Carol Boyer. Handbook of Adoption: Implications for Researchers, Practitioners, and Families. Editor: Rafael A Javier, Amanda L Baden, Frank A Biafora, Alina Camacho-Gingerich. Sage Publication. 2007.

Lesbian, gay, and bisexual (LGB) people form families in various ways, through stepparenting, adoption, foster parenting, surrogacy, and donor insemination, each of which presents a unique set of issues to be addressed (Crespi, 2001; Matthews & Lease, 2000). For the lesbian or gay adoptive family, the usual challenges of adoption are compounded by the ambivalent attitudes of adoption professionals; the social stigma attached to being gay or lesbian; the legal complexity of forming, maintaining, and protecting nontraditional families; and the internalized homophobia of lesbians and gay men who choose to parent (Crawford, McLeod, Zamboni, & Jordan, 1999; Crespi, 2001; Martin, 1993; Matthews & Lease, 2000; Ossana, 2000; Saffron, 1998; Strickland, 1995).

Impact of Professionals’ Attitudes

Attitude plays an important role in forming a positive working relationship with any client, but for mental health professionals who work with the LGB community, attitude has been shown to be a key factor in client perceptions of counselor helpfulness (Liddle, 1996). For these practitioners, it is not enough to be “neutral” toward their clients’ sexual orientation; rather, researchers hold that the most beneficial therapeutic relationships are ones in which the counselor views LGB orientations as normative, thereby avoiding the tendency to judge clients’ lives and relationships through a heterosexist lens (Matthews & Lease, 2000; Morrow, 2000; Ossana, 2000).

While a majority of psychologists report positive attitudes toward gay and lesbian parenting (Crawford et al., 1999), adoption by gays and lesbians is still controversial, and adoption professionals themselves seem to be divided. Some professionals continue to express concern over the possibility of sexual or physical abuse of children—particularly by gay men—as well as the general suitability of gay and lesbian parents to serve as role models for children. These attitudes persist despite a considerable body of evidence showing that children of gay and lesbian parents have no increased risk for physical or sexual abuse, no significant differences in psychological development or emotional adjustment, and no greater chance of becoming lesbian or gay than children raised by heterosexual parents (Allen & Burrell, 1996; Bigner, 1999; Golombok & Tasker, 1996; Mallon, 2000; Martin, 1993; Saffron, 1998; Strickland, 1995).

Stigma and Identity

There is no question that being gay or lesbian places the individual in a stigmatized group. Lesbians and gay men often have a painful, problematic time growing up due to the hostility of mainstream society toward their sexual orientation (Bozett & Sussman, 1989). As a result of this stigma, they may experience isolation, ostracism, and anger as they internalize their oppression (Richardson, Rayes, & Rabow, 1998). Identity development, therefore, is a central challenge to growing up gay or lesbian as these individuals must develop the tools and coping mechanisms necessary to embark on a conscious, deliberate journey of self-discovery in which they can reconstruct a positive gay or lesbian identity based on self-definition, rather than the negative, stereotyped characteristics assigned to them by mainstream society (Fein & Nuehring, 1981; Martin, 1993). Individuals who come out later in life, after being heterosexually married, may struggle with additional identity issues around giving up a privileged, heterosexual identity to identify with a stigmatized, homosexual one (Matthews & Lease, 2000).

Lesbian and gay individuals or couples who wish to adopt must prepare themselves, and later, their adopted child or children, to face an additional loss of privilege. For lesbians and gay men, who are already stigmatized on the basis of their sexual orientation, becoming an adoptive family creates a second layer of stigma, because adoption is often perceived as an inferior way to form a family (Brodzinsky, Schechter, & Henig, 1992; Brodzinsky, Smith, & Brodzinsky, 1998; Pavao, 1998). The child who is adopted by a same-sex couple, then, must not only struggle with the “differentness” experienced by all adopted children (Mallon, 2000) but also incorporate another layer of identity as the child of lesbian or gay parents.

Balancing multiple identities is a significant source of anxiety and stress for LGB families, and counselors must be sensitive to the possibility of multiple oppressions. To practice ethically with this population, counselors should honestly examine their own biases about how family is defined, including the formation of families of choice, and educate themselves about the availability of appropriate resources and support services for nontraditional families. Likewise, counselors must be aware of the legal status of LGB families in the state in which they practice, and they must familiarize themselves with appropriate resources on which to draw (Matthews & Lease, 2000).

