The Mediating Role of Insecure Attachment in the Gap in Parenthood Desire between Lesbian and Gay Individuals and Their Heterosexual Counterparts.

Previous studies have shown that lesbian and gay (LG) individuals, in comparison to their heterosexual counterparts, tend to report lower levels of parenthood desire. While numerous variables have been suggested to explain this gap in parenthood aspirations, no study has investigated the mediating role of avoidant attachment in the association between sexual orientation and parenthood desire. For that purpose, a sample of 790 cisgender Israelis aged 18-49 years (M = 28.27, SD = 4.76) was recruited using convenience sampling. Among the participants, 345 self-reported as predominantly or exclusively lesbian or gay and 445 self-reported as exclusively heterosexual. Participants completed online questionnaires assessing their sociodemographic characteristics, parenthood desire, and avoidant and anxious attachment styles. Mediation analyses were performed using the PROCESS macro, and the results revealed that LG individuals reported lower parenthood desire, higher avoidant attachment, and higher anxious attachment compared to heterosexual individuals. Moreover, avoidant attachment had a significant mediation effect in the association between sexual orientation and parenthood desire. The findings suggest that LG individuals are more likely to report higher avoidant attachment due to possible rejection and discrimination from family members and peers, and this may be associated with lower parenthood desire. The results contribute to the growing body of research on family formation and parenthood aspirations among LG individuals, and specifically studies aimed at delineating the factors that contribute to the gap in parenthood aspirations between sexual minority individuals and their heterosexual counterparts.

A relational investigation of Israeli gay fathers' experiences of surrogacy, early parenthood, and mental health in the context of the COVID-19 pandemic.

Perinatal distress affects approximately 10% of fathers, but little is known about how gay fathers experience the challenges surrounding childbirth and early parenting of a child. This study explored gay fathers' experiences of having a baby via transnational surrogacy, raising that baby as a gay parent, and the context of the COVID-19 pandemic. In-depth qualitative interviews were conducted with 15 Israeli men to understand their experiences of surrogacy and early parenthood, focusing on the impact on their mental health and the relational factors involved. Secondary narrative analysis revealed that fathers constructed surrogacy as a perilous quest that required strong intentionality to undertake. The first year of parenthood was conceptualised alternately as a joyful experience and/or one that challenged fathers' identities and mental health. A relational framework was applied to better conceptualise the fathers' narratives, revealing that actual connections-and the potentials for links-considerably shaped experiences of surrogacy, perinatal distress and recovery. Implications for research and policy are discussed.

Mental Health Disparities Between Lesbian Mothers and Heterosexual Parents: the Mediating Role of Positivity.

Introduction: Previous evidence has shown better mental health outcomes for lesbian mothers, in comparison with heterosexual parents. The present study explored the mediating role of positivity (i.e., the tendency to view life with a positive outlook) in determining these mental health differences. Methods: Seventy-two Israeli lesbian mothers by donor insemination (from 36 families) were compared with 72 Israeli heterosexual parents by assisted reproduction (without donated gametes; from 36 families) on positivity, life satisfaction, and depressive symptomatology. All parents were cisgender and had at least one child born through assisted reproduction, aged 3-10 years. Data were collected between December 2019 and February 2021. Results: Mediational analyses indicated that lesbian mothers reported greater positivity, which was, in turn, associated with greater life satisfaction and less depressive symptomatology. Conclusions: The results pinpoint the possible protective and strengthening role of positivity for lesbian mothers in the pronatalist and familistic environment of Israel. The research contributes to the literature on the mental health of parents with diverse sexual orientations living outside of the USA and Europe. Policy Implications Policymakers and mental health professional should be knowledgeable about the importance of improving positivity as a strategy for reducing depressive symptomatology and promoting life satisfaction among lesbian mothers. Moreover, policy makers and legislators are called to ease the access of sexual minority individuals to parenthood, as in this population parenthood associates with heightened mental health outcomes.

Estimated likelihood of parenthood among sexual minority individuals associates with interpersonal vulnerability and traumatic outlook.

