The Welfare of the Children in Same Sex Families: An Update
Carlo Bastianelli1, Manuela Farris1,2*, Elena Farris1 and Giuseppe Benagiano1
1Department of Gynecological and Obstetrical Sciences and Urological Sciences, Sapienza University of Rome, Italy
2Italian Association for Demographic Education, Italy
Submission: March 14, 2017; Published: April 12, 2017
*Corresponding author: Manuela Farris, Department of Gynecological and Obstetrical Sciences and Urological Sciences, Sapienza University of Rome, Demographic Education, AIED, via Toscana 30, 00187 Rome, Italy, Tel: +39-335-812-8097; Email: manuela.farris@uniromal.it
How to cite this article: Carlo B, Manuela F, Elena F, Giuseppe B. The Welfare of the Children in Same Sex Families: An Update. J Gynecol Women's Health. 2017; 4(1): 555628. DOI: 10.19080/JGWH.2017.04.555628
Abstract
Over the last few years, additional information has been published on the controversial issue of the welfare of children, adolescents and adults raised in a same-sex family context. In their majority, the new data are reassuring, further strengthening the conclusion that the presence of two parents of the same sex, per se produces no negative consequences.
At the same time, following the publication in 2012 of a large study revealing numerous, consistent differences, between children raised in a homo- and hetero-sexual family, several additional reports of the negative consequences of being raised by two parents of the same sex have been published. These investigations, on the one hand, have shown increased levels of emotional problems, including depression; on the other, have been criticized on methodological grounds.
Also negative research has been criticized in many ways for lack of stringent selection and analysis criteria. The abundance of negative findings has had an impact of legislation in a number of countries and helped legalizing adoptions by same-sex couples, as well as shifting public opinion.
The controversy, however, is destined to continue and - if possible - to worsen because its nature is in fact not scientific. It is a battle between the advocates of the right of every individual to found a family irrespective of sexual orientation, and those defending the right of every child to a mother and a father.
Keywords: Same sex families; Same sex couples; Parenting; Psychosocial development of children
Introduction
We have recently reviewed scientific evidence regarding children growing-up in same sex families within the context of an increasing acceptance of same-sex unions in Western countries [1]. This review indicates that a large body of evidence gathered over more than thirty years has almost invariably concluded that there is no evidence of a compromised psychosocial development in children of lesbian or gay men couples.
However, in 2012 a major study, named "the New Family Structures Study" (NFSS) reaching a different conclusion was published [2]. This investigation consisted of a survey of a large, random sample of American young adults (ages 18-39) who were raised in different types of family arrangements and revealed a number of consistent differences, especially between children of lesbian couples and those of non-divorced heterosexual biological parents. The Author stressed that his results are "typicallyrobust in multivariate contexts as well, suggesting far greater diversity in lesbian-parenthousehold experiences than convenience-sample studies of lesbian families have revealed". Thus, the debate was reopened and - as of today - the issue cannot be considered settled.
In fact, the ethical dimension of allowing children to grow in a same-sex family context appears to be founded in matters of principle, rather than constituting an issue to be resolved through scientific investigation [3]. Therefore, refusal, or acceptance of same-sex couples (SSC), same sex marriage (SSM) and same-sex families (SSF) is often viewed as an irremediable contrast between what some consider the fundamental right of a child to have a mother and a father (a right denied to millions of children today) and the right of any individual to found a family This means that the decision by Governments, Parliaments and even, as it recently happened in the Irish Republic, of the average citizen to allow or prohibit same sex unions or marriages and, as a consequence, the use of Assisted Reproduction Technology (ART) [in particular in vitro fertilization and embryo transfer (IVF-ET)], as well as adoption by SSC is normally taken as a consequence of a specific value judgment, not of scientific evidence.
In this sense, throughout the world, two opposite concepts of family structure and values confront each other: on the one hand, there is North America and several major countries of South America, all of Western Europe, Australia and New Zealand. On the other, we have Eastern Europe, several countries of Latin America, Asia and Africa.
To complete the picture, in discussing the social and ethical dimension of SSF it is necessary to bear in mind the major role played by religious beliefs. The legitimacy of these new families is in principle rejected by the three major monotheistic religions (Christianity, Islam and Judaism), who consider that both marriage and the possibility of adopting, or having children should be restricted to couples made-up by a man and a woman (or, by a man and several women), because only these unions are natural. At the same time the official position of the various components of these three religions is not monolithical: Among Protestant Christian denominations a number of Churches in Europe and North America formally allow or practically accept same sex-unions and the ensuing formation of a family. On the other hand, within Islam the Sunni majority does not approve formal adoption of children, even by a heterosexual family
Thus, in their vast majority the world monotheistic religions consider SSM and SSC 'unnatural' and dangerous for society, as well as for children growing within them.