Family of Origin Support

Coming out to one’s family of origin is a major milestone on the gay or lesbian person’s journey of self-discovery and can be complicated by the shame of internalized oppression as well as fear of rejection (Richardson et al., 1998). Families of origin may be split in their willingness to accept a member’s orientation, particularly if their negative feelings are rooted in deeply held religious values (Matthews & Lease, 2000). A family that is forced to confront a member’s homosexuality may suddenly identify itself as defective and may need to struggle to reidentify itself as healthy (Bozett & Sussman, 1989). However, despite the shock and subsequent necessary adjustment, many families ultimately come to accept a member’s gay or lesbian identity and are able to be supportive to some degree (Martin, 1993).

Sharing one’s decision to parent, however, is often an entirely different matter and may be met with a wide range of emotions from enthusiasm, reservation, apprehension, or ambivalence to shock, anger, or even shame from family-of-origin members. Negative reactions may be all the more painful for the lesbian or gay family member when contrasted with the unadulterated joy with which the same news is received when it comes from a heterosexual sibling (Martin, 1993; Matthews & Lease, 2000). The family’s reaction may depend, in large part, on how fully they processed the initial coming out of the gay or lesbian family member and whether or not that information was subsequently shared with extended family and friends. If the family was accepting but kept the information private, then accepting and acknowledging the grandchild may force the rest of the family to “come out” in a way that simply having a gay or lesbian family member did not. To smooth the process, gay men and lesbians must plan ahead in ways that their heterosexual siblings do not, both by coming out (ideally) several years before announcing their plans to parent and by sharing such plans with their family well in advance of the child’s arrival (Martin, 1993).

Social Support

Although an individual or couple’s desire to parent is not related to sexual orientation (Mallon, 2000), lesbians and gay men encounter a considerable amount of social prejudice as they seek to form families (Crespi, 2001). Gay men, particularly, have a difficult time finding social support for their desire to parent, because the idea of a man in the primary parental role challenges the gender stereotype of women as the primary nurturers and caregivers of children. Furthermore, gay men, who may not be traditionally “masculine” in other ways, will have their ability to parent called into question on the basis of their nonconformity to gender roles at multiple levels (Mallon, 2000; Martin, 1993).

Having a gay or lesbian sexual orientation is often perceived as incompatible with child-rearing, and in fact, the level of internalized homophobia experienced by some gay and lesbian individuals may be so intense that they feel themselves unfit to parent or undeserving of having a child. Because gay men and lesbians still cannot legally marry in most states, the rituals and role models that help legitimize heterosexual family forms are denied to them, leaving them to create these new family forms without the public acknowledgment afforded to their more traditional counterparts (Lynch & Murray, 2000; Matthews & Lease, 2000; Ossana, 2000; Saffron, 1998). They may be further dismayed to find that the gay community, in which they have always found support for their sexual orientation and in which they may have a considerable investment in terms of time, energy, and friendships, is not so supportive of their decision to parent (Bigner, 1999; Martin, 1993; Matthews & Lease, 2000).

For these reasons, gay and lesbian families may find that they need to be more involved with the heterosexual community than they are used to, in order to find the support they need as parents, as well as opportunities for their children to socialize. Yet there is a need for them to stay connected to the gay community and make an effort to find gay and lesbian families so that their children can learn that families come in diverse forms and that their own family is legitimate and normal. This can be particularly difficult for LGB families of color because they are less numerous within the gay community. Ultimately, gay and lesbian families may need to exercise a good deal of creativity in finding adequate support for themselves and their children and may find that they cannot meet all their needs in one place (Martin, 1993).

Legal Issues

When heterosexual couples marry and start a family, they do so secure in the knowledge that they have the full support of society and the law. For gay and lesbian couples, however, the process is not nearly so straightforward due to their greater legal vulnerability (Lynch & Murray, 2000). Heterosexuals rarely need to obtain legal counsel before bringing children into their families, whether through birth or adoption, because existing family laws were created specifically with them in mind. Gay and lesbian couples, on the other hand, may form their families through adoption, surrogacy, or donor insemination and must have expert legal advice on their rights—or lack of them—in each of these situations (Martin, 1993).

