Lesbian Mother Families and Gay Father Families in Italy: Family Functioning, Dyadic Satisfaction, and Child Well-Being

The literature underlines that lesbian mother and gay father families are similar to those with heterosexual parents, regarding family functioning, dyadic satisfaction, and child development. This paper compares 40 same-sex families and 40 heterosexual parents in the Italian context. In Italy, it is impossible for same-sex couples or single lesbians and gay men to adopt a child, become married, or enter civil partnerships. The participants were administered self-reports, in order to investigate the dyadic relationships, family functioning, and emotional and social adjustment of their children. Lesbian and gay parents reported higher levels of dyadic adjustment, flexibility, and communication in their family than heterosexual parents. Data from the present study demonstrated that children raised by lesbian and gay parents showed a similar level of emotion regulation and psychological well-being than children raised by heterosexual parents. In Italy, negative attitudes towards same-sex families persist, and educational programs should be developed to deconstruct stereotypes regarding gay and lesbian parent families. These results have important implications in both clinical and social fields.

The number of quantitative studies on same-sex parent families has increased over the last two decades. These studies typically focus on family functioning (Fulcher et al. 2008;Patterson et al. 2004), dyadic adjustment (Kurdek 2004), and the well-being of children raised by same-sex parents (Riggs et al. 2009).
In the USA, there are between 800,000 and 7 million lesbian and gay (LG) parents raising between 1 and 9 million children (Weber 2010). Because of the stigma attached to nonheterosexual identities, same-sex parent families have to face harsh conditions during the formation of the family. Despite these difficulties, the international literature has not found many significant differences between same-sex parent families and heterosexual ones (Crowl et al. 2008;Fedewa et al. 2015). This study therefore aims to compare same-sex parent families and heterosexual parent families regarding their family functioning, dyadic adjustment, and children's social and emotional well-being.

Family Functioning in Same-Sex Families
The international literature (for a review, see Perrin and Siegel 2013) has underlined some important strengths of same-sex parent families: LG parents reported more egalitarian decision making practices, shared housework and childcare more equally, and showed effective parenting (Fulcher et al. 2008;Patterson et al. 2004). Additionally, previous research has found that lesbian and gay relationships (both childless and not) tended to be characterized by creativity and flexibility regarding dyadic functioning and childcare (Lynch and Murray 2000;Reilly and Lynch 1990).
One of the most common stereotypes is that same-sex parent families handle divisions of labor better than those of heterosexual families. However, same-sex parents construct their parenting roles more equitably than heterosexual parents do, which may be an advantage to family functioning (Crouch et al. 2014). Research has demonstrated that same-sex couples tend to negotiate roles and the division of labor by following personal interests and competences, while sharing coparenthood and other important decisions for family functioning (Baucom et al. 2010;Farr and Patterson 2013;Gotta et al. 2011;Patterson et al. 2004;Patterson 2000). Gottman et al. (2003) also underlined that same-sex parent families were more able than heterosexual parent families to communicate effectively and, consequently, to solve family problems.
A consistent part of the literature has focused on families with two lesbians parents (biological, social, or step) (Bos and Sandfort 2010;Gartrell and Bos 2010;Stacey and Biblarz 2001;Wainright and Patterson 2008). An interesting result is the strong relationship between lesbian donor insemination mothers and their children. Lesbian mothers devoted a great deal of time and thought to choosing parenthood and tended to equal or surpass heterosexual married couples in their time spent with children, parenting skills, warmth, and affection (Bos et al. 2007;Golombok et al. 2003;MacCallum and Golombok 2004).
Moreover, some studies on parenting behavior have demonstrated that nonbiological mothers in planned lesbian mother families have superior quality of parent-child interactions (Brewaeys et al. 1997;Golombok and Tasker 1996) and parenting awareness skills (Flaks et al. 1995) to fathers in heterosexual parent families. Stacey and Biblarz (2001) reported that lesbian mother families enjoy a greater level of synchronicity in parenting when compared with heterosexual parent families. Within heterosexual parent families, mothers averaged higher-quality parenting skills than fathers, but within the lesbian mother families, there was no difference between the two parents (Brewaeys et al. 1997;Vanfraussen et al. 2002).
Studies about gay parent families are less numerous, and children raised in these families are often the consequence of previous heterosexual relationships (Crouch et al. 2014;Silverstein et al. 2002). According to Golombok et al. (2014), no great differences were found between gay/lesbian and heterosexual adoptive families. The differences that were identified reflected more positive family functioning in the gay father families. Using interview methodology, they found that gay fathers showed greater amounts of interaction, higher levels of warmth, lower levels of disciplinary aggression, and higher levels of responsiveness than the heterosexual parents did. No differences in parenting and family functioning were identified between gay fathers and lesbian mothers.