BACKGROUND: Lesbian women and gay men (LG) tend to report lower levels of parenthood aspiration than their heterosexual counterparts. While several variables have been suggested to explain this phenomenon, no study has investigated the potential mediating role of interpersonal vulnerability and subjective traumatic outlook in the association between sexual orientation and the estimated likelihood of parenthood. OBJECTIVE: To investigate whether interpersonal vulnerability and subjective traumatic outlook mediate the association between sexual orientation and a lower estimated likelihood of parenthood. METHODS: A sample of 435 childfree, cisgender Israeli participants, aged 18-49 years (M = 27.82, SD = 4.47), were recruited through convenience sampling. 192 participants self-reported as LG (64 lesbian women and 128 gay men). Participants completed online questionnaires assessing their estimated likelihood of parenthood, interpersonal vulnerability, and subjective traumatic outlook. Mediation analyses were performed using the PROCESS macro. RESULTS: LG individuals reported a lower estimated likelihood of parenthood than their heterosexual counterparts. Interpersonal vulnerability and subjective traumatic outlook significantly mediated the association between sexual orientation and a lower estimated likelihood of parenthood. CONCLUSIONS: Despite improvement in the socio-political climate relating to sexual minority rights and access to fertility technologies, LG individuals are still more likely to report a lower estimated likelihood of parenthood in comparison to heterosexual individuals. Moreover, this gap appears to be partially mediated by interpersonal vulnerability and subjective traumatic outlook. The results contribute to the growing body of international research exploring family formation among sexual minority individuals and are relevant for researchers, clinicians, and policymakers.

Assisted Conception Socialization Self-Efficacy Among Israeli Lesbian, Gay, and Heterosexual Parent Families and its Association with Child Externalizing Problems.

This questionnaire-based study compared 36 Israeli lesbian mother families (n = 72 lesbian mothers) formed by donor insemination, 39 Israeli gay father families (n = 78 gay fathers) formed by gestational surrogacy, and 36 Israeli heterosexual parent families (n = 72 heterosexual parents) formed by assisted reproduction (without donated gametes), all with a target child aged 3-10 years. The families were examined for parents' assisted conception socialization self-efficacy, depression, negative and positive affect, life satisfaction, positivity, resilience, social support, and child externalizing problems. Multiple factors associated with child externalizing problems were also examined. Multilevel modeling analyses indicated that parents' assisted conception socialization self-efficacy did not differ between family groups; however, lesbian mothers and gay fathers reported fewer child externalizing problems and greater social support, relative to heterosexual parents. Also, lesbian mothers-but not gay fathers-reported lower levels of depression, greater life satisfaction, and more positivity than did heterosexual parents. Finally, irrespective of family type, greater assisted conception socialization self-efficacy was associated with fewer parent-reported child externalizing problems. Findings are interpreted in light of the cultural socialization framework and Israel's familistic and pronatalist environment. Implications for health professionals, educators, and policymakers working with diverse family forms are discussed.

The desire for more children among Israeli lesbian, gay, and heterosexual couples who became parents through assisted reproduction.

The present online questionnaire-based study compared 72 lesbian mothers by donor insemination (within 36 families), 78 gay fathers by gestational surrogacy (within 39 families), and 72 heterosexual parents by assisted reproduction (without donated eggs and/or sperm; within 36 families), on their desire to have more children and their ideal number of children. All participants self-identified as cisgender, lived in Israel, and had a mean number of two children. The study also explored the predictors of participants' desire for more children. Multilevel modeling analyses indicated that, when participants' actual number of children was controlled for, lesbian and gay parents did not differ from heterosexual parents on their desire for more children and their ideal number of children. Parents' younger age, greater positivity, and lower attribution of responsibility to children for misbehavior, in addition to a lower discrepancy between their actual and ideal number of children, were associated with greater desire for more children. The results suggest that lesbian and gay parenthood may mark an entrance to the Israeli familistic "mainstream," which, in turn, may decrease differences in parenthood aspirations as a function of sexual orientation. The study contributes to the scant literature on the desire for more than one child among parents in diverse family configurations. It further provides family researchers and policy makers with vital information on the most influential factors associated with the desire for more children among lesbian, gay, and heterosexual parents. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Higher Levels of Postnatal Depressive Symptomatology, Post-Traumatic Growth, and Life Satisfaction among Gay Fathers through Surrogacy in Comparison to Heterosexual Fathers: A Study in Israel in Times of COVID-19.

This study aimed to explore the psychological welfare, as indicated by postnatal depressive symptomatology, life satisfaction, and posttraumatic growth (growth after contending with stressful birth events), of Israeli gay fathers through surrogacy in comparison to heterosexual fathers. For that purpose, a sample of 167 Israeli fathers (M = 35.6, SD = 4.4) was recruited (68 identified as gay fathers through surrogacy and 99 as heterosexual fathers). Participants completed questionnaires assessing their postnatal depressive symptomatology, life satisfaction, and sense of posttraumatic growth after becoming fathers. Results indicated that gay fathers through surrogacy reported higher levels of life satisfaction and posttraumatic growth than heterosexual fathers. Yet, gay fathers also reported higher levels of postnatal depressive symptomatology than heterosexual fathers when life satisfaction or posttraumatic growth values were low or medium. The findings were interpreted in light of the hardships associated with cross-border surrogacy and the psychological outcomes associated with succeeding to become fathers after contending with them. The study contributes to the limited literature on postnatal depressive symptomatology and posttraumatic growth among gay fathers through surrogacy and provides clinicians and policymakers with relevant information on the psychological strengths and potential difficulties associated with cross-border surrogacy among gay fathers.