Because adoption laws vary from state to state and most have no legal recognition of same-sex unions, it is often the case that only one partner can be the child’s legal parent. This situation creates a “legal limbo” for the nonlegal parent and an extra level of vulnerability, should the union later dissolve (Lynch & Murray, 2000; Mallon, 2000; Martin, 1993; Matthews & Lease, 2000; Ossana, 2000; Zicklin, 1995). Despite the fact that 96% of U.S. counties have at least one gay or lesbian couple with minor children living at home, only seven states and the District of Columbia have enacted laws that support adoption by same-sex couples (Urban Institute, 2003). This means that same-sex couples must execute multiple, complicated legal documents to try to ensure the same legal protections that heterosexual couples can take for granted (Martin, 1993).

For example, if one partner in a married, heterosexual couple becomes incapacitated through illness or injury, the other is automatically authorized to make medical decisions on his or her behalf and to act in the best interests of any children they have together. Partners in a same-sex couple, however, must execute a durable power of attorney—and be able to produce it on demand— to be legally empowered to make medical decisions for each other in an emergency. However, these documents are not universally honored, so even with such documentation, equal protection is not guaranteed. Furthermore, if the incapacitated partner is the sole legal parent of any child (or children) the couple has, the remaining partner has no legal status as a parent and may lose custody if the legal parent dies. Coparenting agreements can help ease such situations by demonstrating a couple’s intent to parent their children together, but such documents are not legally enforceable and may or may not be honored in a court of law (Martin, 1993).

In most cases, the best way for a same-sex couple to protect their children is through a second-parent adoption, although these are not legal for same-sex couples in every state. As of April 2000, second-parent adoptions by unmarried partners have been granted in only 21 states and the District of Columbia (National Adoption Information Clearinghouse [NAIC], 2000). In some states, the legal definition of a parent is limited to the individual who either is biologically related to the child or performed the initial adoption. However, a second-parent adoption, where available, protects the rights of both parents and allows both of them to claim the child as a dependent for tax purposes, provide health insurance to the child from their employers, take a child to the hospital for emergency care, and share child custody and support, should their union later dissolve. Without a second-parent adoption, none of these rights and protections is available for same-sex families (Martin, 1993).

In addition to the legal issues surrounding primary- and second-parent adoption, two other significant areas of legal concern for same-sex couples are donor insemination and surrogacy. Lesbian couples wishing to conceive by alternative insemination, whether with a known donor or an unknown donor, should seek professional legal advice regarding the pertinent laws in their state. Current laws regarding alternative insemination were written to protect the legal paternity of the husbands in heterosexual marriages, and in a judge’s opinion may or may not apply to a lesbian woman and her partner, who most likely will not be legally married to each other. For this reason, a donor agreement is highly advisable; however, it should be noted that such a document is not legally enforceable. In addition, any deviation from the original parameters of the agreement that affords the sperm donor greater involvement in the child’s life may change his status, in the eyes of the law, to that of a legal father and may entitle him to visitation or even custody. By the same token, gay men wishing to become fathers through surrogacy must obtain legal counsel beforehand because surrogacy is illegal in some states. In other states, it is only illegal if the woman receives payment, although it may be permissible to cover medical and some other expenses. Surrogacy arrangements, even more than those for alternative insemination, are fraught with extreme legal complexity and confusion and should always include a surrogacy agreement, although, again, these documents are not legally enforceable, should the woman change her mind during the pregnancy or even after the child is born (Martin, 1993).

Gay couples considering surrogacy should also consider the fact that, unlike a sperm donor, a woman acting as a surrogate cannot be anonymous, which could have an impact on the child’s sense of identity, as well as his or her wish to search for biological roots. No matter which route a couple takes to parenthood, whether through direct adoption, alternative insemination, or surrogacy, adoption is likely to be involved in one form or another, wherever it is legal, and both prospective parents and counselors would be well-advised to fully consider the implications of each choice before making a final decision.