In view of an ever changing scenario, we decided to update our review [1] evaluating recent literature on the subject.
Materials and Methods
We searched PubMed for articles published during the period January 2014-February 2017 using the words "same sex families; same sex couples parenting; adopting; children health; surrogacy; step child adoption; in vitro fertilization”. The search yielded 56 publications. Following scrutiny of their relevance, we analyzed 28 articles, including several informative reviews. This analysis produced an additional 8 articles dealing with possible negative consequences of growing in a SSF and, in view of the fact that these studies have been published in journals difficult to find by the average reader, emphasis was given to their analysis, while warning of the existence of a ideological bias difficult, if not impossible, to eliminate.
New studies showing lack of negative consequences
Since publication of our review [1], a number of studies have been added to the large body of evidence favoring the thesis that growing in an SSF does not harm children. In addition, important methodological issues have also been reassessed.
In this respect, starting with the observation that analysis of small sub-samples is sensitive to researchers' analytical decisions, Cheng and Powell [4] have reassessed the already mentioned work of Regnerus [2] and have shown the potential for a misclassification of several respondents classified as raised in an SSF. They believe that patterns evidenced in the original article are fragile and may be a function of possible is classifications.
Also Umberson et al. [5] have stressed that data and methods available for the study of same-sex relationships are limited, while-at the same time-results will inform policy debates and legal decisions. For this reason, they reviewed current approaches to this important issue, giving particular attention to gendered contexts and dyadic research designs, quasiexperimental designs, and a relationship biography approach.
Reviewing the field is important, as shown by the Review of research in the field of SSF prepared for the American Sociological Association in its role of Amicus Curiae during the evaluation of same sex marriages by the US Supreme Courts [6]. Clearly, the conclusion reached in this review that observed differences in child well-being are largely due to socioeconomic circumstances and family instability influenced the Court decision.
Among recent studies on the effects of growing in a SSF, a number of important new publications have appeared.
Reczek [7] evaluated whether legalization of SSM in the United States improved the condition of children born in these families and found that the discriminant factor was cohabitation versus marriage. Children in same-sex and different-sex married households are relatively similar to each other on health outcomes, as are children in same-sex and different-sex cohabiting households.
In another study, Farr [8] found that adjustment among children of school age, parents, and couples, as well as family functioning, were similar irrespective of parental sexual orientation. Also Crouch et al. [9] found that children in SSF develop well in terms of health and wellbeing. Specifically, biological relationships, parental gender and parental education were not significantly associated with health and wellbeing. Bos et al. [10], utilized the 2011-2012 National Survey of Children's Health data set and found no differences between household types on family relationships or any child outcomes.
The issue of parental engagement in schools in the context of adoptive parent families or same-sex parent families has been studied by Goldberg & Smith [11]. They assembleda sample of 103 female same-sex, male same-sex, and heterosexual adoptive parent couples (196 parents) of kindergarten-age children. Parents reporting more contact by teachers about positive topics also reported more involvement and greater satisfaction with schools, regardless of family type. Those reporting more contact by teachers about negative topics, on the one hand reported better relationships with teachers; on the other, indicated lower school satisfaction, regardless of family type. The same Authors [12] have also studied same-sex parents' school engagement, and implications for their relationships with and perceptions of their children's schools. They found that parents who perceived their communities as more homophobic had higher levels of school-based involvement.
With regard to school engagement, Prickett et al. [13] demonstrated that women in same-sex couples were more likely than either women or men in different-sex couples to spend time with children. Also, men coupled with other men spent significantly more time with their children than men coupled with women.
One final issue worth of mention relates to barriers in access to healthcare for same-sex attracted parents and their children [14]. When asked these parents reported experiencing uncomfortable feelings or anxiety-when encountering healthcare workers because of difficulty on their part in using a language appropriate for the situation. At the same time, healthcare workers were seeking training, resources and information on concrete strategies for engaging with SSF.
The issue of needs and support to be given to lesbian, gay, bisexual, transgendered and inter-sex parents within the Nordic countries has been the object of a recent systematic review [5]. The review found that almost all studies were qualitative, and only two countries, Sweden and Norway, had lesbian, gay, bisexual, transgendered and inter-sex parents reporting on the health of their children. In addition, all results related to same- sex mothers and indicated that they are generally accepted within the Nordic child health field, but they still face overt and covert heteronormative obstacles, resulting in forms of discrimination and fear.
