Standing in front of his mailbox, four letters in hand, Mark Hansen ticks through all the reasons he shouldn’t mail them.
He doesn’t want to invade the receivers’ privacy. He doesn’t want to turn up a hornets' nest in their lives, which his research shows are full of love and light. And, most importantly, he doesn’t want to push them away.
This news will be shocking. He understands that deeply, and doesn’t take lightly that he may cause them pain. But he feels a “moral obligation” to let these particular people know he exists.
Truth is much better than a lie, even when the truth hurts, he repeats like a mantra.
The letters are his heart inked on paper, and writing them is the first action he’s felt good about since the man he’d called dad revealed a long-held secret in the twilight of his life. There was more to the story of Hansen’s birth than he’d told him, his dad said — but his father had never known how to share it, never found the right time.
'There's part of me that I don't really know': Iowa man learns he's a victim of fertility fraud
Kelsey Kremer, Des Moines Register
After that fateful revelation, Hansen spent hours gazing at his face in the mirror, lost in his own skin. He’d never thought twice about the image staring back at him, but now he searched his features for clues. Bald head. Wide nose. Ears that stuck out as a kid. Full lips. Dimples.
This was his face, he knew, but who was he? The question haunted him like a shadow.
At night — when his house was quiet, but his mind noisy — the computer's blue light illuminated his room as he typed and retyped the letters. For six months, he moved paragraphs from page to page, sentences from here to there, placing every comma, every period, with the precision of a surgeon. He’d pored over the words so much he’d nearly memorized them.
I made the difficult decision to contact you because I feel knowing about a possible half-sibling is important. I truly understand that this may sound far-fetched and may even be unsettling. Imagine how unsettled I have felt learning all of this at 48 years of age.
He desperately wanted to untangle the mystery of where he came from and rebuild the sense of self that a few words whispered in a doctor’s office had ripped away. Online, he’d read about others who’d had parentage surprises finding kindred spirits in their biological family, finding a community and a sense of purpose in telling their stories.
“I wanted to release the turmoil,” Hansen says. “I wanted some normal back in my life, if I could get back to normal.”
He closed the mailbox lid and raised the flag. A tingly heat crawled up his back, a physical manifestation of unrestrained hope, he says. Hope for answers. Hope for acceptance. Hope for himself.
The next day, a strange white car idled near his driveway. The woman behind the wheel looked familiar — sort of like a female version of his mother's fertility doctor.
A family secret is revealed
Hansen and his dad, Rodney, were used to the urologist running late.
By the summer of 2013, they had become frequent visitors to the nondescript office, awash in creams, tans and taupes. The prostate cancer Rodney battled for five years was spreading, and his fragile memory crumbled as his Alzheimer’s worsened.
Hansen had started recording his dad on his iPad that summer, aware he needed to capture memories while his father still had them. He pulled out the camera when his dad started whistling a tune from his childhood, when he got his hair cut and, this day, when his dad started talking about the spelling of their last name, remarking how the “e” in Hansen came from their ancestral homeland in Norway.
“I didn't know what to expect out of my dad's mouth,” Hansen says. “So, I'm kind of joking around with him, asking him to talk."
"I knew that he wouldn't be able to talk to me forever.”
As equipment behind Hansen hummed to life, light glinting off chrome metal, Rodney turned to his son:
Rodney continued, his recollection choppy, as Hansen processed. He couldn’t get Hansen’s mother pregnant, so she went into town and “got injected with something.”
But not with my sperm, he made clear, repeating the sentiment as Hansen sat dumbstruck.
The words rung in Hansen's head.
Hansen, now 55, knew he was conceived by artificial insemination administered by the town doctor, a story he was first told when the media started covering “test tube babies” in the late 1970s. He’d assumed his parents contributed the materials.
“It was shock. It was, ‘What am I?’” Hansen says. “And I was full of questions.”
“Why did you wait 47 years to tell me this now?” Hansen asked.
Rodney looked down, fidgeting in his wheelchair.
