The Impact of Internalized Stigma on LGBT Parenting and the Importance of Health Care Structures: A Qualitative Study
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. Internalized Stigma
3.1.1. (Im)Possibility of Thinking of Oneself as a Mother/Father
Even in diverse people, it is sentenced that “we cannot be parents because we cannot”. So, they just try to accept themselves, but they cannot see that another LGBTIQ+ person can go further and form a family.(J.O., personal communication, 23 April 2019)
All those ghosts appear, that I am not going to be enough because: “Maricón” [derogatory nickname for gay men] or that I am not going to be enough because “I do not have the same characteristics of …”, even I am saying: “It does not correspond”, “I do not have to think that” … I feel that all these situations, that upbringing and the whole model and also it is supported by a social issue, more or less imposing and inquisitive, has come to condition a lot my perception regarding fatherhood, me being a father [Emphasizes] and especially thinking me being a father with my homosexual partner [Emphasizes] … When the conversation has come out, precisely those fears or those limitations that have to do with my own construction, as a subject … It terrifies me, it scares me not to be enough … those structures that have been installed survive, survive, those structures are maintained for many years and there are people of diversity who can never get rid of them or who fight all their lives with them. I think it is essential to mention it, fear is perhaps the very subjective category, but that transcends or involves everything.(Maximiliano, personal communication, 28 May 2020)
3.1.2. Fear of Violating Children’s Rights
Above all, I believe that there are reasons that may be linked to the fear of being judged as a bad father or bad mother for being gay, bisexual, lesbian, or trans, for being a violator of the child’s rights.(M.R., personal communication, 31 May 2019)
What will happen to the child? Because you put yourself in that position [beind discriminated] before and, in one way or another, you play the martyr, you say “Ok, I don’t care!”. But exposing a child to that situation also makes you question yourself … [because you are] putting him in dangerous situations, painful situations.(Maximiliano, personal communication, 28 May 2020)
3.1.3. Fear of Passing on the Stigma to Children
The fear was a subject that we talked about a lot, a lot of time, and we always wanted to be mothers. But we were afraid about what others might say … When you go out, the issue is a fear one has, more than for oneself, but for the children. That they will be rejected too … So, that is the main obstacle: one’s fear.(Saau, personal communication, 3 February 2020)
I would feel observed … I would feel more concerned about my son in the case of … what would they say to him … what would I say to him if they say something to him and I cannot defend him, or I cannot explain him … I do not know, there are things that I could not answer; maybe it will not happen, but, if it happens, how will I react, how will I protect him. Even if he is little… he will always have to carry that social stigma of having gay parents … [people would think] “And since they are homosexual, the child is also homosexual” … if they say things to me, it does not matter to me, I am an adult, but if they say something to, in this case, is my son. If they hurt him, it will hurt me; it will hurt me. In that case, how do I protect him? … Although maybe there is not so much discrimination… but there is a rejection… or a social reproach, people have their opinion, there are critical people, and they criticize the whole family…. Because they are gay parents, the child is also to blame.(Mau, personal communication, 7 March 2018)
3.1.4. Fear of Presenting an LGBTIQ+ Partner
My partner has two children, with two different women, and he is with me now. Still, he cannot talk about it with his family because they are very homophobic … other people don’t know about our relationship either. Still, we have a relationship [do his children know about your relationship?] We haven’t told them, but I think they understand it implicitly. Many people have a relationship with a person of the same sex, who has children, but they don’t day that it is taboo because it is not well seen in the society in which we live.(Aron, personal communication, 7 March 2018)
The conversation was difficult for me, not for him [his son] … I put a lot of effort into it, I made it very complicated, but not for him. According to my perception, for him, it was easy. It took me a long time to tell him. Although he knew it was obvious, I had to speak it and tell him directly, “I am with a same-sex partner”. It was so hard I did not think it was going to be that difficult. Until I could tell him, and he told me, “I know, I support you, I love you… ok, calm down, dad. I love you as you are, and you have to be calm, and I will support you”. It was like taking a tremendous weight off me. I kind of started sleeping a lot better that day. Because I had a weight, a thing … a burden that did not let me be calm. Until I talked about it openly with him, I no longer have those same restrictions from the moment I spoke. I hug my partner more I am closer to my partner. As we discussed and my son does not mind, I would have liked, having assumed what it was before, to be more calmly participating in my child’s upbringing, as in parenthood.(Sebastian, personal communication, 10 January 2020)
