DOI:10.1542/peds.2009-3153published online Jun 7, 2010;

Pediatrics

Nanette Gartrell and Henny Bos

17-Year-Old AdolescentsUS National Longitudinal Lesbian Family Study: Psychological Adjustment of

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US National Longitudinal Lesbian Family Study:Psychological Adjustment of 17-Year-Old Adolescents

WHAT’S KNOWN ON THIS SUBJECT:

There is a paucity of data on the psychological adjustment of adolescents who have beenreared in lesbian households since birth. No other study hasfollowed a cohort of such offspring from conception throughadolescence, prospectively and longitudinally.

WHAT THIS STUDY ADDS:

This study expands our understandingof psychological well-being in adolescent biological offspring of lesbian mothers and therefore has implications for the pediatriccare of these adolescents and for public policies concerningsame-sex parenting.

abstract

OBJECTIVES:

The objective of this study was to document the psycho-logical adjustment of adolescents who were conceived through donorinsemination by lesbian mothers who enrolled before these offspringwere born in the largest, longest running, prospective, longitudinalstudy of same-sex–parented families.

METHODS:

Between 1986 and 1992, 154 prospective lesbian mothersvolunteered for a study that was designed to follow planned lesbianfamilies from the index children’s conception until they reached adult-hood. Data for the current report were gathered through interviewsand questionnaires that were completed by 78 index offspring when they were 10 and 17 years old and through interviews and Child Behav-ior Checklists that were completed by their mothers at corresponding times. The study is ongoing, with a 93% retention rate to date.

RESULTS:

According to their mothers’ reports, the 17-year-old daugh- ters and sons of lesbian mothers were rated signiﬁcantly higher insocial, school/academic, and total competence and signiﬁcantly lowerin social problems, rule-breaking, aggressive, and externalizing prob-lembehaviorthantheirage-matchedcounterpartsinAchenbach’snor-mative sample of American youth. Within the lesbian family sample, noChild Behavior Checklist differences were found among adolescentoffspring who were conceived by known, as-yet-unknown, and perma-nentlyunknowndonorsorbetweenoffspringwhosemotherswerestill together and offspring whose mothers had separated.

CONCLUSIONS:

Adolescents who have been reared in lesbian-motherfamilies since birth demonstrate healthy psychological adjustment.These ﬁndings have implications for the clinical care of adolescentsand for pediatricians who are consulted on matters that pertain tosame-sex parenting.

Pediatrics

2010;126:000

AUTHORS:

Nanette Gartrell, MD

a,b,c

and Henny Bos, PhD

Center of Excellence in Women’s Health, University of California,San Francisco, San Francisco, California;

Williams Institute,UCLA School of Law, Los Angeles, California;

Graduate School of Pedagogical and Educational Sciences, Faculty of Social and Behavioral Sciences, University of Amsterdam, Amsterdam,Netherlands

KEY WORDS

lesbian families, lesbian mothers, adolescents, psychosocialadjustment, same-sex parents

ABBREVIATIONS

DI—donor inseminationNLLFS—National Longitudinal Lesbian Family StudyAdd Health—National Longitudinal Study of Adolescent HealthCBCL—Child Behavior ChecklistMANOVA—multivariate analysis of varianceDrs Gartrell and Bos had full access to all data in the study and take responsibility for the integrity of the data and the accuracyof the data analysis.www.pediatrics.org/cgi/doi/10.1542/peds.2009-3153doi:10.1542/peds.2009-3153Accepted for publication Mar 23, 2010Address correspondence to Nanette Gartrell, MD, UCSF,Department of Psychiatry 3570 Clay St, San Francisco, CA 94118.E-mail: ngartrell@onebox.comPEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275).Copyright © 2010 by the American Academy of Pediatrics

FINANCIAL DISCLOSURE:

Dr Gartrell has been reimbursed for travel expenses associated with speaking at symposia sponsored by the Williams Institute at UCLA School of Law; Dr Bos has no ﬁnancial relationships relevant to this article to disclose.

ARTICLES

PEDIATRICS Volume 126, Number 1, July 2010

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According to US census data, an esti-mated 270 313 American childrenwere living in households headed bysame-sex couples in 2005, and nearly twicethatnumberhadasinglelesbianor gay parent.

Although research hadestablished by the late 1960s that ho-mosexuality is not a mental illness,public opinion has been slow to catchup.

