Tordoff Diana M, Moseson Heidi, Ragosta Sachiko, Hastings Jen, Flentje Annesa, Capriotti Matthew R, Lubensky Micah E, Lunn Mitchell R, Obedin-Maliver Juno
Stanford University School of Medicine, Palo Alto, CA (Drs Tordoff, Lunn, and Obedin-Maliver).
Ibis Reproductive Health, Oakland, CA (Dr Moseson and Mx. Ragosta).
AJOG Glob Rep. 2023 Dec 13;4(1):100298. doi: 10.1016/j.xagr.2023.100298. eCollection 2024 Feb.
Although 10% to 20% of cisgender women aged 18 to 40 years have a sexual minority identity (eg, bisexual, lesbian, and queer), there is limited research on the family building and pregnancy experiences of sexual minority cisgender women. Improving our understanding of the family building and pregnancy experiences of cisgender sexual minority women is critical for improving the perinatal health of this population.
This study aimed to compare the mode of family building, past pregnancy experiences, and future pregnancy intentions among cisgender sexual minority women by sexual orientation.
This is an observational study which was conducted using cross-sectional data collected in 2019 from a national sample of 1369 cisgender sexual minority women aged 18 to 45 years.
Most participants (n=794, 58%) endorsed multiple sexual orientations, most commonly queer (n=641, 47%), lesbian (n=640, 47%), and/or bisexual (n=583, 43%). There were 243 (18%) cisgender sexual minority women who were parents. Pregnancy was used by 74% (181/243) of women to build their families. Among participants who used pregnancy, 60% (108/181) became pregnant through sexual activity with another parent of the child, whereas 27% (64/243) of women used donor sperm. An additional 10% (n=24) became parents through second-parent adoption, 10% (n=25) through adoption, and 14% (n=35) through step-parenting. Bisexual women more often used sexual activity to become parents (61/100, 61%) compared with queer (40/89, 45%) and lesbian women (40/130, 31%). In contrast, lesbian (50/130, 39%) and queer (25/89, 27%) women more often used donor sperm to become parents compared with bisexual women (11/100, 11%). Among the 266 (19%) cisgender sexual minority women who had ever been pregnant, there were 545 pregnancies (mean, 2.05 pregnancies per woman). Among those pregnancies, 59% (n=327) resulted in live birth, 23% (n=126) resulted in miscarriage, 15% (n=83) resulted in abortion, and 2% (n=9) resulted in ectopic pregnancy. A quarter of women had future pregnancy intentions, with no differences by sexual orientation. Overall, few participants (16%) reported that all of their healthcare providers were aware of their sexual orientation.
Cisgender sexual minority women primarily built their families through pregnancy and a quarter have future pregnancy desires. In addition, there were important differences in family building methods used by sexual orientation. Providers should be aware of the pregnancy and family-building patterns, plans, and needs of cisgender sexual minority women.
尽管18至40岁的异性恋女性中有10%至20%有性少数身份（如双性恋、女同性恋和酷儿），但关于性少数异性恋女性组建家庭和怀孕经历的研究有限。增进我们对异性恋性少数女性组建家庭和怀孕经历的了解对于改善这一人群的围产期健康至关重要。
本研究旨在按性取向比较异性恋性少数女性的家庭组建方式、既往怀孕经历和未来怀孕意愿。
这是一项观察性研究，使用了2019年从全国1369名年龄在18至45岁的异性恋性少数女性样本中收集的横断面数据。
大多数参与者（n = 794，58%）认可多种性取向，最常见的是酷儿（n = 641，47%）、女同性恋（n = 640，47%）和/或双性恋（n = 583，43%）。有243名（18%）异性恋性少数女性是父母。74%（181/243）的女性通过怀孕组建家庭。在通过怀孕组建家庭的参与者中，60%（108/181）通过与孩子的另一方父母进行性活动怀孕，而27%（64/243）的女性使用捐赠精子。另有10%（n = 24）通过继父母收养成为父母，10%（n = 25）通过收养成为父母，14%（n = 35）通过继父母关系成为父母。与酷儿（40/89，45%）和女同性恋女性（40/130，31%）相比，双性恋女性更多地通过性活动成为父母（61/100，61%）。相比之下，女同性恋（50/130，39%）和酷儿（25/89，27%）女性使用捐赠精子成为父母的比例高于双性恋女性（11/100，11%）。在266名（19%）曾经怀孕的异性恋性少数女性中，共有545次怀孕（平均每名女性2.05次怀孕）。在这些怀孕中，59%（n = 327）分娩活婴，23%（n = 126）流产，15%（n = 83）堕胎，2%（n = 9）宫外孕。四分之一的女性有未来怀孕意愿，不同性取向之间没有差异。总体而言，很少有参与者（16%）报告其所有医疗服务提供者都知晓她们的性取向。
异性恋性少数女性主要通过怀孕组建家庭，四分之一的女性有未来怀孕意愿。此外，不同性取向的女性在家庭组建方式上存在重要差异。医疗服务提供者应了解异性恋性少数女性的怀孕和家庭组建模式、计划及需求。
