Study on Psychological Well-Being of Israeli Gay Fathers
Summary
A study explores psychological well-being of Israeli gay dads; found no differences in psychological well-being between paths to parenthood.

Excerpted from Frontiers in Psychology Full study available here.
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.
Introduction
In light of social, political, and technological developments, gay men are becoming fathers nowadays more than ever before (Carneiro et al., 2017; Carone et al., 2017b). Gay fatherhood has attracted growing research attention in recent years in varied countries (e.g., Tornello et al., 2011; Shenkman and Shmotkin, 2014; Baiocco et al., 2018; Bos et al., 2018), and has focused both on the development of children of gay fathers, alongside the psychological functioning of the parents themselves (e.g., Goldberg et al., 2010; Tornello and Patterson, 2015; Tornello et al., 2015; Shenkman and Shmotkin, 2016, 2019; Farr, 2017; Patterson, 2017; Green et al., 2019), yet little attention has been given to the comparison between different paths to gay fatherhood both in the developmental domain of the children and the psychological well-being of the parents (Tasker, 2013). Thus, this study aims to examine the broad concept of psychological well-being (as indicated by parenthood satisfaction, depressive symptoms, life satisfaction, and the Big Five personality dimensions) among three groups of Israeli fathers: gay men who had become fathers through surrogacy, gay fathers through a previous heterosexual relationship, and heterosexual fathers.
Our current study dwells in the theoretical framework of the family systems theory (Cox and Paley, 1997) which suggests that the development and adaptation of both children and parents are influenced and shaped not only by the family subsystems (e.g., parents and children) but also by the broader socio-cultural context. The sociocultural environment of Israel is a particularly rich terrain for exploring the similarities and differences in psychological well-being as a function of fatherhood route. On the one hand, a familistic society, which Israel is a prime example, promotes and values childbearing more highly than many other Western nations and sanctifies parenthood as the primary path to social acceptance (Tsfati and Ben-Ari, 2019). On the other hand, Israel enacts multiple legal hardships upon gay men who wish to become parents. For example, surrogacy services are not legal for same-sex couples in Israel though they are legal for heterosexual couples, and gay men who wish to become parents via surrogacy turn to highly expensive overseas surrogacy services in South East Asia and North America (Teman, 2010). In addition, the opportunities for gay men to adopt are extremely restricted (Gross, 2014), which makes the surrogacy path, though encompassing multiple ordeals for Israeli gay men, one of the preferred routs to gay fatherhood (Birenbaum-Carmeli, 2016; Tsfati and Ben-Ari, 2019). Succeeding to achieve fatherhood through this desired but difficult path might be linked with a gain in well-being among gay men (e.g., Erez and Shenkman, 2016) and therefore, stands as one of the primary rationales for expecting differences in psychological well-being outcomes as a function of fatherhood route. Also, the above-mentioned conflicting messages from the Israeli socio-cultural context, make it even more interesting to understand whether the different paths chosen by gay fathers relate simply to cohort differences or psychological characteristics, or whether these pathways are linked to distinct differences in psychological well-being in comparison to the patterns recorded by heterosexual fathers.
The current study adopted a comparative approach to examine differences between the three paths to fatherhood. This comparative approach in the context of LGBT families has previously produced important information regarding disparities between heterosexual and gay/lesbian parents with respect to marital and parental rights, division of labor, and well-being (e.g., Hatzenbuehler et al., 2010; Reczek and Umberson, 2012; Shenkman, 2018). However, the comparative approach between gay/lesbian and heterosexual parented families also has been criticized as between−group designs focus primarily on differences based on sexual identities, while other identities that are salient to the experience of LGBT individuals and families become invisible (Fish and Russell, 2018). Our current comparative design, included both a comparison with heterosexual fathers and a comparison between two pathways and experiences of gay fatherhood. Thus, we cast light on different experiences of gay fatherhood while also keeping a point of comparison with heterosexual counterparts.
Pathways to Gay Fatherhood
Four common routes are associated with gay fatherhood worldwide (e.g., Tasker and Patterson, 2007). These include gay men who had become fathers through a previous heterosexual relationship; gay men who had become fathers through adoption; gay men who had become fathers through shared parenting in agreement with a woman; and gay men who had become fathers through surrogacy. In the current study we will focus on the first and last, which are commonly considered as the most distinct in representing two polar social contexts (Tornello and Patterson, 2015). Gay parenting through a previous heterosexual relationship is commonly associated with fatherhood among middle-aged and older gay men who grew up in an environment in which their sexual orientation was considered as pathological and opportunities to become a parent outside of a heterosexual relationship were almost non-existent (Morrow, 2001; Tasker and Patterson, 2007; Tasker, 2013). In contrast gay fatherhood through surrogacy is associated with contemporary planned gay-fathers families, and is achieved through the use of progressive fertility technologies involving donated eggs, in vitro fertilization, and surrogacy with at least some liberal state policies allowing gay men access to these procedures (e.g., Carone et al., 2018a, b). Extremely scarce are studies that directly compare between different pathways to gay fatherhood (e.g., Carroll, 2018), probably because of difficulties inherent in achieving sufficient sample size for each group to allow quantitative comparisons (Roy et al., 2015). Thus, many studies that focus on gay fatherhood tend to combine different paths under one group of “gay fathers” or to concentrate on a single parenthood path (e.g., Shenkman and Shmotkin, 2016; Carone et al., 2017a, b).