2,3

After homosexuality was re-moved from the

Diagnostic and Statis- tical Manual of Mental Disorders

in1973, women who had conceived chil-dren in the context of heterosexualmarriage and identiﬁed as lesbian at the time of divorce faced stiff opposi- tion in the courts when they sought toretain custody.

5–7

Subsequently, stud-ies have shown that there are no sig-niﬁcantdifferencesinpsychosocialde-velopment between children who arereared in lesbian and heterosexualhouseholds.

7–15

These ﬁndings formed the basis of the Technical Report from the American Academy of PediatricsCommitteeonPsychologicalAspectsof Child and Family Health.

Despite more than 3 decades of cross-sectionalresearchdemonstratingthat the psychological adjustment of chil-dren is unrelated to their parents’ sex-ual orientation, the legitimacy of les-bian and gay biological, foster, andadoptive parenting is still under scru- tiny.

8,15,17

Contemporary critics point toa dearth of longitudinal studies on les-bian families and limited data on ado-lescents who have been living in les-bian or gay households since birth.

15,18

Withinthecohortoffamiliesheadedbysame-sex parents in the United States, the ﬁrst generation of children whowere conceived by lesbians throughdonor insemination (DI) is coming of age. This phenomenon provides a richopportunity for social scientists tostudy the well-being of teenagerswho have been raised since birth inwhat is known as planned lesbianfamilies.

8,19–27

Psychosocial research on young chil-dren in planned lesbian families hasfocused primarily on 4 key develop-mental outcomes: psychological adjustment,peerrelationships,familyre-lationships, and progress throughschool.

8,14,15,28

Inyoungchildren,adjust-ment is largely determined by familyfunctioning: regardless of their par-ents’ gender or sexual orientation,children fare better when their par-ents are compatible, share responsi-bilities, provide ﬁnancial stability, andhave healthy interpersonal connec- tions.

During adolescence, peer relations become more important as teen-agers develop a sense of identity, adeeper appreciation of interindividualdifference, and a keener awareness of minority status.

19,29–31

Teenage chil-dren may be more reﬂective about theirearlierexperiencesofstigmatiza- tion,

15,19,27,29,32–35

yet relatively little hasbeen reported about the psychologicalwell-being of adolescents who havebeen raised in lesbian families sincebirth. Studies on the teenage offspringof lesbians are largely based on datagatheredinthe1990s,inwhichthema- jority of teenagers studied were con-ceived in heterosexual relationshipsbefore their mothers divorced andcame out as lesbian.

8,14,29,32,36

These teenagers’ experience differs from that of those who grow up in plannedlesbian families, because having a het-erosexual father may diminish thesense of marginalization that teenag-ers with lesbian parents experience.

In the United Kingdom, Golombok andcolleagues

11,37

have been conducting acomparative study of children whowere reared in fatherless and tradi- tional families that began when the in-dex offspring was a mean age of 6years. At the third follow-up, the 18young adults with lesbian mothersand the 20 reared by single het-erosexual mothers demonstratedhigher levels of self-esteem than the32 reared in 2-parent heterosexualhouseholds.A recent series of reports on the psy-chosocial adjustment of American teenagers with same-sex parentswas based on the National Longitudi-nal Study of Adolescent Health (AddHealth), for which the data were col-lected in 1994 and 1995.

29,30,34

Forty-four adolescents who lived with 2mothers were compared with 44 whowere raised by a mother and a father. No differences between the 2groups were found in peer relations,academic performance, personal adjustment, and health-related risk be-haviors; however, the parents’ sex-ual orientation was not speciﬁed in the Add Health survey, so the analy-ses may be confounded by the inclu-sion of women who live together butdo not identify as lesbian.

29,30,34

The US National Longitudinal LesbianFamily Study (NLLFS) was initiated in1986 to provide prospective data ona cohort of American lesbian fami-lies from the time the children wereconceived until they reach adult-hood.

21–27

At its inception, all NLLFSmothers identiﬁed as lesbian. In thisarticle, the psychological adjustmentof the 17-year-old NLLFS offspringwho were conceived through DI andreared in planned lesbian families iscompared through maternal reportswith those of an age-matched norma- tive sample of American teenagers.Within the NLLFS sample, we analyze the association of adolescent well-being as reﬂected in Child BehaviorChecklist (CBCL) scores with (1)sperm donor status (having a known,as-yet-unknown, or permanently un-known donor); (2) parental relation-ship continuity (whether the off-spring’s mothers are together orseparated); and (3) experiencesof stigma.

GARTRELL and BOS

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