What We Know and What Remains to Be Explored about LGBTQ Parent Families in Israel: A Sociocultural Perspective.

This paper reviews research on gay and lesbian parent families in Israel through cultural lenses while recognizing the diversity of these families. The major aims of the review are: (1) to provide an overview of the situation of LGBTQ parent families in Israel, as well as of the sociocultural background of the Israeli context and its effects on sexual minorities and LGBTQ parent families; and (2) to identify the limitations and lacunas in the existing research and shed light on what remains to be explored. We searched numerous databases for relevant studies, adopting a narrative approach to summarize the main findings while taking into account the literature on the socio-cultural context in Israel and its impact on sexual minorities and LGBTQ parent families. The search yielded empirical results only for gay and lesbian parent families, with studies emphasizing the challenges they face and the factors related to their well-being and that of LGB individuals aspiring to become parents. In addition, it revealed that research on children's psychosocial adjustment as a function of parental sexual orientation is quite scarce in Israel. Moreover, it indicated the absence of investigations of bisexual, transgender, or queer parents. We conclude that the sociocultural context of Israel, including its pronatalist and familistic orientation, may play an important role in shaping the experiences of LGBTQ parent families, and should be taken into consideration when studying LGBTQ parents.

The moderation of socio-demographics in physical and mental health disparities among Israeli gay and heterosexual middle-aged and older men.

OBJECTIVES: Physical and mental health disparities were explored among Israeli middle-aged and older gay and heterosexual men alongside the moderating role of age, relationship status, and place of birth. METHOD: 173 middle-aged and older gay men were individually matched with 173 middle-aged and older heterosexual men at the age range of 50-86 (M = 60.56, SD = 8.42). All participants completed measures of doctor visits, physical health comorbidity, depressive symptoms, and anxiety. RESULTS: Israeli middle-aged and older gay and heterosexual men did not significantly differ on physical or mental health indicators. However, a more differential analysis revealed that older age and relationship status had a moderating role, such that older gay men reported more physical health comorbidity in comparison to older heterosexual men. Similarly, gay men who were not in a steady relationship reported more frequent visits to the doctor and more anxiety in comparison to heterosexual men who were not in a steady relationship. Additionally, immigration history appeared as a potential resiliency factor, such that gay men who were not born in Israel reported less frequent doctor visits and less anxiety in comparison to heterosexual men who were not born in Israel. CONCLUSIONS: This study presents a pioneering examination of physical and mental health disparities in an Israeli sample of middle-aged and older gay and heterosexual men. These results may call the attention of clinicians and policymakers to both vulnerabilities and strengths of middle-aged and older gay men.

Deciding to parent or remain childfree: Comparing sexual minority and heterosexual childless adults from Israel, Portugal, and the United Kingdom.

This study compared Israeli, Portuguese, and British childless lesbian, gay, bisexual (LGB) and heterosexual adults on parenthood aspirations as indicated by their desire and intent to become a parent and their concern about childlessness. For this purpose, 168 childless adults (57 self-reported as LGB) in Portugal were matched on sociodemographic variables with 168 participants from the United Kingdom and 168 participants from Israel, resulting in a sample of n = 504 (Mage = 28.26, SD = 6.17). Participants were recruited through convenience sampling and completed online questionnaires assessing parenthood desire, intent, and concern about childlessness. Results indicated that participants from Israel and Portugal reported higher levels of parenthood desire, intent, and concern about childlessness than participants from the United Kingdom. Parallel patterns also appeared separately for LGB and heterosexual participants between the countries. Heterosexual participants from Israel scored higher than counterparts from Portugal on parenthood intention and concern about childlessness. In addition, LGB participants in general reported lower levels of parenthood desire, intentions, and concern about childlessness than did heterosexual participants. The findings are interpreted in light of the different sociocultural contexts of the countries, that is, the individualistic values characterizing the U.K. versus the familistic values characterizing the Israeli and Portuguese contexts, alongside a strongly pronatalist stance evident in Israel and economic context in Portugal. The study contributes to the scant comparative literature on parenthood aspirations among LGB individuals as a function of cultural context by providing a multicontextual viewpoint on parenthood aspirations, sexual orientation, and diverse sociocultural contexts. Implications for clinicians are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The moderation of attachment in the association between depressive symptoms and self-harm among a clinical sample.

