‘COVID-sorting’: How we decide whom to get close to and whom to avoid

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I was recently interviewed, as a gay psychiatrist treating gay patients who lived through the AIDS epidemic, about my perspectives on living through a COVID pandemic: Were there parallels and contrasts between the two? A month later, listening to patients remotely via teletherapy, I’m experiencing an unsettling similarity to serosorting, a phenomenon that emerged during the AIDS epidemic.

Dr. Jack Dresche, MD, is clinical professor of psychiatry at Columbia University, and training and supervising analyst at the William A. White Institute, both in New York. He also is emeritus editor of the Journal of Gay & Lesbian Mental Health.
Dr. Jack Drescher

Serosorting is the practice of choosing a sexual partner based on their HIV serostatus. Sorting out who was positive from who was negative allowed people to give themselves permission to have unprotected sex without risk of getting HIV. However, it was not uncommon to make those decisions without really knowing a potential partner’s actual serostatus. In fact, a lot of people serosorted by guessing.

Why not just ask a potential partner, “What’s your serostatus?” Apparently, for some, introducing the subject of HIV was deemed a sexual buzzkill. Instead, assumptions were made based on outer appearances.

Did someone look healthy? Were they well built? Were they overweight, meaning not emaciated from AIDS? If so, they were presumed negative and safe to have risky, unprotected sex with them.

Some imagined age correlated with serostatus. Since anyone older than some arbitrary age – like 30, to pull a number out of a hat – was expected to be more likely to have HIV than someone under 30, they would use that guideline in choosing sexual partners. However, these decisions were made without factual knowledge, like a blood test, but using some internal reasoning process.

Which brings us to what might be called “COVID-sorting.”

Some of my patients believe they had COVID-19, although they’d not been tested to either confirm or disprove that belief. Others had positive COVID-19 antibody tests, which they believe provides immunity. Among that group, some had symptoms, others did not.

Yet regardless of what they actually know or don’t know, patients are making calculations about managing physical distancing using their own internal formulas. They make risk calculations having little to do with actual knowledge of public health precautions on preventing COVID’s spread.

For example, one patient was planning a Memorial Day weekend in a shared Fire Island house with five friends and acquaintances. All six live alone and, as far as he knows, all are physically distancing. Consequently, my patient doesn’t think house-sharing is anything to worry about, even though he doesn’t know how scrupulously others have followed distancing guidelines.

Another patient, recovering at home after being ill with COVID-19, felt safe inviting someone over for sex who had also been ill and recovered. He didn’t think they could infect each other, presuming, not altogether unreasonably, they were both immune.

Finally, there are those who don’t know whether they had COVID-19, but think they did because they experienced influenza-like symptoms. They are giving themselves permission to meet up with others who feel the same.

Yet a Mount Sinai study, which has not yet been peer-reviewed, raises fascinating issues about immunity. The study included 719 people who suspected they had COVID-19 based on some respiratory symptoms. The majority, 62%, had no antibodies. Researchers believe they mistook influenza, another viral infection, or allergies for COVID-19 (medRxiv. 2020 May 5. doi: 10.1101/2020.04.04.2008516).

The study also included 624 people who tested positive for the virus and recovered. All but three developed antibodies. Many assume those who are antibody-positive are now immune. They may be right. However, we don’t know definitively that they are, and if they are, we do not yet know how long immunity may last. Further, as reported in the New York Times, just because you test positive for antibodies, doesn’t mean you have them.

It should be underscored that COVID-sorting is not limited to gay men or psychiatric patients. Central Park, these days, is filled with many unmasked, nonsocially isolating people of all sexual orientations and genders who are making their own questionable decisions. And as many states have begun opening up restrictions on social gatherings, we are seeing an all-too-human psychological mindset with wider implications – rising numbers of cases. As we move forward, all of us will have to decide for ourselves, and not only in sexual situations, how to get on with our lives in a post–COVID-19 era.

Given how much is still unknown, it is likely each of us will come up with our own algorithm of risk assessment. It is likely that the formulas used will not necessarily be based on scientific facts, although that would be ideal. If past epidemic and recent pandemic behaviors are any indicators, people’s actions will reflect some combination of their own needs and desires, their own comfort level with risk-taking, and their relative understanding of complex subjects like virology, immunology, epidemiology, and public health. The challenge faced by public health officials today is to translate complex scientific and medical issues into messages average people can understand.

What exactly can be done? I’m not exactly sure, but I hope that improved education and communication can help. In the first 2 decades of the AIDS epidemic, efforts were made to change and tailor HIV-prevention messages to specific, at-risk demographic groups. Today, public health messages aimed at preventing COVID-19’s spread that resonate with older people can fall on a younger person’s deaf ears. One message size does not fit all. Hopefully, public health officials and government leaders will act on this sooner rather than later.
 

Dr. Drescher, a psychoanalyst, is clinical professor of psychiatry at Columbia University, and training and supervising analyst at the William A. White Institute, both in New York. He also is emeritus editor of the Journal of Gay & Lesbian Mental Health. Dr. Drescher has no other disclosures.

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I was recently interviewed, as a gay psychiatrist treating gay patients who lived through the AIDS epidemic, about my perspectives on living through a COVID pandemic: Were there parallels and contrasts between the two? A month later, listening to patients remotely via teletherapy, I’m experiencing an unsettling similarity to serosorting, a phenomenon that emerged during the AIDS epidemic.

Dr. Jack Dresche, MD, is clinical professor of psychiatry at Columbia University, and training and supervising analyst at the William A. White Institute, both in New York. He also is emeritus editor of the Journal of Gay & Lesbian Mental Health.
Dr. Jack Drescher

Serosorting is the practice of choosing a sexual partner based on their HIV serostatus. Sorting out who was positive from who was negative allowed people to give themselves permission to have unprotected sex without risk of getting HIV. However, it was not uncommon to make those decisions without really knowing a potential partner’s actual serostatus. In fact, a lot of people serosorted by guessing.

Why not just ask a potential partner, “What’s your serostatus?” Apparently, for some, introducing the subject of HIV was deemed a sexual buzzkill. Instead, assumptions were made based on outer appearances.

Did someone look healthy? Were they well built? Were they overweight, meaning not emaciated from AIDS? If so, they were presumed negative and safe to have risky, unprotected sex with them.

Some imagined age correlated with serostatus. Since anyone older than some arbitrary age – like 30, to pull a number out of a hat – was expected to be more likely to have HIV than someone under 30, they would use that guideline in choosing sexual partners. However, these decisions were made without factual knowledge, like a blood test, but using some internal reasoning process.

Which brings us to what might be called “COVID-sorting.”

Some of my patients believe they had COVID-19, although they’d not been tested to either confirm or disprove that belief. Others had positive COVID-19 antibody tests, which they believe provides immunity. Among that group, some had symptoms, others did not.

Yet regardless of what they actually know or don’t know, patients are making calculations about managing physical distancing using their own internal formulas. They make risk calculations having little to do with actual knowledge of public health precautions on preventing COVID’s spread.

For example, one patient was planning a Memorial Day weekend in a shared Fire Island house with five friends and acquaintances. All six live alone and, as far as he knows, all are physically distancing. Consequently, my patient doesn’t think house-sharing is anything to worry about, even though he doesn’t know how scrupulously others have followed distancing guidelines.

Another patient, recovering at home after being ill with COVID-19, felt safe inviting someone over for sex who had also been ill and recovered. He didn’t think they could infect each other, presuming, not altogether unreasonably, they were both immune.

Finally, there are those who don’t know whether they had COVID-19, but think they did because they experienced influenza-like symptoms. They are giving themselves permission to meet up with others who feel the same.

Yet a Mount Sinai study, which has not yet been peer-reviewed, raises fascinating issues about immunity. The study included 719 people who suspected they had COVID-19 based on some respiratory symptoms. The majority, 62%, had no antibodies. Researchers believe they mistook influenza, another viral infection, or allergies for COVID-19 (medRxiv. 2020 May 5. doi: 10.1101/2020.04.04.2008516).

The study also included 624 people who tested positive for the virus and recovered. All but three developed antibodies. Many assume those who are antibody-positive are now immune. They may be right. However, we don’t know definitively that they are, and if they are, we do not yet know how long immunity may last. Further, as reported in the New York Times, just because you test positive for antibodies, doesn’t mean you have them.

It should be underscored that COVID-sorting is not limited to gay men or psychiatric patients. Central Park, these days, is filled with many unmasked, nonsocially isolating people of all sexual orientations and genders who are making their own questionable decisions. And as many states have begun opening up restrictions on social gatherings, we are seeing an all-too-human psychological mindset with wider implications – rising numbers of cases. As we move forward, all of us will have to decide for ourselves, and not only in sexual situations, how to get on with our lives in a post–COVID-19 era.

Given how much is still unknown, it is likely each of us will come up with our own algorithm of risk assessment. It is likely that the formulas used will not necessarily be based on scientific facts, although that would be ideal. If past epidemic and recent pandemic behaviors are any indicators, people’s actions will reflect some combination of their own needs and desires, their own comfort level with risk-taking, and their relative understanding of complex subjects like virology, immunology, epidemiology, and public health. The challenge faced by public health officials today is to translate complex scientific and medical issues into messages average people can understand.