While comparisons between different pathways to gay fatherhood are scarce, some comparisons between gay fathers through surrogacy and heterosexual fathers via assisted reproduction have been conducted. Van Rijn-van Gelderen et al. (2018) for example compared the well-being of gay fathers through surrogacy with heterosexual IVF parent families from three European countries (United Kingdom, the Netherlands, and France) and found no differences on parental stress, depression, anxiety, or relationship satisfaction between the two groups.
Shenkman et al. (2018), compared Israeli gay fathers with children from a previous heterosexual relationship and heterosexual fathers and found gay fathers reported higher levels of personal growth (feelings of continued development and self-improvement alongside a sense of personal fulfillment). The authors suggested that gay fathers from a previous heterosexual relationship had probably overcome numerous challenges entailed in the complex course of coming out to oneself and their ex-spouse and children. Coping successfully with such challenges could result in the construction of a new meaning to life, which might then explain the high levels of personal growth displayed. In another Israeli study, gay men who had pursued several different routes to gay fatherhood (fatherhood through surrogacy, a shared parenting agreement with a woman, and adoption) were compared with heterosexual fathers. Some differences between gay and heterosexual fathers emerged showing gay fathers reporting greater satisfaction with life and general happiness than did heterosexual fathers (Erez and Shenkman, 2016). No group differences were observed in self-reported positive and negative emotions. This lack of difference between gay fathers from a variety of routes to parenthood and heterosexual fathers on negative emotions, alongside the absence of differences on levels of neuroticism and depressive symptomatology, was again confirmed by Shenkman and Shmotkin (2019). Thus, in a familistic society such as Israel, success in becoming a gay father might ameliorate the adverse consequences of minority stress, thus resulting in no difference or even more positive psychological well-being outcomes for gay men compared with heterosexual men upon attaining fatherhood (Shenkman and Shmotkin, 2014, 2016, 2019).
Research exploring differences between gay and heterosexual men on Costa and McCrae’s (1992) Big Five personality traits, namely, extraversion, neuroticism, conscientiousness, agreeableness, and openness to experience, has produced mixed results. While some research teams have found no profound differences between the groups on personality traits in countries such Israel and New Zealand (e.g., Greaves et al., 2017; Ifrah et al., 2018), others have indicated that gay men were slightly higher than heterosexual men on agreeableness, conscientiousness, neuroticism, and openness to experience (e.g., Lippa, 2005; Zheng et al., 2011). Significant results have been interpreted in light of minority stress theory (Meyer, 2003) and the possible association between greater exposure to prejudice, discrimination, and social disapproval and particular personality features (Zheng et al., 2011). It was proposed, for example, that gay men and lesbian women may experience, on average, higher levels of neuroticism (e.g., higher levels of anxiety and depression and reduced levels of self-esteem) compared to heterosexual men and women, because of the stress related to their prevalent experience with prejudice and discrimination (Lippa, 2005). However, these studies did not specifically focus upon gay fathers.
Conclusion and Implications for Practice
This study was one of the first to compare three routes to fatherhood, namely heterosexual fathers, gay fathers through a heterosexual relationship and gay fathers through surrogacy, on diverse psychological well-being concomitants. Our results mainly emphasize the psychological well-being of fathers and the similarities between the fatherhood groups. Nevertheless, some differences did appear, especially when comparing heterosexual fathers with gay fathers through surrogacy. These differences portray gay fathers through surrogacy as more extraverted and more satisfied with both their parenthood and their life in general. While minority stress theory (Meyer, 2003) usually sheds light on the adversities gay men may endure due to their minority status, the current findings suggest that gay fatherhood, at least within the Israeli context, can be interpreted as a resiliency factor, meaning that in such a familistic and pronatal society, success in becoming a gay father might ameliorate some of the adverse outcomes of minority stress, and therefore result in no differences or even more positive outcomes for gay fathers through surrogacy than for heterosexual fathers on psychological well-being indicators (Shenkman and Shmotkin, 2014, 2019). This interpretation echoes the theoretical framework regarding family systems (Cox and Paley, 1997) that guided our study, and which proposes that psychological outcomes of both children and parents are also influenced by the broader socio-cultural context, and in our current study, the Israeli familistic society.
An application of the current findings appears especially relevant to clinicians working with gay fathers, revealing the potential benefits of fatherhood through surrogacy in regards to psychological well-being. Additionally, it seems that psycho-education focused both on the resiliency as well as the difficulties of gay life trajectories, could allow for a more integrative and perhaps optimistic outlook on gay fathers as a minority group.
Our current results also suggest that the novel comparison of two paths to gay fatherhood, namely through a previous heterosexual relationship or through surrogacy, revealed no differences in psychological well-being even when controlling for sociodemographic factors. Thus, future studies should further explore other variables, such as ones that relates to social and family support, when trying to pinpoint more similarities and differences between these two groups. Future studies should also explore bisexual and transgender fathers who were not included in the current study and are even less studied groups when comparing different routes to fatherhood.
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