3.1.5. Greater Difficulties in the Experience of Parenthood for Intersex/Trans People
In the case of intersex or trans people, I feel that they are even more misunderstood than a person of diversity in general. A person of sexual diversity who is also intersex or trans has a more significant burden before society and much more discrimination. it is more difficult for them.(Sebastian, personal communication, 10 January 2020)
First, for someone who is trans… We talk about it with my friends as they are gay or bi[sexual]. First, the fact of assuming that your partner is trans. There is a matter of transphobia … First, it is that barrier. The second is that the mere fact of being trans and publicly being trans … they are more violated. People do not assume their name, the name that they have. They do not endorse, perhaps the way of dressing, “I know that his genitalia is female. Why does he feel like a man?” And so. And that is added to the fact that they are in a relationship with someone and have children: “No, this person is a deviant, degenerate person”. They end up being much more violated than a cisgender person. They would be excluded in all social aspects. At least my friend, she, being on the street, feels discriminated. And it is sad because she wants to be the way she feels.(Ivan, personal communication, 1 January 2020)
3.1.6. Generate Psychoeducation on LGBTIQ+ Parenting as a Strategy
To end or reduce discrimination, the stigmas that exist need to show parenthood experiences from diversity. To show that nothing happens, that the world is not ending, it is not terrible. That boys and girls can be just as happy with heterosexual parenthood as with LGBTIQ+ people’s parenting, to show that, the reality … So that can be normalized, so it is not something strange or wrong.(Sebastian, personal communication, 10 January 2020)
Being gay or being a lesbian or being trans does not negatively affect your son or daughter’s sexual orientation and gender identity; but rather, what has a negative impact is the prejudice or discrimination concerning those sexual orientations and gender identity. Eventually, the risk lies in stigmatization due to negative attitudes towards this type of family. We would say, by society in general. If it did not exist, there would be no danger. So, all the studies show that there is no danger in the child’s psychological well-being. There may be problems in integration, but not since they live with two mothers or two fathers, but rather the stigma associated with it, but exercised by the general population.(J.B., personal communication, 7 January 2019)
3.2. Demands on the Health Care System
3.2.1. Free Health Services
We need that the State establishes support plans, understanding that parenting is not the same as being a parent of sexual diversity. There should be support from the State to provide support to these people … guidance, psychological support, accompaniment.(Sebastian, personal communication, 10 January 2020)
It is a class issue. It is much easier when you are in a high social and economic segment; I mean, you can enter into the parenting dynamic. … there is a play on words we use “It is very different to be gay than to be a fag”, the gay man is a homosexual who has money. Based on that social and economic position, you have freedom. On the other hand, the fag who has no money is screwed.(Maximiliano, personal communication, 28 May 2020)
3.2.2. Gender Identity Perspective and Inclusive Treatment Provided by Health Personnel
For us trans people, if we go to a medical service, either Government or private health service, which is instead government health service, because no job pays you to have private medical assistance. We run into the discriminatory issue, from not wanting to attend you, not understanding or not empathizing a little bit with your gender identity, making it visible that you are not the person you project.(S.T., personal communication, 7 April 2020)
Training professionals is essential. Midwives in the clinics are not prepared to take care of bi or lesbian girls … one of the main focuses is educating the nurses … they could take the opportunity to give information that does not appear in the books. It is dangerous, it is dangerous that we are so ignorant … yes, they discriminate, but they discriminate out of ignorance. It should not be that simple. They would not have to ask stupid questions … I do not even want to think about what a 16-year-old girl thinks, who wants to know a little more, and has to ask the midwife; or if a woman has to report that her girlfriend hit her, how does she do it?(Alicia, personal communication, 11 February 2020)
3.2.3. Mental Health Programs with a Community Approach
The first time a support group was done with people of diversity, it was in the framework of alcohol and drugs health program that focused on diversity, and that was the only way the program could be accepted, and then they carried it out.(J.O., personal communication, 23 April 2019)
In her case [her partner], there is this kind of perform as heterosexual, for example, at work. We have reflected on it, had to ask for advice, we have done therapy to consider these things like: “Hey if the children are going to school, you have to assume it [being lesbian]”.(Saau, personal communication, 3 February 2020)