“I don’t know.”
Born in Martensdale, Hansen had a Norman Rockwell childhood: a farm kid with a BB gun and a go-kart and a few dogs. Inquisitive and mechanically inclined since as far back as he can remember, Hansen helped his dad in his free time, tinkering with the combine, fixing the tractor, passing lazy days fishing.
In the summer, Rodney’s family visited, and Hansen and his cousins ran through the fields with aplomb. Hansen didn’t have the big bones or the blond hair of the Hansen clan, his cousin said, but she always chalked it up to the genes on his mother’s side.
His parents divorced when he was a teenager, and Hansen chose to live with his dad at the farmhouse with his BB gun and his go-kart and his dogs. Father and son settled into a new routine. He didn’t have his mom’s French-fried potatoes anymore — the best, he says — but the pair started a new tradition: French toast for breakfast.
“I was friends with my dad,” Hansen says. “He would kid me and joke around with me, and we would just do things together. It was good.”
Hansen drifted toward math, science and computers in school. He’d always been a little Manichean, seeing the world in dualities, and he liked the topics’ black-and-white nature. You did a calculation and you got an answer. You performed an experiment and you proved a result. You painstakingly matched 1 and 0s and an output appeared on your screen.
At Iowa State, he studied engineering, leaving to start a decades-long career as a Department of Transportation planner and cartographer, leading the team that tracks in intricate detail Iowa's highways, trails, bridges and railroads.
Room for interpretation, living in any sort of gray area, that always made him uncomfortable.
A paternity test later confirmed Rodney’s story. They were not father and son.
Rodney’s comprehension slid quickly after that appointment. He’d never be aware enough again to talk about what happened with his wife in that doctor’s office in 1964, and four months later he died from his illnesses.
A few days after the urologist visit, Hansen pulled his childhood doctor’s obituary, wanting to put a face to the hunch stalking his thoughts.
Bald head. Wide nose. Ears that stuck out a bit. Full lips. Dimples.
The man he’d never really known, but the face he remembered from his own mirror.
The name matched the doctor’s signature on his birth certificate: Dr. Sidney Yugend.
What was added in a back room
Family lore says Hansen came out blue.
The umbilical cord wrapped tightly around his shoulder, Hansen was pin-droppingly silent at birth, a stillness his mother, HaLayne, noticed despite her 27-hour-delivery stupor.
Yugend gently untangled the cord, HaLayne remembered in a home video, and quipped: He’ll be crying in a minute.
With one big thwack on the bum, Hansen made his grand debut. Later that day, he met his older sister, Melissa, just a toddler then, who handed him a peony, a moment captured in a beloved family picture.
Hansen called his mother soon after Rodney’s confession, but HaLayne assured him the sperm used for his conception was her ex-husband’s. Nobody ever told her anything different, and she certainly never consented to anyone else’s material being used, she told Hansen.
Yugend was monitoring her cycle, HaLayne said by way of explanation, and Rodney was on vitamins to counteract the mumps he contracted as a teenager, a disease now known to affect fertility.
She and her husband had sex and used a condom to collect a sample, which she took to the clinic. She handed it over to Yugend, she said, and he took it to the back room to "mix something with it" to make it work better.
“Jokingly and a little bit seriously, I said, ‘Like what mom, Red Bull?’” Hansen says.
He repeated the specimen’s trail back to her, ensuring it went from her hands to the doctor’s to the back room.
“Then the light bulb went on in my head,” Hansen says.
“I figured out what was added to my dad's sample to make it work better, and that's when I started doing a little bit more research on who this doctor was.”
A Minnesota native, Yugend moved to Indianola in 1943 after serving in the Medical Corps during World War II. Prominent in the area, he was well-liked, known for making house calls and generally going out of his way to see patients, the local newspaper reported.
“He was polished and starched … just looked like he got out of the shower,” HaLayne recalled in the home video. And he was “extremely, extremely” tender, she added, a quality echoed by Melissa, who remembered him in a letter as “a kindly man who always wore a bow tie and gave me a sucker at the end of the doctor visit.”
