The recent publication of our research on child health in same-sex families has gained a little media attention this week following my piece in the Conversation. I have had some wonderful feedback from members of the community who feel that this research provides valuable insights into the many diverse ways in which same-sex attracted people are raising children. But in the background the usual group of critics have set about trying to undermine our work.
One issue that has been raised is that of bias. There are many types of bias that can have an impact on research and this is one key area that academics like myself make every effort to account for. In clinical sciences the randomised control trial is the gold standard for eliminating bias, but in many population studies this is not always an achievable methodology. You can’t take a group of children, for example, and randomly allocate them to being raised by same-sex attracted parents or heterosexual parents. When bias cannot be completely omitted it is important to acknowledge its potential influence and this is something authors will highlight when considering the limitations of their work.
When researching child health in same-sex families the first problem is identifying, and then recruiting, such families. In Australia there is only one way that this can be achieved: through convenience sampling. Overseas, attempts have been made to draw representative samples from population surveys. While perhaps removing the volunteer nature of the sample these studies do suffer from small sample sizes, as the same-sex parent population within any population sample will be very small. This strategy is not an option in Australia where there are no population datasets that capture parent sexual orientation. Thus the volunteer sample is the only option. This is where the first criticisms of our study have been leveled.
It is argued that only parents with a vested interest in promoting positive health outcomes will volunteer. While this cannot be discounted as a possibility there is no evidence to suggest that this is the case. The underlying aim of the study was to characterise health and wellbeing and to understand the influence of stigma on child health in this context. As any parent will tell you what is paramount is ensuring that your children have the best health opportunities available. To intentionally corrupt research so that it cannot identify where problems may lie is doing yourself, and your children, a disservice. Only by providing an accurate picture of your child’s health will you know what can be done if there are issues. And in a context where stigma might be having a negative impact this is important to identify.
Further to this is the fact that significantly positive outcomes were only identified on a handful of scales. Overall 29 different measures of health and wellbeing were included in our study. Almost all showed no difference to the general population. Only 3 measures showed a significant difference, albeit a positive one for same-sex families. If same-sex attracted parents were systematically working to ensure an outcome that shows their children in the best light would there not be a more consistent skewing across all the scales? What is more likely is that there truly is something within same-sex families that shows a benefit on those three measures.
While the criticism has touched on the methodology, the limitations of which are clearly outlined in the published paper, there has also been an unfortunate focus on more personal aspects of the research. Some groups have highlighted the fact that I, the lead author on the paper, am a gay man raising children, suggesting that this is a conflict of interest and introduces inappropriate bias.
The research team for this study is based within the Jack Brockhoff Child Health and Wellbeing Program at the University of Melbourne. This Program is led by Professor Elizabeth Waters, an internationally renowned child health researcher who leads work on many aspects of child health including obesity, oral health, disability and disaster recovery, to name a few. She is also a heterosexual parent and second author on the paper. The rest of the research team bring a range of research experiences and family backgrounds. But is there any relevance to their personal situations? All published papers go through a rigorous peer review process that is blind to such things, assessing work on its methodological merits alone. To suggest that my family situation is of relevance implies that no heterosexual researcher can produce unbiased work on heterosexual families. Or that any non-Caucasian researcher would be able to objectively conduct research on racial discrimination and child health.
Increasingly, across all areas of research, there is a move towards the publication of protocols. This establishes the theoretical underpinnings and methodological basis of studies and allows a continued process of transparency to be engaged from the outset. Our recently published findings on same-sex families took this approach and a protocol was published in the early phases of the project. By being up front and transparent at all times about the research we are allowing the work to be continually interrogated.
Research on same-sex families always draws critics. There is a small but vocal minority who do not accept family forms that fall outside the traditional mother-father construct. It is interesting to note that at the same time as criticising methodologies such as ours these same groups would baulk at including questions around sexual orientation on national surveys such as the Census. It is up to the scientific community to consider the merits of our work and place it in its appropriate context in terms of future health interventions and policy work.
It will never be possible to exclude bias completely from all research. But in the mean time it is up to us, the researchers, to maintain objectivity, be open about limitations, and be true to the evidence that our work provides.
Dr Simon R Crouch
Lead Investigator, the Australian Study of Child Health in Same-Sex Families (ACHESS)