How Does Adoption Affect the Health of Same-Sex Couples?

With increasing acceptance of same-sex marriages in the public sphere I thought I would give treatment to some psychological research in the area. There is often rhetoric on the adoption rights of same-sex couples and how these adoptions affect the health of the child. However, little air time is given to how adoption affects the health of same-sex couples. After all adoption is a complex and often stressful process for any couple. Throughout development, homosexual individuals go through many of the same transitions as heterosexuals. However, in some cases, these transitions may be more stressful due to issues such as heteronormativity, stigmatization, institutionalized heterosexism and social prejudice (Goldberg & Smith, 2011). Given these factors the transition into parenthood, while representing a time of heightened stress among heterosexual couples, may uniquely influence the well-being of homosexual couples. In this more formal blog entry I analyze factors affecting depression and anxiety of homosexual couples as they transition into adoptive parenthood.

The number of homosexual couples choosing adoption is increasing (Goldberg & Smith, 2011), but there is little research on how the transition to adoptive parenthood affects homosexual couples. Further, adopted children are at greater risk for emotional and behavior problems, many of which are associated with relationship quality and psychological well-being of the parents (Goldber, Smith, & Kashy, 2010). A better understanding of factor influencing mental health during this transition will inform effective therapies and support for this population that will result in relevant and important outcomes (Killian, 2010).

Social support, self-concept and depression/anxiety

Goldberg & Smith (2011) was the only study found that directly examined how social support influences changes in anxiety and depression after adoption for same-sex couples. The study measured state legal climate and relationship quality as well as support from the neighborhood, workplace, family and friends. State legal climate was classified as either positive or negative using the Human Rights Campaign’s “Family Equality Index”. All other measures were self-reported questionnaires that gathered the participants’ perception of support (e.g. “I rely on family for social support”). The authors also measured “internalized homophobia” which examined whether the individual thinks positively (or negatively) about their sexual orientation (what this paper refers to as self-concept).

The results indicated that social support (as measured by state laws for adoption) moderated the relationship between individuals’ self-concept (internalized homophobia) and changes in depression/anxiety through the adoption period. Participants high in internalized homophobia before adopting showed an increase in depression and anxiety after adopting in a negative legal context but a decrease in depression and anxiety when the adoption was conducted in a positive legal context.

The authors also found a number of main effects social support has on depression and anxiety over the adoption period. Lower perceived gay-friendliness in the neighborhood and higher internalized homophobia were related to higher depression (but not anxiety). Perceived support from friends was related to lower anxiety (but not depression). Higher levels of perceived workplace support, family support and relationship quality were associated with lower levels of depression and anxiety.

Similarly, Ross, Epstein, Anderson, & Eady  (2009) found that social support (at various levels) plays an important role in psychological outcomes after adoption. They conducted structured interviews with seventy-four individuals who legally adopted a child into a same-sex relationship under new laws in Ontario, Canada. After transcription and coding three major themes were identified: supportive experiences, unsupportive experiences, and identity-base experiences. Results indicated that participants living in small neighborhoods (where they were well known and well supported) had positive feelings with regard to the adoption experience. However, if the small community was unsupportive, participants characterized the experience as more difficult. Further, findings recognize the interaction between external social support, self-concept and psychological well-being. In other words, the most positive experiences around adopting were expressed by couples working with agencies that identified their sexual identity as a potential strength in parenting an adopted child. Agencies that legitimize same-sex parenting through recognition of the strengths inherent in it may have bolstered the prospective parents’ self-concept (the belief in their ability to parent as a sexual-minority). This change in confidence may, in turn, have influenced positive changes in anxiety and depression surrounding adoption (though these conclusions are beyond the scope of the authors’ analysis).

Another relevant study by Goldberg, Smith, & Kashy (2010) had similar findings. In their analysis of relationship quality before and after adoption the authors examined similarities and differences between gay male, lesbian and heterosexual couples. The results suggest that, on average, all parents, regardless of sexual orientation and type of relationship, experience a decline in the quality of relationship. However, higher adoption agency satisfaction is related to lower relationship conflict post adoption (particular among same-sex couples). The study also found that higher depression before adoption led to larger increases in relationship conflict among all couples, however it is likely that this relationship is bidirectional (relationship conflict leads to higher depression as well). These findings highlight the influence positive social support (as provided by agencies) has on many psychological outcomes that include (and are related) depression and anxiety.


Overall, the current research suggests that social support influences the development of depression and anxiety as same-sex parents transition into adoptive parenthood. However, the mechanism behind this relationship remains unclear. While the influence of social support may show the strongest impact on depression/anxiety when acting through the individuals’ self-concept, it is important to note that self-concept may in fact be derived from various areas of social support. Most studies, however, measure social support solely through the participants’ perception of support. In order to understand the relationship between social support and self-concept more objective measures of social support should be utilized. Also of note, social support moderated self-concept and depression/anxiety when it was related to institutional processes involved in adoption (i.e. state laws or adoption agencies). Perhaps some areas of social support (e.g. family support) contribute more directly to certain psychological outcomes while other, more peripheral, areas of social support (e.g. societal laws) are buffered through self-concept. More research is needed to ascertain the process by which social support influences depression and anxiety in this context.

This area of research is relatively young, but holds promise for developing strategies to assist same-sex couples through the adoption process. Encouraging organizations and agencies to help same-sex couples develop positive self-concept in the context of adoption may improve psychological well-being throughout the process. This may be particularly important among homosexual males who appear to be more prone to self-doubt, due to their sexual orientation, in their ability to parent (Downing, Richardson, Kinkler, & Goldberg, 2009; Ross et al., 2009). Promulgating knowledge within LGBTQ communities about the strengths in adoptive parenting as a sexual minority may also reduce negative psychological outcomes after adoption while encourage more couples to adopt (Ross et al, 2009). Future work should consider the process by which social support, self-concept and depression/anxiety are related in an effort inform intervention strategies.


Downing, J., Richardson, H., Kinkler, L., Goldberg, A. (2009). Making the decision: Factors influencing gay men’s choice of an adoption path. Adoption Quarterly, 12, 247-271.

Goldberg, A.E., Smith, J.Z. (2011). Stigma, social context, and mental health: Lesbian and gay couples across the transition to adoptive parenthood. Journal of Counseling Psychology, 58,139-150.

Goldberg, A.E., Smith, J.Z., & Kashy, D.A. (2010). Preadoptive factors predicting lesbian, gay, and heterosexual couples’ relationship quality across the transition to adoptive parenthood. Journal of Family Psychology, 24, 221-232.

Killian, M. L. (2010). The political is personal: Relationship recognition policies in the United States and their impact on services for LGBT people. Journal of Gay & Lesbian Social Services, 22, 9-21.

Ross, L.E., Epstein, R., Anderson, S., & Eady, A. (2009). Policy, practice, and personal narratives: Experiences of LGBYQ people with adoption in Ontario, Canada. Adoption Quarterly, 12, 272-293. 

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