Wednesday 24 July 2013

The kids are alright! Research continues to demonstrate the children of LGBTI parents are thriving

The results of what is reported to be the world’s largest study to date exploring the impact of LGBTI parenting on child health and development are expected in September 2013. 

The study is being undertaken by the Australian Study of Child Health in Same-Sex Families (ACHESS).  The ACHESS is being conducted as part of the Jack Brockhoff Child Health and Wellbeing Program at the University of Melbourne.  It is the first study in Australia to consider the health and wellbeing of children with same-sex attracted parents.

The ACHESS is based on data collected on five hundred children aged from birth to seventeen years old.  Focussing on mental, physical and social wellbeing, the study also interviewed 315 LGBTI parents.  The adult participants were asked to complete the Child Health Questionnaire (CHQ).  The CHQ is a series of internationally recognised surveys designed to test for general quality of life. 

Whilst the full results of the ACHESS are still a couple of months away, an interim report is already available.  It suggests that children brought up by LGBTI parents are happier and healthier than their peers brought up by heterosexuals. 
 

On measures of general health and family cohesion, children aged 5 to 17 years with same-sex attracted parents scored significantly better when compared to Australian children from all backgrounds and family contexts.  For all other health measures there were no statistically significant differences.

Unsurprisingly, however, the study confirmed that children with same-sex attracted parents continued to face discrimination in a variety of contexts.

Said Dr Simon Crouch, the lead researcher on the ACHESS on this particular finding:

“One of our hypotheses is that this experience of discrimination does have an impact on child health and well being.”

What is perhaps most significant is that this impact appears to be a positive one.  In the face of discrimination, children with LGBTI parents are developing at least as well as the children not exposed to it. 

A detailed description of the ACHESS protocol and background research can be found online.
 

It may be the world’s largest – and to that extent is doubtless an important study – but the trends emerging from the ACHESS duplicate those from similar research around the world.  Earlier this year, a British study undertaken by Cambridge University’s Centre for Family Research confirmed the adopted children of same-sex parents were thriving.  Same-sex adoptive parents were found to be raising children just as successfully as heterosexual ones.  Gay men were found to be faring particularly well in managing the parenting challenges presented by children who had negative and damaging experiences in early life.  There was no evidence to support speculation that children's masculine or feminine tendencies were affected by having gay or lesbian parents.  Family life and the quality of relationships were very similar for children regardless of their parents' sexual orientation.

Professor Susan Golombok, the report’s co-author, commented on the results: 

Overall we found markedly more similarities than differences in experiences between family types.”
 
Quoted in the Independent at the time, she added: 

"What I don't like is when people make assumptions that a certain type of family, such as gay fathers, will be bad for children. The anxieties about the potentially negative effects for children of being placed with gay fathers seem to be, from our study, unfounded."

And a US study published in October 2012 undertaken by psychologists from the University of Central Los Angeles looking at welfare and development depending on whether adopted children were placed with gay, lesbian or heterosexual parents arrived at the same conclusion.  The children in that study ranged in age from 4 months to 8 years.  They presented with multiple risk factors at the time of adoption, including premature birth, prenatal substance exposure, abuse or neglect, and multiple prior placements.  The psychologists studied the children two months, one year and two years after they were placed with a family.  They found very few differences among the children at any of the assessments over the two-year period following placement.  All children achieved significant gains in their cognitive development, and their levels of behaviour problems remained stable.  This was despite the fact that the children adopted by gay and lesbian families had more risk factors at the time of their placement; out of nine risk factors, they averaged one additional risk factor, compared with the children adopted by heterosexual parents.

Said Letitia Anne Peplau, research professor of psychology at UCLA and co-author of the study:

"The children adopted by gay and lesbian parents had more challenges before they were adopted and yet they end up in the same place, which is impressive."

So let’s see what the final ACHESS report brings later this year, in terms of:

Ø                  whether further analysis of the data identifies the ways in which LGBTI discrimination affects children and their families, and
Ø                  characterising overall health and wellbeing in more detail.

But in the meantime, the evidence-led conclusion is unarguable.  The outcomes of all credible studies are consistent and support one conclusion:  children – whether they join the families through adoption, surrogacy or in some other way - brought up by LGBTI parents flourish!