What exactly can be done? I’m not exactly sure, but I hope that improved education and communication can help. In the first 2 decades of the AIDS epidemic, efforts were made to change and tailor HIV-prevention messages to specific, at-risk demographic groups. Today, public health messages aimed at preventing COVID-19’s spread that resonate with older people can fall on a younger person’s deaf ears. One message size does not fit all. Hopefully, public health officials and government leaders will act on this sooner rather than later.
 

Dr. Drescher, a psychoanalyst, is clinical professor of psychiatry at Columbia University, and training and supervising analyst at the William A. White Institute, both in New York. He also is emeritus editor of the Journal of Gay & Lesbian Mental Health. Dr. Drescher has no other disclosures.

I was recently interviewed, as a gay psychiatrist treating gay patients who lived through the AIDS epidemic, about my perspectives on living through a COVID pandemic: Were there parallels and contrasts between the two? A month later, listening to patients remotely via teletherapy, I’m experiencing an unsettling similarity to serosorting, a phenomenon that emerged during the AIDS epidemic.

Dr. Jack Dresche, MD, is clinical professor of psychiatry at Columbia University, and training and supervising analyst at the William A. White Institute, both in New York. He also is emeritus editor of the Journal of Gay & Lesbian Mental Health.
Dr. Jack Drescher

Serosorting is the practice of choosing a sexual partner based on their HIV serostatus. Sorting out who was positive from who was negative allowed people to give themselves permission to have unprotected sex without risk of getting HIV. However, it was not uncommon to make those decisions without really knowing a potential partner’s actual serostatus. In fact, a lot of people serosorted by guessing.

Why not just ask a potential partner, “What’s your serostatus?” Apparently, for some, introducing the subject of HIV was deemed a sexual buzzkill. Instead, assumptions were made based on outer appearances.

Did someone look healthy? Were they well built? Were they overweight, meaning not emaciated from AIDS? If so, they were presumed negative and safe to have risky, unprotected sex with them.

Some imagined age correlated with serostatus. Since anyone older than some arbitrary age – like 30, to pull a number out of a hat – was expected to be more likely to have HIV than someone under 30, they would use that guideline in choosing sexual partners. However, these decisions were made without factual knowledge, like a blood test, but using some internal reasoning process.

Which brings us to what might be called “COVID-sorting.”

Some of my patients believe they had COVID-19, although they’d not been tested to either confirm or disprove that belief. Others had positive COVID-19 antibody tests, which they believe provides immunity. Among that group, some had symptoms, others did not.

Yet regardless of what they actually know or don’t know, patients are making calculations about managing physical distancing using their own internal formulas. They make risk calculations having little to do with actual knowledge of public health precautions on preventing COVID’s spread.

For example, one patient was planning a Memorial Day weekend in a shared Fire Island house with five friends and acquaintances. All six live alone and, as far as he knows, all are physically distancing. Consequently, my patient doesn’t think house-sharing is anything to worry about, even though he doesn’t know how scrupulously others have followed distancing guidelines.

Another patient, recovering at home after being ill with COVID-19, felt safe inviting someone over for sex who had also been ill and recovered. He didn’t think they could infect each other, presuming, not altogether unreasonably, they were both immune.

Finally, there are those who don’t know whether they had COVID-19, but think they did because they experienced influenza-like symptoms. They are giving themselves permission to meet up with others who feel the same.

Yet a Mount Sinai study, which has not yet been peer-reviewed, raises fascinating issues about immunity. The study included 719 people who suspected they had COVID-19 based on some respiratory symptoms. The majority, 62%, had no antibodies. Researchers believe they mistook influenza, another viral infection, or allergies for COVID-19 (medRxiv. 2020 May 5. doi: 10.1101/2020.04.04.2008516).

The study also included 624 people who tested positive for the virus and recovered. All but three developed antibodies. Many assume those who are antibody-positive are now immune. They may be right. However, we don’t know definitively that they are, and if they are, we do not yet know how long immunity may last. Further, as reported in the New York Times, just because you test positive for antibodies, doesn’t mean you have them.

It should be underscored that COVID-sorting is not limited to gay men or psychiatric patients. Central Park, these days, is filled with many unmasked, nonsocially isolating people of all sexual orientations and genders who are making their own questionable decisions. And as many states have begun opening up restrictions on social gatherings, we are seeing an all-too-human psychological mindset with wider implications – rising numbers of cases. As we move forward, all of us will have to decide for ourselves, and not only in sexual situations, how to get on with our lives in a post–COVID-19 era.

Given how much is still unknown, it is likely each of us will come up with our own algorithm of risk assessment. It is likely that the formulas used will not necessarily be based on scientific facts, although that would be ideal. If past epidemic and recent pandemic behaviors are any indicators, people’s actions will reflect some combination of their own needs and desires, their own comfort level with risk-taking, and their relative understanding of complex subjects like virology, immunology, epidemiology, and public health. The challenge faced by public health officials today is to translate complex scientific and medical issues into messages average people can understand.

What exactly can be done? I’m not exactly sure, but I hope that improved education and communication can help. In the first 2 decades of the AIDS epidemic, efforts were made to change and tailor HIV-prevention messages to specific, at-risk demographic groups. Today, public health messages aimed at preventing COVID-19’s spread that resonate with older people can fall on a younger person’s deaf ears. One message size does not fit all. Hopefully, public health officials and government leaders will act on this sooner rather than later.
 

Dr. Drescher, a psychoanalyst, is clinical professor of psychiatry at Columbia University, and training and supervising analyst at the William A. White Institute, both in New York. He also is emeritus editor of the Journal of Gay & Lesbian Mental Health. Dr. Drescher has no other disclosures.

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Point/Counterpoint: Lessons Learned From the Lesbian Family Study

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Point/Counterpoint: Lessons Learned From the Lesbian Family Study

Data Are Limited but Valuable.

The U.S. National Longitudinal Lesbian Family Study has provided a treasure trove’s worth of much-needed data about the children being raised by lesbian mothers. Initiated in 1986, the current wave of the study reports on a mere 78 adolescents at age 17 years.

This study lands in the middle of an intense political debate around issues of marriage equality and adoption by gay and lesbian parents. Though the American Psychiatric Association supports the right of gay and lesbian adults to adopt, the law on this issue in many states is unclear, and, in a few states, expressly prohibited.

Dr. Serena Yuan Volpp     

Though the sample size is small, several of the findings in this study deserve comment. First, none of the teenagers reported any sexual or physical abuse by their parents (Arch. Sex. Behav. 2010 [doi:10.1007/s10508-010-9692-2]). This finding is a direct rebuttal to the claim that gay and lesbian parents are more likely to abuse sexually their children.

However, as the authors point out, most perpetrators of childhood sexual abuse in the home are heterosexual males. About four-fifths of the kids in the NLLFS study had no adult males in the household. The stereotype about gay adults sexually abusing children is quite gender-specific (toward males), and this study cannot directly address this misperception.

The study also begins to address questions around sexual identity and sexual behavior. In terms of behavior, the children of lesbian moms were significantly older than their peers at the age of first heterosexual contact. None of the girls raised by lesbian moms had ever been pregnant. While the girls were more likely than were their peers to report history of sexual contact with other girls, the boys were not more likely than their peers to report history of sexual contact with other boys.

The lack of matching by race/ethnicity and socioeconomic status does hamper this comparison, as norms about sexual behavior in teens vary by socioeconomic/cultural subgroups.

As for sexual identity, the vast majority of the adolescents in the NLLFS rated themselves a Kinsey 0-1 (exclusively or predominantly heterosexual) (81% of the girls and 91.9% of the boys). About one-fifth of the girls rated themselves in the Kinsey 2-4 spectrum (not exclusively heterosexual or homosexual). None of the girls and 5.4% of the boys rated themselves a Kinsey 5-6 (predominantly homosexual). For this part of the results, there is no comparison group. Research about sexuality in men and women has been confirming long-held general impressions that sexual identity is more fluid in women than in men. A prior study of children of lesbian mothers, compared with children raised by heterosexual mothers, noted that more of the young adults raised by lesbian parents reported a sexual experience with someone of the same gender. However by age 23.5 years (on average), there was no difference in self-identification as lesbian or gay between the two groups. What if, in fact, the girls in the study continued to report a relatively high rate of bisexual identity in successive waves of the study? There should be nothing inherently threatening about that. Emphasizing that most studies have shown that kids of gay and lesbian parents do not seem to grow up disproportionately gay serves only to appease those who still feel that homosexuality is an illness or a moral failing.

One thing to keep in mind: The subjects in this study represent a particular cohort of families, that of lesbians who planned to conceive in the 1980s, when planned lesbian families were much less common than they are today. The wave of children being raised by gay men started even later. Although the prospective design of the study helps to eliminate recall bias, the subjects are not a randomized sample. Both moms and kids in this study are surely well-aware that they are representing lesbian families to an unfriendly nation.

Although unlikely in the current climate, it would be ideal if further studies could be funded to do similar work with children being born today, to both lesbian parents and gay male parents.

Dr. Volpp is a clinical associate professor of psychiatry at New York University. She is the unit chief of the residency training unit at Bellevue Hospital, also in New York, and serves on the board of the Association of Gay and Lesbian Psychiatrists.

    Dr. Jack Drescher 

Findings Challenge Old Assumptions.

