American College of Pediatricians – March 2013

ABSTRACT: Are children reared by two individuals of the same gender as well adjusted as children reared in families with a mother and a father? Until recently the unequivocal answer to this question was “no.” Within the last decade, however, professional health organizations1, academics, social policymakers and the media have begun asserting that prohibitions on parenting by homosexual couples should be lifted. In making such far-reaching, generation-changing assertions, any responsible advocate would rely upon supporting evidence that is comprehensive and conclusive. Not only is this not the situation, but also there is sound evidence that children exposed to the homosexual lifestyle may be at increased risk for emotional, mental, and even physical harm.

Biology matters
Over thirty years of research confirms that children fare best when reared by their two biological parents in a loving low conflict marriage. Children navigate developmental stages more easily, are more solid in their gender identity, perform better academically, have fewer emotional disorders, and become better functioning adults when reared within their natural family.2,3,4,5,6,7,8 This is, in part, because biology contributes to parent-child bonding.9

While single parenthood, adoption, and remarriage are each loving responses to failure of the natural family, children reared in these settings face unique challenges.9,10 Single parents face greater financial challenges and time constraints. Consequently, children of single mothers often spend significantly less time with both biological parents. Children within step-families can experience difficulties forging a relationship with the stepparent, and be faced with a sense of divided loyalties. Every adopted child must come to terms with a sense of rejection from her biologic parents and a longing to know her roots. While not insurmountable, these challenges can have a negative impact on a child’s development.9,10 Clearly apart from rare situations, depriving a child of one or both biologic parents, as homosexual parenting requires in every case, is unhealthy.

Children need a mother and a father
There are significant innate differences between male and female that are mediated by genes and hormones and go well beyond basic anatomy. These biochemical differences are evident in the development of male and female brain anatomy, psyche, and even learning styles.11 Consequently, mothers and fathers parent differently and make unique contributions to the overall development of the child.11,12,13 Psychological theory of child development has always recognized the critical role that mothers play in the healthy development of children. More recent research reveals that when fathers are absent, children suffer as well. Girls without fathers perform more poorly in school, are more likely to be sexually active and become pregnant as teenagers. Boys without fathers have higher rates of delinquency, violence, and aggression.12,13

Gender-linked differences in child rearing styles between parents are complementary and protective for children. Erik Erikson was among the first to note that mother-love and father-love are qualitatively different. Mothers are nurturing, expressive, and more unconditional in their love for their children. Father-love, by contrast, often comes with certain expectations of achievement.13 Subsequent research has consistently revealed that parenting is most effective when it is both highly expressive and highly demanding. This approach to parenting “provides children with a kind of communion characterized by inclusiveness and connectedness, as well as the drive for independence and individuality [which is] virtually impossible for a man or woman alone to combine effectively.”13

Gender differences are also reflected in the way mothers and fathers use touch with their children. Mothers frequently soothe, calm, and comfort with touch. Fathers are more likely to use touch to stimulate or excite their children during play. Mothers tend to engage with children on their level providing opportunities for children to take charge and proceed at their own pace. As fathers engage in rough and tumble play, they take on a teaching role like that of a coach. Roughhousing between fathers and sons is associated with the development of greater self-control in adolescent boys.13

Gender-linked diversity is also observed in parental approaches to discipline. “The disciplinary approaches of fathers tend toward firmness, relying on rules and principles. The approach of mothers tends toward more responsiveness, involving more bargaining, more adjustment toward the child’s mood and context, and is more often based on an intuitive understanding of the child’s needs and emotions of the moment.”13 Consequently, being reared by a mother and a father helps sons and daughters moderate their own gender-linked inclinations. Boys generally embrace reason over emotion, rules over relationships, risk-taking over caution, and standards over compassion. Girls generally place greater emphasis on emotional ties, relationships, caution, and compassion. Over time opposite-sexed parents demonstrate to their children the value of opposing tendencies.

Research on homosexual parenting
Studies that appear to indicate neutral to favorable child outcomes from homosexual parenting have critical design flaws. These include non-longitudinal design, inadequate sample size, biased sample selection, lack of proper controls, failure to account for confounding variables, and perhaps most problematic – all claim to affirm the null hypothesis.14,15,16 Therefore, it is impossible for these studies to provide any support for the alleged safety or potential benefits to children from same-sex parenting.

