Assisted Reproductive Technologies

There many gay men and lesbians having children through heterosexual marriage, adoption, artificial insemination with donor sperm, and surrogacy and egg donation. As you can imagine, issues may arise medically, legally, socially and emotionally. Counseling prior to embarking on the path to parenthood, during the process, and after a family is formed can be extremely helpful.

Parenting concerns of gay couples are not different than those of heterosexuals. All potential parents share concerns about their ability to be good parents, the affordability of parenting, questions about the suitability of bringing children into a world like the one in which we live, and about how a child changes a person’s/couple’s life. Couples using artificial reproductive technologies may also share concerns about the biological connection to the child; conceiving with a third party; societal attitudes towards ART; educating family, friends, and the general public; and disclosure to the child and family In addition, there are unique issues for gay and lesbian couples.

These issues include internalized homophobia and societal homophobia. Internalized homophobia is a term used to represent the negative and distressing thoughts and feelings experienced by lesbians and gay men about their sexuality, which are attributed to experiences of cultural heterosexism and victimization. I this is an issue, a clinician who displays sensitivity and awareness of lesbian and gay clients’ unique issues can be found.

The first question gay and lesbian couples need to ask themselves before conceiving a child is to ask whether or not it is okay for them to have a child. These couples may wonder if friends and family will support their choice and whether their children will suffer from having same-sex parents instead of having a mother and father. Confronting internalized homophobia, accepting oneself completely, and addressing unexamined feelings must also be addressed by the would-be parents.

ART options require decisions such as whose sperm or eggs to use and who will carry the child. The partner who uterus, sperm or eggs were not used may questions their status as a full and equal parent. Working these issues through with a psychologist and seeing a lawyer specializing in reproductive issues are essential.

The couple should decide what last name to use and what their children will call them. The couple should discuss how to talk to their children about their family. Parents are encouraged to tell age-appropriate truth and avoid lying or deceit. The couple may wonder how much to tell others about the details of their children’s conception. Talking with other parents who have had children through ART can be extremely helpful in deciding when and how to share with children and other adults and families.

Same-sex and heterosexual couples and individuals who are using assisted reproductive technologies have the luxury of carefully considering these issues way before conception. Entering into parenthood with these issues worked out and sorted medically, legally, socially, and emotionally allows couples to then focus on and enjoy be parents.

Risks To Positive Identity Development

Alcoholic or chemically dependent lesbians carry a double stigma in a society intent on denying the existence of both lesbianism and alcoholism or chemical dependency in women. The prevalence of alcoholism or chemical dependency in the lesbian community is unknown but presumed to be high.

An early study in the 1970’s done by M.T. Saghir and E. Robins (Male and female homosexuality, A comprehensive investigation) that is still often sited, used a small control group. They found that 35% of a samples of lesbians were alcoholic or abused alcohol at some point in their lives. Their findings were the most comprehensive at the time and are still widely quoted and comprised of the “best estimate” as to the prevalence of alcoholism and alcohol abuse in the lesbian community.

If the estimate even approximates the actual prevalence, alcoholism and alcohol and drug abuse are now in epidemic proportion in the lesbian community. Since this first comprehensive study, larger-scale studies have been done that have concluded a serious problem within our community that needs to be addressed.

Detailed information about lesbians’ habitual patterns of alcohol or drug consumption is largely unavailable and typically a matter of speculation. There does appear to be some evidence that lesbians engage in multiple substance abuses and exhibit mixed patterns of drug and alcohol use. Obviously, however, if we are to avoid speculation or erroneous extrapolation to lesbians, much work needs to be done to document the drug and alcohol consumption patterns in large and representative groups of lesbians.

There are some risk factors for lesbians. A larger than expected proportion of the lesbian community may be the adult children of alcoholic parents. Another risk factor for some lesbians is heavy reliance on lesbian bars or other public or private drinking settings to socialize and be “out.” Ambivalence or conflict concerning one’s lesbianism can also represent a risk factor that may represent a problem for development of chemical dependency or alcoholism.

Although the alcoholic or chemically dependent lesbian shares treatment issues with the larger group of alcoholic or chemically dependent woman, some issues are unique for the lesbian community.

Both Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) form the cornerstone of recovery for thousands of individuals, including many lesbians. Some women and some lesbians resist attending AA and NA meetings because many of the groups are male-dominated and members of some groups are homophobic. There is also resistance to attend these programs because of their emphasis on surrender and powerlessness and the meeting format for its focus on members’ personal recounting of adverse incidents that occurred during their years of alcoholic drinking or addiction.

