Ross Douthat asks why adoption is so difficult while going to a fertility clinic is so easy, especially when children of anonymous sperm donors often have deep psychological dilemmas. Of children with a donor parent, "Large minorities report being troubled both by 'the circumstances of my conception' and by the fact 'that money was exchanged in order to conceive me,' says Douthat. "Americans conceived through sperm donation also are more likely to feel alienated from their immediate family than either biological or adopted children."