Public knowledge and attitudes towards non‑conventional gestation in the United Kingdom: Results from a cross-sectional online survey experiment

Research question What does the British public know and think about three forms of non-conventional gestation (NCG)—surrogacy, uterus transplantation (UTx), and artificial placentas (AP)—and their variants: traditional surrogacy (TS), gestational surrogacy (GS), and UTx from living (LUTx) versus deceased donors (DUTx)? Design A quota-sampled cross-sectional online survey experiment in the United Kingdom recruited 1,646 adults (51% female) via a research panel. Respondents were randomly assigned to surrogacy (n=548), UTx (n=549), or AP (n=549) conditions. Within-subject ratings assessed TS versus GS and LUTx versus DUTx. Subjective knowledge and attitudes were measured before socio-demographic variables. Complete-case data were analysed using ANOVA, correlations, and linear regressions. Results The percentage of respondents with positive attitudes varied across surrogacy (85.9%; n=471/548), UTx (82.0%; n=450/549), and AP (64.8%; n=356/549). Variant-specific information reduced support for surrogacy and UTx, although attitudes remained favourable. Differences in support between surrogacy/UTx, TS/GS, and LUTx/DUTx were not significant. Most participants (74.3-82.7%) reported low knowledge of NCGs. Higher subjective knowledge predicted more positive attitudes towards UTx (β=.11), LUTx (β=.13), and AP (β=.38). Age negatively predicted attitudes towards UTx (β=-.20), LUTx (β=-.14), and AP (β=-.22), indicating that younger respondents were more supportive of these newer NCGs, while older age predicted greater support only for TS (β=.11). Religion predicted lower support for surrogacy (β=-.15), TS (β=-.10), and GS (β=-.10). Political orientation predicted higher support for UTx (β=.15), LUTx (β=.10), and DUTx (β=.09). Other demographics had minimal effects. Conclusions Public support for NCGs is shaped by the level of detail provided as well as subjective knowledge and socio-demographic factors, although associations vary across NCG forms and variants. Further research should examine information sources and other influences on attitudes.