Some feminists argue that women alcoholics and addicts in recovery have low self-esteem and are further burdened by guilt and shame when recounting or being reminded of their actions and behaviors while drinking or using drugs. Other advocates of the AA approach, many of whom are also feminists, argue that recognition of powerlessness over alcohol or drugs paradoxically empowers the alcoholic and addict and discussion of past events in an accepting and supportive atmosphere is an affirming experience and begins the process of self-forgiveness and self-healing.

Another issue that can be different for lesbians is denial and rationalization. Denial may play an adaptive role in staving off anxiety related to homophobia and living in a homophobic society.

Lesbians tend to experience more negative affect in their lives than other women. This would include depression, low self-esteem, isolation and feelings of rejection and anxiety. Generally, for some lesbians, particularly those who are heavily closeted or otherwise isolated from positive lesbian role models, negative affective states may be more pronounced than they are for chemically dependent heterosexual women.

Closely related to negative affective states is the issue of internalized homophobia, or the internalization of homophobic or negative societal attitudes and stereotypes of homosexuality. A convenient model for assessing the extent of internalized homophobia or for evaluating the extent of development of a positive lesbian identity is provided by V.C. Cass (Homosexual identity formation: A theoretical model. Journal of Homosexuality, 4, PP 219-235). Cass outlines six stages in the development of a positive homosexual self-identity, including Identity Confusion, Identity Comparison, Identity Tolerance, Identity Acceptance, Identity Pride and Identity Synthesis.

These stages of positive identity development for lesbians affect many more than those dealing with just alcohol and chemical abuse. All lesbians deal with these stages of development at various points in their lives and sometimes more than one at the same time.

The fact that some lesbians drink and do drugs to cope does not mean that all lesbians don’t have other ways of dealing with the challenging issues facing us. All addictive and unhealthy behaviors that are used to cope are risks. We need to build a strong support system within our lesbian communities that allows lesbians who need help with all ways of coping to “come out” and find accepting and genuine guidance and support.

INTERNALIZED HOMOPHOBIA

I would like to address a very challenging and oppressive issue lesbians encounter. The issue is homophobia. Facing this complicated interwoven system of thinking, so prevalent in our society, is essential to empowering our identity, our relationships, and our quality of life. Regardless of the number of successful, or unsuccessful, coping mechanisms we utilize with our conscious awareness to deal with or deny its presence, it is always there and active in our psyches and in our world.

Homophobia is a term used to describe the fear of, aversion to, or discrimination against homosexuality or homosexuals. It can also mean hatred, hostility, disapproval of, or prejudice towards homosexuals, or homosexual behavior. The term is frequently used in academic and scientific journals, but homophobia is not a clinical phobia. There are people who disagree with any usage of the concept homophobia and several dictionaries characterize this type of fear irrational.

The concept of homophobia was first introduced by psychologist George Weinberg in his 1972 book Society and the Healthy Homosexual. It was published one year before the American Psychiatric Association voted to remove homosexuality from its list of mental disorders.

In recent years some people have tried to introduce new terms such as heterosexism because it doesn’t have the association with a phobia. Heterosexism refers to the privileging of heterosexuality over homosexuality. Recent psychological literature has suggested the term homonegitivity to differentiate between fear-based thinking instead of reflecting disapproval of homosexuality.

Gregory Herek, seeking to avoid both focus on individual psychology of “homophobia” and the collective cultural factors of “heterosexism” has proposed the term “sexual prejudice”, referring to “all negative attitudes based on sexual orientation, whether the target is homosexual, bisexual, or heterosexual.”

In a 1998 address, Coretta Scott King asserted that, “Homophobia is like racism and anti-Semitism and other forms of bigotry in that is seeks to dehumanize a large group of people, to deny their humanity, their dignity and personhood.”

Various psychoanalytic theories explain homophobia as a threat to an individual’s same-sex identity, which can cause repression, denial, depression, confusion and numerous health issues. This form of homophobia is called “internalized homophobia”. It occurs when a person who is gay feels that being homosexual is wrong or immoral. Internalized homophobia produces uncomfortable feelings when a lesbian is unable to accept and love herself as a homosexual. We usually associate this experience with “being in the closet”. There may be times when being "out" is safe and comfortable and other situations when a decision is made to not share who we are. When these feelings are present, we can be riddled with the frightening perception that we are not normal. This activates an uncomfortable split in our psyches and forces our lesbian identity into our unconscious.

When lesbians are in the closet, two distinct forces are at play. Entrophobia is the fear or discomfort with your own sexuality. Entrophobia creates a lot of torment. Negative voices shouting internalized homophobic judgments in your head berate you unmercifully for being attracted to woman. The fear and interference this produces can sabotage many areas of your life if not made conscious. Damaging your sense of self is the most serious consequence of feeling unconsciously uncomfortable with your sexuality. Some of the symptoms of entrophobia commonly experienced are guilt, inadequacy, anger and depression.