Tuesday 23 July 2013

The human cost of unregulated commercial surrogacy

In one of last week’s blogs, I looked at the burgeoning commercial surrogacy industry in Nepal.  Interest groups there were concerned that the lack of regulation left vulnerable and disenfranchised women at risk of exploitation.  Reference was made to the Indian experience, and how the absence of a legal framework left Indian surrogate mothers ill-protected.

The extent of the vulnerability of surrogate mothers in India is highlighted in a recent report from the Centre for Social Research (CSR).  The Centre is a non-profit, non-governmental organisation based in New Delhi working to empower Indian women and help protect their fundamental rights and freedoms.

India has long been a popular destination for prospective parents from Australia, the UK and elsewhere seeking to have a child through surrogacy.  CSR estimate that the resulting surrogacy industry, which is flourishing in the absence of legal protections, is worth about US$2 billion.

Looking to see whether the industry was as deeply exploitative as feared, the CSR undertook a survey of 100 surrogate mothers and 50 commissioning parents in Mumbai and New Delhi. 

CSR’s report, “Surrogacy Motherhood:  ethical or commercial? summarises the trends emerging from that survey.  Even taking into account the relatively small sample size, those trends are alarming, and include the following: 

Ø                  surrogacy agreements between the surrogate mother and the commissioning parents were normally signed in the second trimester, after the pregnancy had been confirmed. 

Ø                  most surrogate mothers were not given a copy of their agreement and were not aware of its terms.  "The freedom of the surrogate mother is an illusion," says the report.

Ø                  surrogacy agreements rarely addressed issues relating to the health and wellbeing of the surrogate mother.  Where they did, it was usually only incidental to the health of the child she was carrying. 

Ø                  if a congenital defect was detected in utero, or the child was not of the preferred gender, it was often chemically aborted, and often without the surrogate mother's consent or knowledge.  According to the report, "There have been instances where the contracting individual has specified the sex of the baby, refused to take the baby if it was not born normal and filed a suit against the surrogate saying she had broken the contract."

Ø                  surrogate mothers were paid about 1% or 2% of the fees charged by the clinic.  Where the pregnancy was terminated, or the commissioning parents refused to take the child, the surrogate was often only paid half of the agreed fee.  Some surrogates were paid nothing.

Ø                  the actual payment received by the surrogate mother ranged from between 2.1 and 4 lakh of Rupees (between about £2,300 and £4,350), depending on where the arrangement was undertaken. 
 

Compare this with India’s average per capita income – in February 2013, this was estimated to be 68,750 Rupees (£750).  So, whilst only a fraction of what clinics are earning, a surrogate mother can earn the national average annual income many times over from a single pregnancy. 

Ø                  the fate of children born with congenital defects was unclear.  Only 6% of commissioning parents in New Delhi and 26% in Mumbai said that they would take the baby regardless.

Ø                  there was an increasing trend to use more than one surrogate mother. Commissioning parents looked upon it as a more economical option, since some clinics offered “2-mothers-for-1-guaranteed-pregnancy” discounts.

Ø                  most surrogate mothers stayed in hostels or shelters during the pregnancy to avoid the stigma of being a surrogate and to avoid being infected with STIs during pregnancy.

Ø                  many commissioning parents are ethnically Indian themselves, living in Western countries where surrogacy was illegal.
 

The report includes some appalling anecdotes about the extent of the oppression rife in the surrogacy industry.  In one instance: 

"a shocking case of surrogacy was unearthed in the Bombay International Airport, where a foreigner couple went for surrogacy in India only for organ transplant for their sick child in their country."

Unsurprisingly, the resounding recommendation is for a clear legal framework.  There was insufficient protection for the surrogate mother’s health, or to protect her from exploitation. 

“Surrogacy arrangements have made child a ‘saleable commodity’, and complications have arisen regarding the rights of the surrogate mother, the child and the commissioning parents.  As there is no legal provision to safeguard the interests of the surrogate mother, the child, or the commissioning parents in India, looking at such an issue from commercial or business point of view has complicated the matter further.”

Further research was required, the report concluded, to assist in initiating legal provisions to properly regulate surrogacy practices and protect the interests of the surrogate mother and, crucially, the child.

At which point (and at the risk of sounding like a broken record) I return to one of my favourite topics from recent weeks …
 

I looked in a blog a few weeks ago at European research on whether a standardised surrogacy framework within the EU was achievable.  A similar piece of research is underway via the Hague Conference, with a correspondingly broader scope. 

