Parenting and the Adjustment of Children Born to Gay Fathers Through Surrogacy

Are the children alright? A systematic review of psychological adjustment of children conceived by assisted reproductive technologies

The present systematic review aims to assess the psychological adjustment of children born through assisted reproductive technologies (ARTs) and to screen for clinical problems when compared with normative data from the standardized indexes of mental health. Following PRISMA guidelines, the search was conducted from inception through September 2021 using APA PsycInfo, APA PsycArticles, Psychology and Behavioural Sciences Collection, Academic Search Complete, Pubmed, Scopus, Web of Science, Scielo, and RCAAP. Search terms related to ART and children's psychological adjustment were combined to Boolean operators to identify relevant published studies in English, French, Italian, Portuguese and Spanish. Peer-reviewed studies focused on the psychological adjustment of ART children aged between the 3 and 11 years were included. From a total of 337 results, 45 papers were eligible to be included in this review. Data extraction was performed independently by two authors and revised and confirmed by other two authors. All children scored below the clinical range for psychiatric symptoms when compared with normative data for the Strengths and Difficulties Questionnaire (SDQ) or the Achenbach System of Empirically Based Assessment (ASEBA), regardless of type of ART and different family configurations. Further, some evidence suggests that surrogacy children with gay fathers present the lowest levels of psychological problems when compared to normative data. These findings enable practitioners to develop an informed view of ART children mental health outcomes to help parents find more adaptive strategies to navigate their chosen pathways in healthier ways.

Clinical Considerations for Children of Lesbian, Gay, Bisexual, Transgender, Queer, Intersex, Asexual, and All Sexually and Gender Diverse Families

The visibility of lesbian, gay, bisexual, transgender, queer, intersex, asexual, and all sexually and gender diverse (LGBTQIA+) families is growing. Anti-LGBTQIA+ rhetoric and actions continue to shape the public discourse, legislation, and health care. This article highlights unique challenges and strengths of children raised by LGBTQIA+ parents. Health care professionals should be cognizant of challenges and resiliencies these children experience in a normative society regarding gender identity, sexual orientation, and sex development. Clinicians can conduct inclusive and nonjudgmental family and social histories in welcoming practices, with careful consideration of unique familial dynamics these children may experience at home.

Neither Parents' Sex Nor the Type of Family Modulates Attentional Bias Toward Infant Faces: A Preliminary Study in Different-Sex and Same-Sex Parents

An attentional bias toward infant versus adult faces has been detected in parents and positively associated with sensitive caregiving behaviors. In previous research, the attentional bias has been measured as the difference in attention, in terms of reaction times, captured by infant versus adult faces; the larger the difference, the greater the cognitive engagement that adults deployed to infant faces. However, research so far has been mostly confined to samples of mothers, who have been more represented than fathers. Moreover, new family forms, especially same-sex families of men, have been left out of research. To clarify potential sex differences and extend previous findings to diverse family forms, we implemented a modified Go/no-Go attentional task measuring attentional bias to infant faces in parents with children aged from 2 to 36 months. The sample (N = 86) was matched and included 22 fathers and 22 mothers from different-sex families and 20 fathers and 22 mothers from same-sex families. Overall, the results confirmed that infant faces induced a greater attentional bias compared to adult faces. Moreover, we found that neither the type of family nor parents' sex modulated the attentional bias toward infant faces. The findings are discussed in relation to the importance of understanding the correlates of parental response to infant cues going beyond a heteronormative perspective on parenting.

