Researching for LGBTQ Health

LGBTQ Families and Parenting

Papers on Adoption

Policy and Practice Regarding Adoption by Sexual and Gender Minority People in Ontario

In 2000, changes to the Ontario Child and Family Services Act made it possible for lesbian and gay couples to jointly adopt a child. This research investigated the extent to which Ontario adoption agencies and licensees are supportive of adoption by sexual and gender minority people. Results indicate that while overall, there is support for sexual and gender minority adopters in Ontario, disparities exist on the basis of agency type (public vs. private vs. international; religious/cultural affiliation) and location (urban centres vs. smaller communities), as well as the applicants’ identity (lesbian/gay vs. other minority identities). Policy and practice implications of these findings are be discussed.

Policy, Practice, and Personal Narratives: Experiences of LGBTQ People with Adoption in Ontario, Canada

In 2000, the Ontario Child and Family Services Act was amended to permit same-sex adoption. The goal of our research was to examine whether this legislative change has translated into increased access to adoption for lesbian, gay, bisexual, trans, and queer (LGBTQ2S+) people. Forty-three LGBTQ2S+ individuals/couples who had either adopted successfully or were approved for adoption since 2000 completed a narrative interview. In this paper, we will draw from participants’ stories of adoption to illustrate the current strengths and limitations of the adoption system in Ontario, Canada, and to offer recommendations for further improvements to facilitate access for LGBTQ2S+ people.

Lesbian and queer mothers navigating the adoption systems: impacts on mental health 

Increasing numbers of lesbian, gay, bisexual, transgender, transsexual, and queer (LGBTQ2S+) people are choosing to parent through adoption. The minimal research available, focused particularly on lesbian and gay adoptive parents, suggests they face significant barriers to adoption (including being held to a higher standard than heterosexual adoptive parents), homophobia from child welfare professionals, and limited social support post-adoption. These issues have significant implications for the mental health of LGBTQ2S+ adoptive parents, but have not been researched to date. Seven interviews were conducted with Canadian lesbian and queer adoptive parents to examine the mental health impact of adoption and identify barriers to accessing health and social services. Adoptive parents described multiple challenges related to the adoption process and becoming a parent. Further research is needed to identify the long-term mental health effects of the stress of the adoption process on lesbian and queer parents, and their need for support services.

Adaptation to Parenthood During the Post-Adoption Period: A Review of the Literature

Substantial research has been conducted on new parents’ adjustment during the transition to biological parenthood. However, very little is known about adjustment experiences during the transition to adoptive parenthood. Such information could assist in creating support systems for adoptive parents similar to those that currently exist for biological parents. A systematic literature review was conducted to examine individual and relational adjustment outcomes during the transition to adoptive parenthood, limited to those studies that examined the immediate post-adoption period through 3 years post-placement. By searching six databases using a variety of keywords including post-adoption, adapt, and parent, 11 research studies were identified that reported on parental mental health, physical health, and intimate partner relationship satisfaction in the immediate post-adoption period. The studies reviewed appear to indicate that post-adoption depression is relatively common, although perhaps less so than depression among biological parents. It is difficult to draw conclusions about physical health and relationship satisfaction as only one study directly assessing each outcome was located. Findings suggest that additional research is warranted to provide a clearer characterization of physical and psychological adaptation to parenthood among adoptive parents.x

Current Practices and Barriers to the Provision of Post-Placement Support: A Pilot Study from Toronto, Ontario, Canada

Research investigating the practices of and barriers to provision of post-placement adoption support is sparse and has primarily focused on the perspectives of adoptive parents. This pilot study aims to contribute to this limited literature by investigating current practices and barriers from the perspective of adoption professionals. Eighteen adoption workers from two public adoption agencies in Toronto, Ontario, Canada, participated in two focus groups to discuss the post-placement supports they provide and/or utilise, as well as any barriers faced during support provision. Data were analysed using a descriptive phenomenological approach. Workers identified several key challenges to providing post-placement support, including barriers both internal (systemic) and external to the adoption system. The results suggest that further research in this area is warranted, ultimately to assist in the development of strategies to overcome barriers faced by adoption workers as they attempt to provide post-placement support.

The transition to adoptive parenthood: A pilot study of parents adopting in Ontario, Canada

Research indicates that the transition to adoptive parenthood can be challenging for many adoptive parents, but that the provision of post-placement services may mitigate these challenges. However, little is known about the specific post-placement service needs of adoptive parents during this transition. This paper describes a pilot project from Ontario, Canada which sought to explore the support needs of adoptive parents in the post-placement period. Eight semi-structured interviews were conducted with nine newly placed adoptive parents. Eight of the nine participants were married; two had adopted internationally, five had adopted through the public system in Ontario and the remaining participant utilized private adoption. Through our analysis of the data, we identified two meta-themes: a) challenges and b) facilitators accompanying the transition to adoptive parenthood. Grounded theory methodology was used to develop these themes into a conceptual framework describing the transition to adoptive parenthood. This framework posits that each parent negotiates a particular set of challenges and facilitators associated with their specific adoption experience. In future, this framework can become a tool to assist adoptive parents and practitioners to proactively identify and address potential challenges during the transition to parenthood.

