Child Emotional Problems in
Same-Sex Parent Families:
The Discovery of Irreducible
Difference
The Rev. Dr. Paul Sullins
The Catholic University of America
Marriage and Religion Research Institute (MARRI)
American Sociological Association Amicus Brief (2/23/13),
Hollingsworth v. Perry, p. 3
“[T]he claim that same-sex parents produce less
positive child outcomes than opposite-sex parents—
either because such families lack both a male and
female parent or because both parents are not the
biological parents of their children—contradicts
abundant social science research. …
 Whether a child is raised by same-sex or
opposite-sex parents has no bearing on a child’s
wellbeing.”

Child Well-Being in Same-Sex Parent Families: Review of Research Prepared for
American Sociological Association Amicus Brief
Wendy D. Manning• Marshal Neal Fettro•Esther Lamidi
Popul Res Policy Rev (2014) 33:485–502, Abstract



“We conclude that there is a clear consensus in the social
science literature indicating that American children living
within same-sex parent households fare just as well as those
children residing within different-sex parent households over
a wide array of well-being measures: academic performance,
cognitive development, social development, psychological
health, early sexual activity, and substance abuse.
Our assessment of the literature is based on credible and
methodologically sound studies that compare well-being
outcomes of children residing within same-sex and differentsex parent families.
Differences that exist in child well-being are largely due to
socioeconomic circumstances and family stability.”
“Our assessment of the literature is based on credible and methodologically
sound studies that compare well-being outcomes of children residing within
same-sex and different-sex parent families.”
In a recent review of 49 same-sex parenting studies prior to 2010, 47 of which
concluded that there were no differences in child well-being compared to
opposite-sex families, Allen found that not a single study involved a
representative sample large enough to distinguish differences if they
existed. The mean sample size of children with same-sex parents was only
39 (Rosenfeld 2013:757), virtually guaranteeing Type II error (failing to detect
a true effect) regarding population differences. Only four studies used a
probability (random) sample at all; the largest of these included only 44 female
same-sex families. The remainder based their “findings” on conveniently
available or selected groups of participants, often recruited from biased,
politically aware sources such as “LGBT events, bookstore and newspaper
advertisements, word of mouth, networking and youth groups” (Allen
2013:640; see this article or Marks 2012 for comprehensive lists of study
sample sizes and sources.).
Drawing a probability sample of sufficient size to discern population
differences with any statistical power, however, presents substantial
difficulties for what Rosenfeld (2013:963) has colorfully termed the
“needle-in-a-haystack” population of same-sex parents. According to
the U.S. Census, same-sex couple households comprise less than 0.005
(five one-thousandths, or one-half of one percent) of U.S. households
with children.[i] To attain a sample of 800 same-sex couples, which has
been estimated to be the minimum sample size needed to make
inferences for this population, would require drawing at least 160,000
cases, assuming a perfect response rate. Same-sex couples, moreover,
tend to have somewhat lower than normal response rates, perhaps due
to stigma, and female couples are more likely to be raising children
than males, resulting in an extremely low yield for same-sex parents,
and particularly gay male parents, in randomized population samples.
The National Health Interview Survey (NHIS) is the principle source of public
health information about the United States population. Since 1957 the United
States Centers for Disease Control and Prevention’s National Center for Health
Statistics has annually interviewed between 35,000 and 40,000 households,
collecting data on 75,000 to 100,000 individuals comprising a nationally
representative sample of the civilian noninstitutionalized population of the
United States.
The present study examines combined 1997-2013 NHIS data, consisting of
information on 1,598,006 persons, including 207,007 sample children.
This sample included 2,751 same sex couples—2,304 cohabiting and 447
spousal—consisting of 1,387 male couples and 1,384 female couples; 582
couples—406 female and 176 male—had children under age 18 in the home. A
more extensive battery of health questions, including the measures of emotional
health used in this study, was completed for 512 children sampled, one per
family, from the same-sex parenting families.
The 0-10 scale used on NHIS (SDQ-EX) was calibrated against
a sample with known clinical diagnoses by a team from the
Harvard University School of Public Health, who discovered
that a high score (6 or more) screened for 12-month clinical
diagnoses, as determined by a more extensive clinical
assessment, with a positive predictive value of 74%, negative
predictive value of 98%, and overall concordance (AUC) of .80.
(Kessler, Gruber, and Sampson 2006:55, Table 28)
Child Emotional Problems (in percent)
Comparing Opposite-Sex and Same-Sex Parent Families
25
21.2
19.4
20
17.8
17.1
15
10.3
10.5
10
7.5
6.9
5
0
Clinical Emotional
Problems - SDQ or
Direct Report
Developmental
Child received
Disability (ADHD,
medical treatment for
Learning Disability or emotional problem
Intellectual Disability)
Children with OS Parents
Child prescribed
medication for
emotional problem
Children with SS Parents
Source: National Health Interview Survey (CDC-NCHS) 1997-2013. (N=207,007). Data are a representative
sample of all U.S. children. All contrasts shown are statistically significant at .01
OS/SS Differences in child emotional problems
are unaffected by
parent education and income
family stability
age, race and sex of child
peer stigmatization or bullying
parent emotional problems
Most of these affect the overall risk of child
emotional problems, but do not cause more
problems in SS families than they do in OS
families.