European gay fathers via surrogacy: Parenting, social support, anti-gay microaggressions, and child behavior problems

The present study investigated child behavior problems, parenting styles, coparenting, and couple relationship satisfaction in 67 European gay father families via surrogacy and 67 European heterosexual parent families via unassisted conception, all with children aged 1.5-10 years (M = 3.57 years, SD = 2.09). The two family groups were matched for child age and gender. In the gay father group only, the associations between family anti-gay microaggressions, family/friend support, and other main variables also were explored. Children of gay fathers had fewer externalizing and internalizing problems compared to children of heterosexual parents. Also, gay fathers reported more effective parenting styles, greater coparenting quality, and higher couple relationship satisfaction compared to heterosexual parents. Overall, child externalizing problems (i.e., aggression, rule-breaking) and internalizing problems (i.e., anxiety, depression) were more strongly associated with being raised in a heterosexual parent family, more authoritarian parenting, and lower positive coparenting. Specific to the gay father sample, anti-gay microaggressions experienced by family members were associated with more child internalizing problems, lower positive coparenting, and lower social support from family and friends. These results refute concerns about possible detrimental effects on child development of surrogacy conception or of being raised by gay fathers. The results further suggest that family therapists treating child behavior problems should focus mainly on improving the coparenting relationship, reducing authoritarian/punitive parenting styles, and (for gay father families specifically) coping with anti-gay microaggressions and lack of social support outside the nuclear family.

Exploring the intersection of gender identity and homoparental family structure: Implications for educational, family and personal well-being in Spanish students

This study explores the relationship among self-perceived gender, family type (heteroparental or homoparental) and socioeconomic factors concerning various educational, family and personal well-being domains. The data are derived from a large sample of 69,088 students from 465 schools (65% public; 35% private or semi-private) in Spain. Five separate multi-level generalized mixed (logistic or linear) regression models were calculated. Key findings include that non-binary students from homoparental families reported lower evaluations in multiple dimensions, suggesting the need for additional support. Likewise, students from homoparental families exhibited lower personal well-being and family relationship assessments, possibly due to perceived social stigmatization and peer bullying. This study sheds light on the complexities of gender identity and family type in educational settings, emphasizing the importance of addressing these issues for students' well-being and academic success.

Male homoparenting and its challenges: an integrative literature review

This study aims to elucidate the challenges faced in the exercise of male homoparenting, through an integrative literature review. Following PRISMA guidelines, empirical studies from the last 22 years were analyzed, independently collected by four researchers using the PubMed and APA PsychNet databases, with the descriptors "Homosexuality, Male" and "Father". The results reveal the unique and complex reality faced by homosexual men in the parental context. While some studies highlight significant challenges, such as stigmas and social prejudices, others do not observe such difficulties. The decision to become a father among homosexual men is influenced by factors specific to their reality, in a context where parenthood is not widely accepted. The findings of this study emphasize the need to understand the complex interactions among individual, social, and cultural factors in male homoparenting. In summary, this study highlights the need for inclusive and diversity-sensitive approaches to support family well-being.

Prosocial and externalizing behaviors in children raised by different-and same-gender parent families: new directions in parenting research

Introduction

Limited research focused on the association between parenting practices and children's prosocial and externalizing behaviors comparing same- and different-gender parent families. The present study considered 76 Italian families (73% same-gender and 27% different-gender parent families) with 8-year-old (SD = 2.17; 49% assigned female at birth) children born through assisted reproductive techniques, to explore parenting practices and children's prosocial and externalizing behaviors.

Method

We ran a Multiple-group-by-couple Structural Equation Model in which we estimated the predictive role of parenting on children's behaviors, controlling for age, gender, and family socioeconomic status using the Maximum Likelihood estimation.

Results

Results showed that both same- and different-gender parent families reported high levels of parental warmth and very low levels of hostility and rejection; regarding children's behaviors, both same- and different-gender parent families reported high levels of prosociality and low levels of externalizing behaviors. In addition, same-gender parents reported significantly higher levels of children's prosociality and parental warmth than different-gender parents. Regarding associations between parenting practices and behaviors, we found a positive association between positive parenting practices and increasing children's prosocial behaviors and decreasing children's externalizing behaviors, in both same- and different-gender families, controlling for family background characteristics.

Conclusion

The present study encourages future research to investigate how specific parenting practices can influence behavioral adjustment in children, focusing on same-gender parent families.