In a recent film, "The Kids Are All Right," two lesbian moms (Julianne Moore and Annette Bening) each conceive a child using the same anonymous sperm donor and then raise the children together. At the film’s outset, the children, aged 18 and 15 years, seek out and find their sperm donor (Mark Ruffalo). This "reunion" provides the dramatic tension of the film (no spoilers here).

 

 

The film, critically acclaimed and commercially successful, increased public awareness of same-sex couples’ using assisted reproductive technologies to create new family arrangements. While somewhat eye-opening to heterosexual moviegoers unfamiliar with these families, these trends are not news. In the 1970s, at the modern gay liberation movement’s start, women leaving heterosexual marriages took their children and raised them with lesbian partners. By the 1990s, a veritable gay baby ("gayby") boom ensued, as male and female same-sex couples, never heterosexually married, had children.

Children of the gayby boom are the subjects of the recently published study under discussion, "Adolescents of the U.S. National Longitudinal Lesbian Family Study: Sexual Orientation, Sexual Behavior, and Sexual Risk Exposure." The NLLFS study was launched to provide prospective data on a cohort of lesbian families" from conception until adulthood, includes "84 planned lesbian families [with] a 93% retention rate to date," and includes 39 adolescent girls and 39 adolescent boys conceived through donor insemination.

Among other things, the study found "no reports of physical or sexual victimization by a parent or other caregiver." That’s good to know, but why look for evidence of "victimization" in the first place? The authors say their goal was to "contradict the notion, offered in opposition to parenting by gay and lesbian people, that same-sex parents are likely to abuse their offspring sexually."

Studies like these are the interface between scientific research and the culture wars. Sadly, opponents of same-sex couples as parents frequently appeal to cultural stereotypes of homosexuals as predatory and potentially harmful to children. These kinds of assumptions (like asking "When did you last stop beating your wife?") put potential parents in the position of defending themselves against unwarranted character defamation. Increasingly, courts have struck down state bans on gay and lesbian adoption that make broad, stereotypical assumptions about these parents as members of a group rather than looking at a potential individual parent or couple’s actual qualities.

The study does not address parenting by gay male couples and more research is needed in this area as well. The authors note the study’s limitations: a nonrandom sample; neither matched nor controlled for socioeconomic status, race/ethnicity, or region of residence; and a small sample size.

I would add a further limitation in the social context that led to doing this study. According to the U.S. Census Bureau, about 581,000 same-sex couples lived in the United States in 2009. Although no reliable surveys exist about how many U.S. children are living in homes with gay and lesbian parents, estimates range from 1 million to 14 million. The numbers are growing, and the important research issues should not be whether millions of gay parents are harming millions of kids or making them gay. Instead, further research must focus on the kind of effective care, social policies, and legal protections these children and families need.

Dr. Drescher is a Distinguished Fellow of the American Psychiatric Association and serves as president-elect of the Group for the Advancement of Psychiatry. He is also coeditor of "Uncoupling Convention: Psychoanalytic Approaches to Same-Sex Couples and Families" (New York: The Analytic Press, 2004).

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Data Are Limited but Valuable.

The U.S. National Longitudinal Lesbian Family Study has provided a treasure trove’s worth of much-needed data about the children being raised by lesbian mothers. Initiated in 1986, the current wave of the study reports on a mere 78 adolescents at age 17 years.

This study lands in the middle of an intense political debate around issues of marriage equality and adoption by gay and lesbian parents. Though the American Psychiatric Association supports the right of gay and lesbian adults to adopt, the law on this issue in many states is unclear, and, in a few states, expressly prohibited.

Dr. Serena Yuan Volpp     

Though the sample size is small, several of the findings in this study deserve comment. First, none of the teenagers reported any sexual or physical abuse by their parents (Arch. Sex. Behav. 2010 [doi:10.1007/s10508-010-9692-2]). This finding is a direct rebuttal to the claim that gay and lesbian parents are more likely to abuse sexually their children.

However, as the authors point out, most perpetrators of childhood sexual abuse in the home are heterosexual males. About four-fifths of the kids in the NLLFS study had no adult males in the household. The stereotype about gay adults sexually abusing children is quite gender-specific (toward males), and this study cannot directly address this misperception.

The study also begins to address questions around sexual identity and sexual behavior. In terms of behavior, the children of lesbian moms were significantly older than their peers at the age of first heterosexual contact. None of the girls raised by lesbian moms had ever been pregnant. While the girls were more likely than were their peers to report history of sexual contact with other girls, the boys were not more likely than their peers to report history of sexual contact with other boys.

The lack of matching by race/ethnicity and socioeconomic status does hamper this comparison, as norms about sexual behavior in teens vary by socioeconomic/cultural subgroups.

As for sexual identity, the vast majority of the adolescents in the NLLFS rated themselves a Kinsey 0-1 (exclusively or predominantly heterosexual) (81% of the girls and 91.9% of the boys). About one-fifth of the girls rated themselves in the Kinsey 2-4 spectrum (not exclusively heterosexual or homosexual). None of the girls and 5.4% of the boys rated themselves a Kinsey 5-6 (predominantly homosexual). For this part of the results, there is no comparison group. Research about sexuality in men and women has been confirming long-held general impressions that sexual identity is more fluid in women than in men. A prior study of children of lesbian mothers, compared with children raised by heterosexual mothers, noted that more of the young adults raised by lesbian parents reported a sexual experience with someone of the same gender. However by age 23.5 years (on average), there was no difference in self-identification as lesbian or gay between the two groups. What if, in fact, the girls in the study continued to report a relatively high rate of bisexual identity in successive waves of the study? There should be nothing inherently threatening about that. Emphasizing that most studies have shown that kids of gay and lesbian parents do not seem to grow up disproportionately gay serves only to appease those who still feel that homosexuality is an illness or a moral failing.

One thing to keep in mind: The subjects in this study represent a particular cohort of families, that of lesbians who planned to conceive in the 1980s, when planned lesbian families were much less common than they are today. The wave of children being raised by gay men started even later. Although the prospective design of the study helps to eliminate recall bias, the subjects are not a randomized sample. Both moms and kids in this study are surely well-aware that they are representing lesbian families to an unfriendly nation.

Although unlikely in the current climate, it would be ideal if further studies could be funded to do similar work with children being born today, to both lesbian parents and gay male parents.

Dr. Volpp is a clinical associate professor of psychiatry at New York University. She is the unit chief of the residency training unit at Bellevue Hospital, also in New York, and serves on the board of the Association of Gay and Lesbian Psychiatrists.

    Dr. Jack Drescher 

Findings Challenge Old Assumptions.

In a recent film, "The Kids Are All Right," two lesbian moms (Julianne Moore and Annette Bening) each conceive a child using the same anonymous sperm donor and then raise the children together. At the film’s outset, the children, aged 18 and 15 years, seek out and find their sperm donor (Mark Ruffalo). This "reunion" provides the dramatic tension of the film (no spoilers here).

 

 

The film, critically acclaimed and commercially successful, increased public awareness of same-sex couples’ using assisted reproductive technologies to create new family arrangements. While somewhat eye-opening to heterosexual moviegoers unfamiliar with these families, these trends are not news. In the 1970s, at the modern gay liberation movement’s start, women leaving heterosexual marriages took their children and raised them with lesbian partners. By the 1990s, a veritable gay baby ("gayby") boom ensued, as male and female same-sex couples, never heterosexually married, had children.

Children of the gayby boom are the subjects of the recently published study under discussion, "Adolescents of the U.S. National Longitudinal Lesbian Family Study: Sexual Orientation, Sexual Behavior, and Sexual Risk Exposure." The NLLFS study was launched to provide prospective data on a cohort of lesbian families" from conception until adulthood, includes "84 planned lesbian families [with] a 93% retention rate to date," and includes 39 adolescent girls and 39 adolescent boys conceived through donor insemination.

Among other things, the study found "no reports of physical or sexual victimization by a parent or other caregiver." That’s good to know, but why look for evidence of "victimization" in the first place? The authors say their goal was to "contradict the notion, offered in opposition to parenting by gay and lesbian people, that same-sex parents are likely to abuse their offspring sexually."

Studies like these are the interface between scientific research and the culture wars. Sadly, opponents of same-sex couples as parents frequently appeal to cultural stereotypes of homosexuals as predatory and potentially harmful to children. These kinds of assumptions (like asking "When did you last stop beating your wife?") put potential parents in the position of defending themselves against unwarranted character defamation. Increasingly, courts have struck down state bans on gay and lesbian adoption that make broad, stereotypical assumptions about these parents as members of a group rather than looking at a potential individual parent or couple’s actual qualities.

The study does not address parenting by gay male couples and more research is needed in this area as well. The authors note the study’s limitations: a nonrandom sample; neither matched nor controlled for socioeconomic status, race/ethnicity, or region of residence; and a small sample size.

I would add a further limitation in the social context that led to doing this study. According to the U.S. Census Bureau, about 581,000 same-sex couples lived in the United States in 2009. Although no reliable surveys exist about how many U.S. children are living in homes with gay and lesbian parents, estimates range from 1 million to 14 million. The numbers are growing, and the important research issues should not be whether millions of gay parents are harming millions of kids or making them gay. Instead, further research must focus on the kind of effective care, social policies, and legal protections these children and families need.