Those with experience of transnational surrogacy in any capacity – commissioning parents, surrogate mothers, legal advisers, etc – are invited to share them by contacting the Hague Conference’s Permanent Bureau.  Legal professionals with relevant practical experience are invited to complete a Questionnaire online.  Responses close at the end of September 2013.

The Indian research demonstrates that, only by identifying the nature and extent of the issues that arise due to current surrogacy practices, can a properly formulated legal, medical and ethical framework emerge. 

Wednesday 17 July 2013

Nepal's booming trade in commercial surrogacy

Within Asia, India has long been a popular destination for prospective parents from Australia, the UK and elsewhere who seek to have a child through surrogacy.  Commercial surrogacy in India is booming, and the government there is struggling to regulate what has become an industry.

The exponential growth of commercial surrogacy appears now to have spread to India’s neighbour, Nepal.  Human rights organisations doing research on commercial surrogacy in Nepal point to a marked increase in such cases.  This is particularly so along the Terai (or Madhesh) region on the shared Indian / Nepalese border.

Initial research on behalf of NAWHRD has identified the border areas of Nepalgunj, Biratnagar and Jhapa (amongst others) as fast turning into attractive destinations for commercial surrogacy.

The organisation’s chairperson, Renu Raj Bhandari, has called upon the Nepalese authorities to pay attention to the phenomenon and to regulate it.

India is already a world hub for surrogacy arrangements. And because of long standing ties between India and Nepal, it can be assumed that women in Nepal are and will continue to become increasingly sought as gestational surrogates, too. 

“In the preliminary phase of the research we are conducting we have found that some areas in the Tarai belts have already attracted service seekers”.   

A local human rights activist and advocate, Meera Dhungana, agrees:

“Poverty is the basic reason behind thriving business of commercial surrogacy in India. We know the status of poor women in Nepal. If we expect to act only after the problem grows, many women are going to be exploited badly.”

Surrogacy always throws up complicated legal and ethical issues, and international surrogacy all the more so.  The Nepalese experience demonstrates that the wave of surrogacy as a global phenomenon continues to crest.  I looked in a recent blog at European research on whether a standardised response to surrogacy within the EU was achievable.  A similar piece of research is underway via the Hague Conference, on a broader scale. 

Those with experience of transnational surrogacy in any capacity – commissioning parents, surrogate mothers, legal advisers, etc – are invited to share them by contacting the Hague Conference’s Permanent Bureau.  Legal professionals with relevant practical experience are invited to complete a Questionnaire online.  Responses close at the end of September 2013,
 
Those considering surrogacy – whether as commissioning parents or surrogates – should seek specialist advice as early in the process as possible.  If there are potential problems with a surrogacy arrangement, early identification and management will help ensure a positive outcome. 

Tuesday 16 July 2013

A statistical analysis of recent adoption trends, and the pursuit of a financial agenda

The government has today published the latest round of adoption statistics for England and Wales.  These focus on Quarter 3 of 2012-2013.  The patterns emerging are identified in the Department for Education’s Quarterly Adoption Survey.

The report examines data collected through a voluntary survey, covering the characteristics of children who were at any stage in the adoption process, and the timelines of their journey.    

Some of the key themes identified include:

Ø                  there was a statistically significant decrease (about 18%) in the number of adoption orders between Quarter 4 of 2011-12 and Quarter 3 of 2012-13.

Ø                  comparing the same periods, there were increases in adoption matches and placements (up 13% and 15%, respectively).

Ø                  the adoption process for older children, disabled children, children from black or minority ethnic (BME) groups and sibling groups takes longer than the national average.

It takes an extra thirteen months for children aged five or older at placement. 

It takes an additional two months if the child is disabled, if the child is considered for adoption as part of a sibling group or for BME children.

Ø                  in the third quarter of 2012-13 more BME children were placed with adoptive parents compared to the last quarter of 2011-12 (increasing by over 30%).

Ø                  the time from a child entering care to placement with adoptive parents saw a 7% decrease (around 43 days) between quarter 4 of 2011-12 and quarter 1 of 2012-13.

Ø                  as at 31 December 2012, there were considerably more children awaiting adoption than there were prospective adopters – about 6,600 compared to 1,800.

Ø                  applications for approval as prospective adoptive parents increased overall (by 4%) from the last quarter of 2011-12.

Ø                  approvals of new adopters increased by 25% during the same period.

Ø                  the timeliness from application to approval and from approval to matching improved across all quarters for adopters.

