Adolescents of the US National Longitudinal Lesbian Family Study: the impact of having a known or an unknown donor on the stability of psychological adjustment.

BACKGROUND: The current study is based on the US National Longitudinal Lesbian Family Study (NLLFS), which was designed to document the development of the first generation of lesbian families with children conceived through donor insemination. Data were collected in five waves, first at insemination or during pregnancy, and subsequently when the index children were 2, 5, 10 and 17 years old. The study is ongoing, with a 93% retention rate to date. The purpose of the current investigation was to assess changes in psychological adjustment of the index offspring between the time that they were 10 and 17 years old (T4 and T5) and to examine the effects of having a known or an as-yet-unknown donor. METHODS: The total T5 sample consisted of 78 adolescents. The mothers in 74 families completed a Child Behaviour Checklist (CBCL) on their offspring at both T4 and T5: 26 of these offspring had been conceived through known sperm donors and 48 through unknown donors. Changes in psychological adjustment were assessed through computations of stability coefficients between T4 and T5 on all CBCL subscales, and by means of a general linear model (GLM). RESULTS: On 10 out of 11 CBCL subscales, the stability coefficients were not significantly different for adolescents with known and unknown donors. Findings from the GLM showed that no main effect for donor type was found; for offspring in both donor groups thought problems and rule-breaking behaviour were higher and scores on social problems and aggressive behaviour were lower at T5 than T4. CONCLUSIONS: The development of psychological well-being in the offspring of lesbian mothers over a 7-year period from childhood through adolescence is the same for those who were conceived through known and unknown donors.

Prevalence of hormone replacement therapy and antidepressant use in peri- and postmenopausal women.

OBJECTIVE: To examine the prevalence of hormone replacement therapy (HRT) and antidepressant use in peri- and postmenopausal women. DESIGN: Prevalence survey. SUBJECTS: Peri- and postmenopausal outpatients (N = 253) at five medical clinics. METHODS: Participants completed a 47-item questionnaire requesting information on mood changes associated with menstruation, childbirth, oral contraceptive use, and menopause. Peri- and postmenopausal participants were asked to rate the severity of dysphoric symptoms experienced during the menopausal transition and to specify whether HRT, antianxiety medication, or antidepressant medication relieved the symptoms. RESULTS: Forty percent of respondents experienced more severe depression than anticipated during menopause, but only 8% were treated with antidepressants. Forty-six percent of respondents were treated with HRT. CONCLUSIONS: The data suggest that antidepressant and antianxiety medications are more helpful than HRT in relieving peri- and postmenopausal depression or anxiety. However, most women managed the mood changes associated with menopause without psychopharmacologic intervention. This is consistent with other reports on the transitory nature of peri- and postmenopausal depression for most women.

Shoestring science.

ABSTRACT Nanette K. Gartrell, MD, is a psychiatrist, teacher and researcher who has served on the faculties of Harvard Medical School and the University of California, San Francisco. For the past thirty years, without relying on major grants, she has been gathering data to depathologize lesbianism. Her earliest investigations contributed to the effort to remove "homosexuality" from the list of mental disorders. More recently, Dr. Gartrell has been conducting a national, longitudinal study of lesbian families. In this overview of her research career, Dr. Gartrell discusses the strategies that she has used successfully for pursuing scientific investigations on a shoestring budget.

Rainbow philanthropy.

ABSTRACT Martina Navratilova was the first professional athlete to proclaim her lesbianism. After retiring from a stunning tennis career, Martina Navratilova has emerged as a prominent author, television commentator, and public speaker. She is an influential advocate of lesbigay causes, and a major contributor to the lesbigay community. This article describes Martina's "passion [and] #1 cause"-the Rainbow Endowment.

The National Lesbian Family Study: 3. Interviews with mothers of five-year-olds.

This third report from a longitudinal study of lesbian families presents data obtained from interviews with mothers of five-year-old children conceived by donor insemination. Results indicated that 87% of the children related well to peers, 18% had experienced homophobia from peers or teachers, and 63% had grandparents who frankly acknowledged their grandchild's lesbian family. Of the original couples, 31% had divorced. Of the remainder, 68% felt that their child was equally bonded to both mothers. Concerns of lesbian families are discussed.

The National Lesbian Family Study: 2. Interviews with mothers of toddlers.

In this second report from a longitudinal study of lesbian families in which the children were conceived by donor insemination, interviews yielded the following data: Most couples shared parenting co-equally; the majority felt closer to their family of origin; adoptive co-mothers felt greater legitimacy as parents; biology and nurture received the same ratings for mother-child bonding; and political and legal action had increased among many participants. The impact of these findings and that of homophobia on lesbian family life are discussed.

If this is tuesday, it must be dee confessions of a closet polyamorist.

SUMMARY The author discusses the evolution of non-monogamy in a 24-year lesbian relationship. The couple's initial agreement stipulated that outside liasions be concealed as much as possible. More recently, the couple has established a complex system for incorporating other paramours into their lives.

The national lesbian family study: 1. interviews with prospective mothers.

This first report from a longitudinal study of 84 lesbian families, 70 of which include a co-mother as well as a birthmother whose child was conceived by donor insemination, presents interview data on parental relationships, social supports, pregnancy motives and preferences, stigmatization concerns, and coping strategies. Methodological limitations of studying this special population are noted, and plans for follow-up interviews over the course of 25 years are outlined.

Hormones and sexual orientation: a questionable link.