One powerful factor explains: Biological Parentage
Distinguishes children being raised by
◦ 1. Both biological parents, or
◦ 2. Only one of his/her biological parents (step or single
parent family), or
◦ 3. Neither biological parent (i.e., adopted children)
Including
biological parentage in the statistical models
explains all the OS/SS variation and renders all other
causal factors insignificant.
 Bio Parentage is both necessary and sufficient to
account for the higher rate of emotional problems
observed among children with same-sex parents.
Child Emotional Problems by Biological Parentage:
NHIS 2001-2013
Child Emotional Problems by Biological Parentage
Comparing Opposite-Sex and Same-Sex Parents: NHIS 2001-2013
35%
30%
High SDQ or Serious Emotional Problem
Children living with both
bio parents have far
fewer emotional
problems…
25%
21.1%
19.1%
20%
14.6%
15%
10.3%
10%
5%
4.3%
0%
35%
Opposite Sex
Same Sex
Both Bio Parents
Opposite Sex
Same Sex
One Bio Parent
Opposite Sex
Same Sex
No Bio Parents
High SDQ or Serious Emotional Problem
30%
25%
21.3%
20%
15%
10.3%
… but there are
no such children
in same-sex
families.
10%
5%
4.3%
0%
Both Bio Parents
One Bio Parent
No Bio Parents
(They make up almost twothirds of children in
opposite-sex families)
Child Emotional Problems by Family Structure
Including Same-Sex Spousal and Cohabiting Parents:
NHIS 2001-2013
30%
25%
High SDQ or Serious Emotional Problem
Marriage or
family
structure
alone has a
mixed and
weak effect,
which does
not clearly
differentiate
same-sex
and
oppositesex families.
20%
17.9%
15%
10.0%
10.8%
10%
8.2%
5%
7.9%
4.3%
0%
Nuclear
Other Married
Cohabiting
Single Parent
Same-Sex Spousal
Same-Sex
Cohabiting
The apparent effect of family structure is really due to the fact that …
Almost all
children
with
parents in
an intact
first
marriage
live with
both bio
parents
“First, research clearly demonstrates that family
structure matters for children, and the family structure
that helps children the most is a family headed
by two biological parents in a low-conflict marriage.
Children in single-parent families, children born to
unmarried mothers, and children in stepfamilies or
cohabiting relationships face higher risks of poor
outcomes than do children in intact families headed
by two biological parents.”
Kristin Anderson Moore, Susan M. Jekielek, and Carol Emig, "Marriage from a Child’s
Perspective: How Does Family Structure Affect Children, and What Can We Do about It?",
Child Trends Research Brief, June 2002 (Emphasis added)
“Children who grow up in a household with only
one biological parent are worse off, on average,
than children who grow up in a household with
both of their biological parents” regardless of the
parents’ race, education and marital status,
including remarriage.
McLanahan, Sara, and Gary D. Sandefur. 1994. Growing up with a Single Parent: What
Hurts, What Helps. Harvard University Press. Page 1.
1
The higher risk of emotional problems for
children in same-sex parent families has little or
nothing to do with the quality of parenting, care,
or other relational characteristics of those
families.
2
•But if the strongest benefits for child well-being are conferred only on
the biological offspring of both parents;
•and since same-sex relationships cannot, at least at present, conceive a
child that is the biological offspring of both partners, in the way that
every child conceived by opposite-sex partners is such;
• then same-sex partners, no matter how loving and committed,
can never replicate the level of benevolence for child well-being
that is possible for opposite-sex partners.
3
This defect, moreover, is an essential and
permanent feature of same-sex relationships; it
is part of their definition, an irreducible
difference that cannot be amended or
abrogated by improving the circumstances,
stability, legal status or social acceptance of
same-sex couples.
The primary benefit of marriage for children may not be that it tends to
present them with improved parents (more stable, financially affluent,
etc., although it does do this), but that it presents them with their own
parents. This is the case for 98% of children in nuclear families—which
most successfully fulfill the formal civil premise of marriage, that is,
lifelong and exclusive partner commitment—compared to less than half
of children in any other family category, and no children in same-sex
families. Whether or not same-sex families attain the legal right, as
opposite-sex couples now have, to solemnize their relationship in civil
marriage, the two family forms will continue to have fundamentally
different, even contrasting, effects on the biological component of
child well-being, to the relative detriment of children in same-sex
families. Functionally, opposite-sex marriage is a social practice that,
as much as possible, ensures to children the joint care of both
biological parents, with the attendant benefits that brings; same-sex
marriage ensures the opposite.