Impact of Infertility

Perhaps the most profound set of issues to be faced before deciding to adopt are those surrounding infertility (Brodzinsky et al., 1992; Brodzinsky et al., 1998; Crespi, 2001; Pavao, 1998). For lesbians, this is an especially complicated issue and will require sensitivity and patience on the part of the counselor. Many lesbians contemplating motherhood encounter internalized homophobia and have a difficult time feeling “entitled” to a child. Failure to conceive may heighten a woman’s feelings of being “defective” and may spark a resurgence of her early awareness of her own differentness as well as the impact of negative sociocultural messages she may have internalized about being lesbian. Furthermore, unlike in heterosexual marriages, a lesbian partner’s infertility does not necessarily rule out the possibility of a biological child, so not only must a lesbian who is infertile process the usual feelings of loss, grief, shame, and inadequacy, she may also have to work through the conflict of wanting to support her partner’s giving birth when she herself cannot. Grieving one’s own infertility under such circumstances can be a lengthy and complicated process. Because of this complex intersection of factors, lesbian couples are just as likely to be divided in their decision to become parents as they are to agree at the outset, and one partner will often persuade the other over a period of time (Crespi, 2001).

Socially, infertile lesbians are not a well-supported group. Even the woman’s other lesbian friends may not understand why she continues to struggle to conceive, once she does not do so easily. Extensive, painful fertility testing and surgical procedures can disrupt a woman’s professional and home lives to such a degree that she begins to question her desire to become a mother. For the partners of these women, the only available support groups may be heterosexual, and the supportive partner may find herself in a support group for “husbands” that fails to address her particular situation (Martin, 1993).

For some lesbian couples, however, adoption is the first choice. The reasons for this vary from couple to couple but include each parent having an equal connection to the child, providing a loving home to a child in need, having personal experience with adoption, one or both partners having an adverse medical history, and the ability to choose the child’s gender. Once the couple has agreed to adopt, there are other choices to be made, including the ethnicity of the child (particularly for interracial couples) and, depending on the state of residence, which partner will be the child’s legal parent (Crespi, 2001).

Counselors must be sensitive to the ways in which the sexual orientation and identity development of lesbian clients affect their experience of infertility, as well as their readiness to move toward a decision to adopt. The couples’ multicultural identities will be a critical element in the decisions they make as well as their eventual experience of becoming an adoptive family.

Advantages of Having Gay or Lesbian Parents

Despite the considerable hostility, prejudice, and discrimination experienced by lesbian and gay individuals and couples who parent, studies involving the children of same-sex parents highlight a number of advantages to having gay or lesbian parents. First, lesbians and gay men tend to do a great deal of soul-searching regarding their desire and aptitude for parenting (Crespi, 2001; Martin, 1993). Many explore these issues in a tangible way by first entering the foster care system to confirm their desire to parent as well as to prove to themselves and others that they are up to the task. Because gay men and lesbians put such forethought into the decision to parent, virtually every child is wanted and planned for (Martin, 1993). Due to the nature of their relationship, gay and lesbian couples are already prepared for one of them not having a biological relationship to any child they may have (Martin, 1993), and children raised by lesbian mothers express a concept of family membership that is earned through quality of relationship rather than by genetic kinship (Saffron, 1998).

Another advantage of having gay or lesbian parents is that they are generally less conforming to traditional gender roles, whereas those modeled by heterosexual parents tend to be more restrictive, affecting children’s views of what it means to be male or female and the concomitant potentials for achievement (Bigner, 1999; Ossana, 2000; Saffron, 1998). Divisions of labor in lesbian relationships, where earning income, providing child care, and doing household chores are often shared, offer a more egalitarian relationship model, compared with traditional heterosexual marriages (Saffron, 1998). Children of gay fathers who provide a model of androgyny and healthy self-respect/acceptance are more apt to adopt these same attitudes, helping them transcend traditional gender roles, which are increasingly less functional in an evolving, contemporary society. Furthermore, children with androgynous role models learn to participate in relationships in an egalitarian manner rather than basing their associations on constructs of social or physical superiority (Bigner, 1999). Daughters of lesbian mothers—and heterosexual daughters in particular—expressed a better understanding of how to establish appropriate boundaries, while respecting the needs of others, and displayed a better ability to stand up for themselves in interpersonal relationships (Saffron, 1998).

Gay and lesbian parents who are “out” to their children and have successfully integrated their sexual orientation into a positive self-concept are able to model pride and self-acceptance in a stigmatized identity (Martin, 1993; Saffron, 1998). Although literature on gay fathers is scarce, those who are out to their children tend to have more stable lifestyles, are more likely to be in a committed domestic relationship with a partner, and are perceived by their children as more authentic and trustworthy, whereas nondisclosure has been associated with perceptions of the father as being less authentic, less trustworthy, and less deserving of respect (Bigner, 1999).

