Adolescent Health self-esteem, gender identity, or emotional health

By Live Dr - Wed May 20, 3:43 am

An analysis of multiple studies of 500 households shows that rearing children in a same-sex household does not affect the their self-esteem, gender identity, or emotional health, a Boston researcher reported.

“Pediatricians need to recognize that there are variations in families and learn what kind of advice to give them to optimize the child’s development,” said Ellen Perrin, MD, professor of pediatrics at Tufts-New England Medical Center in Boston, Massachusetts.

The researcher and colleagues looked at data from 15 studies evaluating possible stigma, teasing, social isolation, adjustment, sexual orientation, and strengths. The findings were presented here at the American Academy of Pediatrics National Conference and Exhibition.

“The vast consensus of the studies is that children of same-sex parents do as well as children whose parents are heterosexual in every way,” Dr. Perrin said. “In some ways, children of same-sex parents actually may have advantages over other family structures.”

It has been estimated that one to six million children are being reared by committed lesbian or gay couples in this country. Some children were born to a heterosexual couple and later raised by a same-sex couple; others were placed in foster homes, were adopted, or conceived through a surrogate mother through artificial insemination.

Previous studies of same-sex parenting have been criticized for being biased, but Dr. Perrin said the research team was extremely careful to select only solid, evidence-based research for review.

Based on nine studies from 1981 to 1994 of 260 children, aged three to 11 years, reared by either heterosexual mothers or same sex-mothers after divorce, the researchers found there was no difference in intelligence of the children, type or prevalence of psychiatric disorders, self-esteem, well-being, peer relationships, or parental stress. “The children all had a similar emotional experiences with divorce,” she said.

What they did find was that after divorce children being reared by lesbian mothers had more contact with fathers than children reared by divorced heterosexual mothers, Dr. Perrin said. “There are interesting suggestions that these children are more tolerant of differences.”

A separate longitudinal study of 37 children of 27 divorced lesbian mothers and an equal number of children with divorced heterosexual mothers found no differences in behavior, adjustment, gender identity, and peer relationships.

“What is exciting about this study was that they followed the children 11 years later when they became adults,” Dr. Perrin said. “But they still found no difference in adjustment, self-esteem, psychiatric or psychological problems, family relationships, or in identifying sexual orientation.”

Four other large studies of more than 100 couples that evaluated children either born or adopted into families found that same-sex parents were more likely to have contact with extended family for social support as well as a more equal division of labor in the home. However, children of same-sex parents did experience some stigmatization.

“The researchers found no differences in the parents other than that lesbian couples share household and child care tasks more equitably,” said Dr. Perrin. “The children of lesbian couples also appeared to be less aggressive, more nurturing to peers, more tolerant of diversity, and more androgynous,” playing with toys for both boys and girls.

A further analysis of the National Longitudinal Study of Adolescent Health used randomly selected representative data from 44 adolescents aged 12 to 18 years. The study compared children living with two women in a “marriage-like” relationship to teenagers living with two heterosexual parents.

The study showed that the adolescents were similar in intrapersonal adjustments such as self-esteem, depression, and anxiety. They also were similar in school success, family relationships, and neighborhood integration, Dr. Perrin said.

“What is striking is that there are very consistent findings in these studies,” she concluded. “But further study conducted in a long-term systematic manner in community samples needs to be conducted.”

Dr. Perrin pointed out that “as pediatricians we have a lot of different kinds of roles. We need to be extremely careful about confidentiality with these families and assure them that their family constellation won’t be broadcast. This will give us a better chance of learning more about the family and providing needed advice and discussing some of the issues.”

“This is valuable information,” Carol Berkowitz, MD, told Medscape. She is the immediate past president of the AAP and professor and executive vice chair in the Department of Pediatrics at Harbor-UCLA Medical Center in Torrance, California. “This subject evokes a lot of emotions that have influenced some studies. Some studies in the past were weighted based on nothing more than their own views.”

The value of this presentation is these are all evidence-based studies, Dr. Berkowitz said, adding this information will help pediatricians in their practices and for setting policy.

AAP 2005 National Conference and Exhibition: Concurrent Seminar F340. Presented Oct. 10, 2005.

Reviewed by Gary D. Vogin, MD

Young people feel better after sex.

Not earth-shattering news, you say?

Children’s Hospital Boston researcher Dr. Lydia A. Shrier, lead author of a study that reached that conclusion, understands why you’d react that way, but hear her out. She says that until we know what adolescents really think about sex, anyone trying to help them have safer sex — or no sex — might be wasting their time.

“If we don’t understand exactly how they feel around the time of sex, we’re going to miss the boat with our risk reduction or abstinence messages,” said Shrier, whose study appears in the Journal of Adolescent Health. “We all know that feelings are very much connected to how we behave.”

To assess young people’s emotions, Shrier’s team gave hand-held computers to 67 adolescents and young adults, 15 to 21 years old, and randomly beeped them at least every three waking hours for a week. A message would then pop up on the participants’ PDAs asking them how they were feeling and whether they had had sex since the previous page. To be in the study, the young people had to say they were sexually active.

That’s different from asking people what they think about sex or to remember later what they felt like at the time, Shrier emphasized. This nearly real-time report of how they felt makes the study different from previous work, including her own, she said.

“We examined real events in these kids’ lives as they were happening. We didn’t ask them to recall things or to select out a particular thing,” she said. “We asked them to monitor themselves with computers and respond to signals, so we were getting what was actually going on.”

The study also stands apart from surveys that asked adolescents their feelings about their first sexual experiences, which tended to be more negative than what the researchers found this time.

Policy makers need to pay attention, Shrier said.

“Without taking a political stance, I’d just say we all want people to ultimately be sexually healthy adults, whatever our beliefs are,” she said. “And whether we want kids to reduce sexual risk or be abstinent, we have to understand the feelings of the young people having sex.”

Posted by Elizabeth Cooney

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