Showing posts with label Stigma-Gay. Show all posts
Showing posts with label Stigma-Gay. Show all posts

January 17, 2019

Gay Fathers Face Major Stigma As Parents


(Reuters Health) - Even as parenting by same-sex couples becomes more common in the U.S., many gay men and their families still experience discrimination and are stigmatized by relatives, neighbors, salespeople and other members of their communities, a study suggests.

Creating families has gotten easier over the years for gay men. Medical advances have made it possible for them to father children through surrogacy, and more adoption and foster agencies have encouraged them to become parents to non-biological children. And the U.S. Supreme Court legalized gay marriage nationwide in 2015, advancing legal parenting rights for same-sex couples with children.

But almost two-thirds of gay fathers experience stigma based on their status as homosexual dads, and half of them avoid situations out of fear of mistreatment or discrimination, the current study found.

Their children experience stigma, too. One-third of gay fathers said their kids were stigmatized by other children, and one in five dads said their children had avoided forming friendships out of fear of mistreatment or discrimination.

“Legal protections today are much more expansive than they were a decade ago, which in turn means that the stigma faced by gay fathers - and, by extension, lesbian mothers - should be less than in the past,” said Brian Powell, a sociology researcher at Indiana University in Bloomington who wasn’t involved in the study.

“But these protections are not universally provided across all states,” Powell said by email.

For the study, researchers surveyed 732 gay fathers with 1,316 children in 47 states.

Researchers ranked states based on how many legal protections they offered to gay parents that covered things like marriage, civil unions, domestic partnerships, adoption, child custody and anti-bullying policies. 

Not surprisingly, gay fathers were more likely to report stigma affecting their lives in states with fewer legal protections. They also reported more active discrimination in states with fewer legal protections, particularly from family members and in religious settings.

Overall, about 35 percent of the families in the study were formed through adoption or foster care, 15 percent with the assistance of a pregnancy carrier or surrogate, and 39 percent through a heterosexual relationship.

Families in states with more legal protections for gay parents were more likely to be formed by surrogacy, while men in states with few legal protections were more likely to become fathers through heterosexual relationships, the study found.

Many fathers reported barriers to becoming parents. About 41 percent had difficulties with adoption and one-third encountered problems arranging custody of children born in heterosexual relationships.

The study can’t prove whether parenting status or sexual orientation directly impacts discrimination, and it wasn’t nationally representative.

Most participants were white, and it’s also possible that gay fathers from other racial or ethnic groups might report different experiences, Dr. Ellen Perrin of Tufts Medical Center in Boston and colleagues write in Pediatrics.

Even so, the results underscore that legalizing gay marriage in the U.S. hasn’t eliminated discrimination and stigma experienced by same-sex parents, said Julia Raifman, a researcher at the Boston University School of Public Health who wasn’t involved in the study.

“These findings suggest that stigma persists for gay fathers, who reported experiencing the most stigma in religious institutions, in restaurants, and from neighbors,” Raifman said by email. “In states with less equal rights, gay men who wish to become fathers may be less likely to be able to become a parent and those who do become parents are more likely to experience stigma directed toward them.”

SOURCE: Pediatrics, online January 14, 2019.

October 11, 2018

Stigma Against Gays Can Be Deadly



By Dhruv Khullar, M.D

I’ve never been sure what to expect when meeting someone who’s just tried to take his own life. But I’ve learned to stop expecting anything. 

Sometimes, the person in front of me barely speaks, staring right through me, lost in a deep catatonic depression. Sometimes he or she can’t stop talking, breathlessly describing what happened as if we’re gossiping at brunch after an hour of SoulCycle.

Yesterday, my patient, a 20-something graduate student, swallowed a jumble of unmarked pills, hoping to die, after his father told him never to come home again. Today, he greeted me with a soft smile, his delirium starting to clear, his heart beating normally again.

“Whoops,” he said.

He’d been a happy kid who aimed to please. He once felt so bad for lying about having done his homework before playing video games, he told me, that he’d grounded himself. Sociable but square, he didn’t drink until he was 21, even though he’d gone to a college with a reputation for partying. Deeply religious, he was gay but desperately wanted not to be.

