University of Michigan School of Social Work, Ann Arbor, Michigan, United States of America.
University of Michigan School of Information, Ann Arbor, Michigan, United States of America.
PLoS One. 2022 Jul 26;17(7):e0271945. doi: 10.1371/journal.pone.0271945. eCollection 2022.
Many lesbian, gay, bisexual, transgender (trans), queer, and other sexual and gender minority (LGBTQ+) people desire to conceive children. Yet, LGBTQ+ peoples' experiences are scant in reproductive health literature, particularly around pregnancy loss-a stigmatized and distressing pregnancy outcome. Informed by minority stress theory, this qualitative study aimed to explore the experiences of multi-level stigma and resilience among LGBTQ+ people in the context of conception, pregnancy, and loss. Seventeen semi-structured individual interviews (25-70 minutes) were conducted (2019) with a purposive sample of LGBTQ+ people in the United States (U.S.) who had experienced pregnancy loss (n = 14) or in an intimate partnership in which a pregnancy was lost (n = 3) in the last two years. Transcribed interviews were analyzed thematically. Participants described the profound sadness of pregnancy loss due to unique challenges of LGBTQ+ conception. Multiple types of stigma manifested at intrapersonal (e.g., anticipated sexual stigma upon disclosure), interpersonal (e.g., unsolicited advice about conception decisions), and structural levels (e.g., differential requirements to access conception compared to heterosexual/cisgender couples). Resilience was also seen individually (e.g., purposeful disclosure of conception, pregnancy, and loss), relationally (e.g., connecting with other LGBTQ+ community members), and collectively (e.g., creating/engaging in LGBTQ+-specific conception, pregnancy, and loss online spaces). LGBTQ+ people experience minority stressors of multi-level stigmatization throughout the pregnancy process, which limits their access to social support after experiencing pregnancy loss. However, individual, relational, and collective resilience strategies abound in response. Thus, minority stress theory can also be applied to recognize strengths-based and affirming approaches to reproductive healthcare for LGBTQ+ people.
许多女同性恋、男同性恋、双性恋、跨性别者（trans）、酷儿和其他性和性别少数群体（LGBTQ+）的人都希望生育孩子。然而，在生殖健康文献中，很少有关于 LGBTQ+人群的经验，特别是在妊娠丢失方面——这是一种被污名化和令人痛苦的妊娠结局。本研究以少数群体应激理论为指导，旨在探讨 LGBTQ+人群在怀孕、怀孕和流产背景下经历多层次污名和韧性的情况。通过目的性抽样，我们对美国 17 名（25-70 分钟）在过去两年中经历过妊娠丢失（n=14）或在伴侣妊娠丢失（n=3）的 LGBTQ+人群进行了半结构式访谈。对转录的访谈进行了主题分析。参与者描述了由于 LGBTQ+怀孕的独特挑战而导致的妊娠丢失的深刻悲伤。多种类型的污名表现在个人层面（例如，在透露性取向时预期的性污名）、人际层面（例如，对怀孕决策的不请自来的建议）和结构层面（例如，与异性恋/顺性别伴侣相比，获得怀孕的要求不同）。个人层面（例如，有目的地透露怀孕、妊娠和流产）、关系层面（例如，与其他 LGBTQ+社区成员建立联系）和集体层面（例如，创建/参与 LGBTQ+特有的怀孕、妊娠和流产在线空间）也可以看到韧性。LGBTQ+人群在整个怀孕过程中经历着多层次污名化的少数群体应激源，这限制了他们在经历妊娠丢失后获得社会支持的机会。然而，个人、关系和集体的韧性策略也比比皆是。因此，少数群体应激理论也可以应用于识别基于优势和肯定的 LGBTQ+人群生殖健康护理方法。