Data on the long-term outcomes of children placed in homosexual households is sparse and gives reason for concern.17 This research has revealed that children reared in homosexual households are more likely to experience sexual confusion, engage in risky sexual experimentation, and later adopt a homosexual identity.18,19,20,21,22 This is concerning since adolescents and young adults who adopt the homosexual lifestyle are at increased risk for mental health problems, including major depression, anxiety disorders, conduct disorders, substance dependence, and especially suicidal ideation and suicide attempts.23

Risks of the homosexual lifestyle to children
Finally, research has demonstrated considerable risks to children exposed to the homosexual lifestyle. Violence between homosexual partners is two to three times more common than among married heterosexual couples.24,25,26,27,28 Homosexual partnerships are significantly more prone to dissolution than heterosexual marriages with the average homosexual relationship lasting only two to three years. 29,30,31 Homosexual men and women are reported to be promiscuous, with serial sex partners, even within what are loosely-termed “committed relationships.” 32,33,34,35,36
Individuals who practice a homosexual lifestyle are more likely than heterosexuals to experience mental illness 37,38,39, substance abuse 40, suicidal tendencies41,42 and shortened life spans.43 Although some would claim that these dysfunctions are a result of societal pressures in America, the same dysfunctions exist at inordinately high levels among homosexuals in cultures where the practice is more widely accepted.44

In summary, tradition and science agree that biological ties and dual gender parenting are protective for children. The family environment in which children are reared plays a critical role in forming a secure gender identity, positive emotional well-being, and optimal academic achievement. Decades of social science research documents that children develop optimally when reared by their two biological parents in a low conflict marriage. The limited research advocating child-rearing by homosexual parents has severe methodological limitations. There is significant risk of harm inherent in exposing a child to the homosexual lifestyle. Given the current body of evidence, the American College of Pediatricians believes it is inappropriate, potentially hazardous to children, and dangerously irresponsible to change the age-old prohibition on homosexual parenting, whether by adoption, foster care, or reproductive manipulation. This position is rooted in the best available science.