Data for the period January to March 2013 has recently been collected and the corresponding statistical analysis will be published in Autumn 2013.

No doubt, the positive aspects of the statistics from Quarter 3 of 2012-13 will be used by the government as demonstrative of its commitment to improving the adoption process.  I have looked at whether there is any substance to that expressed commitment in real terms in a couple of recent blogs – here and here.
 
No-one could seriously quarrel with the proposition that, where it is the best option for the particular child or children, the process of adoption should move as swiftly and efficiently as possible to that conclusion.  However, those working within the process – social workers, guardians, lawyers – caution that adoption is not the only solution for children who cannot live with their parents.  There may be children for whom long-term fostering is more appropriate, or whose interests would be best met through an intra-family placement (possibly supported by a special guardianship order). 

This is not a popular view with government myrmidons pushing a particular approach in furtherance of a financial agenda.  From a central government perspective, adoption is a cheaper alternative than ongoing local authority support.  Every child adopted is one less requiring funding, as the baton of financial responsibility passes from the State to the adoptive parents.

This blind rush towards adoption as the only “good” outcome is starting the have a pernicious effect.  In my day-to-day practice, I’m seeing instances of local authorities advocating adoption as the only solution, and not even paying lip-service to other alternatives.  Speaking with other practitioners, it appears these are not isolated occurrences.  This is hardly surprising, when the local authority’s government paymasters make it plain that the adoption agenda must be pursued over all others, and that continuing funding is dependent on arbitrary targets being achieved.  I’d be interested to hear from others whether they have had similar, or indeed different, experiences.    

Hearkening back to a theme I looked at last week, I’d like to see an analysis of the support provided to adoptive parents by local authorities after adoption.  What happens once the spotlight is no longer shining on the process?  What help are families actually being offered to adjust in the aftermath of the adoption order?  How many adoptions break down subsequently due to lack of effective support?  For obvious reasons, I doubt these are statistics the government will be looking to collate and publish any time soon. 

Friday 12 July 2013

What happens after adoption? How a lack of support is failing children and families

The government is quick to trumpet at every opportunity its commitment to vulnerable children by speeding up adoption processes.  It has recently outlined   measures to ensure adopters are approved more quickly.  Changes include a two-stage approval process for adopters to ensure the majority are approved within six months.   A fast-track procedure for foster carers and previous adopters who wish to adopt will also be introduced.

Announcing some of these reforms in May 2013, Minister for Children and Families Edward Timpson, claimed prospective adopters had been dissuaded from adopting children in the past because of delays.  So we’re overhauling the system to encourage more people to adopt, and making it swifter, more effective and robust,” he said. 

All very commendable.  But what happens next?  What help do families get to manage the complex needs of children and young people who often have had extremely difficult early life experiences? 

There are two answers to that:  one theoretical and one based in reality.
 

Taking them in that order, local authorities have an obligation to make adoption support services available to adoptive parents and children.  Authorities are required to undertake assessments of adoption support needs when requested by an adoptive child, their adoptive or natural parent/s, or their former guardian/s.

Support, which ought to be tailored to the particular needs of the child and his or her family, might include therapeutic help for the child and training for his or her parents to help them meet any special needs.  Financial support is also available, and may likewise assist in ensuring that the child’s particular needs are met.  Respite care might be offered in appropriate cases, to ensure families are able to continue to cope with stressful and difficult home environments in the aftermath of adoption.

This constellation of resources is designed to ensure that the children affected by adoption – who have often had profoundly damaging and difficult early lives with the corresponding physical, mental and emotional consequences – have the best chance of flourishing. 
 

So much for the theory:  what’s the reality?

Unfortunately, it is often very different.  As attractive as this package of support might appear, adoption support services are often extremely difficult to engage.  Local authorities, with limited budgets, often fight tooth and nail to avoid having to spend money to help families once the adoption order has been made.

The plight of those affected was the feature of a recent excellent piece in The Guardian.  One father recounted how his adoptive son returned to foster care after eight years.  We couldn't cope, it was just too stressful”.  He and his wife had battled for years to access post-adoption support for the traumatised child.  They never secured funding for the specialist therapy they believed he needed.

"Our lawyer was arguing in court that we needed this help.  The judge was practically begging the social services to do something. But the lawyer for social services said it was a health issue, not their responsibility."

Another mother described post-adoption support as “shocking”.  Her adoptive son had become physically abusive following his childhood experiences.  The local authority, when asked to help, did nothing. 
 