Attentional bias to infant faces might be associated with previous care experiences and involvement in childcare in same-sex mothers

Background

Attentional bias toward infant faces is associated with parental sensitivity and supports the infant-caregiver attachment relationship, ultimately fostering child health outcomes. However, experience-related determinants of parents' attentional bias to infant faces have been poorly investigated. We examined attentional bias to infant versus adult faces in a sample of same-sex mothers (N = 76), and whether it varied depending on maternal involvement in childcare and the perceived quality of past experiences of care.

Method

A Go/no-Go attentional task was used to compare the effects of infant and adult faces in retaining attention. Maternal involvement in childcare was measured using items addressing nurturing behaviors. Memories of past experiences of care were collected using the short-form version of the Parental Acceptance-Rejection scale.

Results

Results confirmed that infant faces induced greater attentional bias compared to adult faces. More involved mothers were more biased, in terms of attention, to infant versus adult faces. Attentional bias to infant versus adult faces increased as mothers felt more rejected by their own fathers during childhood.

Discussion

Our findings suggested that attentional bias to infant faces might be associated with past experiences of care and direct commitment in childcare in same-sex mothers. Robust and accurate empirical findings on same-sex parent families are essential to inform social policies supporting these families' well being.

Single fathers' experiences of using egg donation and surrogacy to start a family

STUDY QUESTION

What are the experiences of single men using egg donation and surrogacy as a route to parenthood?

SUMMARY ANSWER

The fathers mainly had a positive relationship with the surrogate and simultaneously exercised agency, and experienced challenges, during the process of surrogacy.

WHAT IS KNOWN ALREADY

Little is known about single men's experiences of egg donation and surrogacy arrangements. Studies have focused on single men's decision-making processes about the use of surrogacy and family functioning once these families are formed. Questions remain about how fathers experience and navigate the process of surrogacy as a single man.

STUDY DESIGN, SIZE, DURATION

The study is an international, in-depth qualitative study of fathers who chose to begin a family and parent alone. Data were collected between 2018 and 2021 as part of a larger study of solo fathers with different routes to parenthood. The present study reports on 21 fathers who used surrogacy and egg donation to begin their family. The average age of the fathers was 44 years, the fathers had young children aged 6 years or younger, and lived in countries across Australia, Europe, and North America.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Purposive sampling was used to recruit participants. In-depth semi-structured interviews were conducted. Interview topics included fathers' experiences of the process of using egg donation and surrogacy, and navigating the relationship with the surrogate. The audio-recorded interviews lasted around 2 hours and were subsequently transcribed verbatim.

MAIN RESULTS AND THE ROLE OF CHANCE

Data were analysed using reflexive thematic analysis and qualitative content analysis. Most of the fathers chose an identifiable egg donor. Regarding the relationship with the surrogate, many fathers had remained in contact with her, but to differing degrees, and they generally reported positive relationships. Thematic analysis led to the identification of three themes relating to the fathers' experiences of choosing surrogacy as a single man: the ability to make choices; challenges and constraints; and special relationship.

LIMITATIONS, REASONS FOR CAUTION

Due to the variation between different countries regarding laws on surrogacy, contextual factors may have impacted on the experiences of single fathers, and the sample size was small. However, the research provides new insights into an area with little academic literature.

WIDER IMPLICATIONS OF THE FINDINGS

Given the growing trend of single men having children through surrogacy, the findings suggest that this new path to parenthood can be both rewarding and challenging. Single men may benefit from tailored support and counselling to help them navigate the surrogacy journey.

STUDY FUNDING/COMPETING INTEREST(S)

This study was funded by the Wellcome Trust (grant number 208013/Z/17/Z). The authors have no conflicts of interest to declare.

TRIAL REGISTRATION NUMBER

n/a.

