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Zhang Y, Huang H, Wang M, Zhu J, Tan S, Tian W, Mo J, Jiang L, Mo J, Pan W, Ning C. Family outcome disparities between sexual minority and heterosexual families: a systematic review and meta-analysis. BMJ Glob Health 2023; 8:e010556. [PMID: 36878725 PMCID: PMC10016267 DOI: 10.1136/bmjgh-2022-010556] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 01/11/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND The number of children in sexual minority parent families has increased. This systematic review aims to synthesise the evidence of disparities in family outcomes between sexual minority and heterosexual families and to identify specific social risk factors of poor family outcomes. METHODS We systematically searched PubMed, the Web of Science, Embase, the Cochrane Library and APA PsycNet for original studies that compared family outcomes between sexual minority and heterosexual families. Two reviewers independently selected studies and assessed the risk of bias of included studies. Narrative synthesis and meta-analysis were conducted to synthesise evidence. RESULTS Thirty-four articles were included. The narrative synthesis results revealed several significant findings for children's gender role behaviour and gender identity/sexual orientation outcomes. Overall, 16 of 34 studies were included in the meta-analyses. The quantitative synthesis results suggested that sexual minority families may perform better in children's psychological adjustment and parent-child relationship than heterosexual families (standardised mean difference (SMD) -0.13, 95% CI -0.20 to -0.05; SMD 0.13, 95% CI 0.06 to 0.20), but not couple relationship satisfaction (SMD 0.26, 95% CI -0.13 to 0.64), parental mental health (SMD 0.00, 95% CI -0.16 to 0.16), parenting stress (SMD 0.01, 95% CI -0.20 to 0.22) or family functioning (SMD 0.18, 95% CI -0.11 to 0.46). CONCLUSION Most of the family outcomes are similar between sexual minority and heterosexual families, and sexual minority families have even better outcomes in some domains. Relevant social risk factors of poor family outcomes included stigma and discrimination, poor social support and marital status, etc. The next step is to integrate multiple aspects of support and multilevel interventions to reduce the adverse effects on family outcomes with a long-term goal of influencing policy and law making for better services to individuals, families, communities and schools.
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Affiliation(s)
- Yun Zhang
- School of Nursing, Guangxi Medical University, Nanning, Guangxi, China
| | - Haimei Huang
- School of Nursing, Guangxi Medical University, Nanning, Guangxi, China
| | - Min Wang
- School of Nursing, Guangxi Medical University, Nanning, Guangxi, China
| | - Jiawen Zhu
- School of Nursing, Guangxi Medical University, Nanning, Guangxi, China
| | - Sumin Tan
- School of Nursing, Guangxi Medical University, Nanning, Guangxi, China
| | - Weiyi Tian
- School of Nursing, Guangxi Medical University, Nanning, Guangxi, China
| | - Jinli Mo
- School of Nursing, Guangxi Medical University, Nanning, Guangxi, China
| | - Li Jiang
- School of Nursing, Guangxi Medical University, Nanning, Guangxi, China
| | - Jieling Mo
- School of Nursing, Guangxi Medical University, Nanning, Guangxi, China
| | - Wei Pan
- Duke University School of Nursing, Durham, North Carolina, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Chuanyi Ning
- School of Nursing, Guangxi Medical University, Nanning, Guangxi, China
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Mazrekaj D, Fischer MM, Bos HMW. Behavioral Outcomes of Children with Same-Sex Parents in The Netherlands. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105922. [PMID: 35627459 PMCID: PMC9141065 DOI: 10.3390/ijerph19105922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/05/2022] [Accepted: 05/07/2022] [Indexed: 02/04/2023]
Abstract
Same-sex parents face substantial stressors due to their sexual orientation, such as experiences of prejudice and prohibitive legal environments. This added stress is likely to lead to reduced physical and mental health in same-sex parents that, in turn, may translate into problematic behavioral outcomes in their children. To date, there are only a few nationally representative studies that investigate the well-being of children with same-sex parents. The current study takes a closer look at children’s behavioral outcomes, reported by a parent, using an adapted version of the emotional, conduct, hyperactivity, pro-social, and peer problems subscales of the Strengths and Difficulties Questionnaire (SDQ). We take advantage of unique data from the Netherlands based on a probability sample from population registers, whereby findings can be inferred to same-sex and different-sex parent households with parents between the ages of 30 and 65, and with children between the ages of 6 and 16 years (62 children with same-sex, and 72 children with different-sex parents). The findings obtained by coarsened exact matching suggest no significant disadvantages for children with same-sex parents compared to different-sex parents. We contextualize these findings in their wider cultural context, and recommend a renewed focus in future research away from deficit-driven comparisons.
