If you're pursuing surrogacy in Ontario, you've likely learned that a psychological assessment is part of the process. Most fertility clinics require one before proceeding with embryo transfer.

But what actually happens in a surrogacy assessment? What questions will you be asked? And what's the purpose of the whole thing?

Here's what you need to know so you can walk in prepared and confident.

Why surrogacy assessments exist

Surrogacy involves significant emotional, legal, and relational complexity for everyone involved: intended parents, surrogates, and the families of each.

The psychological assessment isn't a gatekeeping exercise designed to screen people out. It's a support mechanism intended to:

Ensure all parties understand the emotional dimensions of surrogacy
Identify potential stressors, concerns, or support needs early
Facilitate communication between intended parents and surrogates
Provide recommendations for support throughout the journey
Satisfy the requirements of fertility clinics and, in some cases, legal professionals

In Ontario, surrogacy arrangements are recognized under the Children's Law Reform Act, which was updated in 2017. While the law doesn't mandate psychological assessments (unlike adoption, which does), most fertility clinics voluntarily require them as part of their protocol.

This clinical requirement exists because surrogacy, done well, benefits from preparation. The assessment helps ensure that everyone is emotionally ready, that expectations are aligned, and that potential challenges have been anticipated.

Who completes the assessment

Surrogacy assessments are conducted by mental health professionals with specialized training in reproductive psychology. This is typically a psychologist, social worker, or psychotherapist with experience in third-party reproduction.

At Toronto Therapy Practice, our team includes therapists with extensive experience in surrogacy, egg donation, sperm donation, and other family-building paths. One of our therapists, Naomi, has personal lived experience with surrogacy, which brings an added layer of understanding to the process.

The assessment typically involves:

Individual sessions with each party. Both intended parents (individually or together) and the surrogate will have separate sessions to explore their experiences, motivations, and concerns.

A joint session. This brings intended parents and surrogate together to discuss the relationship, communication expectations, and plans for the pregnancy and beyond.

Partner involvement. If the surrogate has a partner, they're typically included in the assessment process. Their support and understanding are important factors in a successful journey.

Review of relevant history. The assessor will ask about mental health history, family dynamics, previous experiences with pregnancy or fertility, and motivations for pursuing surrogacy.

What the assessment covers

The assessment explores several key areas, and understanding them in advance can help you feel more prepared.

Motivations and expectations

For surrogates: Why do you want to be a surrogate? What do you hope to gain from the experience? How do you imagine the relationship with the intended parents during pregnancy and after birth?

For intended parents: Why have you chosen surrogacy? What are your expectations for the relationship with your surrogate? How have you processed any grief or loss related to not carrying the pregnancy yourself?

These questions aren't about having "right" answers. They're about ensuring that motivations are clear, healthy, and likely to lead to a positive experience for everyone.

Understanding of the process

Do all parties have realistic expectations about the medical, legal, and emotional aspects of surrogacy?

For surrogates, this includes understanding:

The physical demands of IVF protocols and pregnancy
The emotional experience of carrying a baby for someone else
The relinquishment process after birth
How the experience might affect their own family

For intended parents, this includes understanding:

The lack of control over the pregnancy
The reliance on another person to carry your child
The legal processes involved in establishing parentage
The ongoing relationship with the surrogate

Mental health history

The assessor will ask about past and current mental health, including any history of depression, anxiety, trauma, or other concerns.

This isn't about disqualifying anyone. Most people have some mental health history. The goal is to identify support needs and ensure that appropriate resources are in place.

For surrogates, the assessor will be particularly attentive to any history of postpartum depression or pregnancy-related mental health concerns, since these may be relevant to the surrogacy experience.

Coping strategies and support systems

How do you typically handle stress? What resources do you have in place? Who are the people you can lean on?

Surrogacy is a significant undertaking. The assessment helps ensure that everyone has adequate support systems to navigate the challenges that may arise.

Relationship dynamics

For surrogates with partners, the assessment considers the partner's involvement, understanding, and support. Surrogacy affects the whole family, and partner buy-in is important.

For intended parents, the assessment explores the stability of the relationship and how the couple communicates about important decisions.

Plans for existing children

If the surrogate has children, the assessment considers how they've been prepared for the surrogacy and how the experience might affect them. This includes discussing how to explain the pregnancy and birth to children at different developmental stages.

What happens after the assessment

Following the assessment, the mental health professional prepares a report for the fertility clinic. This report typically includes:

A summary of the assessment findings
Confirmation that all parties meet psychological criteria for proceeding
Any recommendations for counseling or support during the journey
Notes on communication plans or potential areas to address

In the vast majority of cases, the assessment results in a clear path forward. If concerns are identified, the report may recommend additional therapy or preparation before proceeding, or may suggest specific supports during the journey.

How to prepare

You don't need to study for a surrogacy assessment. The goal is an honest conversation, not a test you pass or fail.

That said, some reflection beforehand can be helpful:

Think through your motivations. Why are you pursuing surrogacy? What feels meaningful about this path?
Consider your expectations for the relationship. How much contact do you want during the pregnancy? What about after birth? What communication style works for you?
Reflect on your support system. Who will you lean on during this journey? Do you have people who understand and support your decision?
Be prepared to discuss mental health openly. This is a safe, confidential space. Honesty serves you better than trying to present a "perfect" picture.
Come with questions. If anything about the surrogacy process is unclear, the assessment is a good time to ask.

The tone of the assessment

A good surrogacy assessment is warm, professional, and supportive. It's not an interrogation or an evaluation designed to find problems.

At Toronto Therapy Practice, we approach these assessments with the understanding that you're embarking on a meaningful journey. Our goal is to support everyone involved in building families, and to help ensure that the experience is positive for surrogates, intended parents, and the children who result from these arrangements.

Surrogacy assessments at Toronto Therapy Practice

Our team has extensive experience conducting surrogacy assessments for intended parents and surrogates across Ontario. We work with individuals, couples, and families pursuing various paths to parenthood, including gestational surrogacy, traditional surrogacy, and other forms of third-party reproduction.

We also provide ongoing counselling and support throughout the surrogacy journey, not just the initial assessment.

Book a consultation to learn more about our surrogacy assessment process or to schedule your appointment.