Dr. Drescher is a Distinguished Fellow of the American Psychiatric Association and serves as president-elect of the Group for the Advancement of Psychiatry. He is also coeditor of "Uncoupling Convention: Psychoanalytic Approaches to Same-Sex Couples and Families" (New York: The Analytic Press, 2004).

Data Are Limited but Valuable.

The U.S. National Longitudinal Lesbian Family Study has provided a treasure trove’s worth of much-needed data about the children being raised by lesbian mothers. Initiated in 1986, the current wave of the study reports on a mere 78 adolescents at age 17 years.

This study lands in the middle of an intense political debate around issues of marriage equality and adoption by gay and lesbian parents. Though the American Psychiatric Association supports the right of gay and lesbian adults to adopt, the law on this issue in many states is unclear, and, in a few states, expressly prohibited.

Dr. Serena Yuan Volpp     

Though the sample size is small, several of the findings in this study deserve comment. First, none of the teenagers reported any sexual or physical abuse by their parents (Arch. Sex. Behav. 2010 [doi:10.1007/s10508-010-9692-2]). This finding is a direct rebuttal to the claim that gay and lesbian parents are more likely to abuse sexually their children.

However, as the authors point out, most perpetrators of childhood sexual abuse in the home are heterosexual males. About four-fifths of the kids in the NLLFS study had no adult males in the household. The stereotype about gay adults sexually abusing children is quite gender-specific (toward males), and this study cannot directly address this misperception.

The study also begins to address questions around sexual identity and sexual behavior. In terms of behavior, the children of lesbian moms were significantly older than their peers at the age of first heterosexual contact. None of the girls raised by lesbian moms had ever been pregnant. While the girls were more likely than were their peers to report history of sexual contact with other girls, the boys were not more likely than their peers to report history of sexual contact with other boys.

The lack of matching by race/ethnicity and socioeconomic status does hamper this comparison, as norms about sexual behavior in teens vary by socioeconomic/cultural subgroups.

As for sexual identity, the vast majority of the adolescents in the NLLFS rated themselves a Kinsey 0-1 (exclusively or predominantly heterosexual) (81% of the girls and 91.9% of the boys). About one-fifth of the girls rated themselves in the Kinsey 2-4 spectrum (not exclusively heterosexual or homosexual). None of the girls and 5.4% of the boys rated themselves a Kinsey 5-6 (predominantly homosexual). For this part of the results, there is no comparison group. Research about sexuality in men and women has been confirming long-held general impressions that sexual identity is more fluid in women than in men. A prior study of children of lesbian mothers, compared with children raised by heterosexual mothers, noted that more of the young adults raised by lesbian parents reported a sexual experience with someone of the same gender. However by age 23.5 years (on average), there was no difference in self-identification as lesbian or gay between the two groups. What if, in fact, the girls in the study continued to report a relatively high rate of bisexual identity in successive waves of the study? There should be nothing inherently threatening about that. Emphasizing that most studies have shown that kids of gay and lesbian parents do not seem to grow up disproportionately gay serves only to appease those who still feel that homosexuality is an illness or a moral failing.

One thing to keep in mind: The subjects in this study represent a particular cohort of families, that of lesbians who planned to conceive in the 1980s, when planned lesbian families were much less common than they are today. The wave of children being raised by gay men started even later. Although the prospective design of the study helps to eliminate recall bias, the subjects are not a randomized sample. Both moms and kids in this study are surely well-aware that they are representing lesbian families to an unfriendly nation.

Although unlikely in the current climate, it would be ideal if further studies could be funded to do similar work with children being born today, to both lesbian parents and gay male parents.

Dr. Volpp is a clinical associate professor of psychiatry at New York University. She is the unit chief of the residency training unit at Bellevue Hospital, also in New York, and serves on the board of the Association of Gay and Lesbian Psychiatrists.

    Dr. Jack Drescher 

Findings Challenge Old Assumptions.

In a recent film, "The Kids Are All Right," two lesbian moms (Julianne Moore and Annette Bening) each conceive a child using the same anonymous sperm donor and then raise the children together. At the film’s outset, the children, aged 18 and 15 years, seek out and find their sperm donor (Mark Ruffalo). This "reunion" provides the dramatic tension of the film (no spoilers here).

 

 

The film, critically acclaimed and commercially successful, increased public awareness of same-sex couples’ using assisted reproductive technologies to create new family arrangements. While somewhat eye-opening to heterosexual moviegoers unfamiliar with these families, these trends are not news. In the 1970s, at the modern gay liberation movement’s start, women leaving heterosexual marriages took their children and raised them with lesbian partners. By the 1990s, a veritable gay baby ("gayby") boom ensued, as male and female same-sex couples, never heterosexually married, had children.

Children of the gayby boom are the subjects of the recently published study under discussion, "Adolescents of the U.S. National Longitudinal Lesbian Family Study: Sexual Orientation, Sexual Behavior, and Sexual Risk Exposure." The NLLFS study was launched to provide prospective data on a cohort of lesbian families" from conception until adulthood, includes "84 planned lesbian families [with] a 93% retention rate to date," and includes 39 adolescent girls and 39 adolescent boys conceived through donor insemination.

Among other things, the study found "no reports of physical or sexual victimization by a parent or other caregiver." That’s good to know, but why look for evidence of "victimization" in the first place? The authors say their goal was to "contradict the notion, offered in opposition to parenting by gay and lesbian people, that same-sex parents are likely to abuse their offspring sexually."

Studies like these are the interface between scientific research and the culture wars. Sadly, opponents of same-sex couples as parents frequently appeal to cultural stereotypes of homosexuals as predatory and potentially harmful to children. These kinds of assumptions (like asking "When did you last stop beating your wife?") put potential parents in the position of defending themselves against unwarranted character defamation. Increasingly, courts have struck down state bans on gay and lesbian adoption that make broad, stereotypical assumptions about these parents as members of a group rather than looking at a potential individual parent or couple’s actual qualities.

The study does not address parenting by gay male couples and more research is needed in this area as well. The authors note the study’s limitations: a nonrandom sample; neither matched nor controlled for socioeconomic status, race/ethnicity, or region of residence; and a small sample size.

I would add a further limitation in the social context that led to doing this study. According to the U.S. Census Bureau, about 581,000 same-sex couples lived in the United States in 2009. Although no reliable surveys exist about how many U.S. children are living in homes with gay and lesbian parents, estimates range from 1 million to 14 million. The numbers are growing, and the important research issues should not be whether millions of gay parents are harming millions of kids or making them gay. Instead, further research must focus on the kind of effective care, social policies, and legal protections these children and families need.

Dr. Drescher is a Distinguished Fellow of the American Psychiatric Association and serves as president-elect of the Group for the Advancement of Psychiatry. He is also coeditor of "Uncoupling Convention: Psychoanalytic Approaches to Same-Sex Couples and Families" (New York: The Analytic Press, 2004).

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Data Are Limited but Valuable.

The U.S. National Longitudinal Lesbian Family Study has provided a treasure trove’s worth of much-needed data about the children being raised by lesbian mothers. Initiated in 1986, the current wave of the study reports on a mere 78 adolescents at age 17 years.

This study lands in the middle of an intense political debate around issues of marriage equality and adoption by gay and lesbian parents. Though the American Psychiatric Association supports the right of gay and lesbian adults to adopt, the law on this issue in many states is unclear, and, in a few states, expressly prohibited.

Dr. Serena Yuan Volpp     

Though the sample size is small, several of the findings in this study deserve comment. First, none of the teenagers reported any sexual or physical abuse by their parents (Arch. Sex. Behav. 2010 [doi:10.1007/s10508-010-9692-2]). This finding is a direct rebuttal to the claim that gay and lesbian parents are more likely to abuse sexually their children.

However, as the authors point out, most perpetrators of childhood sexual abuse in the home are heterosexual males. About four-fifths of the kids in the NLLFS study had no adult males in the household. The stereotype about gay adults sexually abusing children is quite gender-specific (toward males), and this study cannot directly address this misperception.

The study also begins to address questions around sexual identity and sexual behavior. In terms of behavior, the children of lesbian moms were significantly older than their peers at the age of first heterosexual contact. None of the girls raised by lesbian moms had ever been pregnant. While the girls were more likely than were their peers to report history of sexual contact with other girls, the boys were not more likely than their peers to report history of sexual contact with other boys.

The lack of matching by race/ethnicity and socioeconomic status does hamper this comparison, as norms about sexual behavior in teens vary by socioeconomic/cultural subgroups.

As for sexual identity, the vast majority of the adolescents in the NLLFS rated themselves a Kinsey 0-1 (exclusively or predominantly heterosexual) (81% of the girls and 91.9% of the boys). About one-fifth of the girls rated themselves in the Kinsey 2-4 spectrum (not exclusively heterosexual or homosexual). None of the girls and 5.4% of the boys rated themselves a Kinsey 5-6 (predominantly homosexual). For this part of the results, there is no comparison group. Research about sexuality in men and women has been confirming long-held general impressions that sexual identity is more fluid in women than in men. A prior study of children of lesbian mothers, compared with children raised by heterosexual mothers, noted that more of the young adults raised by lesbian parents reported a sexual experience with someone of the same gender. However by age 23.5 years (on average), there was no difference in self-identification as lesbian or gay between the two groups. What if, in fact, the girls in the study continued to report a relatively high rate of bisexual identity in successive waves of the study? There should be nothing inherently threatening about that. Emphasizing that most studies have shown that kids of gay and lesbian parents do not seem to grow up disproportionately gay serves only to appease those who still feel that homosexuality is an illness or a moral failing.