Same-Sex Family and Dyadic Adjustment
When asked about their dyadic relationships, LG partners report as much satisfaction with their dyadic relationships and with their partner's parenting (Bos et al. 2004(Bos et al. , 2007 and tend to describe their romantic intercourse as stable and happy (Baiocco et al. 2014a;Cardell et al. 1981;D'Augelli et al. 2007;Kurdek 2004Kurdek , 2005Peplau et al. 1982).
Besides this, literature (e.g., see reviews by Patterson 2000;Peplau and Beals 2004) has tried comparing LG and heterosexual couples, focusing on some areas that differentiate romantic relationships from other types of dyadic relationships. One of the most famous studies that focused this topic was by Kurdek (2004). In this study, Kurdek (2004) compared LG couples without children with heterosexual couples. Compared to heterosexual parents, gay and lesbian couples' functioning was psychologically adequate. LG couples only differed from heterosexuals in two areas: (a) LG partners reported lower levels of social support networks than heterosexual parents and (b) gay men and lesbians indicated that they felt less supported in their relationships by their family of origin.
Stability over time is another dimension in which some differences have been found. Studies have underlined that LG couples show lower levels of stability than their heterosexual counterparts (Balsam et al. 2008). This difference could be explained by considering that gay and lesbian partners meet no formal institutionalized blocks to leaving unhappy relationships (Kurdek 2004). As a result, the higher rate of dissolution for gay and lesbian couples might indicate that gay and lesbian cohabiting partners are less likely than heterosexual married partners to carry forward dysfunctional relationships (Adams and Jones 1997;Patterson 2009).
The amount of conflicts faced by LG couples-another area that can interfere with dyadic adjustment-does not differ from those of heterosexual ones. Despite this, some conflicting issues are specific to same-sex couples and are the direct consequence of the social stigma. Often, one reason for conflict is the secret about the sexual orientation of one of the two members: When one of the partners has never Bcome outŵ ith family or friends, due to the fear of being rejected (Baiocco et al. 2014a, b;Patterson 2000), the other partner can perceive this decision as a form of disengagement from the relationship. In addition, the partner who did not come out may feel jealousy, as a consequence of the other's increased commitment in social contexts.

