The post-partum and early infancy period are stressful and a time when mental health issues that are not effectively addressed can have long term negative consequences for all family members. One group of parents that has attracted little attention are queer people whose mental health status and barriers to seeking help are little understood. Of particular concern are those who are known to be more vulnerable to mental health difficulties including queer cis women partnered with men, trans/nonbinary parents, and queer parents who are young, low-income, and/or of colour.
Understanding More
A US study by Goldberg and Frost (2024) studied a sample of 99 queer mothers to ascertain both mental health concerns and barriers to effective support. The authors acknowledge that there has been general work done, with the focus on white, middle-class, middle-aged lesbian mothers with little attention to those who are young, of colour, low income, or queer or bi-sexual. The latter may be more at risk for mental health issues due to experiences of stigma and exclusion from pre-natal care and negative experiences through the birthing process. Additionally, this group may also be more wary of social services and the threat that their child will be removed leading to an avoidance of contexts where their parenting may be observed and downplaying their own mental health concerns if asked.
What Did they Find?
More than three quarters of these parents described mental health challenges, especially mood and anxiety disorders in the year following their baby’s birth, compared to 12% -35% of mothers overall. When asked to explain their experience, the mothers spoke of isolation, lack of partner support, financial issues, difficult birth experiences and gender dysphoria. Isolation, partner issues, and financial issues are risk factors in the general population but may be more intense for this group due to structural stigma and hetero sexism.
Scared to Ask for Help
While two thirds of those who identified suffering mental health difficulties did seek help, they delayed doing so, citing fear of provider judgement, being seen as unfit to be a mother, scrutiny by child protection services and mistrust of these services. Constraints also operated at the internal level with beliefs about being weak and needing to manage alone while also fearing external judgement of family and friends. Fear of provider mistreatment and referral to child protection services was more pronounced in those of colour, single and trans and non-binary mothers. Trans and non-binary participants believed their gender expression and queer identities produced greater scrutiny of their parenting while women of colour were keenly aware of the rate of child removal in their communities. While fearful that services would not be helpful, the impetus for seeking support was the desire to be a good mother, recognition of reaching a critical point or pressure from a partner.
Some Useful Reminders
Recognising the additional constraints that operate on queer mothers to seek help requires ‘an open, nonjudgmental, and reassuring stance in relation to patients to reduce the stigma and fears that contribute to a reluctance to disclose’. Genuinely seeing the person and not their sexual identity, income, relationship status or colour, and offering care, even when it is not directly requested, is a simple, compassionate, and effective stance to support new mothers and their babies. Building these relationships from the beginning may well aid helpful referrals and babies safely remaining with their mothers.
Goldberg, A. E., & Frost, R. L. (2024). “Saying ‘I’m not okay’ is extremely risky”: Postpartum mental health, delayed help-seeking, and fears of the child welfare system among queer parents. Family Process, 00, 1–24. https://doi.org/10.1111/ famp.1303