One thing to keep in mind: The subjects in this study represent a particular cohort of families, that of lesbians who planned to conceive in the 1980s, when planned lesbian families were much less common than they are today. The wave of children being raised by gay men started even later. Although the prospective design of the study helps to eliminate recall bias, the subjects are not a randomized sample. Both moms and kids in this study are surely well-aware that they are representing lesbian families to an unfriendly nation.

Although unlikely in the current climate, it would be ideal if further studies could be funded to do similar work with children being born today, to both lesbian parents and gay male parents.

Dr. Volpp is a clinical associate professor of psychiatry at New York University. She is the unit chief of the residency training unit at Bellevue Hospital, also in New York, and serves on the board of the Association of Gay and Lesbian Psychiatrists.

    Dr. Jack Drescher 

Findings Challenge Old Assumptions.

In a recent film, "The Kids Are All Right," two lesbian moms (Julianne Moore and Annette Bening) each conceive a child using the same anonymous sperm donor and then raise the children together. At the film’s outset, the children, aged 18 and 15 years, seek out and find their sperm donor (Mark Ruffalo). This "reunion" provides the dramatic tension of the film (no spoilers here).

 

 

The film, critically acclaimed and commercially successful, increased public awareness of same-sex couples’ using assisted reproductive technologies to create new family arrangements. While somewhat eye-opening to heterosexual moviegoers unfamiliar with these families, these trends are not news. In the 1970s, at the modern gay liberation movement’s start, women leaving heterosexual marriages took their children and raised them with lesbian partners. By the 1990s, a veritable gay baby ("gayby") boom ensued, as male and female same-sex couples, never heterosexually married, had children.

Children of the gayby boom are the subjects of the recently published study under discussion, "Adolescents of the U.S. National Longitudinal Lesbian Family Study: Sexual Orientation, Sexual Behavior, and Sexual Risk Exposure." The NLLFS study was launched to provide prospective data on a cohort of lesbian families" from conception until adulthood, includes "84 planned lesbian families [with] a 93% retention rate to date," and includes 39 adolescent girls and 39 adolescent boys conceived through donor insemination.

Among other things, the study found "no reports of physical or sexual victimization by a parent or other caregiver." That’s good to know, but why look for evidence of "victimization" in the first place? The authors say their goal was to "contradict the notion, offered in opposition to parenting by gay and lesbian people, that same-sex parents are likely to abuse their offspring sexually."

Studies like these are the interface between scientific research and the culture wars. Sadly, opponents of same-sex couples as parents frequently appeal to cultural stereotypes of homosexuals as predatory and potentially harmful to children. These kinds of assumptions (like asking "When did you last stop beating your wife?") put potential parents in the position of defending themselves against unwarranted character defamation. Increasingly, courts have struck down state bans on gay and lesbian adoption that make broad, stereotypical assumptions about these parents as members of a group rather than looking at a potential individual parent or couple’s actual qualities.

The study does not address parenting by gay male couples and more research is needed in this area as well. The authors note the study’s limitations: a nonrandom sample; neither matched nor controlled for socioeconomic status, race/ethnicity, or region of residence; and a small sample size.

I would add a further limitation in the social context that led to doing this study. According to the U.S. Census Bureau, about 581,000 same-sex couples lived in the United States in 2009. Although no reliable surveys exist about how many U.S. children are living in homes with gay and lesbian parents, estimates range from 1 million to 14 million. The numbers are growing, and the important research issues should not be whether millions of gay parents are harming millions of kids or making them gay. Instead, further research must focus on the kind of effective care, social policies, and legal protections these children and families need.

Dr. Drescher is a Distinguished Fellow of the American Psychiatric Association and serves as president-elect of the Group for the Advancement of Psychiatry. He is also coeditor of "Uncoupling Convention: Psychoanalytic Approaches to Same-Sex Couples and Families" (New York: The Analytic Press, 2004).

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Data Are Limited but Valuable.

The U.S. National Longitudinal Lesbian Family Study has provided a treasure trove’s worth of much-needed data about the children being raised by lesbian mothers. Initiated in 1986, the current wave of the study reports on a mere 78 adolescents at age 17 years.

This study lands in the middle of an intense political debate around issues of marriage equality and adoption by gay and lesbian parents. Though the American Psychiatric Association supports the right of gay and lesbian adults to adopt, the law on this issue in many states is unclear, and, in a few states, expressly prohibited.

Dr. Serena Yuan Volpp     

Though the sample size is small, several of the findings in this study deserve comment. First, none of the teenagers reported any sexual or physical abuse by their parents (Arch. Sex. Behav. 2010 [doi:10.1007/s10508-010-9692-2]). This finding is a direct rebuttal to the claim that gay and lesbian parents are more likely to abuse sexually their children.

However, as the authors point out, most perpetrators of childhood sexual abuse in the home are heterosexual males. About four-fifths of the kids in the NLLFS study had no adult males in the household. The stereotype about gay adults sexually abusing children is quite gender-specific (toward males), and this study cannot directly address this misperception.

The study also begins to address questions around sexual identity and sexual behavior. In terms of behavior, the children of lesbian moms were significantly older than their peers at the age of first heterosexual contact. None of the girls raised by lesbian moms had ever been pregnant. While the girls were more likely than were their peers to report history of sexual contact with other girls, the boys were not more likely than their peers to report history of sexual contact with other boys.

The lack of matching by race/ethnicity and socioeconomic status does hamper this comparison, as norms about sexual behavior in teens vary by socioeconomic/cultural subgroups.

As for sexual identity, the vast majority of the adolescents in the NLLFS rated themselves a Kinsey 0-1 (exclusively or predominantly heterosexual) (81% of the girls and 91.9% of the boys). About one-fifth of the girls rated themselves in the Kinsey 2-4 spectrum (not exclusively heterosexual or homosexual). None of the girls and 5.4% of the boys rated themselves a Kinsey 5-6 (predominantly homosexual). For this part of the results, there is no comparison group. Research about sexuality in men and women has been confirming long-held general impressions that sexual identity is more fluid in women than in men. A prior study of children of lesbian mothers, compared with children raised by heterosexual mothers, noted that more of the young adults raised by lesbian parents reported a sexual experience with someone of the same gender. However by age 23.5 years (on average), there was no difference in self-identification as lesbian or gay between the two groups. What if, in fact, the girls in the study continued to report a relatively high rate of bisexual identity in successive waves of the study? There should be nothing inherently threatening about that. Emphasizing that most studies have shown that kids of gay and lesbian parents do not seem to grow up disproportionately gay serves only to appease those who still feel that homosexuality is an illness or a moral failing.

One thing to keep in mind: The subjects in this study represent a particular cohort of families, that of lesbians who planned to conceive in the 1980s, when planned lesbian families were much less common than they are today. The wave of children being raised by gay men started even later. Although the prospective design of the study helps to eliminate recall bias, the subjects are not a randomized sample. Both moms and kids in this study are surely well-aware that they are representing lesbian families to an unfriendly nation.

Although unlikely in the current climate, it would be ideal if further studies could be funded to do similar work with children being born today, to both lesbian parents and gay male parents.

Dr. Volpp is a clinical associate professor of psychiatry at New York University. She is the unit chief of the residency training unit at Bellevue Hospital, also in New York, and serves on the board of the Association of Gay and Lesbian Psychiatrists.

    Dr. Jack Drescher 

Findings Challenge Old Assumptions.

In a recent film, "The Kids Are All Right," two lesbian moms (Julianne Moore and Annette Bening) each conceive a child using the same anonymous sperm donor and then raise the children together. At the film’s outset, the children, aged 18 and 15 years, seek out and find their sperm donor (Mark Ruffalo). This "reunion" provides the dramatic tension of the film (no spoilers here).

 

 

The film, critically acclaimed and commercially successful, increased public awareness of same-sex couples’ using assisted reproductive technologies to create new family arrangements. While somewhat eye-opening to heterosexual moviegoers unfamiliar with these families, these trends are not news. In the 1970s, at the modern gay liberation movement’s start, women leaving heterosexual marriages took their children and raised them with lesbian partners. By the 1990s, a veritable gay baby ("gayby") boom ensued, as male and female same-sex couples, never heterosexually married, had children.

Children of the gayby boom are the subjects of the recently published study under discussion, "Adolescents of the U.S. National Longitudinal Lesbian Family Study: Sexual Orientation, Sexual Behavior, and Sexual Risk Exposure." The NLLFS study was launched to provide prospective data on a cohort of lesbian families" from conception until adulthood, includes "84 planned lesbian families [with] a 93% retention rate to date," and includes 39 adolescent girls and 39 adolescent boys conceived through donor insemination.

Among other things, the study found "no reports of physical or sexual victimization by a parent or other caregiver." That’s good to know, but why look for evidence of "victimization" in the first place? The authors say their goal was to "contradict the notion, offered in opposition to parenting by gay and lesbian people, that same-sex parents are likely to abuse their offspring sexually."

