Psychological evaluations are one of the most important safeguards in third-party reproduction.
They help determine readiness. Identify areas for education. Explore expectations. Assess emotional preparedness, and provide valuable clinical recommendations.
They are an essential part of ethical family building, but they were never designed to carry the emotional weight of the entire journey.
Somewhere along the way, many programs unintentionally began treating the evaluation as both the beginning and the end of mental health involvement.
The participant completes their screening. The report is submitted. Everyone moves forward.
What often gets overlooked is that the questions don’t stop there. In many ways, they’re just beginning.
The Psychology Behind Ongoing Support
In healthcare, there is a concept called continuity of care.
Continuity of care recognizes that people experience better outcomes when support is consistent across different stages of a journey rather than limited to a single point in time.
The same principle applies in family building.
A psychological evaluation captures one moment.
A participant’s emotional experience continues to evolve.
Relationships change. Expectations shift. Unexpected challenges arise. New questions emerge.
No single evaluation, regardless of how comprehensive, is designed to prepare someone for every conversation, milestone, or decision they may encounter months later.
That’s not a limitation of the evaluation. It’s simply acknowledging what evaluations are designed to do.
The Difference Between Screening and Support
Screening asks questions like:
Is this participant emotionally prepared today?
Are there concerns that should be addressed before moving forward?
What education is needed at this stage?
Support asks different questions.
How is this participant adjusting now?
What new questions have emerged?
How are they navigating uncertainty, relationships, setbacks, or changing expectations?
Both are valuable.
They simply serve different purposes. One assesses readiness. The other helps people remain prepared.
Programs that recognize this distinction often create a very different experience for the people they serve.
Why This Responsibility Shouldn’t Fall on Coordinators Alone
At this point, someone might reasonably ask:
“Isn’t this what agency coordinators or clinic care teams already do?”
In many ways, yes. Great coordinators are often the steady voice participants turn to throughout their journey.
They answer questions. Problem-solve. Coordinate appointments. Navigate logistics. Manage timelines. Communicate with multiple parties.
And, in the middle of all of that, they often become an emotional anchor for the people they serve.
The reality is that they’re already carrying an enormous amount of responsibility.
Many coordinators are simultaneously managing dozens of active cases, responding to urgent situations, keeping complex journeys moving forward, and putting out countless small fires throughout the day.
Expecting them to also provide ongoing psychoeducation, process grief, navigate relationship dynamics, prepare participants for difficult conversations, and support every emotional milestone places an extraordinary burden on professionals who are already doing incredibly demanding work.
This isn’t an argument against coordinators. It’s an argument for supporting them.
Mental health providers and coordinators serve different- but complementary- roles.
A coordinator keeps the journey moving. A mental health provider helps participants make sense of the journey they’re moving through.
When those roles work together, participants receive more comprehensive care, coordinators have a trusted clinical partner to lean on, and programs are better equipped to support both the logistical and emotional realities of modern family building.
The goal isn’t to replace the coordinator’s relationship with the participant. It’s to strengthen it by ensuring emotional support becomes a shared responsibility rather than one more expectation placed on an already overextended team.
What We Know From Research
Research across healthcare consistently demonstrates that anticipatory guidance improves adjustment during major life transitions.
Anticipatory guidance is the practice of preparing people for experiences before they happen rather than responding only after challenges arise.
It’s why pediatricians prepare parents for developmental milestones before they occur.
It’s why surgical teams educate patients about recovery before procedures.
It’s why oncology, transplant, and chronic illness programs increasingly integrate behavioral health throughout treatment rather than relying solely on initial screening.
Family building should be no different.
Preparing participants for communication challenges, changing emotions, uncertainty, relationship dynamics, and unexpected milestones before they encounter them allows them to navigate those moments with greater confidence and resilience.
A Question Worth Asking
If your program provides an exceptional screening process, ask yourself one more question:
What happens after the initial screenings (including psych) are complete?
Where do participants go with the questions they didn’t know they would have?
Who helps them navigate difficult conversations?
Who prepares intended parents for changing emotions after matching?
Who supports gestational carriers through unexpected stressors?
Who helps donors process questions that arise months or years later?
Those moments often shape the participant’s experience just as much as the evaluation itself.
A Different Way to Think About Mental Health
Perhaps it’s time to think about mental health less as a checkpoint…and more as a touchpoint.
Not something participants pass through once.
Something they can return to whenever the journey asks something new of them.
That shift doesn’t replace psychological evaluations. It strengthens them.
Because participants who feel supported throughout their journey are often better equipped to communicate, adapt, and make thoughtful decisions when new situations arise.
A Few Things Worth Remembering
Psychological evaluations remain one of the most valuable components of ethical family building.
They help establish readiness, identify opportunities for education, and protect everyone involved.
But readiness isn’t static.
People continue growing. Relationships continue evolving. Journeys continue unfolding.
The strongest family-building programs recognize that emotional support doesn’t begin and end with screening. It grows alongside the people they serve.
Meet Dr. Sadaf
Dr. Sadaf Sahibzada, PsyD, LMFT, is the founder of Embra Health, where she specializes in the psychological aspects of surrogacy, egg donation, sperm donation, embryo donation, and intended parent support. Through her writing, clinical work, and professional education, she is committed to helping people navigate family building with greater confidence while encouraging agencies and clinics to integrate mental health throughout the entire journey.