Children's Well-Being in Same-Sex Parent Families
Many studies have assessed the developmental and psychosocial outcomes of children whose parents are gay or lesbian. The most common concern was that children's development, relative to sexual identity, mental health, psychological adaptation, and social relationships, would be impaired (Crowl et al. 2008;Fedewa et al. 2015). One of the most common stereotypes is to think about boys with lesbians parents as less masculine and girls with gay fathers as less feminine (Patterson 2006).
On the contrary, studies in which planned lesbian mother families are compared with heterosexual families have revealed no differences in child outcomes, such as social competencies (Patterson et al. 2004;Patterson 2006;Wainright and Patterson 2008), behavioral adjustment (Bos et al. 2007;Fedewa et al. 2015;Golombok et al. 2014;MacCallum and Golombok 2004;Patterson 2009;Stacey and Biblarz 2001), gender identity (Bos and Sandfort 2010;Golombok et al. 2014;Silverstein et al. 2002), and sexual orientation (Bailey et al. 1997;Gartrell et al. 2011;Golombok and Tasker 1996;Schumm 2010). Moreover, Patterson (2000) found that children of lesbian mothers reported higher levels of emotional reactions, such as anger, fear, and sadness, but otherwise expressed a higher sense of well-being than did children of heterosexual mothers. A possible explanation of this result could be that children of lesbian mothers can experience more stressful experiences in their lives but have learned to cope with these stressful events.
Besides these aspects, it seems that children do not have emotional problems or react negatively when they become fully aware of their parents' sexual orientations . Furthermore, Biblarz and Stacey (2010) have underlined how children raised in LG parent families are more likely to not adhere to traditional gender roles (in clothing, activities, games, etc.) and tend to develop a more openminded attitude about their psychosexual development (Bos and Sandfort 2010). Despite this, one aspect that cannot be overlooked is that children of lesbian mothers could worry about the possible negative reactions of their peers regarding their parents' sexual orientation: Specifically, they can become a victim of episodes of social stigmatization by peers (Bos et al. 2004;Clarke et al. 2004;MacCallum and Golombok 2004;Wainright and Patterson 2008;Weber 2010).
Aside from this, one of the most important variables that could interfere with psychological adjustment of children of lesbians and gay parents regards sexual stigma perceived by parents (Brewer and Wilcox 2005;Herek et al. 2002;Katz-Wise and Hyde 2012). This stigma has been identified from social psychology as an associative stigma (Richards 2008): Children of same-sex parent families can face associative stigma because of their parents' stigmatized sexual orientations. Nevertheless, results about children's psychological adjustment and well-being are controversial: Vanfraussen et al. (2002) found that children raised in lesbian mother families were no more likely to have problems with peers (Vanfraussen et al. 2002).
The meta-analysis conducted by Fedewa et al. (2015) involved the analysis of 33 studies (N of children=5272); most of these (26) were published in the USA, the others in Europe. This meta-analysis confirmed the discussed results: The authors did not find a significant effect of sexual orientation and gender on the quality of parentchild relationships, in terms of closeness and warmth.
Besides this, children's psychological adjustment was investigated and, in line with previous research, the authors found that children raised by same-gender parents tend to adjust better than children raised by heterosexual parent groups do (Fedewa et al. 2015).
As underlined previously, children with lesbian or gay parents had higher levels of psychological well-being that included emotional functioning and adherence to culturally defined standards of appropriate behavior; these children expressed less overt problem behaviors, had higherquality peer relationships, experienced less stigmatization by peers, and had higher inner psychological health. These apparently contradictory statements can be understood by looking at the available resources of lesbians and gay parents as the positive support from their minority group (Kuvalanka and Goldberg 2009;Lick et al. 2012). Children, in consequence to the positive family functioning, can learn to cope efficiently with stigma over time (Lick et al. 2013).

The Italian Context
Italy is one of the few European Union countries lacking an equality agenda on issues related to lesbian, gay, bisexual, and transgender (LGBT) rights. According to the European Region of the International Lesbian, Gay, Bisexual, Trans & Intersex Association (ILGA), Italy receives a human rights score for LGBT people of 25 on a scale from 0 to 100 (ILGA-Europe 2014). Different studies have found that, when there is perceived stigma or homophobic stigma, children raised from same-sex parents are more likely to display problems in their psychological and social development Crouch et al. 2014).
In Italy, lesbian mother families and gay father families are exposed to a great amount of stress compared to families in the USA and Canada, as well as in other European countries such as Spain, France, and the UK. Stereotypes in Italy against same-sex parent families are still strong (Baiocco et al. 2013b(Baiocco et al. , 2014c. In addition, it is well-known that the Catholic religion has an important influence on negative attitudes toward LGBT people and same-sex parent families in Italy, although some progress has been made in religious communities regarding the acceptance of homosexuality; for example, Pope Francis recently called for the church to welcome and accept homosexual people (Donadio 2013).
Italy is one of the few European Union countries where same-sex marriage or civil unions are not allowed, it is impossible for same-sex couples or single lesbians and gay men to adopt a child, and children born into families headed by samesex parents are children of only one legal parent (Lelleri et al. 2005). Italian lesbians and gay men usually become parents in the context of a previous heterosexual relationship or by travelling to other countries in order to legally access donor insemination or surrogacy (Baiocco and Laghi 2013;Lingiardi et al. 2012). These differences can be partially explained as a direct consequence of Catholicism: Gender and sexual stereotypes about what is Bnatural^and what is not are strongly correlated with religious beliefs in Italy (Lingiardi et al. 2012).
A research study funded in 2006 by the Superior Sanity Institute (Istituto Superiore di Sanità 2006) on 7000 gays and lesbians reported that 18 % of homosexual men and 21 % of lesbians over 40 were parents. Despite the number of same-sex parent families growing in Italy, only a few studies have focused on LG parenthood. Most of the literature is characterized by case studies, and few are quantitative. In Italy, Famiglie Arcobaleno, or Rainbow Families, is a national association that brings together lesbian mothers and gay fathers, LG persons who plan to have children, and ordinary supporters. The members of the association have increased considerably to about 500 in recent years, comprising 60-75 % women. Nearly 200 parents of children and teenagers are members of the association. Most of the children in Rainbow Families were born within their family. Of the children, 80 % are around 10, while the average age of gay and lesbian parents is between 35 and 40 years old. Even though the situation for same-sex parent families is changing in Italy, the concept of LG parenthood is still little known or at least far from having a particular legal and social recognition.