Studies like these are the interface between scientific research and the culture wars. Sadly, opponents of same-sex couples as parents frequently appeal to cultural stereotypes of homosexuals as predatory and potentially harmful to children. These kinds of assumptions (like asking "When did you last stop beating your wife?") put potential parents in the position of defending themselves against unwarranted character defamation. Increasingly, courts have struck down state bans on gay and lesbian adoption that make broad, stereotypical assumptions about these parents as members of a group rather than looking at a potential individual parent or couple’s actual qualities.

The study does not address parenting by gay male couples and more research is needed in this area as well. The authors note the study’s limitations: a nonrandom sample; neither matched nor controlled for socioeconomic status, race/ethnicity, or region of residence; and a small sample size.

I would add a further limitation in the social context that led to doing this study. According to the U.S. Census Bureau, about 581,000 same-sex couples lived in the United States in 2009. Although no reliable surveys exist about how many U.S. children are living in homes with gay and lesbian parents, estimates range from 1 million to 14 million. The numbers are growing, and the important research issues should not be whether millions of gay parents are harming millions of kids or making them gay. Instead, further research must focus on the kind of effective care, social policies, and legal protections these children and families need.

Dr. Drescher is a Distinguished Fellow of the American Psychiatric Association and serves as president-elect of the Group for the Advancement of Psychiatry. He is also coeditor of "Uncoupling Convention: Psychoanalytic Approaches to Same-Sex Couples and Families" (New York: The Analytic Press, 2004).

Data Are Limited but Valuable.

The U.S. National Longitudinal Lesbian Family Study has provided a treasure trove’s worth of much-needed data about the children being raised by lesbian mothers. Initiated in 1986, the current wave of the study reports on a mere 78 adolescents at age 17 years.

This study lands in the middle of an intense political debate around issues of marriage equality and adoption by gay and lesbian parents. Though the American Psychiatric Association supports the right of gay and lesbian adults to adopt, the law on this issue in many states is unclear, and, in a few states, expressly prohibited.

Dr. Serena Yuan Volpp     

Though the sample size is small, several of the findings in this study deserve comment. First, none of the teenagers reported any sexual or physical abuse by their parents (Arch. Sex. Behav. 2010 [doi:10.1007/s10508-010-9692-2]). This finding is a direct rebuttal to the claim that gay and lesbian parents are more likely to abuse sexually their children.

However, as the authors point out, most perpetrators of childhood sexual abuse in the home are heterosexual males. About four-fifths of the kids in the NLLFS study had no adult males in the household. The stereotype about gay adults sexually abusing children is quite gender-specific (toward males), and this study cannot directly address this misperception.

The study also begins to address questions around sexual identity and sexual behavior. In terms of behavior, the children of lesbian moms were significantly older than their peers at the age of first heterosexual contact. None of the girls raised by lesbian moms had ever been pregnant. While the girls were more likely than were their peers to report history of sexual contact with other girls, the boys were not more likely than their peers to report history of sexual contact with other boys.

The lack of matching by race/ethnicity and socioeconomic status does hamper this comparison, as norms about sexual behavior in teens vary by socioeconomic/cultural subgroups.

As for sexual identity, the vast majority of the adolescents in the NLLFS rated themselves a Kinsey 0-1 (exclusively or predominantly heterosexual) (81% of the girls and 91.9% of the boys). About one-fifth of the girls rated themselves in the Kinsey 2-4 spectrum (not exclusively heterosexual or homosexual). None of the girls and 5.4% of the boys rated themselves a Kinsey 5-6 (predominantly homosexual). For this part of the results, there is no comparison group. Research about sexuality in men and women has been confirming long-held general impressions that sexual identity is more fluid in women than in men. A prior study of children of lesbian mothers, compared with children raised by heterosexual mothers, noted that more of the young adults raised by lesbian parents reported a sexual experience with someone of the same gender. However by age 23.5 years (on average), there was no difference in self-identification as lesbian or gay between the two groups. What if, in fact, the girls in the study continued to report a relatively high rate of bisexual identity in successive waves of the study? There should be nothing inherently threatening about that. Emphasizing that most studies have shown that kids of gay and lesbian parents do not seem to grow up disproportionately gay serves only to appease those who still feel that homosexuality is an illness or a moral failing.

One thing to keep in mind: The subjects in this study represent a particular cohort of families, that of lesbians who planned to conceive in the 1980s, when planned lesbian families were much less common than they are today. The wave of children being raised by gay men started even later. Although the prospective design of the study helps to eliminate recall bias, the subjects are not a randomized sample. Both moms and kids in this study are surely well-aware that they are representing lesbian families to an unfriendly nation.

Although unlikely in the current climate, it would be ideal if further studies could be funded to do similar work with children being born today, to both lesbian parents and gay male parents.

Dr. Volpp is a clinical associate professor of psychiatry at New York University. She is the unit chief of the residency training unit at Bellevue Hospital, also in New York, and serves on the board of the Association of Gay and Lesbian Psychiatrists.

    Dr. Jack Drescher 

Findings Challenge Old Assumptions.

In a recent film, "The Kids Are All Right," two lesbian moms (Julianne Moore and Annette Bening) each conceive a child using the same anonymous sperm donor and then raise the children together. At the film’s outset, the children, aged 18 and 15 years, seek out and find their sperm donor (Mark Ruffalo). This "reunion" provides the dramatic tension of the film (no spoilers here).

 

 

The film, critically acclaimed and commercially successful, increased public awareness of same-sex couples’ using assisted reproductive technologies to create new family arrangements. While somewhat eye-opening to heterosexual moviegoers unfamiliar with these families, these trends are not news. In the 1970s, at the modern gay liberation movement’s start, women leaving heterosexual marriages took their children and raised them with lesbian partners. By the 1990s, a veritable gay baby ("gayby") boom ensued, as male and female same-sex couples, never heterosexually married, had children.

Children of the gayby boom are the subjects of the recently published study under discussion, "Adolescents of the U.S. National Longitudinal Lesbian Family Study: Sexual Orientation, Sexual Behavior, and Sexual Risk Exposure." The NLLFS study was launched to provide prospective data on a cohort of lesbian families" from conception until adulthood, includes "84 planned lesbian families [with] a 93% retention rate to date," and includes 39 adolescent girls and 39 adolescent boys conceived through donor insemination.

Among other things, the study found "no reports of physical or sexual victimization by a parent or other caregiver." That’s good to know, but why look for evidence of "victimization" in the first place? The authors say their goal was to "contradict the notion, offered in opposition to parenting by gay and lesbian people, that same-sex parents are likely to abuse their offspring sexually."

Studies like these are the interface between scientific research and the culture wars. Sadly, opponents of same-sex couples as parents frequently appeal to cultural stereotypes of homosexuals as predatory and potentially harmful to children. These kinds of assumptions (like asking "When did you last stop beating your wife?") put potential parents in the position of defending themselves against unwarranted character defamation. Increasingly, courts have struck down state bans on gay and lesbian adoption that make broad, stereotypical assumptions about these parents as members of a group rather than looking at a potential individual parent or couple’s actual qualities.

The study does not address parenting by gay male couples and more research is needed in this area as well. The authors note the study’s limitations: a nonrandom sample; neither matched nor controlled for socioeconomic status, race/ethnicity, or region of residence; and a small sample size.

I would add a further limitation in the social context that led to doing this study. According to the U.S. Census Bureau, about 581,000 same-sex couples lived in the United States in 2009. Although no reliable surveys exist about how many U.S. children are living in homes with gay and lesbian parents, estimates range from 1 million to 14 million. The numbers are growing, and the important research issues should not be whether millions of gay parents are harming millions of kids or making them gay. Instead, further research must focus on the kind of effective care, social policies, and legal protections these children and families need.

Dr. Drescher is a Distinguished Fellow of the American Psychiatric Association and serves as president-elect of the Group for the Advancement of Psychiatry. He is also coeditor of "Uncoupling Convention: Psychoanalytic Approaches to Same-Sex Couples and Families" (New York: The Analytic Press, 2004).

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Point/Counterpoint: Lessons Learned From the Lesbian Family Study

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Data Are Limited but Valuable.

The U.S. National Longitudinal Lesbian Family Study has provided a treasure trove’s worth of much-needed data about the children being raised by lesbian mothers. Initiated in 1986, the current wave of the study reports on a mere 78 adolescents at age 17 years.

This study lands in the middle of an intense political debate around issues of marriage equality and adoption by gay and lesbian parents. Though the American Psychiatric Association supports the right of gay and lesbian adults to adopt, the law on this issue in many states is unclear, and, in a few states, expressly prohibited.

Dr. Serena Yuan Volpp     

Though the sample size is small, several of the findings in this study deserve comment. First, none of the teenagers reported any sexual or physical abuse by their parents (Arch. Sex. Behav. 2010 [doi:10.1007/s10508-010-9692-2]). This finding is a direct rebuttal to the claim that gay and lesbian parents are more likely to abuse sexually their children.

However, as the authors point out, most perpetrators of childhood sexual abuse in the home are heterosexual males. About four-fifths of the kids in the NLLFS study had no adult males in the household. The stereotype about gay adults sexually abusing children is quite gender-specific (toward males), and this study cannot directly address this misperception.