Gay Fatherhood Experiences and Challenges Through the Lens of Minority Stress Theory

Gay-fatherhood raises questions about hegemonic gender norms and traditional family systems in different contexts and countries. This study explores gay fathers' desires, motivations, and experiences of having a child. Participants' challenges and concerns regarding having and raising children also were explored. Data were obtained through in-person interviews of 11 self-identified gay fathers. The data were then analyzed using interpretive phenomenological analysis (IPA) analysis. The analytical results identified three themes that shed light on participants' desires and experiences of parenthood. These were: (1) innate motives to parent and gender role strains, (2) enacted stigma (i.e., acts of rejection due to sexual orientation and traditional gender roles), and (3) children's social rejection due to their parents' sexuality. The findings of this study stress the influence of contextual factors (stigma) and intrapersonal factors (internalized anti-gay prejudice) in participants' health and well-being. This study potentially tries to expand cultural awareness of research in this field.

Children of Single Fathers Created by Surrogacy: Psychosocial Adjustment Considerations and Implications for Research and Practice

The existence of single-father families formed by surrogacy is becoming a more visible reality, even though this type of family organization is still perceived with stigma and negative attitudes by more traditional sectors of society, because it raises some concerns regarding the psychosocial well-being of children who are born into single-fathers' families via surrogacy, and in many cases, to gay single men who wish to become fathers. On the other hand, available research on the psychosocial well-being of these children is still very scarce and limited to a handful of Western countries. Hence, it is of utmost importance to examine studies that explore the psychosocial adjustment of these children. In this mini review, I show that all the studies revised demonstrate the good psychosocial adjustment of these children, and that they are as likely to flourish as children born into traditional families, even if they may find themselves exposed to prejudice and stigma. In conclusion, single fatherhood and surrogacy do not contribute to any adverse consequences to the children's psychosocial development and adjustment, and there is no observed evidence to why single men, irrespective of their sexual orientation, should not be fathers via surrogacy. Finally, implications for future research and interventions are also discussed.

Solo Fathers and Mothers: An Exploration of Well-Being, Social Support and Social Approval

Research has begun to explore the experiences of single mothers by choice who choose to start a family alone and do so using donated gametes. However, very little is known about the experiences of single fathers by choice, and even less is known about how their experiences might compare to mothers in the same position. This exploratory study of single mothers (n = 19) and fathers (n = 17) by choice examined mental health and social support among mothers who used sperm donation, and fathers who used egg donation and surrogacy, to become parents. Data relating to their reasoning for pursuing solo parenthood, mental health, and social support were analyzed quantitatively. To further explore fathers’ experiences of being a solo parent, a thematic analysis was conducted exploring their descriptions of social responses to their family type. Regarding parental mental health, no statistically significant differences were found between mothers and fathers, and both groups of parents had sought out supportive networks, both before becoming a parent, and as a single parent. Fathers’ responses indicated that they received both supportive and negative reactions, although they generally perceived the majority of interactions to be positive. However, frequent references made by members of the public, or by the media, to their family type being new or different served to reproduce social scripts about normative family types. The study findings, despite the small sample size, contribute to a new understanding of the well-being and experiences of both mothers and fathers who choose to start their family and parent alone.

First clinical report of 179 surrogacy cases in the UK: implications for policy and practice

RESEARCH QUESTION

What implications for policy and practice can be derived from outcomes and trends observed across 8 years of a surrogacy programme in two UK-regulated IVF centres (London, Cardiff)?

DESIGN

Retrospective cohort study analysing surrogacy treatments undertaken between 2014 and September 2021.

RESULTS

Surrogacy continues to rise in popularity in the UK despite the inability of those supporting safe and professional practice to advertise to recruit surrogates. In two IVF centres regulated by the Human Fertilisation and Embryology Authority (HFEA), both the number of surrogacy treatments and the proportion of those undertaken on behalf of same-sex male intended parents increased year on year in the period studied. From a cohort of 108 surrogates, 71 babies were born to 61 surrogates (with five pregnancies ongoing) by February 2022. No statistically significant difference in live birth rates (LBR) was observed between the heterosexual couples and same-sex male couples. Sample sizes of single and transgender intended parents were too small (n < 5) to compare. The use of vitrified oocytes in surrogacy treatments has increased year on year, while fresh oocyte use has declined since peaking in 2019. There was no significant difference in LBR between fresh and vitrified oocyte usage across the cohort.