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Affiliation(s)
- Deni Mazrekaj
- Department of Sociology, Utrecht University, Padualaan 14, 3584 CH Utrecht, The Netherlands
- Nuffield College, University of Oxford, New Road, Oxford OX1 1NF, UK
- Leuven Economics of Education Research (LEER), KU Leuven, Naamsestraat 69, 3000 Leuven, Belgium
- Correspondence: ; Tel.: +31-6-4416-0276
| | - Mirjam M. Fischer
- Institute of Sociology und Social Psychology, University of Cologne, Albertus-Magnus-Platz, D-50923 Cologne, Germany;
| | - Henny M. W. Bos
- Research Institute Child Development and Education, Faculty of Social and Behavioral Sciences, University of Amsterdam, Nieuwe Achtergracht 127, 1001 NG Amsterdam, The Netherlands;
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Downing J, Everett B, Snowden JM. Differences in Perinatal Outcomes of Birthing People in Same-Sex and Different-Sex Marriages. Am J Epidemiol 2021; 190:2350-2359. [PMID: 34010958 DOI: 10.1093/aje/kwab148] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 05/10/2021] [Accepted: 05/14/2021] [Indexed: 12/30/2022] Open
Abstract
It is unknown whether people in same-sex relationships who give birth have different perinatal outcomes than people in different-sex relationships, despite differences in risk factors such as use of assisted reproductive technologies, obesity, smoking, and poor mental health. Marriage equality has established birth certificates as a promising new source of population-based data on births to same-sex married parents. We used birth certificate data from Massachusetts for 201,873 singletons born to married parents from 2012 to 2016. We estimated the associations of several birth outcomes with having a birth parent in a same-sex marriage using propensity score-matched and -unmatched samples. We also tested whether these associations were modified by the use of assisted reproductive technologies. People in same-sex marriages who gave birth had perinatal outcomes related to decreased fetal growth and preterm birth that were similar to those of their peers in different-sex marriages. Use of assisted reproductive technology was associated with decreased fetal growth and increased risk of preterm birth for infants with different-sex parents but not for infants with same-sex parents. More research is needed across other states and to understand why use of assisted reproductive technology is not a risk factor for poor birth outcomes for those in same-sex marriages.
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Kabátek J, Perales F. Academic Achievement of Children in Same- and Different-Sex-Parented Families: A Population-Level Analysis of Linked Administrative Data From the Netherlands. Demography 2021; 58:393-418. [PMID: 33834221 DOI: 10.1215/00703370-8994569] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Although numerous studies have examined how children raised in same-sex-parented families fare relative to children in different-sex-parented families, this body of work suffers from major methodological shortcomings. By leveraging linked administrative data from several population registers from the Netherlands covering the 2006-2018 period (n = 1,454,577), we overcome most methodological limitations affecting earlier research. The unique features of the data include complete population coverage, reliable identification of same-sex-parented families, a large number of children in same-sex-parented families (n = 3,006), multiple objective and verifiable educational outcomes, and detailed measures of family dynamics over children's entire life courses. The results indicate that children in same-sex-parented families outperform children in different-sex-parented families on multiple indicators of academic performance, including standardized tests scores, high school graduation rates, and college enrollment. Such advantages extend to both male and female children, and are more pronounced among children in female than male same-sex-parented families. These findings challenge deficit models of same-sex parenting.
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Affiliation(s)
- Jan Kabátek
- Melbourne Institute: Applied Economic and Social Research, The University of Melbourne, Melbourne, Australia.,ARC Centre of Excellence for Children and Families over the Life Course, Brisbane, Australia.,Institute of Labor Economics (IZA), Bonn, Germany.,CentER, Tilburg University, Tilburg, The Netherlands
| | - Francisco Perales
- School of Social Science, The University of Queensland, Brisbane, Australia.,ARC Centre of Excellence for Children and Families over the Life Course, Brisbane, Australia
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Siegel M, Assenmacher C, Meuwly N, Zemp M. The Legal Vulnerability Model for Same-Sex Parent Families: A Mixed Methods Systematic Review and Theoretical Integration. Front Psychol 2021; 12:644258. [PMID: 33796052 PMCID: PMC8007880 DOI: 10.3389/fpsyg.2021.644258] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 02/16/2021] [Indexed: 11/13/2022] Open
Abstract
Globally, parents and children in same-sex parent families are impacted by many laws related to the parental sexual orientation. These laws vary considerably from one country to another, ranging from full legal recognition to criminalization. The psychological consequences of living in an ambiguous or hostile legal climate likely interfere with parental health, family functioning, and child development. However, a systematic evidence synthesis of the pertinent literature and its placement within a broader psychological model are currently lacking. The aims of this review were thus (1) to systematically review qualitative and quantitative evidence on the impact of sexual orientation laws on same-sex parent families in key domains and (2) to place these findings within a broader model informed by minority stress and family theories. Our review was preregistered and conducted in line with PRISMA guidelines. We searched for qualitative, quantitative, and mixed methods studies on the impact of sexual orientation laws on target outcomes (parental health, family functioning, child outcomes) via systematic database search (PubMed, Scopus, Web of Science) and forward-backward searches. Fifty-five studies published between 1999 and 2020 were eligible for inclusion and were synthesized using a data-based convergent synthesis design. Thirteen descriptive and three overarching analytical themes were identified through thematic synthesis. Linking our findings with minority stress and family theories, we propose a novel legal vulnerability model for same-sex parent families. The model posits that legal vulnerability constitutes an increased risk for parental and child health as well as family functioning through individual and shared pathways between family members. Additionally, the model introduces counteractions that families engage in on the personal, familial, and systemic level to mitigate the impact of legal vulnerability, as well as moderators on the contextual, familial, couple, and individual level that modulate this impact. Implications for research and clinical practice are discussed.