The study also begins to address questions around sexual identity and sexual behavior. In terms of behavior, the children of lesbian moms were significantly older than their peers at the age of first heterosexual contact. None of the girls raised by lesbian moms had ever been pregnant. While the girls were more likely than were their peers to report history of sexual contact with other girls, the boys were not more likely than their peers to report history of sexual contact with other boys.

The lack of matching by race/ethnicity and socioeconomic status does hamper this comparison, as norms about sexual behavior in teens vary by socioeconomic/cultural subgroups.

As for sexual identity, the vast majority of the adolescents in the NLLFS rated themselves a Kinsey 0-1 (exclusively or predominantly heterosexual) (81% of the girls and 91.9% of the boys). About one-fifth of the girls rated themselves in the Kinsey 2-4 spectrum (not exclusively heterosexual or homosexual). None of the girls and 5.4% of the boys rated themselves a Kinsey 5-6 (predominantly homosexual). For this part of the results, there is no comparison group. Research about sexuality in men and women has been confirming long-held general impressions that sexual identity is more fluid in women than in men. A prior study of children of lesbian mothers, compared with children raised by heterosexual mothers, noted that more of the young adults raised by lesbian parents reported a sexual experience with someone of the same gender. However by age 23.5 years (on average), there was no difference in self-identification as lesbian or gay between the two groups. What if, in fact, the girls in the study continued to report a relatively high rate of bisexual identity in successive waves of the study? There should be nothing inherently threatening about that. Emphasizing that most studies have shown that kids of gay and lesbian parents do not seem to grow up disproportionately gay serves only to appease those who still feel that homosexuality is an illness or a moral failing.

One thing to keep in mind: The subjects in this study represent a particular cohort of families, that of lesbians who planned to conceive in the 1980s, when planned lesbian families were much less common than they are today. The wave of children being raised by gay men started even later. Although the prospective design of the study helps to eliminate recall bias, the subjects are not a randomized sample. Both moms and kids in this study are surely well-aware that they are representing lesbian families to an unfriendly nation.

Although unlikely in the current climate, it would be ideal if further studies could be funded to do similar work with children being born today, to both lesbian parents and gay male parents.

Dr. Volpp is a clinical associate professor of psychiatry at New York University. She is the unit chief of the residency training unit at Bellevue Hospital, also in New York, and serves on the board of the Association of Gay and Lesbian Psychiatrists.

    Dr. Jack Drescher 

Findings Challenge Old Assumptions.

In a recent film, "The Kids Are All Right," two lesbian moms (Julianne Moore and Annette Bening) each conceive a child using the same anonymous sperm donor and then raise the children together. At the film’s outset, the children, aged 18 and 15 years, seek out and find their sperm donor (Mark Ruffalo). This "reunion" provides the dramatic tension of the film (no spoilers here).

 

 

The film, critically acclaimed and commercially successful, increased public awareness of same-sex couples’ using assisted reproductive technologies to create new family arrangements. While somewhat eye-opening to heterosexual moviegoers unfamiliar with these families, these trends are not news. In the 1970s, at the modern gay liberation movement’s start, women leaving heterosexual marriages took their children and raised them with lesbian partners. By the 1990s, a veritable gay baby ("gayby") boom ensued, as male and female same-sex couples, never heterosexually married, had children.

Children of the gayby boom are the subjects of the recently published study under discussion, "Adolescents of the U.S. National Longitudinal Lesbian Family Study: Sexual Orientation, Sexual Behavior, and Sexual Risk Exposure." The NLLFS study was launched to provide prospective data on a cohort of lesbian families" from conception until adulthood, includes "84 planned lesbian families [with] a 93% retention rate to date," and includes 39 adolescent girls and 39 adolescent boys conceived through donor insemination.

Among other things, the study found "no reports of physical or sexual victimization by a parent or other caregiver." That’s good to know, but why look for evidence of "victimization" in the first place? The authors say their goal was to "contradict the notion, offered in opposition to parenting by gay and lesbian people, that same-sex parents are likely to abuse their offspring sexually."

Studies like these are the interface between scientific research and the culture wars. Sadly, opponents of same-sex couples as parents frequently appeal to cultural stereotypes of homosexuals as predatory and potentially harmful to children. These kinds of assumptions (like asking "When did you last stop beating your wife?") put potential parents in the position of defending themselves against unwarranted character defamation. Increasingly, courts have struck down state bans on gay and lesbian adoption that make broad, stereotypical assumptions about these parents as members of a group rather than looking at a potential individual parent or couple’s actual qualities.

The study does not address parenting by gay male couples and more research is needed in this area as well. The authors note the study’s limitations: a nonrandom sample; neither matched nor controlled for socioeconomic status, race/ethnicity, or region of residence; and a small sample size.

I would add a further limitation in the social context that led to doing this study. According to the U.S. Census Bureau, about 581,000 same-sex couples lived in the United States in 2009. Although no reliable surveys exist about how many U.S. children are living in homes with gay and lesbian parents, estimates range from 1 million to 14 million. The numbers are growing, and the important research issues should not be whether millions of gay parents are harming millions of kids or making them gay. Instead, further research must focus on the kind of effective care, social policies, and legal protections these children and families need.

Dr. Drescher is a Distinguished Fellow of the American Psychiatric Association and serves as president-elect of the Group for the Advancement of Psychiatry. He is also coeditor of "Uncoupling Convention: Psychoanalytic Approaches to Same-Sex Couples and Families" (New York: The Analytic Press, 2004).

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Data Are Limited but Valuable.

The U.S. National Longitudinal Lesbian Family Study has provided a treasure trove’s worth of much-needed data about the children being raised by lesbian mothers. Initiated in 1986, the current wave of the study reports on a mere 78 adolescents at age 17 years.

This study lands in the middle of an intense political debate around issues of marriage equality and adoption by gay and lesbian parents. Though the American Psychiatric Association supports the right of gay and lesbian adults to adopt, the law on this issue in many states is unclear, and, in a few states, expressly prohibited.

Dr. Serena Yuan Volpp     

Though the sample size is small, several of the findings in this study deserve comment. First, none of the teenagers reported any sexual or physical abuse by their parents (Arch. Sex. Behav. 2010 [doi:10.1007/s10508-010-9692-2]). This finding is a direct rebuttal to the claim that gay and lesbian parents are more likely to abuse sexually their children.

However, as the authors point out, most perpetrators of childhood sexual abuse in the home are heterosexual males. About four-fifths of the kids in the NLLFS study had no adult males in the household. The stereotype about gay adults sexually abusing children is quite gender-specific (toward males), and this study cannot directly address this misperception.

The study also begins to address questions around sexual identity and sexual behavior. In terms of behavior, the children of lesbian moms were significantly older than their peers at the age of first heterosexual contact. None of the girls raised by lesbian moms had ever been pregnant. While the girls were more likely than were their peers to report history of sexual contact with other girls, the boys were not more likely than their peers to report history of sexual contact with other boys.

The lack of matching by race/ethnicity and socioeconomic status does hamper this comparison, as norms about sexual behavior in teens vary by socioeconomic/cultural subgroups.

As for sexual identity, the vast majority of the adolescents in the NLLFS rated themselves a Kinsey 0-1 (exclusively or predominantly heterosexual) (81% of the girls and 91.9% of the boys). About one-fifth of the girls rated themselves in the Kinsey 2-4 spectrum (not exclusively heterosexual or homosexual). None of the girls and 5.4% of the boys rated themselves a Kinsey 5-6 (predominantly homosexual). For this part of the results, there is no comparison group. Research about sexuality in men and women has been confirming long-held general impressions that sexual identity is more fluid in women than in men. A prior study of children of lesbian mothers, compared with children raised by heterosexual mothers, noted that more of the young adults raised by lesbian parents reported a sexual experience with someone of the same gender. However by age 23.5 years (on average), there was no difference in self-identification as lesbian or gay between the two groups. What if, in fact, the girls in the study continued to report a relatively high rate of bisexual identity in successive waves of the study? There should be nothing inherently threatening about that. Emphasizing that most studies have shown that kids of gay and lesbian parents do not seem to grow up disproportionately gay serves only to appease those who still feel that homosexuality is an illness or a moral failing.

One thing to keep in mind: The subjects in this study represent a particular cohort of families, that of lesbians who planned to conceive in the 1980s, when planned lesbian families were much less common than they are today. The wave of children being raised by gay men started even later. Although the prospective design of the study helps to eliminate recall bias, the subjects are not a randomized sample. Both moms and kids in this study are surely well-aware that they are representing lesbian families to an unfriendly nation.

Although unlikely in the current climate, it would be ideal if further studies could be funded to do similar work with children being born today, to both lesbian parents and gay male parents.

Dr. Volpp is a clinical associate professor of psychiatry at New York University. She is the unit chief of the residency training unit at Bellevue Hospital, also in New York, and serves on the board of the Association of Gay and Lesbian Psychiatrists.

    Dr. Jack Drescher 

Findings Challenge Old Assumptions.

In a recent film, "The Kids Are All Right," two lesbian moms (Julianne Moore and Annette Bening) each conceive a child using the same anonymous sperm donor and then raise the children together. At the film’s outset, the children, aged 18 and 15 years, seek out and find their sperm donor (Mark Ruffalo). This "reunion" provides the dramatic tension of the film (no spoilers here).