Papers on Assisted Human Reproduction

Challenges and Mental Health Experiences of Lesbian and Bisexual Women Who Are Trying to Conceive

To date, there is little evidence to inform social work practice with lesbian and bisexual women who are trying to conceive (TTC). The authors report a preliminary examination of the mental health experiences of lesbian and bisexual women who are TTC, through a comparison with lesbian and bisexual women in the postpartum period (PP). Thirty-three lesbian and bisexual women (TTC, n = 15; PP, n = 18) completed standardized questionnaires assessing symptoms of depression and anxiety as well as relationship satisfaction and perceived social support. Qualitative interviews were also conducted to further investigate the experience of TTC. No significant differences were found between groups on any of the dependent variables. Analysis of qualitative data highlighted the challenges for lesbian and bisexual women who are TTC, particularly in terms of difficulty conceiving, lack of support during the conception process, and heterosexism in the fertility system. Women perceived these challenges to conception as having emotional consequences. The findings from this study begin to elucidate the unique context of TTC for lesbian and bisexual women, and they highlight the importance of culturally competent social work practice with this population.

Service use and gaps in services for lesbian and bisexual women during donor insemination, pregnancy, and the postpartum period

Increasing numbers of lesbian and bisexual women are choosing to have children. This qualitative study investigated the degree to which a sample of Canadian lesbian and bisexual women were satisfied with the health and social services that they received during the process of trying to conceive, during pregnancy, and during the early postpartum weeks and months. Three focus groups were conducted: (1) women who were themselves, or whose partners were, in the process of trying to conceive (n = 6); (2) biological parents of young children (n = 7); and (3) women who were non-biological parents of young children or whose partners were currently pregnant (n = 10). Participants were asked to discuss their positive and negative experiences with health and social services during their efforts to conceive and through the perinatal period. Participants were very satisfied with the care they received from midwives, doulas, and public health nurses. Services directed specifically to lesbian, gay, and bisexual parents were also perceived to be important sources of information and support. Many participants perceived fertility services to be unsupportive or unable to address their different health care needs. Participants expressed satisfaction with pregnancy-related services provided by non-physicians and dissatisfaction with services provided by physicians and fertility clinics. There is a strong desire for fertility services specific to lesbian and bisexual women, but even minor changes to existing services could improve the satisfaction of lesbian and bisexual patients.

Perceptions of Predisposing and Protective Factors for Perinatal Depression in Same-Sex Parents

Increasing numbers of women are choosing to have children in the context of same-sex relationships or as “out” lesbian or bisexual individuals. This study used qualitative methods to assess perceived predisposing and protective factors for perinatal depression in lesbian, gay, bisexual, and queer (LGBQ) women. Two focus groups with LGBQ women were conducted: 1) biological parents of young children and 2) nonbiological parents of young children or whose partners were currently pregnant. Three major themes emerged. Issues related to social support were primary, particularly related to disappointment with the lack of support provided by members of the family of origin. Participants also described issues related to the couple relationship, such as challenges in negotiating parenting roles. Finally, legal and policy barriers (e.g., second parent adoption) were identified as a significant source of stress during the transition to parenthood. Both lack of social support and relationship problems have previously been identified as risk factors for perinatal depression in heterosexual women, and legal and policy barriers may represent a unique risk factor for this population. Therefore, additional study of perinatal mental health among LGBQ women is warranted.

Lesbian and bisexual women’s recommendations for improving the provision of assisted reproductive technology services

Qualitative focus groups were conducted with lesbian and bisexual women who were themselves or whose partners were in the process of trying to conceive (n = 6); who were biological parents of young children (n = 7); and who were nonbiological parents of young children or whose partners were currently pregnant (n = 10) to explore their donor insemination service needs and to provide recommendations for improved or additional services. The 10 recommendations generated by participants included providing cues that the service is lesbian and bisexual positive; offering lesbian- and bisexual-specific infertility support; providing opportunities for women to make informed choices about use of interventions consistent with their known or presumed fertility; and offering accessible services to known sperm donors, including gay men.

Celebrating the “Other” Parent: Mental Health and Wellness of Expecting Lesbian, Bisexual, and Queer Non-Birth Parents

Lesbian, bisexual, and queer (LBQ) nonbirth parents have a unique role in the parenting spectrum. The term nonbirth parent refers to the expecting, nonpregnant partner. Previous work suggests that there are unique mental health stressors for LBQ nonbirth parents; however, research addressing this topic is scant. This qualitative study explored the factors that affect mental health and wellness in LBQ nonbirth parents during pregnancy. Results are organized into four themes: biology, connectedness, and relatedness; social recognition; social support; and changes during pregnancy. This study has important implications for clinical practice, policy development, and health promotion activities.

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