Yugend had five children, four daughters and a son who died from polio when he was 16. The family did not respond to interview requests for this story.
In 1983, while Yugend was recovering from bypass surgery, his wife died of Alzheimer’s. Three weeks later, his heart gave out.
“He had taken care of generations of families,” one of his nurses told the local paper. “He was very dedicated to his work. His work was his life.”
Hansen, who is single, became consumed with researching this new family, staying up late searching for answers. He was sullen at work, a little standoffish, totally opposite of his normally bubbly personality, said his colleague Jodi Clement. She never pushed him on what was wrong. But he finally told her by asking, completely out of the blue: “If you had family out there, would you want to know?”
“Well, yeah,” she said. “Yeah, I’d want to know.”
Soon after, he turned on his computer and opened a word document.
A hopeful meeting: 'We have a lot to talk about'
Hansen noticed the white car when he got home from work.
He has a unique house, with a huge round window, so sometimes people stop to look. But this car was idling. He waved politely at the driver, who got out and walked to his door.
“Are you Mark Hansen?” she asked.
“Yeah,” he replied, stepping onto his porch.
Hansen recognized the name from the family trees he’d built. She was one of Yugend’s daughters.
“Oh, Catherine," he said, "we have a lot to talk about."
“I wanted to hug her,” Hansen says, tears welling from the memory. “It’s like, holy crap, that’s my sister that I've never ever known. And I hope to hell that I didn’t hurt her feelings by sending her that letter.”
The pair talked for three hours, conversation freely flowing from Yugend family stories, to her life, to her siblings, Hansen says. She told him the family was Jewish, a religion he knew nothing about.
Catherine asked him to stand up and turn around. So much about him felt familiar, she remarked: his gait, how he sat, his mannerisms, the way he carried himself, how he talked with his hands.
“I wanted to comfort her, and comfort me with the fact that we have this biological bond,” he says. “Here's this fairy tale story that I was hoping would happen… That's what I was truly hoping for.”
For almost a year, Hansen had looked in the mirror, trying to connect to himself. Now, he was closer than ever to feeling at home in his skin again.
As the sun dipped below the horizon, Catherine got up to leave. “Where do we go from here?” Hansen asked.
Catherine said her sister would be coming in soon for a class reunion, and they’d talk about it as a family, Hansen remembered.
This was late May 2014, so he figured the reunion was imminent.
“Should I send you a Christmas card or something?” Hansen asked, positively giddy.
For the first time in a long time, Hansen slept through the night.
With DNA testing, 'Pandora's box is open'
Days dragged into weeks dragged into months dragged into years as Hansen waited to hear from Catherine. He was in limbo again. Sleepless again. Hopeless again.
In 2017, he bought DNA tests, 23andme and then Ancestry. They confirmed he was 50 percent Jewish, an ethnicity foreign to both HaLayne and Rodney.
A few days later, 23andme sent him a notification. He’d matched as a half-sibling to one of the other Yugend sisters.
By the time he signed on to learn more, she’d turned her results private, he says.
Melissa tested herself, too, discovering she was Hansen's full biological sibling.
Never in a million years would I have guessed..., Melissa texted him, but the doctor is my father, too.
Now they knew Yugend had used his own semen one other time — at least.
Physicians in 20 states have been accused of inseminating patients with their own sperm, resulting in hundreds of children, said Traci Portugal, the child of an accused doctor donor and administrator of the Donor Deceived website.
Some of these doctors used their own material for years before accusations became public, she said. Donald Cline, of Indianapolis, fathered 48 children prior to being prosecuted for obstruction of justice and surrendering his medical license in 2017. In Las Vegas, Quincy Fortier treated patients well into his 90s, siring more than 20 children, many of whom have since met and formed a doctor donor-conceived support group.
No doctor in the U.S. has lost his license for this behavior, Portugal added, and at least one — Kim McMorries, who admitted to using his own sperm on a patient in Texas — is still practicing.