Now his father’s disavowal pushed him over the edge, capping a string of stigmatizing experiences at home, at school, and at church. He’d had enough.

For decades, we’ve known that lesbian, gay, bisexual and transgender individuals experience a range of social, economic and health disparities — often the result of a culture and of laws and policies that treat them as lesser human beings. They’re more likely to struggle with poverty and social isolation. They have a higher risk of mental health problems, substance use and smoking. Sexual minorities live, on average, shorter lives than heterosexuals, and L.G.B.T. youth are three times as likely to contemplate suicide, and nearly five times as likely to attempt suicide.

Some of these disparities have interpersonal roots: social exclusion, harassment, internalized homophobia. But often they stem from an explicit denial of rights: same-sex marriage bans, employment discrimination, denial of federal benefits. Discrimination in any form can have serious health consequences: Sexual minorities living in communities with high levels of prejudice die more than a decade earlier than those in less prejudiced communities.

But civil rights advances and growing public acceptance of L.G.B.T. individuals in recent years are among the more transformative social changes in modern American history. And evidence increasingly suggests this shift has measurably improved health care access and health outcomes for L.G.B.T. populations.

The halting, patchwork nature of L.G.B.T. rights expansions across the country has allowed researchers to study the effects on health and well-being by comparing states that expanded rights to those that failed to introduce protections or actively curtailed them. Since Vermont became the first state to formally recognize same-sex partnerships in 2000, many other states either legalized same-sex marriage or conversely, passed constitutional amendments banning it — until the landmark 2015 Supreme Court decision in Obergefell v. Hodges required all 50 states to recognize same-sex marriage

After Massachusetts legalized same-sex marriage in 2003, mental health visits dropped significantly for gay men across the state. Other states that followed suit saw a 7 percent reduction in suicide attempts among L.G.B.T. adolescents. Nationwide, legalization of same-sex marriage is linked to increases in the likelihood that gay men have health insurance and a regular doctor to see.

By contrast, in states that passed same-sex marriage bans in 2004 and 2006, L.G.B.T. individuals experienced a marked rise in mental health problems, including anxiety, alcohol use and mood disorders. (No such increase was found in neighboring states that did not pass bans.)

Sometimes health happens in the hospital room. Sometimes it happens in a courtroom.

But it’s more than just marriage. L.G.B.T. individuals who live in states where it’s legal for businesses to deny people service based on their sexual orientation have a higher risk for mental health problems. One study found a 46 percent increase in the proportion of sexual minorities reporting depression, anxiety and other emotional problems in states that passed denial-of-service laws. Again, no increase was observed in states without these laws.

But there’s reason to believe progress in L.G.B.T. health may be imperiled by a political and social environment that is growing less friendly toward sexual minorities. More states are trying to pass “religious liberty” laws that allow for discrimination based on gender and sexual identity. Several federal health surveys will no longerinclude questions about sexual orientation, making it more difficult for researchers to study disparities. And the Trump administration recently established a new division in the Department of Health and Human Services to defend health professionals who refuse to provide care to people or in situations that conflict with their personal beliefs, which could include the right to treat L.G.B.T. individuals. (L.G.B.T. patients already face discrimination at concerning rates: Nearly 10 percent of gays and lesbians — and 30 percent of transgender individuals — say they’ve been refused care because of their sexual orientation or gender identity.)

I think of my young patient in the hospital bed who had attempted to kill himself. I remember the pain that remained even as the toxins he ingested left his body. And I worry that a new wave of anti-L.G.B.T. rhetoric and policy will mean that he — and people who love like him — will end up feeling more stigmatized, in poorer health, or no longer with us at all.

Dhruv Khullar, M.D., M.P.P. (@DhruvKhullar) is a physician at NewYork-Presbyterian Hospital, an assistant professor in the departments of medicine and health care policy at Weill Cornell, and director of policy dissemination at the Physicians Foundation Center for Physician Practice and Leadership. 

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