Gay and lesbian parents who have struggled with identity formation are uniquely able to teach their children the coping mechanisms that are instrumental in shaping a positive sense of self. Those who have resolved their internal homophobia bring into parenthood the ability to create a positive sense of self in the face of social censure, making them uniquely equipped to value diversity and to pass that value on to their children. Interviews with children of gay and lesbian parents suggest that these children have a greater respect for diversity in others regarding lifestyles, cultures, religions, political views, and values, whereas efforts by heterosexual parents to instill these same progressive values in their children may have a lesser impact because they cannot serve as positive role models of a stigmatized group. Ultimately, personal experience with one kind of oppression can lead to a greater awareness of other forms of oppression in a way that vicarious knowledge cannot (Bigner, 1999; Martin, 1993; Saffron 1998).

Because gay and lesbian parents know firsthand that acceptance from others is unpredictable, they are better able to prepare their children ahead of time that they may encounter hostility and help them benefit from the experience by learning to confront prejudice. Additionally, families that face social censure often develop an openness that more traditional families do not. The coping skills children learn in such families may help them work through their own fears of being different as well as develop greater tolerance for diversity as they mature (Lynch & Murray, 2000; Martin, 1993).

The literature on same-sex families has a number of profound implications for the adopted child. First, having a flexible view of what constitutes a “real” family seems to be inherent in same-sex families, possibly as a result of the primary couple already having learned not to depend on society’s validation and support for the legitimacy of their families. Although more research is needed to establish whether or not these findings can be generalized to all same-sex families, this kind of flexible thinking suggests that same-sex couples already possess the mind-set to view adoptive families as “real” families—a critical value for the adopted child to learn. Second, seeing a parent display pride and confidence in an identity that is stigmatized by society can be a powerful example for any child, but particularly for one who must integrate the stigma of adoption into a positive self-concept. Furthermore, the openness found in nontraditional families may foster an atmosphere in which children feel freer to voice their issues and concerns as well as process their negative social experiences. Because adopted children struggle with a wide range of developmental issues as they mature, this kind of openness may offer a more inviting atmosphere in which to raise difficult topics. Finally, while it is obvious that having gay or lesbian parents can be an advantage to children who find that they themselves are LGB, it is equally possible that the resilience and coping skills modeled by lesbian and gay parents can help a child work through the stigma of adoption to form a positive self-concept as an adopted person.

The “Missing” Parent

Same-sex families, by definition, do not have opposite-sex parents. When the children in these families begin to socialize with other children, and certainly once they start school, they will begin to notice that other families are different, and this will inevitably give rise to questions. Martin (1993) offers an excellent discussion of this subject, in which she emphasizes the importance of understanding what the child is asking. “Why don’t I have a mommy/daddy?” when asked by a very young child, may simply be an inquiry about why his or her family is different from those of friends. This kind of question presents an opportunity for the parents to initiate a discussion about diversity, which can be expanded as the child matures, helping him or her evolve as an individual (Martin, 1993; NAIC, 2000). Also, such a question illustrates how important it is for children to be exposed to both heterosexual and same-sex families so that the normalcy of their own families can be reinforced (Martin, 1993).

From an older child, however, a question about a “missing” parent may be more complicated. For example, the child may be wondering why his or her biological father (or mother) is not actively involved in his or her life. On the other hand, the child may be expressing a desire for more adult attention or the wish to engage in activities that he or she perceives would happen with the absent parent. It is important for parents to listen closely to the child and to explore his or her questions fully in order to know what is being asked. All children need to have adults of both sexes actively involved in their lives, although they need not necessarily live in the home, so having a large and varied support network can be an enormous asset. As children reach adolescence, it is normal for them to seek same-sex role models, and adopted children of this age may develop a need to connect with another person whom they physically resemble (Martin, 1993).

It is important for counselors to keep in mind that the implications of a missing parent might be different for the adopted children of same-sex couples. For example, if the son of lesbian parents believes that his mothers “rejected” his “father” because he is male, he may believe that they will eventually reject him as well. Martin (1993) stresses the importance of letting adopted children know that they were conceived by an egg and a sperm, just like other children, and were born the same way all children are born. In the case of donor insemination or surrogacy, the story will be a bit more complicated, but Martin says that, just as in heterosexual families, the adoption story—especially when there are difficult or painful details—must be presented in a sensitive, age-appropriate manner. Ultimately, although children may express sadness at not having a father (or mother), or may experience frustration at having to repeatedly explain their family form to others, this does not necessarily imply that there will be psychological damage (Martin, 1993).

