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Harvard Commentaries
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Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School


A Parent's Life A Parent's Life
 

Same-Sex Parenting: Pediatric Experts Weigh In


December 29, 2009

When it comes to the topic of gay marriage, it's hard to have a discussion.

It's not that people don't want to talk about it; they do. It's not that people don't have passionate feelings about the subject; they do. What makes it difficult is that for most people, those feelings come from deeply held cultural and religious beliefs, the kind that have been instilled since childhood and shape how we see the world.

When it comes to the topic of gay marriage and children, discussion can become even more difficult. Because now, layered on top of all the deeply held beliefs about marriage are deeply held beliefs about caring for children that come from the same place — and stir fierce, protective feelings in the hearts of people on both sides of the issue.

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Millions Are Affected

According to the 2000 census, there are at least half a million couples of the same gender (sex) in the United States (likely a significant undercount, given census rules about reporting), and around 25% of them are raising children and doing so across 96% of U.S. counties. The exact number of children being raised in these households is hard to determine, but estimates are between 1 and 10 million.

The federal Defense of Marriage Act, which denies federal recognition of same-gender civil marriage and allows states to do the same, became a law in 1996. Since then, the legislative trend has been to limit the ability of same-gender couples to have legally recognized and protected unions. There have also been limitations placed on the ability of both members of a couple to be legal parents of a child if they are of the same gender (which has ramifications, since 6% of same-gender couples are adoptive parents compared with 5.1% of heterosexual couples and 2.6% of unmarried heterosexuals).

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Legal Limits: The Effect on Children

As the country's leading organization for pediatricians and for child advocacy, the American Academy of Pediatrics (AAP) felt that it was important to look at how the legal limits on same-gender couples affected the health and well-being of those one to ten million children. Following the AAP's philosophy that the family is the principal caregiver and center of strength and support for children, and recognizing that their gay and lesbian patients grow up to be gay and lesbian adults who may themselves become parents, they pulled together experts on child health and development to look at "the unique and complex challenges that same-gender couples and their children face as a result of public policy that excludes them from civil marriage." Their findings are published in the July 2006 issue of the AAP's journal Pediatrics.

The authors thoroughly reviewed laws, pending cases, and policies in different states, along with federal statutes. They discovered that the argument that same-gender civil marriage isn't necessary because couples can get the protections they need by drawing up legal agreements is only partially true. There are limited protections that can be obtained that way, such as power of attorney, naming a survivor in one's will, and protecting assets in a trust. But even these agreements could be challenged by family members.

Some of the protections afforded by civil marriage can be very important when it comes to raising children, including:

  • Legal recognition of a child’s relationship to both parents
  • Joint or co-parent adoption
  • Access to employer-based health insurance
  • Protection of assets, such as a home, from creditors
  • Ability of both parents to consent to medical care
  • Recognition as next of kin for the purpose of visiting in the hospital
  • Ability to be involved in a child’s education plan, or even sign permission slips
  • Ability to travel with a child
  • Visitation rights and/or custody of children if a relationship ends, or, if one partner dies, the right of the surviving partner to maintain custody of the child
  • Ability to use the Family and Medical Leave Act to care for a sick partner or nonbiological/non-jointly adopted child

When same-gender couples are not recognized as a couple by law, or when both members of the couple are not allowed to be legally recognized as parents, life can be very precarious for the children and the family.

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Are There Downsides?

The AAP reviewed all the studies they could find on the psychosocial effects on children of growing up in a gay or lesbian home. There are certainly downsides: children growing up in these homes are more likely to be teased and socially excluded by children and adults who do not approve of gay and lesbian parenting.

But when one looks more closely at parenting styles and skills, and at the actual social and emotional development of children, it's harder to find downsides. Studies clearly show that gays and lesbians parent in ways that are fundamentally the same as their straight counterparts. And studies also show that there is no apparent increase in the frequency or severity of emotional or social problems among the children they raise.

As for whether having a gay or lesbian parent makes a child more likely to end up gay or lesbian, research shows that adolescents and adults raised by a homosexual parent are no more likely to identify themselves as homosexual than those who are raised by heterosexual ones.

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Keep it About the Kids

These data may not convince everyone; deeply held beliefs are what they are. But whatever one believes, the reality is that gays and lesbians are raising children — and those children need, and deserve, no fewer rights and protections than children growing up with heterosexual parents. This is our great challenge: to have the difficult discussions, find the middle ground — and take care of all our children.

Claire McCarthy, M.D., is an assistant professor in pediatrics at Harvard Medical School, an attending physician at Children's Hospital of Boston, and medical director of the Martha Eliot Health Center, a neighborhood health service of Children's Hospital. She is a senior medical editor for Harvard Health Publications.

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