Gay and Lesbian Parents

Abstract

To the Editor. I applaud the efforts of Perrin and Kulkin1 to call the attention of pediatricians to the unique concerns of gay and lesbian parents. I, myself, consider it an honor when such parents not only entrust their child's pediatric care to me but also reveal their sexual orientation, a still-risky venture in our society.One statement in the introductory section of that article, however, bothers me, and I believe it is worth elaborating on my disquietude because I suspect that the depth and the complexity of family issues surrounding gay and lesbian parenthood are unfamiliar to many pediatricians. The statement reads as follows:The overall point of the statement—that there is a wide diversity in routes by which gays and lesbians might attain parenthood—is important but the examples cited to denote the range are unlikely in the first instance and insensitive in the second. I doubt there are many wholly symmetrical, apparently heterosexual couples who divorce after each uncovers a same-sex preference, each then easily assimilating into an alternative lifestyle, but that point is arguable. Of greater concern to me is that a husband or wife who has difficulty accepting a spouse's “recently acknowledged homosexuality” may struggle and manifest anger over the destruction of a marriage relationship, oftentimes with children involved, because of an unforeseen and complicated reason over which either party had little or no control. I would urge caution in labeling the “unaccepting” spouse “homophobic.”2To the Editor. Given the authors' goal of promoting compassionate health care for these children, it is unfortunate that they use the term “homophobic” to describe health care providers and other persons involved in the care of these children. This tends to alienate the very people they would like to reach. Such a perjorative and inaccurate term as “homophobic” merits no place in the medical literature. Persons who do not agree with a lesbian or gay world view are generally not “phobic.” They may, however, disagree on moral or psychodynamic grounds. This term also does a disservice to other people who struggle with medically recognized phobias, suggesting that their struggles are due to some sort of moral failure. Persons seeking understanding and compassion would be well served by not deriding others with this stereotypical language.In Reply. I appreciate the two above reminders about the importance of careful use of language. Homophobia is indeed an inadequate term to describe the wide range of negative effects held frequently with regard to homosexuals and homosexuality. Although I do believe that there is an element of fear and anxiety in the disapproval that some people feel about nonheterosexual orientations, the range of disapprobation is broader. Some people may have a moral or religious objection to homosexuality, others may disapprove on grounds of medical risk, and others may be uncomfortable simply with the unfamiliarity of forms of sexual activity different from their own. Although we are sorry to have offended Dr Hammer, we are unaware of a more appropriate term to summarize the range of both subtle and explicit disapproval that people who are not heterosexual in orientation fear and experience from health care providers, as well as from other people with whom they interact.We agree with Dr Rockney's caution that there are a great many factors influencing children and their parents in the wake of divorce. Certainly, the sexual orientation of each parent is only one of these factors, and not necessarily the most salient one. Our effort in the paragraph he quotes was to present two extremes (with each of which we have had clinical experience). As Dr Rockney points out, the betrayal involved in a failed intimate relationship may have nothing whatever to do with homophobia, or may include it to varying degrees. We appreciate Dr Rockney's pointing out some of the complexity that we may inadvertently have skimmed over too lightly.