Current Trends

Although adoption practice has evolved to include a broader range of individuals and couples as potential adoptive parents, adoption agencies often lack a clearly articulated policy regarding gay and lesbian individuals or couples who apply to adopt, creating an ambivalent atmosphere for these candidates (Mallon, 2000). A 2003 survey by the Evan B. Donaldson Adoption Institute found that about 60% of the adoption agencies that responded accept applications from gays and lesbians. However, only about two thirds of these had official policies on gay and lesbian adoption; the rest did not.

Among agencies that had policies, about one third of them were nondiscriminatory. However, gays and lesbians had a better chance of a successful adoption if they were open to adopting an older child, a child with special needs, or a child from another country. More than half of the agencies focusing on special needs and international adoptions reported placing with gay or lesbian parents, while only about one quarter of agencies focusing on domestic infant adoptions did so. However, this should not be taken as indicative that international adoptions are necessarily easy for gays and lesbians. Some countries, such as China, require documentation that prospective parents are not homosexual, while others approach the issue indirectly by requiring all prospective adoptive parents to be legally married. Some countries have no set policy, and more than two thirds of the international adoption agencies in the study reported that they accept gay and lesbian applicants. This suggests a possible ethical dilemma for agencies that place children with gays and lesbians, between honoring the indigenous values of a child’s country of birth and placing him or her in a stable, nurturing home (Evan B. Donaldson Adoption Institute, 2003).

The same study also found that agency directors often did not know the law in their own state, where it applies to gay and lesbian applicants. More than 15% of directors surveyed either incorrectly stated that lesbians and gay men were barred from adopting in their state or were unsure of the applicable state law. In addition, trends are difficult to track as only 43% of responding agencies reported collecting information on sexual orientation (Evan B. Donaldson Adoption Institute, 2003).

Whether they are adopting internationally or domestically, gay and lesbian couples may assume that to adopt the child they envision, they will need to keep their sexual orientation private, but this is not always the case. Some state agencies are prohibited from discriminating on the basis of sexual orientation, whereas others simply leave the matter of disclosure to the couple’s discretion. Although individuals or couples need not voluntarily disclose their sexual orientation, they should tell the truth if asked directly because withholding such information constitutes fraud and may void the adoption. Whether they adopt as an openly gay or lesbian couple or one of them adopts as an individual, any live-in partner will need to be a part of the home study even if he or she is simply identified as another adult living in the home who will assist with child care (Martin, 1993).

Even in states where adoption by lesbians and gays is protected by law, they may still experience considerable discrimination in the adoption process. In states where the law is less clear, same-sex couples may find themselves in a more ambiguous situation. Because gays and lesbians cannot legally marry in most states, they are not protected by the same laws that govern heterosexual adoption (Martin, 1993). The lack of legal protections and social legitimacy, coupled with the difficulties that lesbian and gay couples encounter at some agencies, creates an atmosphere in which couples are encouraged to hide or misrepresent their relationship to increase their chances of a successful adoption. Often, this means that only one partner receives the preadoption training and counseling that is crucial for a successful adoption, leaving the other partner ill prepared for the experience of adoptive parenthood (Pavao, 1998).

Implications for Counseling

To competently counsel lesbian and gay clients, counselors must make an active effort to understand the mental health needs of this population and must remain aware of their own attitudes and values as they pertain to homosexuality in general as well as toward gay and lesbian parenting specifically (American Counseling Association [ACA], 2005). Before working with gay and lesbian individuals or families, it is recommended that mental health professionals first have systematic training in sexual diversity, yet only 36% of the psychologists surveyed by Crawford et al. (1999) reported having received such training. It is, therefore, crucial for mental health professionals to educate themselves to gain the necessary competence to serve this population (ACA, 2005).