 

 

The film, critically acclaimed and commercially successful, increased public awareness of same-sex couples’ using assisted reproductive technologies to create new family arrangements. While somewhat eye-opening to heterosexual moviegoers unfamiliar with these families, these trends are not news. In the 1970s, at the modern gay liberation movement’s start, women leaving heterosexual marriages took their children and raised them with lesbian partners. By the 1990s, a veritable gay baby ("gayby") boom ensued, as male and female same-sex couples, never heterosexually married, had children.

Children of the gayby boom are the subjects of the recently published study under discussion, "Adolescents of the U.S. National Longitudinal Lesbian Family Study: Sexual Orientation, Sexual Behavior, and Sexual Risk Exposure." The NLLFS study was launched to provide prospective data on a cohort of lesbian families" from conception until adulthood, includes "84 planned lesbian families [with] a 93% retention rate to date," and includes 39 adolescent girls and 39 adolescent boys conceived through donor insemination.

Among other things, the study found "no reports of physical or sexual victimization by a parent or other caregiver." That’s good to know, but why look for evidence of "victimization" in the first place? The authors say their goal was to "contradict the notion, offered in opposition to parenting by gay and lesbian people, that same-sex parents are likely to abuse their offspring sexually."

Studies like these are the interface between scientific research and the culture wars. Sadly, opponents of same-sex couples as parents frequently appeal to cultural stereotypes of homosexuals as predatory and potentially harmful to children. These kinds of assumptions (like asking "When did you last stop beating your wife?") put potential parents in the position of defending themselves against unwarranted character defamation. Increasingly, courts have struck down state bans on gay and lesbian adoption that make broad, stereotypical assumptions about these parents as members of a group rather than looking at a potential individual parent or couple’s actual qualities.

The study does not address parenting by gay male couples and more research is needed in this area as well. The authors note the study’s limitations: a nonrandom sample; neither matched nor controlled for socioeconomic status, race/ethnicity, or region of residence; and a small sample size.

I would add a further limitation in the social context that led to doing this study. According to the U.S. Census Bureau, about 581,000 same-sex couples lived in the United States in 2009. Although no reliable surveys exist about how many U.S. children are living in homes with gay and lesbian parents, estimates range from 1 million to 14 million. The numbers are growing, and the important research issues should not be whether millions of gay parents are harming millions of kids or making them gay. Instead, further research must focus on the kind of effective care, social policies, and legal protections these children and families need.

Dr. Drescher is a Distinguished Fellow of the American Psychiatric Association and serves as president-elect of the Group for the Advancement of Psychiatry. He is also coeditor of "Uncoupling Convention: Psychoanalytic Approaches to Same-Sex Couples and Families" (New York: The Analytic Press, 2004).

Data Are Limited but Valuable.

The U.S. National Longitudinal Lesbian Family Study has provided a treasure trove’s worth of much-needed data about the children being raised by lesbian mothers. Initiated in 1986, the current wave of the study reports on a mere 78 adolescents at age 17 years.

This study lands in the middle of an intense political debate around issues of marriage equality and adoption by gay and lesbian parents. Though the American Psychiatric Association supports the right of gay and lesbian adults to adopt, the law on this issue in many states is unclear, and, in a few states, expressly prohibited.

Dr. Serena Yuan Volpp     

Though the sample size is small, several of the findings in this study deserve comment. First, none of the teenagers reported any sexual or physical abuse by their parents (Arch. Sex. Behav. 2010 [doi:10.1007/s10508-010-9692-2]). This finding is a direct rebuttal to the claim that gay and lesbian parents are more likely to abuse sexually their children.

However, as the authors point out, most perpetrators of childhood sexual abuse in the home are heterosexual males. About four-fifths of the kids in the NLLFS study had no adult males in the household. The stereotype about gay adults sexually abusing children is quite gender-specific (toward males), and this study cannot directly address this misperception.

The study also begins to address questions around sexual identity and sexual behavior. In terms of behavior, the children of lesbian moms were significantly older than their peers at the age of first heterosexual contact. None of the girls raised by lesbian moms had ever been pregnant. While the girls were more likely than were their peers to report history of sexual contact with other girls, the boys were not more likely than their peers to report history of sexual contact with other boys.

The lack of matching by race/ethnicity and socioeconomic status does hamper this comparison, as norms about sexual behavior in teens vary by socioeconomic/cultural subgroups.

As for sexual identity, the vast majority of the adolescents in the NLLFS rated themselves a Kinsey 0-1 (exclusively or predominantly heterosexual) (81% of the girls and 91.9% of the boys). About one-fifth of the girls rated themselves in the Kinsey 2-4 spectrum (not exclusively heterosexual or homosexual). None of the girls and 5.4% of the boys rated themselves a Kinsey 5-6 (predominantly homosexual). For this part of the results, there is no comparison group. Research about sexuality in men and women has been confirming long-held general impressions that sexual identity is more fluid in women than in men. A prior study of children of lesbian mothers, compared with children raised by heterosexual mothers, noted that more of the young adults raised by lesbian parents reported a sexual experience with someone of the same gender. However by age 23.5 years (on average), there was no difference in self-identification as lesbian or gay between the two groups. What if, in fact, the girls in the study continued to report a relatively high rate of bisexual identity in successive waves of the study? There should be nothing inherently threatening about that. Emphasizing that most studies have shown that kids of gay and lesbian parents do not seem to grow up disproportionately gay serves only to appease those who still feel that homosexuality is an illness or a moral failing.

One thing to keep in mind: The subjects in this study represent a particular cohort of families, that of lesbians who planned to conceive in the 1980s, when planned lesbian families were much less common than they are today. The wave of children being raised by gay men started even later. Although the prospective design of the study helps to eliminate recall bias, the subjects are not a randomized sample. Both moms and kids in this study are surely well-aware that they are representing lesbian families to an unfriendly nation.

Although unlikely in the current climate, it would be ideal if further studies could be funded to do similar work with children being born today, to both lesbian parents and gay male parents.

Dr. Volpp is a clinical associate professor of psychiatry at New York University. She is the unit chief of the residency training unit at Bellevue Hospital, also in New York, and serves on the board of the Association of Gay and Lesbian Psychiatrists.

    Dr. Jack Drescher 

Findings Challenge Old Assumptions.

In a recent film, "The Kids Are All Right," two lesbian moms (Julianne Moore and Annette Bening) each conceive a child using the same anonymous sperm donor and then raise the children together. At the film’s outset, the children, aged 18 and 15 years, seek out and find their sperm donor (Mark Ruffalo). This "reunion" provides the dramatic tension of the film (no spoilers here).

 

 

The film, critically acclaimed and commercially successful, increased public awareness of same-sex couples’ using assisted reproductive technologies to create new family arrangements. While somewhat eye-opening to heterosexual moviegoers unfamiliar with these families, these trends are not news. In the 1970s, at the modern gay liberation movement’s start, women leaving heterosexual marriages took their children and raised them with lesbian partners. By the 1990s, a veritable gay baby ("gayby") boom ensued, as male and female same-sex couples, never heterosexually married, had children.

Children of the gayby boom are the subjects of the recently published study under discussion, "Adolescents of the U.S. National Longitudinal Lesbian Family Study: Sexual Orientation, Sexual Behavior, and Sexual Risk Exposure." The NLLFS study was launched to provide prospective data on a cohort of lesbian families" from conception until adulthood, includes "84 planned lesbian families [with] a 93% retention rate to date," and includes 39 adolescent girls and 39 adolescent boys conceived through donor insemination.

Among other things, the study found "no reports of physical or sexual victimization by a parent or other caregiver." That’s good to know, but why look for evidence of "victimization" in the first place? The authors say their goal was to "contradict the notion, offered in opposition to parenting by gay and lesbian people, that same-sex parents are likely to abuse their offspring sexually."

Studies like these are the interface between scientific research and the culture wars. Sadly, opponents of same-sex couples as parents frequently appeal to cultural stereotypes of homosexuals as predatory and potentially harmful to children. These kinds of assumptions (like asking "When did you last stop beating your wife?") put potential parents in the position of defending themselves against unwarranted character defamation. Increasingly, courts have struck down state bans on gay and lesbian adoption that make broad, stereotypical assumptions about these parents as members of a group rather than looking at a potential individual parent or couple’s actual qualities.

The study does not address parenting by gay male couples and more research is needed in this area as well. The authors note the study’s limitations: a nonrandom sample; neither matched nor controlled for socioeconomic status, race/ethnicity, or region of residence; and a small sample size.

I would add a further limitation in the social context that led to doing this study. According to the U.S. Census Bureau, about 581,000 same-sex couples lived in the United States in 2009. Although no reliable surveys exist about how many U.S. children are living in homes with gay and lesbian parents, estimates range from 1 million to 14 million. The numbers are growing, and the important research issues should not be whether millions of gay parents are harming millions of kids or making them gay. Instead, further research must focus on the kind of effective care, social policies, and legal protections these children and families need.

Dr. Drescher is a Distinguished Fellow of the American Psychiatric Association and serves as president-elect of the Group for the Advancement of Psychiatry. He is also coeditor of "Uncoupling Convention: Psychoanalytic Approaches to Same-Sex Couples and Families" (New York: The Analytic Press, 2004).

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