In Iowa, Portugal is aware of 10 other doctor donor-conceived children, who, through her, declined to speak with the Register.
Back in the 1960s, using fresh sperm was the norm, experts say. And in almost all doctor donor cases, the physician told patients the sperm was from an anonymous donor or that he was “adding something” to their partner’s sample to make it work better.
“When you talk to male physicians of a certain age, it is not unusual to hear stories about people basically walking down the hall of the medical school or looking for the best-looking resident and saying, ‘Hey, come here, I need a sperm sample,’” said Sean Tipton, spokesman for the American Society for Reproductive Medicine.
“In the early days of medical sperm donation, that's where the sperm mostly came from.”
Doctors also often told patients not to discuss the terms of their conception with their children “on the grounds that it was bad for family relations, on the grounds that it was bad or traumatizing for the child's identity,” said Jody Madeira, a law professor whose research concentrates on fertility fraud.
While anonymity and confidentiality were standard in the era, it was never acceptable for a physician to use his own semen or to lie to his patients, Tipton and Madeira agreed.
Although the insemination incidents happened decades ago, the mass availability of direct-to-consumer genetic testing has only recently brought many of them to light. As those tests continue to saturate the market, more people will find out they aren’t biologically related to the parents who raised them.
“No one predicted the wide-ranging impacts of over-the-counter DNA tests,” said Kara Rubinstein Deyerin, CEO of Right to Know, a nonprofit education and advocacy group for victims of misattributed parentage.
“There is no such thing as secrecy now, no such thing as family secrets,” she said. “The skeletons in the closet, that closet door is not locked. Pandora’s box is open.”
A deceptive practice creates second-class citizens
A thin layer of snow dusted Hansen’s front porch as New Year’s Eve 2017 approached. After years without contact, Hansen was resigned to the fact that the Yugends weren’t interested in a relationship.
Then a certified letter arrived. His chest tightened, a tingly heat crawling up his back, as he ripped open the envelope.
“We are all in agreement that a relationship with you is something we do not want to pursue,” the typed note read. “We feel we have nothing in common to share.”
Nothing. In. Common. The words read like stabs, each a puncture to the hope that he’d let himself have, the hope he’d held on to for so long.
“It hurt my heart. Because I have this biological connection to these people, undisputable biological connection to these people, and they don't want to share details about my father,” he says.
He pauses. “Our father.”
In the years since, Hansen has joined Facebook groups for people struggling with parentage surprises, whether because of a concealed tryst, a closed adoption or deception around assisted conception. Online he found validation for his emotions, comfort in their shared misery.
“For as abnormal as a situation is, my feelings are fairly normal in comparing notes with other people similar to me,” he says.
He may not have gained a family, but he's found a community and, recently, a purpose in speaking out on the need for fertility fraud legislation.
The recent groundswell of doctor donors’ children going public has ignited an interest in passing laws criminalizing physicians' use of their own sperm without patients’ consent. In the past two years, six states have put statutes on their books, and another nine have introduced bills as a direct result of activism from fertility fraud victims.
This session of the Iowa Legislature, Hansen worked with lawmakers to introduce a bill to expand the definition of sexual abuse to include the act of a physician implanting his own sperm in a patient without her consent.
"Based upon my mother's adamant position that she did not know the doctor was using his own semen and did not give consent, the actions of her doctor are highly disturbing," he said while testifying. "His genetic material was inserted into my mother and, as a result, his genes have a permanent existence in me and my family tree."
After unanimously passing the Senate, the bill was amended in the House and, again, unanimously approved. The updated version now awaits another vote in the Senate, which Hansen is hopeful will happen in the waning days of the session.
The Society for Reproductive Medicine hasn't taken a stance on these fertility fraud bills, Tipton says, but members are keeping tabs on the movement. Pointing out that there hasn’t been an allegation of this crime in the 21st century, Tipton says stricter regulations on human tissues enacted during the Clinton administration seem to have made this activity harder to conceal.
