structural forms are varied. In2010, married adults were raising 65.3%of all children in this country.
The other34.7% of children (25.9 million of 74.63million children) were living in a varietyof situations. Many were being raised byparents who were single or cohabiting,either by choice or by circumstance.Growing numbers of grandparents arestepping in as parents to 2.5 millionchildren when necessary.
When none of a child
s biological relatives is availableor able to provide necessary nurturingand support, other arrangements exist to nurture children. Foster parenting andadoption are substitute arrangements that can provide
nancial, emotional,social, and legal support for children. In2007,
400000 children were in fostercare, and 130 000 children were adoptedby unrelated adults.
Increasing numbers of same-gendercouples are raising children today,and the numbers are likely to increasein the future. The US 2010 Censusreported that 646464 households in-cluded 2 adults of the same gender.
These same-gender couples are rais-ing
115 000 children aged
18 yearsand are living in essentially all coun- ties of the United States.
When thesechildren are combined with single gayand lesbian parents who are raisingchildren, almost 2 million children arebeing raised by gay and lesbianparents in the United States.
Civil marriage is the legal and socialinstitution in modern society that servesas the basic building block for familystructure and child-rearing. Marriage isgenerally considered the optimal re-lationship between 2 adults who shareresponsibility for children. Marriagebrings 2 extended families together toprovide long-term security and socialand emotional support to all membersof the newly formed family. Marriageoffers many legal rights and responsi-bilities, including the joint responsi-bility to care for children and to makedecisions (including medical decisions)for them. A report from the AAP Task Force on the Family noted that marriedcouples have more
nancial and socialresources to nurture and raise children.
married men and womenare physically and emotionally healthierand are less likely to engage in healthrisk behaviors . . . than are unmarriedadults.
A number of studies havedocumented
a positive relationship be- tween the quality of marital life andfamily functioning.
The Task Force re-port emphasized:
As we move forward, the Academy and pediatricians standready to serve all children in all families,regardless of the family structure inwhich they live.
There are few social or legal restric- tions limiting the ability of 2 unrelatedadults to marry in the United States.These include (1) age: states have dif-ferent age limits before which parentalpermission is required for marriage;(2) numerosity: there is a long-standingprohibition on bigamy/polygamy; (3) the existence of blood relationships;and (4) cognitive capacity to consent.The only other exception applies toadults seeking same-gender relation-ships (in most states).There is extensive research documenting that there is no causal relationship be- tween parents
sexual orientation andchildren
s emotional, psychosocial, andbehavioral development.
Many stud-ies attest to the normal development of children of same-gender couples when the child is wanted, the parents havea commitment to shared parenting,and the parents have strong social andeconomic supports. Indeed, current re-search has concluded that
In all, it isnow well-established that the adjust-ment of children and adolescents isbest accounted for by variations in thequality of the relationships with theirparents, the quality of the relationshipbetween the parents or signi
cantadults in the children
s and adolescents
lives, and the availability of economicand socio-economic resources.
Therefore,theAAPhasendorsed,formore than a decade, a policy supporting thebene
ts ofboth parentsin a same-gendercouple having legal rights and respon-sibilities for their child(ren), for example, through second-parent or coparent ad-option.
A special article in
in2006 reviewed the legal issues associatedwith civil marriage, civil union, and do-mestic partnership and noted a numberof disparities for children growing up invarious legal arrangements.
The Amer-ican Medical Association has recentlynoted the disparities that exist forparents of the same gender who lack marriage equality as well as for theirchildren.
Many other professionalorganizations have adopted policies urg-ing legislative changes and legal mecha-nisms, including adoption, fosterparenting, and civil marriage, for gay andlesbian adults who wish to be parents.*Civil unions and domestic partnershipsdo not confer the same legal rights,protections, and bene
ts to children thatcivil marriage provides.
Public policy related to marriage andfamily is largely a state function. Con-sequently, the laws across the country that regulate marriage, adoption, andfoster parenting by gay men and les-bians are an inconsistent patchwork.Even civil marriage in a state that
*National organizations that support marriageequality: American Civil Liberties Union (June1998), National Association of Social Workers(June 2004), American Psychological Association(July 2004), American Psychiatric Association (May2005), American Psychoanalytic Association(January 2008), American Bar Association (August2010), American College of Nursing (July 2012),and American Academy of Family Physicians(October 2012). National organizations thatsupport gay and lesbian parenting and thenurturing of children: American Academy of Childand Adolescent Psychiatry, American College of Obstetrics and Gynecology, American MedicalAssociation, Child Welfare League of America,National Adoption Center, National EducationAssociation, North American Council on AdoptableChildren, and Voice for Adoption.
FROM THE AMERICAN ACADEMY OF PEDIATRICS