Aim and Hypotheses
The aim of the present work is to compare lesbian mother families, gay father families, and heterosexual parent families on dyadic and family functioning, as well as children's adjustment. Regarding the variables just mentioned, the group of lesbian and gay men parents was compared with a group of heterosexual parents similar for age, level of education, and age of children. We hypothesize that, compared with heterosexual parents, LG parents: (1) report similar or higher levels of dyadic adjustment (Hypothesis 1) and (2) report higher levels of family functioning and an adequate level of cohesion and flexibility (Christopher and Sprecher 2000;Silverstein et al. 2002;Stacey and Biblarz 2001) (Hypothesis 2).
Regarding the children's psychological adjustment, we hypothesize that: (3) children raised by LG parents show a similar level of psychological well-being to children raised from heterosexual parents (Hypothesis 3.1). Due to Italian culture and its social sexual stigma regarding nonheterosexual identities and same-sex families (Baiocco et al. 2013b(Baiocco et al. , 2014aBaiocco and Laghi 2013), we hypothesize higher levels of peer relationship problems reported by LG parents (Hypothesis 3.2).

Participants and Procedures
Data were collected on 20 gay fathers, 20 lesbian mothers, and 40 heterosexual parents, equally distributed by gender, age, and level of education. All of the 80 families were planned parented families: The lesbian mothers became parents from artificial insemination and the gay fathers from a gestational surrogacy (done in the USA or Canada), while the heterosexual parents were the biological parents of the children. The majority of the LG parents (32 out of 40) were members of the Italian Rainbow Family Association, and we asked them to involve other same sex parents (n=8) that they knew personally who might have been interested in this research. A total of 66.6 % of the same-sex parent families accepted to participate in the study. Straight parents were recruited in the same kindergartens and same classes of children of lesbian and gay male parents who participated in the present study: 85 % of the heterosexual parents accepted to participate in the study. All participants responded individually to the same questionnaire packet with face-to-face administration. Participation in the study was voluntary and anonymous, and participants were encouraged to answer as truthfully as possible. The analysis of variance did not show any significant differences between LG parents and heterosexual parents regarding age, F(1, 78)=0.01, p=.98; the age of the child, F(1, 78)=0.88, p=.35; or level of education, F(1, 78)= 0.21, p=.89. The level of education for both samples was 18 years (M=17.75; SD=3.08), which corresponds to a master's degree. Furthermore, regarding the duration of the relationship (years: M=7.83; SD=1.45), no significant differences were found between LG parents and heterosexual parents, F(1, 78)=.93, p=.34 (Table 1).
The genders of the children were also equally distributed between LG parents (16 boys and 24 girls) and heterosexual parents (19 boys and 21 girls). The parents were asked to specify the role of their partner for the child (in the same-sex parent families and heterosexual parent families, too). All of the parents considered their partner as the father/mother of the child. Significant differences were found between LG parents regarding age, F(1, 38)=12.69, p<.001; and level of education, F(1, 38)=27.74, p<.001. Gay parents (M age = 42.70; SD = 3.61) were older than lesbians (M age = 37.20; SD= 5.89) and reported higher levels of education (gay men: M education = 19.75; SD = 2.21; lesbian: M education =15.85; SD=2.60).