This paper critically reviews the studies which explore a possible causal relationship between sex hormones and the development of sexual orientation. Early studies focused on hormone measurements in adult men and women. While definitive interpretations are hindered by methodological problems, the studies as a whole do not support a causal relationship between postnatal hormone levels and sexual orientation. More recently, a theory that prenatal hormone levels produce varying degrees of brain androgenization and subsequent dimorphic sex role behavior has consistently been supported by studies in lower mammals. Attempts to generalize the causes of sexual orientation from animals to humans have been controversial. Efforts to measure the estrogen feedback as an indication of brain androgenization have produced inconsistent results. Studies of men and women who experienced defect in hormone metabolism (i.e., CAH and testicular feminization) have not found a concurrent increase in homosexual behavior. Overall, the data do not support a causal connection between hormones and human sexual orientation.

Physician-patient sexual contact. Prevalence and problems.

To document the current prevalence of physician-patient sexual contact and to estimate its effect on involved patients, 10,000 family practitioners, internists, obstetrician-gynecologists, and surgeons were surveyed. Of the 1,891 respondents, 9% acknowledged sexual contact with 1 or more patients. Even in the unlikely case that none of the nonrespondents had sexual contact with patients, its prevalence among all 10,000 physicians surveyed would still be 2%. Of respondents, 23% had at least 1 patient who reported sexual contact with another physician; 63% thought this contact was "always harmful" to the patients. Almost all (94%) responding physicians opposed sexual contact with current patients; 37% also opposed sexual contact with former patients. More than half of respondents (56%) indicated that physician-patient sexual contact had never been addressed in their training; only 3% had participated in a continuing education course focusing on this issue. Clear and enforceable medical ethics codes concerning physician-patient sexual contact are needed, as well as preventive educational programs for medical schools and residency programs.

Sexual abuse of patients by therapists: strategies for offender management and rehabilitation.

Many therapists are unsure of how to respond to reports of sexual abuse of patients by previous therapists. The results of strategies developed in Minnesota and other jurisdictions suggest ways to handle the reporting, management, and rehabilitation of offenders in therapist-patient sexual abuse cases.

Management and rehabilitation of sexually exploitive therapists.

State legislators and mental health professionals in Minnesota have been active in developing strategies to improve reporting, management, and rehabilitation of sexually exploitive therapists. In 1985 and 1986, the legislature criminalized sexual contact by a therapist with a current or emotionally dependent former patient, established sexual exploitation by a therapist as a statutory cause of action, and required that all licensed health professionals report to the Board of Medical Examiners any physician who engages in sexual or sexually suggestive contact with a patient. The Walk-In Counseling Center, a nonprofit agency in Minneapolis, has taken an active role in evaluating exploitive therapists for licensing boards and employers to determine their rehabilitation potential. Mental health professionals and lawmakers have also collaborated in the development of strategies for preventing sexual exploitation and abuse by therapists.

Psychiatric residents' sexual contact with educators and patients: results of a national survey.

In a national survey of PGY-4 psychiatric residents, 4.9% of the 548 respondents indicated that they had been sexually involved with psychiatric educators and 0.9% reported that they had been sexually involved with patients. Most residents reported no or minimal instruction in their residency programs about educator-resident and resident-patient sexual contact. The authors compare these results with those from previous surveys of psychologists. They discuss the need for expanding training curricula to include specific education on sexual exploitation.

Psychiatrist-patient sexual contact: results of a national survey, II: Psychiatrists' attitudes.

In a national random-sample survey of 1,423 practicing psychiatrists, the overwhelming majority of the respondents (98%) said that therapist-patient sexual contact is always inappropriate and usually harmful to the patient. However, 29.6% said that such contact after termination of therapy might sometimes be acceptable. Psychiatrists who acknowledged having had sexual contact with one or more patients (N = 84) differed markedly from their peers in their attitudes. The majority (74%) of these offenders believed that sexual contact could be appropriate after termination; many apparently rationalized their behavior in this manner. The authors discuss the need for systematic professional education on the subject.

Psychiatrist-patient sexual contact: results of a national survey. I: Prevalence.

In a nationwide survey of U.S. psychiatrists, 7.1% (N = 1,057) of the male and 3.1% (N = 257) of the female respondents acknowledged sexual contact with their own patients. Eighty-eight percent of the sexual contacts occurred between male psychiatrists and female patients. All offenders who had been involved with more than one patient were male. Forty-one percent of the offending psychiatrists sought consultation because of their sexual involvement with patients. The authors compare these results with those of previous surveys of psychiatrists and psychologists and discuss the need for addressing this problem within the psychiatric profession.

Increased libido in women receiving trazodone.

The author presents the cases of three depressed women whose libido increased to above premorbid levels during trazodone treatment. Two patients resisted discontinuing the drug because of this pleasurable side effect.

A pilot study of women's attitudes towards breast-conserving surgery with primary radiation therapy for breast cancer.

Breast-conserving surgery ("lumpectomy") with primary radiation therapy is gaining acceptance as an alternative to mastectomy for breast cancer. Currently, little is known about the specific immediate and long-range biopsychosocial effects of breast-conserving therapy as compared to more traditional mastectomy procedures. Physicians' speculations about the women who chose breast-conserving treatment as opposed to mastectomy seem to have been influenced by the scientific debate concerning the efficacy of this procedure. This study is a preliminary investigation of the attitudes and experiences of women receiving breast-saving therapy for carcinoma of the breast.