And another mother told how her adoptive daughter had only been able to get the intensive support that had transformed her through direct payments, as an adult. 

"Social services would say, in shorthand, 'you're the mum, lots of mums with disabled children have difficult things to deal with, you have to manage'."

All too often, local authorities avoid providing help to those in need by sticking to the letter of their obligations.  Whilst they are obliged to undertake post-adoption assessments, there is no corresponding obligation then to fund the services to meet any needs identified. 

Recent changes to adoption law dance around what those working with adopted children and their families recognise is a fundamental problem.  The reality is that no additional resources have been committed by the government to local authorities to ensure that support services are available when and where needed.
 

As one of the mothers quoted in The Guardian piece observed, there’s no point in the government developing new adoption policies without any corresponding commitment to support parents who take on children with extensive early trauma. 

"Adoption isn't just this lovely thing.  It starts with a terrible loss, and if you don't deal with that at the beginning, then you store up problems in the future."

Children adopted from care have a range of needs due to their early life experiences, often of abuse or neglect.  The behavioural problems that this may cause are not resolved simply by being adopted.  If the government is serious about its commitment to adoption, it ought to put its money where its mouth is.  Make available in an effective way the support that these families need and deserve.  Because speeding up the adoption process is perfectly pointless if what then develops is a series of adoptions that break down because of inadequate post-adoption help. 



Thursday 11 July 2013

The Iron Curtain closes - Russia's anti-LGBTI adoption agenda

A few months ago, I looked in one of my blogs at Anglo-Russian intercountry adoption developments.  This followed the vote in the Commons in this country in favour of marriage equality.  In response, Russian officials warned that there might be consequences for British nationals seeking to adopt Russian children.

It turns out that wasn’t just sabre-rattling.  True to their word, the Russian parliament adopted a bill on support for orphaned children in its third and final reading in late June 2013.  The new law imposes a ban on the adoption of Russian national children by same-sex foreign couples.  Head of the parliamentary Committee on Security and Resistance to Corruption, Irina Yarovava, said:

"The decision to prohibit foreign same-sex couples from adopting Russian children is a measure to ensure the children’s safety and constitutional rights.

"Attempts to simulate the institution of the family and demands for allowing adoptions by same-sex couples are unnatural from the standpoint of the laws of nature and the institution of family law."

On 3 July 2013, President Vladimir Putin signed off on the legislation.  The Kremlin said in a Statement that:

“the measure is aimed at guaranteeing a harmonious and full upbringing for children in adoptive families.” 

For good measure, the new law also forbids adoptions by unmarried individuals who live in countries with laws that permit same-sex unions.

Russia’s recent track-record on LGBTI issues is hardly a commendable one, with parliament voting in mid-June almost unanimously to pass a law to punish the “promotion” of homosexuality with fines and gaol terms.  The law bans what it calls the “propaganda of non-traditional sexual relations” to minors. The word “homosexual” was removed from the text but in parliament one of the law’s backers said “traditional” relations were between a man and a woman.

It outlaws the spreading of information aimed at forming non-traditional sexual attitudes among children,” said Duma deputy Elena Mizulina.  She also confirmed that it would become an offence to say that gay and straight relationships were equal, describing that as “a distorted perception”. 

Under the law people can be fined up to a maximum of over €2,000 if the offence is committed via the media.  Foreigners who promote homosexuality can be fined, detained for 15 days and deported.

That bill will now go to the Russian Senate before being signed into law by President Vladimir Putin – steps considered to be a formality.

Back to adoption:  according to New York’s Russian Children’s Welfare Society, there are currently more than 700,000 orphans in Russia.  This figure is increasing annually at a rate of 113,000 children.

Some of those hundreds of thousands of vulnerable children will be denied a chance to experience a loving family environment, on account of a prejudice about how worthy or otherwise prospective adopters are based upon their sexual equipment.  A view which runs contrary to all credible studies on topic, which consistently show the sexual orientation of adoptive or foster parents makes precisely no difference to the quality of the parenting they provide (see, for example, Cambridge University’s Centre for Family Studies’ research from March 2013).  

The real tragedy is that, whilst mewling about guaranteeing children a harmonious and full upbringing, the rule which excludes a particular group of individuals as potential adopters achieves just the opposite.  It only serves to narrow the pool of potential adopters and to ensure that vulnerable children in need of a stable family placement are denied one.