Old and new studies showing negative consequences
Following the publication of Regnerus’ work [2], the possibility that growing in an SSF setting may be harmful to children has been reevaluated. In particular, Paul Sullins of the Catholic University of America has recently criticized studies reporting "no differences" in well-being between children in same sex unions and those in heterosexual families. Starting with the observation that by necessity most studies reporting no difference utilized small samples, he tested whether the validity of such "small non-random samples" can be replicated in a large population sample. He used a representative sample of 207,007 children, including 512 with same-sex parents, from the U.S. National Health Interview Survey [16] and found that emotional problems were more than doubled in children with same-sex parents than for children with opposite-sex parents [minimum risk ratio 2.4, 95% confidence interval 1.7-3.0]. Interestingly, he also found that, whereas risk was elevated in the presence of parent psychological distress and moderate in case of family instability, it was unaffected by stigmatization. He concluded that full biological parentage, a modality not possible for same-sex parents, does influence child emotional problem outcomes. Sullins [17] also reevaluated three studies by Wainright & Patterson [18-20] on 44 SSC and found what he considered major inaccuracies in these studies. In particular, 27 out of the 44 adolescents were in fact living with opposite-sex parents and, after correction, the 17 adolescents truly living in a SSF fared significantly worse than did their counterparts. Sullins concluded that adolescents with same-sex parents, on the one hand experience significantly lower autonomy and higher anxiety, on the other perform better in school. Finally, when comparing 'unmarried' to 'married' same-sex parents, he found that on an-average child depressive symptoms rose from 50% to 88%; daily fearfulness or crying rises from 5% to 32%. His final conclusion:"The longer a child has been with same-sex parents, the greater the harm".
In his latest work Sullins [21] points out that even in the past there have been researchers who found important differences, starting with an Australian study [22] showing that in the majority of cases, the most successful are children of married couples, followed by children of cohabiting couples and finally by children of homosexual couples. Then in 2013, Allen [23] identified self-reported children living with same- sex parents in a 20% sample of the 2006 Canada cen sus and examined the association of household type with children's high school graduation rates. Allen pointed out that his "large random sample allows for control of parental marital status, distinguishes between gay and lesbian families, and is large enough to evaluate differences in gender between parents and children". This investigation concluded that children living with gay and lesbian families in 2006 were about 65 % as likely to graduate compared to children living in opposite sex marriage families. In addition, daughters of same-sex parents seem to do considerably worse than sons. Sullins [21] also refers to the reevaluation carried out by Schumm [24] of the old Australian study by Sarantakos [22], noting that "Sarantakos' research produced many interesting findings on children's academic performance, sexual orientation, use of alcohol and drugs, sexual deviance, and gender identity with respect to parents' parenting values, relationship stability, conflict, monogamy, and religiosity or moral values, many of which have been corroborated by U.S. or British research”. He also praised the quality of this research, especially in the context of the situation existing at that time and concluded that it was definitely above average, especially for research done 20 or more years ago. Unfortunately, these studies seem to have been published in Journals not indexed by PubMed.
Going back to Sullins most recent essay [21], he reiterates thatthe very nature of SSC produced a myriad of studies utilizing what he callled "an almost universal dependence on convenience samples" and pointed out that "no study has yet explored the connection, if any, between late onset distress and precipitating conditions in children living in a SSF. This investigation found that at age 28, adults raised by SSC were at over twice the risk of depression as persons raised by heterosexual parents.
In all fairness, Sullins warns that his findings should be interpreted with caution for several reasons; however, they warrant more policy attention to children raised in SSF.
Results obtained by Sullins were criticized in a letter to the Editor by Frank [25], who started by saying: "I was appalled, if not surprised, to see the publication of Donald Sullins' study” and goes on noting that 74 studies collected by his team in the What We Know Project [26], have found no evidence that the sexual orientation of parents does not influence the wellbeing of children. Sullins' reply [27] retorts that Frank's claims are based on a series of confusions, errors and mischaracterization of the state of knowledge on this subject. He goes on that whereas some of the points made by Frank have merit, these very points tend to undermine research carried by those showing no negative effects for children raised in SSF. He mentions Messinger [28] who took the position that intimate partner violence (IPV) among same-sex couples is largely ignored by policy makers and researchers and for this reason carried out a secondary data analysis of the National Violence Against Women Survey. His multiple variable regression analysis of U.S. adult same-sex IPV utilized a nationally representative sample (N=14,182) and showed that, independent of sex, respondents with a history of same-sex relationships are more likely to experience verbal, controlling, physical, and sexual IPV.
Sullins goes on with an itemized response and concludes that Frank's criticisms of his study are unfounded.
