Updated: Jun 27
For the social media version of this, see the Instagram post. Black text is written on an ombre style background depicting the colors of the lesbian flag. The text reads as follows: Queering Perinatal Mental Health (because the heteronorms of the perinatal world are suffocating)
Erasure of Lesbian Parents in Maternal Mental Health
maternal mental health month #mmhm
Reductive Lesbian Stereotypes in Perinatal Care
Lesbians can be nonbinary, trans, or cis, masculine or feminine. Reductive stereotypes in perinatal mental health care are inaccurate and damaging.
"I'm a genderfluid mostly masc presenting lesbian and I was the gestational carrier for our first pregnancy. Nearly every single pregnancy appointment or baby shopping related trip was a nightmare because they never addressed me first, always my wife, until I started really showing. This was upsetting and I think it contributed to my feelings of loneliness in postpartum." - T.S., Georgia
Trans lesbian women can breastfeed their babies with the support of informed lactation consultants. This may be a protective factor to deter PMADs and provide meaningful bonding for mother and baby. Mental healthcare providers often lack education on this common occurrence.
Trans lesbian mothers may or may not be biologically related to their children. Assumptions from clinicians about these parenting structures can create barriers to mental health screenings or care.
Lesbian parents have stated that they are asked about infertility in doctor's offices, even if this isn't why they seek out clinical fertility support. Solo lesbian parents report being asked about the father of the baby in doctor's offices.
Research & Lack of Clinical Data Addressing Intersectionality
The majority of research on PMADs has been conducted on heterosexual parents.
The majority of lesbian perinatal data has been conducted on cisgender, white, co-parenting couples living in major urban centers.
There is a significant lack of data that addresses lesbian pregnancy or postpartum and chronic pain, disability or illness.
There is little to no guidance for mental health clinicians on the impacts of SA, ACEs or other traumatic experiences on lesbian perinatal experiences.
Of the research conducted, results suggest that perinatal depression may be more common among lesbian parents relative to heterosexual parents.
Prior Mental Health History as a PMAD Risk
Prior history of mental health needs such as anxiety or depression are predictors of PMADs. Due to minority stress and other stigma-related factors, rates of psychiatric disorders, including major depression and anxiety disorders, are frequently reported in higher numbers for 2SLGBTQIA+ populations.
While previous mental health data for those who identify specifically as lesbians has not been clearly captured statistically, researchers attribute that to a lack of lesbian-centered surveys and data collection groupings.
Lack of Social Support as a PMAD Risk
Lack of social supports is a risk factor for PMADs. A common anecdotal misconception is that a two lesbian household provides more emotional support than in a heterosexual household. There is a lack of empirical evidence to support this. Instead, data does show that single-parent lesbian heads-of-household struggle with higher rates of isolation and lack of support, lesbian parents often feel disconnected from community members who don't have children and are frequently othered by hetero families. Additionally, lesbians living in rural areas have little to no accessible community.
As with many sexual or gender minority communities, there is a great deal of rejection from families of origin. For lesbian parents, there have been some indications that these relationships improve as the child gets older. While the later is good news, unfortunately, the prevalent time for perinatal mood and anxiety disorders is during pregnancy and postpartum.
Legal & Financial Upheaval as a PMAD Risk
For lesbian families, there are usually significant expenses and legal hurdles. From ensuring second parent adoption and birth certificate bureaucracy, to potential custody consideration from known or unknown sperm donors, there is a great deal of legal and financial, stress and anxiety-inducing burdens lesbian parents wade through.
"I wanted to use an unknown donor because I didn't have anyone to ask. This seemed actually a lot more expensive and I would have had to have him relinquish custody. Also, I've been reading a lot and listening to the voices of kids conceived via unknown donors and I have some heavy moral thoughts on this. I don't really have many alternatives and feel conflicted about how to proceed." - G.G., New York
The Experiences of Non-Gestational Lesbian Parents
Non-gestational lesbian parents often report feelings of isolation and lack of support from heteronormative parenting structures and other parents. They also feel left out of rituals celebrating 'motherhood' or 'fatherhood' like Mother's Day or Father's Day.
Non-gestational lesbian parents report a lack of social recognition as they are sometimes perceived and treated as though they are not the 'real' parent by family and society-at-large.
Non-gestational lesbian parents that are not biologically related to their child have reported feelings of anxiety, jealousy, inadequacy, and lack of connectedness to the baby.
There is a lack of resources like support groups and clinical understanding regarding these feelings and experiences.
Lesbian Partnership Needs Postpartum
Postpartum lesbian parents report a lack of support, resources or adequate information as it relates to being in a lesbian couple in the postpartum period. The majority of the guidance and information that exists centers on heterosexual postpartum sex norms and heterosexual parenting role norms. Even commonly parroted obstetrical guidelines such as 'no sex until 6-8 weeks postpartum' does not center the intimacy needs of a lesbian postpartum couple.
As we move into maternal mental health month and advocate for the perinatal community, it is important to keep the needs of lesbian families in mind.
Lesbian perinatal families as may face:
A lack of systemic supports and resources for gestational and non-gestational parents
Erasure of trans lesbian motherhood
Limited reporting on PMADs in perinatal lesbian families
Legal and financial burdens
A lack of clinical understanding around their developmental needs and norms
There is so much more to add about maternal mental health within lesbian perinatal experiences. As mental health clinicians, consider your role in contributing to the mental wellness of lesbian perinatal families by ensuring that you are a competent, informed, and unbiased provider.