Measures
Demographic information was collected using an identifying information form. Parents were asked about their sexual orientation, socioeconomic context, methods of family formation, and the duration of their romantic relationship.
The Dyadic Adjustment Scale-Short Form (DAS-7; Hunsley et al. 2001) was used to assess the participants' relationship satisfaction. This instrument is the seven-item version of the longest DAS (Gentili et al. 2002;Spanier 1976). On a 6point Likert scale, the participants had to evaluate their agreement, cohesion, and dyadic satisfaction. High scores describe a couple that shares interests, spends quality time together, and perceives the relationship as satisfying. In the present study, the internal consistency was α=.83.
The Family Adaptability and Cohesion Evaluation Scale (FACES IV; Baiocco et al. 2013a;Olson 2011) is a self-report designed to assess family functioning. The FACES-IV is composed of 62 items and six scales, two balanced scales-cohesion and flexibility, assessing central-moderate areas-and four unbalanced scales-enmeshed, disengaged, chaotic, and rigid-that assess the lower and upper ends of cohesion and flexibility. The internal consistency in this research varied from α=.72 (cohesion) to 0.85 (rigid).
The Emotion Regulation Checklist (ERC; Molina et al. 2014) consists of 24 items structured to assess the central processes to emotionality and regulation in children, such as affective lability, intensity, valence, flexibility, and situational appropriateness. Items are rated on a 4-point Likert scale assessing the frequency of behaviors, from 1 (almost always) to 4 (never), and are divided into two subscales: emotional regulation and lability/negativity. Emotional regulation is evaluated by eight items that investigate situationally appropriate affective displays, empathy, and emotional self-awareness. The lability/negativity subscale is composed of 15 items assessing inflexibility, dysregulated negative affect, and the unpredictability and suddenness of mood change. In the present research, the internal consistency was α=.80 for emotional regulation and α=.82 for the lability/negativity subscale.
The Strengths and Difficulties Questionnaire (SDQ; Goodman 2001; Tobia and Marzocchi 2011) is a brief behavioral screening questionnaire for children aged about 3-17 years old that evaluates five dimensions: emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, and prosocial behavior. Lower scores indicate better emotional and social well-being, with the exception of the prosocial scale. In the present research, internal consistency varied from α = .71 (prosocial behavior) to 0.82 (hyperactivity).

Data Analysis
To conduct bivariate and multivariate analyses related to independent variables, we used the Statistical Package for the Social Sciences (SPSS 21). Group differences were analyzed with multivariate analysis of variance (MANOVA). The internal consistency of the overall scale and subscales was measured by Cronbach's alpha coefficient. Pearson correlation coefficients were calculated to assess the convergent validity of the scale.

Discussion
The aim of the present work is to fill a gap within Italian scientific research about lesbian parent families and gay parent families, a topic that is becoming important for its social, legal, and psychological implications. Although Italian legislation does not recognize same-sex marriage or LG parenthood, this has not interfered with the growing number of same-sex families. Although same-sex parent families face the same phases of the life cycle, LG parent families face additional developmental tasks: The necessity to be integrated in the social environment as a recognized family, with the same rights and duties of heterosexual parent families, and to protect their families from the negative attitudes and rejection from Italian society (Lingiardi et al. 2005).
The first two hypotheses aimed to verify the possible differences between same-sex parents and heterosexual parents regarding dyadic adjustment and family functioning. Despite the current controversy surrounding same-sex relationships, international survey data indicate that between 40 and 60 % of gay men and between 45 and 80 % of lesbians are currently involved in a stable romantic relationship (Morris et al. 2002). Coherently with the data just mentioned, the LG couples investigated in our study were all involved in stable romantic relationships (the average duration of the relationship was 8 years), and no significant differences were found between LG parents and heterosexual parents.
In our study, sexual orientation seems to be a relevant variable in regard to the levels of dyadic satisfaction perceived by couples (Hypothesis 1). The ability to establish and maintain a satisfying relationship with one's partner that is characterized by commitment, affection, and the sharing of interests seems to be higher within LG couples, as underlined by previous literature ( Bos et al. 2004;Kurdek 2004Kurdek , 2005. The LG couples investigated in this study perceived their family as more flexible and more able to communicate about family statements (Hypothesis 2) (Gotta et al. 2011;Gottman et al. 2003).
Data from the present study demonstrated that children raised by LG parents showed similar levels of psychological well-being than children raised by heterosexual parents. According to the hypothesis, no differences were found regarding emotional regulation and the SDQ dimensions (Hypothesis 3.1). However, contrary to our expectations (Baiocco et al. 2013b;Lingiardi et al. 2012Lingiardi et al. , 2005, no differences were found concerning the level of peer problems reported by parents (Hypothesis 3.2). Same-sex parents did not report higher levels of peer problems in their children's lives. This unexpected result may be the consequence of the unique strength shown by LG parents, which could be due to belonging to the Italian Rainbow Family Association (the majority of the LG parents, 32 out of 40, were members of the Italian Rainbow Family Association). They found creative ways of being a Bdifferent^family, exhibiting flexibility in managing everyday life problems, which may help all members in family life transitions (D'Amore and Baiocco 2014)