A thorough review of whether the outcomes for children of growing with gay, lesbian, or bisexual parents are in general the same as those educated by heterosexual parents has been carried out by Schumm [29] who addressed the meaningful differences that have been found studying the effects of same-sex parenting. He specifically stressed the existence of theoretical and methodological limitations often found in this area of study and quotes sixteen articles that he published on this subject.
His systematic analysis addressed three specific questions: the stability of same-sexparental relationships; the issue of child outcomes in general and the specific outcomes in children adopted by same-sex couples.
He found out that relationship instability appears to be higher among gay and lesbian parent couples. With respect to outcomes in children, he noted that while parental self-reports usually present few significant differences, self-reporting may in itself represent an important confounding factor. In addition, parent couple instability may be a key mediating factor influencing outcomes for children. He therefore believes that to conclude that parental sexual orientation produces no effect whatsoever in terms of child outcomes, appears premature, especially in the light of recent investigations indicating possible negative outcomes. Finally, with regard to studies comparing outcomes for children adopted by same-sex and heterosexual couples, he identified a number of methodological limitations and expressed the opinion that present knowledge is still too limited concerning family functioning among same-sex adoptive families.
He concluded that there is a need for high-quality research on same-sex families, especially families with gay fathers and those with lower income.
The influence of legislation and public opinion
A number of recent articles have evaluated effects of changes in legislation and in public opinion on same sex unions and their children.
An interesting case is that of the Netherlands, the first country to authorize same-sex marriages, where Trandafir [30] studied the effect of legalization of same-sex marriage on heterosexual formal unions. After creating a data set covering the period 1995-2005, he found heterogeneous effects, with presumably more-liberal individuals marrying less and potentially moreconservative individuals marrying more after passage of the new legislation. This work was reevaluated by Dinno [31] who challenged the conclusion of an absence of evidence of effects, because Trandafir did not also look for equivalence in rates of opposite-sex marriage. In a subsequent study, Trandafir [32] utilized data from OECD member countries for the period 1980-2009 and again concluded that the introduction of SSM or alternative measures had no negative effects on family formation.
Of the opposite sign is the study by Schwartz et al. [33] who evaluated the consequences of the 2014 Law in Nigeria prohibiting Same-Sex Marriage. They used information from the Nigerian TRUST cohort for HIV prevention and treatment services for men who have sex with men (MSM). Over a 16 months period, 707 MSM participated in the study. They found that fear of seekinghealth care was significantly higher in postlaw visits than in pre-law visits.
An evaluation of public opinion on the issue of same-sex unions was carried out by Pinsof & Haselton [34] who noted that the average citizen remains markedly divided over this issue. They suggested that opposition to SSM be a consequence of two major orientations: individual differences in short-term mating orientation; and mental associations between homosexuality and sexual promiscuity. They concluded that mating psychology plays a central role in attitudes toward same-sex marriage.
Another investigation of social attitudes towards SSC in Europe has been conducted by Takacs et al. [35] who evaluated social attitudes on same-sex adoption in 28 European countries. They highlighted factors both at the individual and country-level that can determine social acceptance or rejection of this specific kind of adoption. Indeed, there was a strong association between social attitudes towards adoption by SSC and the existence of legislation permitting such practice.
A third, recent study investigated attitudes towards same sex parenting in Australia [36] and concluded that the increased awareness to same-sex families did not produce a widespread acceptance of these family structures. They investigated attitudes by the public and concluded that they differ according to the type of union, with greater acceptance of parenting by lesbians couples.
Some evolution seems to have occurred in Poland where a change in public opinion thinking has been reported by Mizielinska & Stasinska [37] who showed that heterosexual marriage as the ideal has been slowly undermined by the emergence of new narratives on alternative families. They concluded that "some undesired alliances among supporters and opponents of same sex partnership" still existed and that these may present a danger for further change.
Finally, a study [38] compared beliefs of Spanish and Chile an university students on possible effects of same-sex parenting on their children. Results indicate a kind of modern and subtle rejection based on hetero-normativity, with men having a greater degree of rejection.
Conclusion
It seems fair to conclude that an analysis of data published over the last few years continues to show, on the one hand the absence of problems for children growing in a homosexual context and, on the other a clear ideological divide between those supporting and those opposed to SSF.
At present, it seems impossible to open a scientific and neutral debate between the two camps. This is due to an irremediable conflict between supporters of the right of every individual, regardless of sexual orientation, to form a family and those insisting that every child has a fundamental right to have a mother and a father.
It is our opinion that information gathered by scientific research will not resolve the dilemma of whether children rights are violated by their growing in a SSF.
Conflict of Interest
The authors report no conflicts of interest. The authors alone are responsible for the content and the writing of the paper Theauthors received no funding for this study.
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