BACKGROUND: Self-harm is a severe health problem worldwide and in particular in clinical settings. The association of depression and self-harm has been extensively studied alongside various variables that have been examined as moderating this association. However, no previous study has examined the moderating role of attachment in this association. AIM: We explored the role of attachment orientation in moderating the association between depressive symptoms and self-harm among a sample of patients in a community mental health clinic. METHOD: This study was a de-identified archival study of patients' medical charts, and used a convenience sample of 199 patients, which completed self-report measures following the initial intake appointment as part of clinic procedures. RESULTS: Findings showed that both attachment anxiety and avoidance moderated the association between depressive symptoms and self-harm, such that depressive symptoms were positively associated with self-harm only when attachment anxiety scores were high, and attachment avoidance scores were high or average. CONCLUSIONS: Attachment anxiety and avoidance should be assessed in the initial intake of patients as it has a contribution to understanding self-harm vulnerability among new patients. Future studies should explore this moderation longitudinally so causality could be inferred.

The Mediating Role of Attachment Avoidance in the Association between Sexual Orientation and Mental Health.

The current study examined whether attachment avoidance mediates the association between being a sexual minority (gay men or lesbian women) and poorer mental health outcomes. For this purpose a community-dwelling sample of 350 gay men and lesbian women (M = 30.39, SD = 6.82) and 445 heterosexual men and women (M = 26.95, SD = 3.11) completed measures of attachment avoidance, depressive symptoms, anxiety symptoms and life satisfaction. Results showed that gay men and lesbians reported poorer mental health. Moreover, attachment avoidance had a mediating effect on the association between being a sexual minority and depressive symptoms, anxiety symptoms and life satisfaction. These findings are some of the first to suggest empirical support for the role of attachment avoidance in accounting for the mental health vulnerability of gay men and lesbians. The results contribute to a better understanding of the minority stress model and should be addressed by practitioners.

Pathways to Fatherhood: Psychological Well-Being Among Israeli Gay Fathers Through Surrogacy, Gay Fathers Through Previous Heterosexual Relationships, and Heterosexual Fathers.

This study explored differences in psychological well-being as assessed by life satisfaction, parenthood satisfaction, depressive symptoms and the Big Five personality dimensions among 219 Israeli fathers; 76 gay men who had become fathers through a heterosexual relationship, 63 gay men who had become fathers through surrogacy, and 78 heterosexual men. After controlling for sociodemographic characteristics, gay fathers through surrogacy reported greater satisfaction with parenthood, greater satisfaction with their lives, and reported higher levels of extraversion when compared to heterosexual fathers. No significant differences emerged between the three groups on depressive symptoms, neuroticism, conscientiousness, agreeableness, and openness to experience. These findings emphasize the predominant similarities and some possible differences on psychological well-being between the different paths to fatherhood. This study is one of the first to compare several paths to fatherhood on psychological well-being, thus illuminating the contribution of fatherhood route to psychological well-being in an era where gay men are increasingly becoming fathers in diverse ways.

Duration of untreated psychosis and response to treatment: an analysis of response in the OPTiMiSE cohort.

Some, but not all, studies have found longer duration of untreated psychosis (DUP) to be associated with poor response to treatment and more severe negative symptoms in schizophrenia. The aim of the current analysis was to investigate these parameters in a large cohort of patients in their first psychotic episode. The OPTiMiSE cohort included 446 patients with DUP up to two years, who were administered amisulpride for 4 weeks (Phase I). Patients who did not meet Andreasen remission criteria were randomized to double-blind continuation of amisulpride or olanzapine for 6 additional weeks in a blinded study (Phase II). Analyses showed that shorter DUP was associated with lower baseline CGI scores (p<0.001, r = 0.184), PANSS total (p = 0.025, r = 0.106) and PANSS negative subscale scores (p = 0.023, r = 0.107). Remitters had a significantly shorter mean DUP compared to non-remitters both in Phase I (24.5 weeks ±24.3 vs. 35 weeks ± 32.2, p = 0.01, t=-2.521) and in Phase II (24.3 weeks ± 26.4 vs. 38.3 weeks ± 31.3, p = 0.031, t=-2.194). Logistic regression analyses showed a significant effect of DUP on treatment response both in phase I (p = 0.008) and phase II (p = 0.041). Linear regression analyses found that DUP significantly affects PANSS Total change at the end of phase I (p = 0.028) but not at the end of phase II (p = 0.236). Based on these findings, it is possible to conclude that shorter DUP is associated with better response to treatment, particularly during the first weeks after treatment initiation. These findings highlight the need for early identification of the first psychotic episode.