Limitations of the Study
There were important limitations to our study. First, we used a convenience sample, and we did not consider how social class or ethnicity might interrelate with parenthood and children's well-being. In the present research, the lesbian and gay participants were parents who mainly lived in the downtown areas of major cities in the north and center of Italy and with high socio-cultural statuses and these characteristics could affect the possibility to generalize results to other same-sex families in Italy. However, as already underlined, same-sex couples in Italy have to face several prejudices as well as feelings of rejection due to cultural and religious influences. These negative attitudes are more frequent and embedded in small towns and cities, especially in southern Italy: This could be the main reason why most of the same-sex couples have moved to the largest cities (Baiocco et al. 2014a, b). Future studies may verify the stability of our results in a sample of lesbian parent families and gay parent families living in small cities and/or rural areas.
Socioeconomic and cultural statuses are important variables to take into account for the possibility to access parenthood. The majority of Italian lesbian mothers became parents from artificial insemination (in particular, in Spain, Greece, Belgium, or Holland) and the gay fathers from a gestational surrogacy (done in the USA or Canada) that are not legal in Italy. However, it requires, in particular for gay men, high economic capital to afford medical and legal expert advice, paying fees and applications, and to travel to other countries in order to become parents. Due to these reasons, even if there are a large number of lesbian and gay couples in Italy who desire to become parents, the possibility to achieve this goal can be considered a privilege only for those who can afford what is an expensive process from both economic and social perspectives (Baiocco et al. 2013b(Baiocco et al. , 2014aBaiocco and Laghi 2013). We can consider that these lesbian and gay parents form a vanguard for others in lesbian and gay communities who wish to become parents but may not be able to make this happen yet.
Another difficulty in this field is that, in Italy, large-scale data sets that afford the possibility of studying same-sex parent families are not available, and this could likely bias the sampling, which is direct to the LG families who are enrolled in specific associations and organizations. Other researches on the same topics, especially in the USA and in Canada, can take advantage of secondary data from national large population studies on families and their conditions, which became more and more specific, e.g., including information on sexual orientation, marital status, and housing situation (Russell and Muraco 2013). We hope that, in the future, there will be the possibility in Italy to have large-scale surveys that will include possibilities to identify and understand same-sex parent families. Finally, another potential limit is the possibility of social desirability bias when research participants respond in ways that present their sons/daughters and their families in the most desirable light possible. Additionally, it would be of interest to use qualitative methods to further analyze the perceived social stigma among LG parents about their family and the direct and indirect effects on their children's development, as well as provide suggestions for future policies and research in Italy.
The Italian context should be enriched by cultural initiatives that focus on gender differences and sexual orientation, with the goal to prevent social sexual stigma and to promote the social recognition of same-sex parent families. Gay and lesbian parents, particularly in Italy, generally have to face significant additional challenges compared to Btraditionalf amilies: They have to fight against prejudices and denigrating thoughts about their dyadic relationship, family functioning, and children's well-being, and they have to raise their children in the absence of specific laws for LG couples and families, since Italy is one of the few EU Countries that does not have recognized same-sex unions or any kind of adoption. In light of this consideration, the results of the present paper could add relevant aspects to the same-sex marriage and adoptions debate in line with other European States standards.
We believe that psychological research can make an important contribution in limiting the negative effects of prejudice against sexual minorities and can specifically help to structure interventions aimed at promoting scientific knowledge, inclusion, and tolerance. In Italy, negative attitudes towards samesex families persist; thus, educational programs should be developed to deconstruct stereotypes regarding gay and lesbian parent families. It is our hope that this paper will contribute to the scientific understanding and promotion of psychological well-being, not only for children but also for their parents and extended families.