CONCLUSIONS

The number of surrogacy treatments steadily increased, with clear evidence that the proportion of same-sex male couples accessing surrogacy is a major contributor to this growth. Vitrified/warmed oocyte use now outstrips the use of fresh oocytes in the surrogacy treatment cycles studied here. The results represent a strong basis for supporting the liberalization of regulatory reform expected to be introduced in the UK later in 2022.

What We Know and What Remains to Be Explored about LGBTQ Parent Families in Israel: A Sociocultural Perspective

This paper reviews research on gay and lesbian parent families in Israel through cultural lenses while recognizing the diversity of these families. The major aims of the review are: (1) to provide an overview of the situation of LGBTQ parent families in Israel, as well as of the sociocultural background of the Israeli context and its effects on sexual minorities and LGBTQ parent families; and (2) to identify the limitations and lacunas in the existing research and shed light on what remains to be explored. We searched numerous databases for relevant studies, adopting a narrative approach to summarize the main findings while taking into account the literature on the socio-cultural context in Israel and its impact on sexual minorities and LGBTQ parent families. The search yielded empirical results only for gay and lesbian parent families, with studies emphasizing the challenges they face and the factors related to their well-being and that of LGB individuals aspiring to become parents. In addition, it revealed that research on children’s psychosocial adjustment as a function of parental sexual orientation is quite scarce in Israel. Moreover, it indicated the absence of investigations of bisexual, transgender, or queer parents. We conclude that the sociocultural context of Israel, including its pronatalist and familistic orientation, may play an important role in shaping the experiences of LGBTQ parent families, and should be taken into consideration when studying LGBTQ parents.

Different Placement Practices for Different Families? Children's Adjustment in LGH Adoptive Families

Objective

The purpose of this study was to examine the characteristics of children placed with lesbian, gay, and heterosexual adopters, and to examine children’s problem behaviors and positive psychosocial adjustment across the three family types.

Background

There is evidence that children with hard-to-place profiles may be more likely to be matched with lesbian and gay parents. In addition, children adopted from care face greater developmental difficulties than children raised by their birth families, although adoptive parents may buffer the negative effects of early adversity on their children’s psychosocial adjustment.

Method

A final sample of 149 adoptive families from across the United Kingdom was recruited: 71 heterosexual parented, 39 lesbian parented, and 39 gay parented.

Results

The results showed that gay and lesbian parents were more likely than heterosexual parents to be matched with hard-to-place children, partially because they were more open to being matched with children with hard-to-place profiles. However, no differences among the three family types on children’s psychosocial adjustment were found, when controlling for children’s early adversity.

Conclusion

Adopted children displayed similar levels of problem behaviors and positive adjustment in lesbian, gay, and heterosexual parented families. Early adversity and having a physical problem/disability accounted for much of the variance in problem behaviors whereas parenting did not. In contrast, it was suggested that parenting processes, namely, parental closeness, may help to explain children’s positive adjustment.

Same-sex male couples and single men having children using assisted reproductive technology: a quantitative analysis

RESEARCH QUESTION

How do same-sex male couples (SSMC) and single men perceive their experience of using assisted reproductive technology (ART) in Canada; what factors contribute to their experience and the decisions made throughout the ART process?

DESIGN

This cross-sectional study used an anonymous online survey to gather exploratory data (between August 2018 and August 2019) about participant experience and decision-making considerations, for SSMC and single men internationally who had undergone ART in Canada. The survey was accessed by 145 individuals; 98 participants were included in the final analysis. Statistical Package for the Social Sciences (SPSS) was used for quantitative analysis.