Theoretical orientation is another area that counselors must carefully consider when working with same-sex adoptive families, to ensure that their approach is flexible enough to allow diverse clients to feel supported and validated (Fukuyama & Ferguson, 2000). At present, there is very little empirical research that evaluates the effectiveness of particular theories or conceptual frameworks with LGB clients. Even interventions that are becoming common practice in working with this population, such as bibliotherapy and referral to support groups, have not been evaluated as to how—or even if—they contribute to the effectiveness of individual therapy alone. LGB clients, in general, present to counselors a unique collection of clinical needs and so may derive the most benefit from an integrated or eclectic therapeutic approach incorporating a wide array of tools and interventions that can be customized by the adept, sensitive counselor into a personalized approach for each client (Fassinger, 2000).

Distinguishing among different kinds of family issues is a critical skill that counselors must develop in working with both LGB clients and adoptive families. Counselors must be able to differentiate among issues that are pertinent to sexual orientation and those that are either irrelevant or merely tangential to it (Martin, 1993; Matthews & Lease, 2000). Likewise, it is important for the counselor to separate issues that are common to all developing families from those that are related to the family’s adoptive status (Brodzinsky et al., 1998). For practitioners working with LGB adoptive families, the convergence of sexual orientation, developmental, and adoptive issues will present a unique set of clinical challenges, so continuing education is crucial.

Best Practices

The literature brings up a number of issues that are unique to practicing individual and couple/family therapy with the LGB population, and some “best practices” may be gleaned that will benefit counselors wishing to work with these clients.

• Lesbians and gay men tend to do a great deal of self-examination before deciding to parent and may seek counseling as part of their decision-making process (Crespi, 2001; Martin, 1993). Counselors should be prepared to assist clients in examining their internalized homophobia, social support system, financial resources, emotional temperament, and desire to parent as well as any other issues the client feels may be pertinent.
• There is not a great deal of empirical research on same-sex couples and even less on multicultural issues within those couples (Ossana, 2000). Counselors should consider not only the impact of multiple oppressions on same-sex couples of color but also how couple differences in race, ethnicity, religion, socioeconomic class, age, level of “outness,” and so on influence the couple dynamic.
• Same-sex parents tend to adjust their level of outness to accommodate their children’s comfort level (Lynch & Murray, 2000). It is possible that such adjustments might bring up old issues of internalized homophobia that the partners thought were resolved, which may need to be addressed through counseling.
• Gay male couples may have a more difficult time building close, intimate relationships due to the fact that men are socialized to be more autonomous and less emotionally expressive and to resolve their differences either through confrontation or separation rather than negotiation. Forging a strong therapeutic bond with these couples is critical. Counselors must honor the men’s relationship and point out its strengths to instill the hope that change is possible and, at the same time, must create an environment in which the partners feel safe in trying out new behaviors to replace the ones that no longer work (Tunnell & Greenan, 2004).
• Relationships between gay male couples are often initially based on sexual compatibility and, due to male-based values about sexuality, may not be monogamous. Because family therapy has an intrinsic bias toward monogamy and tends to characterize open relationships as unstable and/or problematic, counselors are advised to examine their personal biases in this area and to educate themselves on open relationships (Bettinger, 2004).
• Counselors should closely examine their personal feelings regarding specific sexual practices of LGB couples and how those feelings affect their ability to work with this population in a nonjudgmental way. Without this critical self-knowledge, clinicians may have a more difficult time identifying and managing countertransference issues of either a negative or positive nature (Bettinger, 2004).
• Same-sex couples in which one partner identifies as bisexual may encounter issues of fear, mistrust, and divisiveness. Counselors may need to help the partners explore and clarify what bisexuality means for them in the context of their relationship and must be prepared to provide educational and/or support resources (Bradford, 2004).

Critique of the Literature

The literature included in this review was, with only a few exceptions, not specific to lesbian and gay adoptive families as such. Rather, most of the articles and studies concentrated either on adoptive couples (with the implied presumption of heterosexuality) or on gay and lesbian families in aggregate, with an acknowledgment that adoption is but one of several ways in which these families are formed. However, it is important to note that, whether same-sex families adopt directly or give birth through donor insemination or surrogacy, adoption is likely to be a part of the picture, wherever it is legal. What was lacking in all the literature, in general, was a consideration of multicultural issues. To be fair, obtaining a sufficient number of participants to perform meaningful studies of the needs and experiences of diverse adoptive families, whether same sex or heterosexual, is likely quite challenging, but there is less sensitivity to multicultural issues in the literature than there could be.