The other force at play when you are “in the closet” is xenophobia. Xenophobia is the fear of being different. It is usually experienced as a fear of parental or social rejection. The way this works in our psyches is that we unconsciously feel different in an unacceptable way. The excessive fear of being unacceptable and the possibility of being abandoned can lead to powerful self-doubt accompanied by feelings of shame, guilt, fear, and anxiety. Not being able to fulfill parental and societal expectations can have a paralyzing and debilitating effect on self-esteem. Unconsciously feeling bad about feeling different can create havoc in all areas of life.

It is much simpler to project our unconscious fears outside of ourselves onto parents, people at work, and society than to deal with the personal homophobia that is torturing us inside. It feels safer to criticize these external views that are threatening us. We are bombarded everyday by hetero-centric themes, images, and stories, so much so, that it has become a hardwired notion in most of us that being heterosexual is the only way to be. After all, our social homophobic environment explicitly or implicitly supposes everyone is heterosexual.

From the hetero-centric point of view, anyone who doesn’t fit into this mold is considered deviant. This makes homophobia lurk within lesbians, while perceiving that it is coming from the outside. After all, we were raised with our family’s beliefs, religious values and within the homophobic environment of our culture and society. It is likely when we were growing up, most people didn’t even think about homosexuality. Their prejudices remain to this day in their unconscious as core beliefs. The familiarity of being immersed in this way of thinking influences us as well. If we let these beliefs go unquestioned, we are extremely vulnerable to negative self-talk and denial of our true selves. It also makes us easy targets for other people’s judgments.

Internalized homophobia brings insecurity and intolerance. There are many ways our unconscious homophobia manifests. Probably the most common one is “passing”. This happens whenever we dress and act as if we are heterosexual. Another way is avoiding being seen with lesbians who are “out” for fear of being discovered by association. Failing to share things in our lives creates a wall of protection that can hide our discomfort. Feeling superior to heterosexual women by rejecting them or believing that lesbians are no different from them can be another coping mechanism. Having huge out-of-proportion negative feelings about lesbians as parents, artificial insemination, and bi-sexual, lesbian, gay or transgender people is another way the intolerance of our unconscious internalized homophobia appears.

One of the problems in recognizing our struggles with internalized homophobia is that it is something we rarely talk about. The isolation this produces, keeps us locked in our own loop, with no way out. Lesbians often feel shame even having these feelings. This makes the topic seem out of the question to talk about with other lesbians. The fear of being rejected by society pales when doubts and self-hatred for being a lesbian emerge in the company of other lesbians.

One important way healing can begin for lesbians is to establish a safe forum within our community to be able to talk about internalized homophobia. We do not have to face these feelings alone. Every lesbian struggles with these learned beliefs. Heterosexuals also need to open their minds and hearts to better understand. We are dealing with a collective issue that will continue to create confusion and pain for everyone until it is dealt with.

In order to live in a healthy way, it is so important for lesbians to become conscious of the deep scars remaining from growing up with all the disapproving homophobic messages sent by our families, schools, churches and society. We deserve a safe and comfortable world where we can be happy, live authentically and feel proud of whom we are. Separating from our learned way of thinking will help us discover our own belief systems and values. This awareness can help us live a more authentic and empowered life. Being able to validate and celebrate being a lesbian is the path to a healthy self-identity.

Once our awareness becomes conscious and integrated, the opinions of others will no longer carry the power they do now. This will make it possible to let them have their unresolved homophobic beliefs without taking them on as our own. It will put us in the position of offering them positive role models and let them have a new experience of lesbians as we live our lives in a secure balanced way.

Mary Oliver, one of my favorite poets and winner of the Pulitzer Prize for Poetry, included in her book Dream Work, a poem that beautifully captures the struggle, the understanding and the hope for our transformation of internalized homophobia.

WILD GEESE

You do not have to be good.
You do not have o walk on your knees
For a hundred miles through the desert, repenting.
You only have to let the soft animal of your body
Love what it loves.
Tell me about despair, yours, and I will tell you mine.
Meanwhile the world goes on.
Meanwhile the sun and the clear pebbles of the rain
Are moving across the landscapes,
Over the prairies and the deep trees,
The mountains and the rivers.
Meanwhile the wild geese, high in the clean blue air,
Are heading home again.
Whoever you are, no matter how lonely,
The world offers itself to your imagination,
Calls to you like the wild geese, harsh and exciting—
Over and over announcing your place
In the family of things.