The positive effect that access to individual therapy has on LGBTIQ+ people could be crucial. Group therapy or support groups where information and experiences can be shared become relevant too. Interventions with a community focus would have an additional positive effect in terms of promoting self-management and the formation of stable intersectoral support networks, where nurturing exchanges between LGBTIQ+ people could be generated: “For diverse paternities and maternities, I tell you, I haven’t seen it. I always see aids in general… not as something specific”.(Ivan, personal communication, 1 January 2020)
LGBTIQ+ parents take their children to psychologists, and they also actively participate in these sessions … Group workshops, where the experience could be shared, where doubts could be demystified. I don’t know, whatever may appear as a doubt within this maternity or paternity. To generate links with the educational places where they have their children. To open the subject, not to close it, because it should be normalized.(C.V., personal communication, 16 December 2019)
3.2.4. Guarantee Access to Assisted Fertilization Programs
The fertilization through FONASA [Chile’s public health system], which is now open, has unlimited quotas that were limited before. Even so, they require you to be married to a man. So that’s how it was, and I remember that it was very controversial because single women and women who are married to other women are not eligible for the benefit that FONASA gives, supposedly, to the entire population, so it was a bit difficult.(Na, personal communication, 17 May 2019)
First, the main obstacle is that here in Chile, we do not have … How do you say this? The access … that you could, let’s say, get pregnant with sperm … you have to do it totally through the private health system, which is very expensive. And, on the other hand, there are countries like Argentina, where everyone can access assisted fertilization, where the State subsidizes you. If you have any problem, regardless of whether you may have fertility problems or not … In my case, the most challenging thing was that the economic cost … it would be my second treatment. We are not going to continue like this either … it is already a lot of money, so no. Spending so much… That is always there. We talked about this problem, how many times to try, within the possibilities.(Saau, personal communication, 3 February 2020)
3.2.5. Generate Collaborative Alliances with a Community Approach between Health Services, Civil Society, and LGBTIQ+ Organizations
There should be an institution of its own, which, if it is going to be governed by the State or, in this case, by the Municipality, should be a house of diversity exclusively or people of sexual diversity … focused on problems… current problems of sexual diversity, which are: adoption, being thrown out of the house. These aggressions are becoming more and more notorious … there is a lack of support.(J.O., personal communication, 23 April 2019)
[Interventions could be made in] spaces of greater informality to work with neighborhood associations, workshops, and things like that. They may be able to enter other areas that are not traditional. I say this because I feel that way, you cannot wait ten, fifteen, twenty years for cultural changes to occur regarding what the children are being taught; I believe that intervention has to be more concrete and more profound from today, from now on. In that sense, precisely incorporating education in non-traditional spaces is decisive to generate change.(Maximiliano, personal communication, 28 May 2020)
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characterization Data | Participant Pseudonym |
---|---|
Trans man, activist, 21 years old, Chile, zero children | J.O. |
Gay male, researcher, 47 years old, Colombia, zero children | M.R. |
Lesbian woman, psychologist, 37 years old, Chile, two children | Saau |
Gay man, make-up artist, 30 years old, Chile, two children | Aaron |
Bisexual man, self-employed, 34 years old, Chile, one child | Sebastian |
Trans woman, activist, 34 years old, Mexico, zero children | S.T. |
Bisexual woman, psychotherapist, 34 years old, Chile, zero children | C.V. |
Lesbian woman, physician, 24 years old, Chile, zero children | Na |
Bisexual man, student, 27 years old, Chile, zero children | Ivan |
Bisexual man, teacher, 33 years old, Chile, zero children | Maximiliano |
Gay man, psychologist, 33 years old, Chile, zero children | Mau |
Gay man, researcher, 47 years old, Chile, zero children | J.B. |
Bisexual woman, self-employed, 35 years old, Chile, one child | Alicia |
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Alday-Mondaca, C.; Lay-Lisboa, S. The Impact of Internalized Stigma on LGBT Parenting and the Importance of Health Care Structures: A Qualitative Study. Int. J. Environ. Res. Public Health 2021, 18, 5373. https://doi.org/10.3390/ijerph18105373
Alday-Mondaca C, Lay-Lisboa S. The Impact of Internalized Stigma on LGBT Parenting and the Importance of Health Care Structures: A Qualitative Study. International Journal of Environmental Research and Public Health. 2021; 18(10):5373. https://doi.org/10.3390/ijerph18105373
Chicago/Turabian StyleAlday-Mondaca, Carolina, and Siu Lay-Lisboa. 2021. "The Impact of Internalized Stigma on LGBT Parenting and the Importance of Health Care Structures: A Qualitative Study" International Journal of Environmental Research and Public Health 18, no. 10: 5373. https://doi.org/10.3390/ijerph18105373