RESULTS

Four out of five participants had a positive overall experience of using ART in Canada. Having the social support of knowing others who had previously pursued ART, and needing to work with multiple egg donors, were found to affect overall experience significantly. Agencies were the most common way for intended parents to connect with third parties. Major factors men considered when choosing an egg donor included medical history, physical attributes, personality and temperament, ethnicity, and education; they tended to select gestational surrogates who had similar lifestyle values to themselves. Most coupled survey respondents created embryos using each partner's spermatozoa (73.6%).

CONCLUSIONS

This exploratory study expands on limited knowledge of the current topic, identifying key areas for future research. Most SSMC and single men, domestic and internationally, had a positive experience pursuing ART in Canada to have children. Research on the experiences of SSMC and single men and decision-making considerations should continue.

The psychological wellbeing of ART children: what have we learned from 40 years of research?

Our understanding of what makes a family has changed dramatically in recent decades due to advances in reproductive technologies accompanied by changing social attitudes. But what has the impact been on children? This article presents a summary of research on parent-child relationships and the psychological adjustment of children in families created by assisted reproduction. The findings show that families with lesbian mothers, gay fathers, and single mothers by choice, and families created by donor conception and surrogacy, are just as likely to flourish as traditional families, and sometimes more so, although the children from these families will sometimes face prejudiced attitudes from others. It is concluded that the quality of family relationships and the wider social environment matter more for children's psychological wellbeing than the number, gender, sexual orientation, or biological relatedness of their parents.

Children with Trans Parents: Parent-Child Relationship Quality and Psychological Well-being

Objective. Families with trans parents are an increasingly visible family form, yet little is known about parenting and child outcomes in these families. This exploratory study offers the first quantitative assessment of parent-child relationship quality and child socio-emotional and behavioral adjustment in families with a self-identified trans parent with school-aged children. Design. A sample of 35 families (37 trans parents, 13 partners, and 25 children aged 8-18 years) was recruited primarily through social media. Parents, children, and teachers were administered a range of standardized interview and questionnaire assessments of parent-child relationship quality, quality of parenting, psychological adjustment, and gender-related minority stress. Results. Parents and children had good quality relationships, as assessed by both parents and children, and children showed good psychological adjustment. Child age at the time the parent communicated their gender identity to the child was unrelated to child outcomes. Conclusions. Parents and children in trans parent families had good quality relationships and children showed good psychological adjustment. The findings of this exploratory study challenge commonly held concerns about the potentially negative effects on children of growing up with a trans parent.

Postdelivery adjustment of gestational carriers, intended parents, and their children

Surrogacy raises a number of concerns about the psychological adjustment of the surrogate, the parents, and the child. Despite surrogacy becoming more common, research into the postdelivery psychological adjustment of the individuals involved has lagged far behind. This review examines research on the psychological adjustment of surrogates and their children. It then presents findings from studies assessing parents' psychological health and parent-child relationships, and children's adjustment within families formed through surrogacy. Finally, it examines how children born through surrogacy feel about their birth and toward their surrogate. Overall, studies have shown good psychological outcomes for surrogates, parents, and children, but research is still very limited, particularly in relation to the geographical location of the research, the ages of the children studied, and the lack of longitudinal projects. Different forms of surrogacy now exist under the umbrella term of "surrogacy." There is now greater diversity in terms of who is using surrogacy, their motivations for using it, whose gametes are used for the pregnancy, and how a surrogacy arrangement is managed. There is therefore a need for future studies to examine the consequences of these different forms of surrogacy on the postdelivery psychological health of surrogates, surrogacy parents, and their children.