Despite the shortcomings in the literature, some preliminary conclusions are possible. Clearly, being the adopted child of lesbian or gay parents adds one more layer of stigma and oppression than would be present if heterosexual parents had adopted the child. Homonegative social attitudes and discrimination, coupled with the lack of legal recognition of same-sex unions, confers a lower status on these children than would be enjoyed by a child whose parents’ decision to adopt was viewed more positively by mainstream society. From this point of view, having same-sex parents could be perceived as simply imposing one more hurdle on a child whose ability to form a positive sense of self is already compromised.

Yet at the same time, lesbian and gay parents seem uniquely able to model a positive self-concept of an otherwise stigmatized identity, and the coping skills they have developed over time can be invaluable to a child learning to cope with multiple levels of differentness. The literature suggests that gay and lesbian parents can instill in their children an awareness of oppression and respect for diversity in an experiential way that is not available to heterosexual parents. So it may be that the very stigmas that make parenthood more difficult for lesbian and gay couples have allowed them to develop the resilience and coping skills necessary to succeed in this difficult task and to teach their children to value themselves for who they are rather than by the judgments of others. The process of self-discovery that lesbians and gay men engage in may also make them more understanding of an adopted child’s need to search for his or her roots to form a more complete identity. For this reason, it may be advisable for counselors to explore the level of identity development of lesbian or gay couples wanting to adopt.

Parenting is not an easy task, even under the best of circumstances, and parenting well is an even greater challenge. Adoptive parenting brings with it a unique constellation of challenges and issues, but the wise counselor will help each individual or couple identify the particular qualities and strengths they bring to the table when embarking on the adoptive journey.

Implications for Birth Parents

Thus far, this chapter has spoken at length about the impact of social and legal issues on gay and lesbian adoptive parents as well as the implications for the children they adopt. But what of the birth parents of children who may be adopted by LGB individuals or couples? How might social and legal issues that affect gay and lesbian adoptive families affect them?

One way in which these concerns might manifest is in the birth parents’ choice of agency. Birth parents whose personal values are incompatible with LGB orientations may be more selective about the adoption agencies to which they relinquish their children, selecting only those that do not accept gay or lesbian applicants. If finding such an agency proves to be too difficult, some birth parents may opt for an open adoption, in which they are able to play a more active role in choosing the adoptive parents of their child rather than leaving the matter to chance.

Some birth parents may object to having a gay or lesbian individual or couple adopt their child, either because of the stigma involved or because they believe their child is more likely to be physically or sexually abused, to have psychological or other developmental problems, or to grow up to be gay or lesbian than if he or she were raised by heterosexual parents. Because a preponderance of the literature refutes these beliefs (Allen & Burrell, 1996; Bigner, 1999; Golombok & Tasker, 1996; Mallon, 2000; Martin, 1993; Saffron, 1998; Strickland, 1995), it is incumbent on counselors and adoption professionals to educate birth parents who may have such concerns.

Birth parents who have no values-based objection to their children being raised by gay men or lesbians may still have other, more practical concerns. Even those who are not well versed in the intricate legal challenges faced by LGB parents may have a general understanding that these alternative families are legally vulnerable in ways that traditional families are not. Hence, they may have concerns about the long-term stability and legal status of the children in a gay or lesbian adoptive family. Birth parents who are aware of these kinds of issues may be reluctant to have their child adopted by a gay or lesbian individual or couple due to their concerns for the child’s potential health care needs and financial well-being rather than any objection to the parents’ sexual orientation per se.

Conclusion

While lesbian and gay individuals or couples wishing to adopt may face considerable challenges with respect to social stigma, it is also possible that those who have integrated a positive sense of self already possess the requisite skills to successfully meet them. As non-traditional family forms become more common, researchers might further explore how our current theories meet—or fail to meet—the needs of these families so that counselors may serve them with competence and sensitivity.

Reflection Questions

1. What responsibility do counselors—as individuals and as a profession—have to advocate for social change on behalf of their lesbian, gay, and bisexual (LGB) clients?
2. How might various theoretical orientations need to be adapted to address the needs of LGB families?
3. How is identity development for LGB individuals and that for adopted persons similar? How is it different?
4. Are there ways in which mainstream culture reinforces the idea that adoptive and other alternative families are not “real” families?