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Affiliation(s)
- Magdalena Siegel
- Department of Developmental and Educational Psychology, University of Vienna, Vienna, Austria.,Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | | | - Nathalie Meuwly
- Department of Psychology, Institute for Family Research and Counseling, University of Fribourg, Fribourg, Switzerland
| | - Martina Zemp
- Department of Clinical and Health Psychology, University of Vienna, Vienna, Austria
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Mattawanon N, Kummaraka U, Oon-arom A, Manojai N, Tangpricha V. Reproductive desires in transgender and gender diverse adults: A cross-sectional study in Thailand. INTERNATIONAL JOURNAL OF TRANSGENDER HEALTH 2021; 23:362-374. [PMID: 35799958 PMCID: PMC9255026 DOI: 10.1080/26895269.2020.1864560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To explore the desires and barriers to fertility preservation among transgender women and gender diverse people assigned male at birth in Thailand. Material and methods: This study is a cross-sectional study in clinic-based setting. The data was obtained from a questionnaire. Three hundred and three participants visiting the Gender Care Clinic at Chiang Mai University Hospital and Mplus clinics between April 2019 and December 2019 were included. Of these, 199 were transgender women and 104 were gender diverse people assigned male at birth. Results: The overall parental desire was 30.4% which was similar across the 2 groups (p = 0.897). A genetically related child was preferred in 40.9% of transgender women and 50.5% of gender diverse group (p = 0.115). Factors impacting a parental desire were a good relationship with family (OR 2.905, 95%CI 1.315-6.420, p = 0.008), being in a stable relationship (OR 4.183, 95%CI 1.738-10.069, p < 0.001) and belief in a positive attitude of society toward LGBTQ parenting (OR 2.572, 95%CI 1.207-5.479, p = 0.014). Access to fertility preservation services was low. The majority of transgender women (75.3%) and gender diverse people (95.2%) never received a consultation regarding fertility. The utilization rate of fertility treatments was 5.3% in our study. Conclusion: Transgender women and gender diverse people assigned male at birth have parental desires for a genetically related child. However, access to reproductive information, consultation and services were very limited. Social support along with competent health services might increase access to reproductive services in transgender and gender diverse populations.
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Affiliation(s)
- Natnita Mattawanon
- Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Unyamanee Kummaraka
- Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | - Awirut Oon-arom
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | | | - Vin Tangpricha
- Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
- Section of Endocrinology, Atlanta VA Medical Center, Decatur, Georgia, USA
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Reczek C. Sexual- and Gender-Minority Families: A 2010 to 2020 Decade in Review. JOURNAL OF MARRIAGE AND THE FAMILY 2020; 82:300-325. [PMID: 33273747 PMCID: PMC7710266 DOI: 10.1111/jomf.12607] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
OBJECTIVE To review research on sexual and gender minority (SGM) families-including lesbian, gay, bisexual, transgender, queer, asexual, and intersex (LGBTQAI+) families- from 2010-2020. BACKGROUND Research on the SGM population has increased and diversified in the past decade. RESULTS This paper reviews three subareas that make up the majority of research on SGM families today: (1) SGM family of origin relationships, (2) SGM intimate relationships, and (3) SGM-parent families. This review also highlights three main gaps in the existing literature: (1) a focus on same-sex and gay and lesbian families (and to a lesser extent bisexual and transgender families) and a lack of attention to the families of single SGM people as well as intersex, asexual, queer, polyamorous, and other SGM families; (2) an emphasis on white, socioeconomically advantaged SGM people and a failure to account for the significant racial-ethnic and socioeconomic diversity in the SGM population; and (3) a lack of integration of SGM experiences across the life course, from childhood to old age. CONCLUSION The next decade should aim to examine the full range of SGM family ties, include more vigorous examinations of race-ethnicity and socioeconomic status, and develop more robust accounts of family across the life course with novel theory and data sources across the methodological spectrum.
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