“For the most part, we feel like they're unnecessary and redundant,” he said of the bills. “But we don't feel like they're going to do any harm.”
While most states have fraud laws that could cover some forms of fertility fraud, Madeira says the statute of limitations has often expired for people who don’t discover a doctor’s deception until decades later. And, some state’s fraud laws are written so that only the mother — the party who entered into a contract with the doctor — has a right to sue. Madeira believes the resulting children and in some cases the mother’s partner are also victims who should be able to bring actions.
“It's assumed that informed consent protects patients from being defrauded by doctors … but there's really no safety net unless your state has passed legislation,” she said.
In California, where Portugal’s biological father practiced, she doesn’t have standing to sue, and her mother has decided against bringing a case. The doctor, who has not been receptive to Portugal’s contacts, retired last year.
Portugal filed a complaint with the state medical board this fall, hoping that his license would not be renewed when it came up in the spring.
In March, she heard that it had been.
“I feel like donor conception as a whole has taken the rights away from those it creates and created second-class citizens,” she said. “How I have been treated and seen is like I am the bastard child of the 21st century.”
Eventually, the pain begins to ebb
With the late afternoon sun pouring into his kitchen, Hansen clears the table and props up his computer. On Tuesdays he attends “Gan,” an online introduction to Judaism class he signed up for during quarantine. Gan, Rabbi Emily tells the gathered, is the Hebrew word for the Garden of Eden, the beginning of all things, as well as for preschool.
Being at the beginning feels right for Hansen, not only for Judaism, but for figuring out what the rest looks like. People who have had DNA surprises often talk about having their foundation shaken, having those first definitions of who you are in life — your ethnicity, your traditions, your biological line — wiped away with spit in a vial.
But all that isn’t really gone, Hansen says. The people he thought were family still claim him as such, and his close friends are like family, too. He celebrates the Norwegian heritage he grew up with, and still enjoys lefse and kringla at holidays.
“I am the same person, but I'm a whole different person, too. And that's just the journey that I am on,” he says.
Sometimes he’ll lie awake, wondering again why the family that science says is his won’t accept him. Friends say it’s not him they are rejecting; it’s the thought that their father did something unethical. But that doesn’t make the dismissal easier.
“We have an interesting opportunity here to get to know each other as brother and sister, but as strangers,” too, he says.
“What our parents did to make us is not our responsibility. We are here because of what they did, but it's not our fault."
Three people played a role in Hansen’s creation, and with all long dead, he’ll never be able to untangle exactly what happened. It’s a gray area that he’ll live with forever, one he's slowly learning to be comfortable in.
“I think just over time I've gotten used to it,” he says “The knife isn’t as sharp as it once was. It's still there, but it isn't a painful jabbing. Every once in a while, it's kind of a poking.”
A few days after class, Hansen drives to the edge of Indianola, turns into the local cemetery and follows the road until it runs out. Flanked by peony bushes, Yugend’s grave is simple speckled polished stone. Three rocks perch on its base, a Jewish tradition of remembrance, he recently learned.
When he goes to HaLayne and Rodney’s graves, he has memories, stories that he can share. He's told Rodney that he understands how scared he must have been, worried he'd lose the love and affection of his son. He didn't, Hansen says, though he wished the secret had been revealed earlier.
But at Yugend's grave, there’s nothing — nothing to move Hansen's head or his heart, nothing other than the cold of the day.
He comes to show respect, he says, to tell the doctor that he’s happy he’s alive, and that he’s lived a good life. Hansen wonders what Yugend would have said if he were to have knocked on the doctor's door. He likes to think that he would have invited his son in.
When a bright red cardinal flies overhead, Hansen stops talking. Superstition says cardinals are the souls of deceased loved ones visiting you. For today, Hansen decides, he’ll believe that’s true.
It’s all he really has.
Where hope once existed, only questions remain.
Kelsey Kremer is an Emmy-winning photojournalist for the Register. Follow her on Twitter and Instagram @Kelsey_Kremer.