Stigma Experiences, Mental Health, Perceived Parenting Competence, and Parent-Child Relationships Among Lesbian, Gay, and Heterosexual Adoptive Parents in the United States

Adoptive parents often face stigma related to "non-traditional" family structures. Lesbian and gay (LG) adoptive parents often face additional stigmatization based on sexual identity, which in turn may negatively affect parents' mental health. Despite controversy about LG parenting, research demonstrates that family processes are more strongly associated with individual outcomes than family structure. Thus, family systems and minority stress theories provided our conceptual foundation in examining how adoptive LG parents' stigma experiences were associated with mental health, parenting competence, and parent-child relationships. Participating families (N = 106; n = 56 LG parent families) were originally recruited from five US domestic private infant adoption agencies and completed two waves of data collection (W1, W2; 91% retention) when children were preschool-age (M age = 3.01 years) and school-age (M age = 8.36 years), respectively. Data for the current study are largely drawn from W2. Via Qualtrics, parents completed assessments of mental health symptoms, adoption stigma, and perceived childcare competence. LG parents also reported on their experiences of homonegative microaggressions, and children responded to a measure about their relationships with parents. No significant differences emerged as a function of parental sexual orientation and gender except that lesbian mothers, heterosexual mothers, and gay fathers all reported higher parenting competence than heterosexual fathers. Although parents' mental health did not significantly predict parent-child relationship quality, parents' perceived competence and LG parents' current homonegative microaggression experiences did (e.g., greater competence, greater closeness; more microaggressions, lower closeness). Consistent with our conceptual framework, our results-derived from parent and child reports-demonstrate that although adoptive and LG parent families experience stigma, family processes (rather than structure) are most associated with individual outcomes. Researchers, policy makers, and practitioners should work together to employ identity-affirming practices to reduce stigma and support adoptive family functioning and well-being.

Introduction to the special issue: Social science perspectives on contemporary lesbian family life, 2009-2019

It has been over ten years since the last special issue regarding lesbian family lives appeared in the Journal of Lesbian Studies (volume 12, issue 2-3). In my introduction to this special issue, I offer perspectives on contemporary lesbian family lives from 2009-2019, considering three key questions: (1) What important social and legal changes have occurred over the last decade? (2) What have we learned about lesbian family lives during this time period? (3) What do we still not yet know?

Paternité gay et GPA : entre lien génétique et lien affectif

Cadre de la recherche : À côté des pères « classiques », reliés génétiquement à leur enfant et conjoint de la mère, il existe des pères adoptifs, des pères seuls, des beaux-pères, des pères non génétiques. Au sein de cette diversité apparaissent les pères gays. Mais choisir la paternité gay est un phénomène relativement récent qui nécessite d’affronter un environnement légal et social hostile et qui défie les normes de genre.

Objectifs : Explorer les représentations de la parenté et de la paternité et notamment l’importance accordée ou non au lien génétique chez les pères gays ayant eu recours à une gestation pour autrui.

Méthodologie : L’article s’appuie sur des entretiens menés auprès de 36 hommes gays en couple qui ont eu recours à la gestation pour autrui pour devenir père d’un enfant ou de jumeaux agés d’environ 4 mois.

Résultats : Probablement conscients de l’importance accordée au lien génétique dans les représentations sociales dominantes, les pères interrogés sont très attentifs à ce que leurs proches ne fassent pas de distinction. Mais ces mêmes représentations ne sont pas absentes chez ces pères, notamment au moment de la mise en œuvre de la conception. En effet, un certain nombre d’entre eux a implanté des embryons de l’un et de l’autre pour se donner une chance d’avoir des jumeaux génétiquement reliés à chacun des pères. Dans le cas d’une deuxième GPA, ils tiennent assez souvent à ce que le deuxième enfant (deuxième jumeau ou grossesse future) soit du père qui n’a pas donné son sperme la première fois.

Conclusions : Les observations recueillies montrent que les représentations de la paternité sont diversifiées et combinent des représentations fondées sur l’engendrement avec des représentations davantage fondées sur la parentalité.

Contribution : L’article met en évidence la complexité des représentations de la paternité. Celles-ci ne se résument pas aux liens biogénétiques mais accordent également une grande importance aux liens électifs.

