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At 22, Cathy Holm was newly married, settling into a new home in Las Vegas, Nevada, and struggling to start a family. It was the early 1960s, and infertility was a largely taboo topic; devoid of options, she looked up a doctor listed as a fertility specialist in the phonebook. Dr Quincy Fortier, a respected obstetrician who opened Sin Citys first womens hospital, had a record of helping couples achieve a viable pregnancy, and promised to inseminate Holm with a sample of her husbands sperm.

Decades later, in March 2018, Holms daughter, Wendi Babst, bought an ancestry kit to celebrate her retirement as a detective in the Clackamas county, Oregon, sheriffs office. Like many Americans, Babst was hoping to glean a comprehensive picture of her genealogy, but she was unnerved by her DNA test results: numerous close matches, despite no known first cousins or half-siblings, and the repetition of a name she hadnt heard of, Fortier.

The database unmasked, with detached clarity, a dark secret hidden in plain sight for decades: the physician once named Nevadas doctor of the year, who died in 2006 at age 94, had impregnated numerous patients with his own sperm, unbeknownst to the women or their families. The decades-long fertility fraud scheme, unspooled in the HBO documentary Baby God, left a swath of families 26 children as of this writing, spanning 40 years of the doctors treatments shocked at long-obscured medical betrayal, unmoored from assumptions of family history and stumbling over the most essential questions of identity. Who are you, when half your DNA is not what you thought?

For Babst and several other Fortier relatives now connected as unintentionally uncovered half-siblings, the idea of closure is really impossible, Hannah Olson, the films director, told the Guardian. Filmed over two years, Baby God investigates how painful and circuitous and unfinished it can be for victims of different kinds of sexual violence.

Olson had come to know the sometimes thorny journey of uncovering genealogy well as a producer on Finding Your Roots with Henry Louis Gates Jr, a show transformed by the advent of commercial DNA testing and the internet communities sprung from the blacklight shed on family secrets. What was once the work of combing through records birth certificates, death certificates, hospital archives sometimes became an inadvertent Pandoras box of secrets. All of a sudden it became a thing where we had to reveal to people that their father wasnt the person they thought their father was, or their grandfather wasnt the person they thought he was, she said.

In the most extreme cases, such as with Fortier or Cline, there were dozens of misled offspring. The Fortier case rocked the Nevada medical establishment, but was not an isolated incident; there are at least two dozen American doctors known to have perpetrated so-called fertility fraud, such as the widely covered case of Dr Donald Cline in Indianapolis, who fathered at least 50 children through his medical practice. Fortier was likely an egregious case of physician betrayal, but far from the only one, Olson realized this was a phenomenon.

Baby God initially follows Babsts personal investigation, as she retraces her mothers steps and requests records on Fortier, who practiced medicine for more than 60 years in Nevada, won physician of the year in 1991 and never lost his medical license. Two of Fortiers former patients sued the doctor for fraudulently inseminating them with his own sperm in the mid-2000s, as reported by the Las Vegas Review-Journal; the cases were settled out of court, allegedly with an agreement to prevent the plaintiffs from speaking publicly, and Fortier never had to admit wrongdoing (Fortier did, however, acknowledge his paternity of the four children in question in his will, and left open the possibility that more biological children would later be revealed).

That reality a once unknowable crime now made plainly knowable has now come to pass, and the film features interviews with several of Fortiers previously unknown children, each grappling with and tracing their way into a new web of half-siblings, questions of lineage and inheritance, and reframing of family history. Babst, who started as a cop at 19, dove into her own investigation, sourcing records on Dr Fortier that eventually revealed allegations of sexual abuse and molestation against his own stepchildren.

Brad Gulko, a human genomics scientist in San Francisco who bears a striking resemblance to the young Fortier, initially approached the revelation from the clinical perspective of biological motivations for procreation. I feel like Dr Fortier found a way to justify in his own mind doing what he wanted to do that didnt violate his ethical norms too much, even if he pushed them really hard, he says in the film. Im still struggling with that. I dont know where Ill end up.

The film quickly morphed, according to Olson, from an investigation of the Fortier case and his potential motivations to the larger, unresolvable questions of identity, nature versus nurture. At first it was like lets get all the facts, were going to figure it out, what are his motivations, it will be super clear, said Olson. She interviewed two former colleagues, whose cavalier, brash attitudes toward sex and reproduction one whipped out his phone to show photos of abnormal uteruses and female genitalia nestled within his camera roll, and both seemed unperturbed by the idea of their sperm unknowingly used by Dr Fortier make the doctors deception seem less like an isolated pathology and more the extreme manifestation of widespread attitudes toward female fertility: a doctor knows best attitude, belief that women dont need to know, ends justified the means, coupled with the lack of frozen sperm, which didnt become common practice until the 1980s.

But as the investigation deepened, we ended up discovering much darker things than I imagined, said Olson, including the alleged abuse of his stepchildren, one of whom he inseminated with his own sperm and shipped off to a Minnesota home for unwed mothers. The subsequent child, a son named Jonathan, was adopted by the Minnesota family, and appears in the films second half as a more recent addition to the half-siblings web. Fortiers two youngest children, who stood by him during his trials and after his death, recall their father in the film as a kind, generous man; one daughter, Sonia Fortier, says she does not want to know if the abuse allegations were true. (Fortier denied the charges, according to the Review-Journal, and no charges were ever brought).

In the wake of DNA testing, some states have sought to enact laws specifically targeting the past crimes of fertility fraud, including Indiana, where some of Clines descendants have backed such legislation. But Olson sees such legislation as a distraction from the Fortier cases larger, more unsettling questions. Looking for answers for this kind of fertility fraud in the law is kind of misguided, because its always been illegal. Its battery, its malpractice, you cant put something in someones body without their consent, she said. Thats why it was more important for me to focus on the attitudes that gave way to this and the emotions.

Towards the end, it became about making peace with ones parents, and does it matter what our parents have done? Does DNA matter? The sliver of a phenomenon captured in Baby God takes a very bizarre case to illuminate something that may be universal, she said. Were all just trying to make peace with our parents.

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Baby God: how DNA testing uncovered a shocking web of fertility fraud - The Guardian