumers who learned that the man they presumed to be their father was not, in fact, their biological parent as a result of the DNA analysis (e.g., Ash 2018, Davis 2007). Recently, research has begun to emerge regarding these consumers and their subsequent experiences (Grethel et al., 2022; Guerrini et al., 2022).

The uncovering of misattributed paternity, also called NPE in genealogy (non-paternity events or not parent expected), can occur in a multitude of ways, such as by identifying previously unknown first-degree relatives, learning that siblings are genetically half-siblings, discovering an unexpected ethnicity and more.

Many studies have attempted to determine the prevalence of NPEs in present-day populations and throughout history. Estimates range from less than 1% to over 10% (International Society of Genetic Genealogy, 2022). Recently, Guerrini et al. surveyed 23,196 people who used the DTC service FamilyTreeDNA and found that 5% of participants discovered an unexpected biological parent of any gender (Guerrini et al., 2022). While this number represents misattributed paternity of both mothers and fathers, it suggests 5% as an upper limit to the number of paternal NPEs among DTC DNA test users. This number may also represent the upper limit in the general population, as those suspicious about their paternity may be more inclined to use the tests.

Anecdotal tales of NPEs have circulated throughout history, yet it has never been so easy for a person to discover a misattributed paternity or establish it with such certainty. Furthermore, social media has allowed thousands of individuals who have discovered their NPE status to form groups discreetly for the first time in history. These individuals use the privacy provided by online groups to discuss their discovery and its effect on their lives in an understanding environment (Teitell, 2019; Zhang, 2018). A recent study by Grethel et al. performed a qualitative study of 27 NPEs. In their study, NPEs often reported a profound sense of grief and loss and an unstable sense of who they were in their family context. They reported feelings of shock, denial, anger, fear, confusion, isolation, extreme emotional responses, and bodily sensations such as feeling frozen, dazed, and dysregulated. Though the situation is of no fault of their own, many felt the discovery brought about shame and a desire for secrecy. Those who chose to reveal their findings often experienced their difficulties were invalidated by friends and family (Grethel et al., 2022).

Recognizing these recent developments, DNA testing companies have offered some guidance to their customers, but their ability to offer support is limited at best (Brown, 2018). A leading group on Facebook named “DNA NPE Friends”, visible to group members only, led to the establishment of the non-profit “NPE Friends Fellowship” in 2018, intending to provide community support and education to those affected by an NPE discovery. As of February 2023, 8900 members are part of the “DNA NPE Friends” Facebook group.

Previous medical literature examined the moral and social implications of disclosing incidentally-found misattributed paternity in medical settings (Hercher and Jamal, 2016; Palmor and Fiester, 2014). However, to our knowledge, this is the first study to explore, describe and quantify the psychiatric sequela of a large cohort of individuals who discovered their unexpected paternity on their own.

We surveyed NPEs under the hypothesis that the independent discovery of a misattributed father in adult life would lead to various psychiatric symptoms. Furthermore, we assumed factors related to the discovery, demographics, subsequent encounters with family members, and personal reactions influence these symptoms.

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