Cross-border surrogacy: Experiences of heterosexual and gay parents in Sweden

INTRODUCTION

Surrogacy is a controversial method of assisted reproduction that is not permitted in many countries. While there is some evidence that families following surrogacy seem to fare well, there is limited knowledge about the experiences of parents who turn to cross-border surrogacy. The aim of the present study was therefore to investigate the experiences of heterosexual parents and gay fathers who chose cross-border surrogacy to have a child.

MATERIAL AND METHODS

This cross-sectional survey describes the experiences of 30 families (18 heterosexual parent and 12 gay father families). Participants were recruited through a website for a Swedish surrogacy interest group. The participants were requested individually to complete a postal questionnaire including study-specific questions on their experiences of disclosure and the Swedish Parenting Stress Questionnaire.

RESULTS

All couples but one were still living together and had a child (3 months to 5 years). Parenting stress levels were generally low and were not related to sexual orientation. While almost all parents were open about the child's mode of conception in contacts with health care, gay fathers were significantly more open about using surrogacy in contacts with preschool (P = 0.004) and child recreational activities (P = 0.005) compared with heterosexual parents. A majority described being treated positively or "as any other parent" in these contexts.

CONCLUSIONS

Heterosexual and gay parents reported low levels of parenting stress and generally experienced positive or neutral reactions to their parenthood in contacts with healthcare providers, in preschool, and in the child's recreational activities.

Gay fathers' motivations for and feelings about surrogacy as a path to parenthood

Study question

Why do gay men choose to start their families through surrogacy?

Summary answer

Most fathers chose surrogacy because they considered adoption to be a less desirable and/or accessible path to parenthood.

What is known already

Little is known of gay fathers' motivations to use surrogacy as a path to parenthood over and above other forms of family building, such as adoption, and no studies have examined fathers' satisfaction with the surrogacy process.

Study design size, duration

This study used a cross-sectional design as part of a larger investigation of parent-child relationships and child adjustment in 40 gay father surrogacy families. Multiple strategies (e.g. surrogacy agencies, social events and snowballing) were used to recruit as diverse a sample as possible. Data were obtained from 74 fathers (in 6 families only 1 father was available for interview).

Participants/materials, setting, method

Semi-structured interviews, lasting ~1 h, were conducted in the family home (65%) or over Skype (35%) with 74 gay fathers (35 genetic fathers, 32 non-genetic fathers and 7 fathers who did not know or did not disclose who the genetic father was), when the children were 3-9 years old.

Main results and the role of chance

Genetic and non-genetic fathers were just as likely to want to become parents and had similar motivations for choosing surrogacy as a path to parenthood. Most fathers (N = 55, 74%) were satisfied with surrogacy and were satisfied (N = 31. 42%) or had neutral feelings (N = 21, 28%) about their choice of who would be the genetic father. Most fathers received supportive reactions to their decision to use surrogacy from both families of origin (e.g. parents, siblings) (N = 47, 64%) and from friends (N = 63, 85%).

Limitations, reasons for caution

Although diverse recruitment strategies were used, data were obtained from a volunteer sample. Therefore, the possibility that fathers who had a positive surrogacy experience may have been more likely to participate in the study, and therefore introduce bias, cannot be ruled out. Due to the high average annual income of the fathers in the study, findings may not generalize to gay fathers with lower incomes.

Wider implications of the findings

It is often assumed that parents' primary motivation for using ART is to have a genetic connection to the child. This study revealed that whilst genetic fatherhood was important for some gay fathers in surrogacy families, it was not important for all. This information will be of use to surrogacy agencies and organizations supporting men who are considering the different routes to parenthood.

Study funding/competing interest(s)

This work was funded by the Wellcome Trust [097857/Z/11/Z] and the Jacob's Foundation. None of the authors has any conflict of interest to declare.

Trial registration number

N/A.