Originally posted January 22, 2004
Revised March 26, 2009

©2009 American College of Pediatricians

1.  American Academy of Pediatrics, “Co parent or Second-Parent Adoption by Same-Sex Parents,” Pediatrics. 109(2002): 339-340.
2.  Heuveline, Patrick, “Shifting Childrearing to Single Mothers: Results from 17 Western Countries, “Population and Development Review 29, no.1 (March 2003) p. 48.
3. Kristen Andersen Moore, “Marriage from a Child’s Perspective: How Does Family Structure Affect Children and What Can We Do About It?” (Washington, D.C.: Child Trends, Research Brief, June 2002) pp.1-2.
4.  Sara McLanahan and Gary Sandfeur, Growing Up with a Single Parent: What Hurts, What Helps (Cambridge: Harvard University Press, 1994), p. 45.
5. Sotirios Sarantakos, “Children in Three Contexts: Family, Education, and Social Development,” Children Australia, vol. 21 (1996): 23-31.
6. Jeanne M. Hilton and Esther L. Devall, “Comparison of Parenting and Children’s Behavior in Single-Mother, Single-Father,
and Intact Families,” Journal of Divorce and Remarriage 29 (1998): 23-54.
7. Elizabeth Thomson et al., “Family Structure and Child Well-Being: Economic Resources vs. Parental Behaviors,” SocialForces 73 (1994): 221-42.
8. David Popenoe, Life Without Father (Cambridge: Harvard University Press, 1996), pp. 144, 146.
9. Glenn Stanton Why Marriage Matters (Colorado Springs: Pinon Press, 1997) p. 97-153.
10. SchneiderB, AtteberryA, Owens A. Family Matters: Family Structure and Child Outcomes. Birmingham, AL: Alabama Policy Institute;2005:1-42.Available at
11. Sax, Leonard. Why Gender Matters: What Parents and Teachers Need to Know About the Emerging Science of Sex Differences (New York: Doubleday, 2005).
12. Blankenhorn, David. Fatherless America. (New York: Basic books, 1995).
13. Byrd, Dean. “Gender Complementarity and Child-rearing: Where Tradition and Science Agree,” Journal of Law & Family Studies, University of Utah, Vol. 6 no. 2, 2005.
14. Robert Lerner, Ph.D., Althea Nagai, Ph.D. No Basis: What the Studies Don’t Tell Us About Same Sex Parenting, Washington DC;Marriage Law Project/Ethics and Public Policy Center, 2001.
15. P. Morgan, P. Morgan Children as Trophies? Examining the Evidence on Same-Sex Parenting, Newcastle upon Tyne, UK; Christian Institute, 2002.
16. J. Paul Guiliani and Dwight G. Duncan, “Brief of Amici Curiae Massachusetts Family Institute and National Association
for the Research and Therapy of Homosexuality,” Appeal to the Supreme Court of Vermont, Docket No. S1009-97CnC.
17. American Academy of Pediatrics, Perrin, EC, and the committee on psychosocial aspects of child and family health. “Technical report: Co parent or Second-Parent Adoption by Same-Sex Parents,” Pediatrics. 109(2002): 343. The Academy acknowledges that the “small, non-representative samples … and the relatively young age of the children suggest some
18. F. Tasker and S. Golombok, “Adults Raised as Children in Lesbian Families,” American Journal of Orthopsychiatric Association, 65 (1995): 213.
19.  J. Michael Bailey et al., “Sexual Orientation of Adult Sons of Gay Fathers,” Developmental Psychology 31 (1995): 124-129.
20. Ibid., pp.127,128.
21. F. Tasker and S. Golombok, “Do Parents Influence the Sexual Orientation of Their Children?” Developmental Psychology 32 (1996): 7.
22. Judith Stacey and Timothy J. Biblarz, “(How) Does the Sexual Orientation of Parents Matter,” American Sociological Review 66 (2001): 174, 179.
23. Judith Stacey and Timothy J. Biblarz, “(How) Does the Sexual Orientation of Parents Matter,” American Sociological Review 66 (2001): 174, 179.
24. Gwat Yong Lie and Sabrina Gentlewarrier, “Intimate Violence in Lesbian Relationships: Discussion of Survey Findings and Practice Implications,” Journal of Social Service Research 15 (1991): 41-59.
25. D. Island and P. Letellier, Men Who Beat the Men Who Love Them: Battered Gay Men and Domestic Violence (New York: Haworth Press, 1991), p. 14.
26. Lettie L. Lockhart et al., “Letting out the Secret: Violence in Lesbian Relationships,” Journal of Interpersonal Violence 9 (1994): 469-492.
27. “Violence Between Intimates,” Bureau of Justice Statistics Selected Findings, November 1994, p. 2.
28. Health Implications Associated With Homosexuality (Austin: The Medical Institute for Sexual Health, 1999), p. 79.
29. David P. McWhirter and Andrew M. Mattison, The Male Couple: How Relationships Develop (Englewood Cliffs:Prentice-Hall, 1984), pp. 252-253.
30. Saghir and E. Robins, Male and Female Homosexuality (Baltimore: Williams & Wilkins, 1973), p. 225; L.A. Peplau
and H. Amaro, “Understanding Lesbian Relationships,” in Homosexuality: Social, Psychological, and Biological Issues, ed. J. Weinrich and W. Paul (Beverly Hills: Sage, 1982).
31. M. Pollak, “Male Homosexuality,” in Western Sexuality: Practice and Precept in Past and Present Times, ed. P. Aries and A. Bejin, translated by Anthony Forster (New York, NY: B. Blackwell, 1985), pp. 40-61, cited by Joseph Nicolosi in Reparative Therapy of Male Homosexuality (Northvale, New Jersey: Jason Aronson Inc., 1991), pp. 124, 125.
32. A. P. Bell and M. S. Weinberg, Homosexualities: A Study of Diversity Among Men and Women (New York: Simon and Schuster, 1978), pp. 308, 309; See also A. P. Bell, M. S. Weinberg, and S. K. Hammersmith, Sexual Preference (Bloomington: Indiana University Press, 1981).
33. Paul Van de Ven et al., “A Comparative Demographic and Sexual Profile of Older Homosexually Active Men,” Journal
of Sex Research 34 (1997): 354.
34. A. A. Deenen, “Intimacy and Sexuality in Gay Male Couples,” Archives of Sexual Behavior, 23 (1994): 421-431.
35. “Sex Survey Results,” Genre (October 1996), quoted in “Survey Finds 40 percent of Gay Men Have Had More Than 40 Sex Partners,” Lambda Report, January 1998, p. 20.
36. Marie Xiridoui, et al., “The Contribution of Steady and Casual Partnerships to the Incidence of HIV infection among
Homosexual Men in Amsterdam,” AIDS 17 (2003): 1029-1038. [Note: one of the findings of this recent study is that those classified as being in “steady relationships” reported an average of 8 casual partners a year in addition to their partner (p.1032)] 37. J. Bradford et al., “National Lesbian Health Care Survey: Implications for Mental Health Care,” Journal of Consulting and Clinical Psychology 62 (1994): 239, cited in Health Implications Associated with Homosexuality, p. 81.
38. Theo G. M. Sandfort, et al., “Same-sex Sexual Behavior and Psychiatric Disorders,” Archives of General Psychiatry 58
(January 2001): 85-91.
39. Bailey, J. M. Commentary: Homosexuality and mental illness. Arch. Gen. Psychiatry. 56 (1999): 876-880. Author states, “These studies contain arguably the best published data on the association between homosexuality and psychopathology, and both converge on the same unhappy conclusion: homosexual people are at substantially higher risk =for some form of
emotional problems; including suicidality, major depression, and anxiety disorder, conduct disorder, and nicotine
40. Joanne Hall, “Lesbians Recovering from Alcoholic Problems: An Ethnographic Study of Health Care Expectations,”
Nursing Research 43 (1994): 238-244.
41. R. Herrell et al., “Sexual Orientation and Suicidality, Co-twin Study in Adult Men,” Archives of General Psychiatry 56 (1999): 867-874.
42. Vickie M. Mays, et al., “Risk of Psychiatric Disorders among Individuals Reporting Same-sex Sexual Partners in the National Comorbidity Survey,” American Journal of Public Health, vol. 91 (June 2001): 933-939.
43. Robert S. Hogg et al., “Modeling the Impact of HIV Disease on Mortality in Gay and Bisexual Men,” International Journal of Epidemiology 26 (1997): 657.
44. Sandfort, T.G.M.; de Graaf, R.; Bijl, R.V.; Schnabel. Same-sex sexual behavior and psychiatric disorders. Arch. Gen. Psychiatry. 58 (2001): 85-91.