Self-Perceived Parental Role and Mental Health Concomitants Among Israeli Gay and Heterosexual Fathers.

In this study we examined the association between self-perceived parental role and adverse mental health (indicated by depressive symptoms, neuroticism, and negative affect) in a sample of 82 Israeli gay fathers (Mean age = 39.57, SD = 6.70) that were individually matched with 82 heterosexual fathers (Mean age = 39.11, SD = 7.88). Results showed that although self-perceived parental role was associated with adverse mental health, this association was moderated by sexual orientation, such that a significant negative association between self-perceived parental role and adverse mental health was evident only among gay fathers. The findings are understood by features of gay fatherhood, which is intentional and purposeful, and usually achieved after contending with particular difficulties in the journey to fatherhood. These features presumably shape the perceived parental role, and thus may link more strongly with lower levels of adverse mental health among gay fathers, compared to heterosexual fathers.

Attachment avoidance and parenthood desires in gay men and lesbians and their heterosexual counterparts.

Objective: We explored the desire to be a parent, attachment avoidance and their associations in a sample of gay men and lesbians and their heterosexual counterparts. Background: Previous research suggested a link between minority stress and higher attachment avoidance. However, the association between attachment avoidance and parenthood desires as a function of sexual orientation was not studied. Methods: The sample was composed of 883 community-dwelling participants (51.1% women, 30.57% identified as gay men and 14.15% as lesbians) that were recruited through convenience sampling. Results: Gay men and lesbians reported less desire to be parents than their heterosexual counterparts and higher attachment avoidance. However, the association between attachment avoidance and less desire for parenthood was moderated by sexual orientation, such that the correlation between attachment avoidance and lesser desire for parenthood was only found for heterosexual men and women. Conclusion: These findings pinpoint the potential vulnerability of gay men and lesbians to develop greater attachment avoidance and the impact of sexual orientation on the association between attachment avoidance and the desire to be a parent. The moderation effect is discussed in terms of the specific reproductive alternatives available to gay men and lesbians vs. the heterosexual population.

The association between negative attitudes toward aging and mental health among middle-aged and older gay and heterosexual men in Israel.

OBJECTIVES: The association between negative attitudes toward aging and mental health (indicated by depressive symptoms, neuroticism, and happiness) was explored among Israeli middle-aged and older gay and heterosexual men. METHOD: In a community-dwelling sample, 152 middle-aged and older gay men and 120 middle-aged and older heterosexual men at the age range of 50-87 (M = 59.3, SD = 7.5) completed measures of negative attitudes toward aging, depressive symptoms, neuroticism, and happiness. RESULTS: After controlling for socio-demographic characteristics, the association between negative attitudes toward aging and mental health was moderated by sexual orientation, demonstrating that negative attitudes toward aging were more strongly associated with adverse mental health concomitants among middle-aged and older gay men compared to middle-aged and older heterosexual men. CONCLUSIONS: The findings suggest vulnerability of middle-aged and older gay men to risks of aging, as their mental health is markedly linked with their negative attitudes toward aging. This vulnerability should be addressed by clinicians and counselors who work with middle-aged and older gay men.

Interpersonal vulnerability among offspring of Holocaust survivors gay men and its association with depressive symptoms and life satisfaction.

The aim of the current study was to examine whether offspring of Holocaust survivors (OHS) gay men report higher interpersonal vulnerability in comparison to non-OHS gay men, and to further assess whether that vulnerability mediates the association between having a Holocaust background and mental health outcomes (depressive symptoms and life satisfaction). For this purpose, a community-dwelling sample of 79 middle-aged and older OHS and 129 non-OHS gay men completed measures of hostile-world scenario (HWS) in the interpersonal domain, satisfaction from current steady relationship, depressive symptoms and life satisfaction. Results indicated that OHS reported higher HWS interpersonal vulnerability and lower satisfaction from current relationship in comparison to non-OHS gay men. Also, having a Holocaust background had an indirect effect on depressive symptoms and life satisfaction through HWS interpersonal vulnerability as well as through satisfaction from current relationship. These findings are the first to suggest interpersonal vulnerability of older OHS, in comparison to non-OHS, gay men, and an association between this vulnerability and adverse psychological outcomes. This interpersonal vulnerability, possibly representing HWS threats of both early family-based trauma and current sexual minority stress, along with its implications, should be addressed by practitioners who work with older gay men having a Holocaust background.