Screwed-up Medical Misfortunes

A little bit of this, and a little bit of that, will a whole lot of medical “stuff” added in!

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Archive for July, 2006

Discussion: African American Struggles Continue

Posted by Administrator on July 30, 2006

All the aforementioned statistics are presented to stress how formidable the hurdles African Americans face really are. “Given these disparities in wealth, it comes as little surprise why whites do better than others, and particularly better than blacks, on almost every measure, and that they do so over generations” (Squires, 2006). Whether studying psychology or not, one should be able to see how these factors can have a large impact on the black individual, and their outlook on race. Children go through many stages in the developmental process, and African Americans are more likely to explore their racial identity. The world thinks of them in terms of race, so they too have to consider themselves in this manner (Rosenblum & Travis, 2006).  Some black children start off by following the white dominant culture because it is viewed as “better”, but once racial discrimination is inflicted on them, an opposition to white culture can occur.  Some teens refuse to engage in any act that could be perceived as a “white activity”.  Growing up, I always wondered why black individuals had such a close bond with each other and how something as simple as color can bring people together so much.  Even as I grow older and have become intertwined into the black culture, I still realize no matter how close I am to some individuals; the black bond they share is something special that I have no part in. I believe I now have a better understanding of the concept though; it is not about skin color, it is about a common struggle. While researching for the last post, I read some excerpts to my partner out of the text, and discussed my thoughts on the matter at hand.  The subject of race has come up countless times in our five years of being together, but I noticed a bit of discomfort on his part. When I asked what was wrong, he simply stated, “I am living it”. I then realized regardless of the research I do, or how assimilated I may be, I will never know what it feels like to be discriminated against in such a manner.  Sure, I know how discrimination feels.  I would dare to say everyone has experienced bias in some sort or fashion, but blacks in the
United States experience a more extreme form than most other Americans.   

African Americans have a strike against them from birth, even if it is not apparent to them until they get older.  Though progress has been made in the last century, the statistics presented are not very pleasant. There are many thriving blacks, but the road to success is not always an easy one.  Some lose their black friends because their values may be viewed as part of the white society.  Others face tremendous difficulties because of racial profiling.  We, as a human race, must become aware of the trials our fellow men and women face every day: “Recognizing the continuing black/white divide is a vital next step in the struggle for racial justice in the
United States” (Squires, 2006). 

You can download/open the entire document African American Struggles

It contains the references I used and is in Microsoft Word format.

Posted in Misc | Leave a Comment »

Black Crime and Incarceration

Posted by Administrator on July 30, 2006

The chance of an African American male going to prison is almost 30% higher than a white man (Frazier, 2005).  While most view this statistic as “blacks commit more crimes”, one should see how skin color alone increases the percentage of arrests for blacks.  For one, the average jail sentence, for the same crime, is 6 months longer for blacks than whites (Frazier).  How is that considered justice?  This only tells white individuals they can get away with much greater crimes and do less time, because they are privileged.  Rosenblum & Travis (2006) speak on how black parents have to instruct their children on how to deal with getting pulled over, because it is inevitable due to their skin color.    

You can download/open the entire document African American Struggles

It contains the references I used and is in Microsoft Word format. 

Posted in Misc | Leave a Comment »

Employment Barriers for African Americans

Posted by Administrator on July 30, 2006

If you were interviewing two people with equal skills, one with a felony record and one without, who would you pick?  Well, research shows employers are more likely to pick the individual with a felony record if he or she is white and the other applicant is black. Also, individuals with “white sounding” names are more likely to get a job than those with “African American names” (Squires, 2006). These study results, along with the statistics on education and housing, may very well account for the 50% unemployment rate for black men in New York City and the double-digit average for all other black men over the age of twenty (Frazier, 2005). 

Not only do blacks have a harder time getting jobs, they tend to make less than whites.  As of 2002, the median household net worth for Caucasians was $88,651, and a mere $5,988 for blacks.  Latinos even had a $2,000 net income above blacks (Squires, 2006). In 2000, black males earned 64 cents to the dollar, only up 14 cents from 1960 (Texeira, 2006).  In addition, the mean earning in 2003 of black males with a professional degree compared to white males with the same degree was $37,264 less (Vital Statistics, 2006).

You can download/open the entire document African American Struggles

It contains the references I used and is in Microsoft Word format.

Posted in Misc | Leave a Comment »

Black Housing Discrimination

Posted by Administrator on July 30, 2006

Some people would probably ask why, if black schools are so bad, people of color don’t just get up and move to a more diverse, integrated community.  Regrettably, this is much more difficult than it sounds.  Rosenblum and Travis (2006) state, “blacks remain the most spatially isolated population in
U.S. history”, because over 30% of African Americans live in neighborhoods that are 90% black. It has been found that regardless if the black individuals moving into a neighborhood have equal or greater wealth than their white counterparts and crime does not go up, whites will still move away because they think the more blacks moving in, the “worse” the neighborhood will be (Rosenblum & Travis). In one survey, 20% of whites, 33% of Hispanics, and 40% of Asians said they would rather live in a neighborhood without any blacks. “Blacks are the least favored neighbor by all other racial and ethnic groups” (Squires, 2006). Historically, one facet of segregation has been to bar black individuals from purchasing homes in certain areas (Texeira, 2006).   Even if this were not the case, some blacks do not want to feel discriminated against and choose to stay in a black neighborhood (Rosenblum & Travis).
Also, while over 75% of whites own homes, the figure is less than half for African Americans.  Surprisingly, blacks are 60% more likely to be denied for a home loan than white counterparts even when credit scores are the same (Texeira, 2006).  The most current national housing inequity study revealed illegal discrimination was encountered in 20% of visits to a rental or real estate agent. Even phone calls are screened for the “recognizable black voice” (Squires, 2006). 

You can download/open the entire document African American Struggles

It contains the references I used and is in Microsoft Word format.

Posted in Misc | Leave a Comment »

Inequality in Black School Systems

Posted by Administrator on July 30, 2006

“White privilege is most explicitly demonstrated by inequalities in the distribution of wealth” (Squires, 2006).  This inequality is apparent to the black majority in all stages of life.  To begin with, school systems containing a high percentage of blacks are often poorly maintained, crowded, and unsafe.  For instance, a survey in 2002 showed African American students had a 29% chance of attending a school with trash on the floor, opposed to 18% for white students; a 10% chance of having graffiti on their walls, opposed to 3%; and a 12% chance of damaged ceilings, compared to 7%. Sadly, these results correspond to students who place the lowest on achievement tests (U.S., 2005). In an article entitled “Still Separate, Still Unequal:
America’s Educational Apartheid” (2005), Mr. Kozol speaks of an eight-year old girl from a school in the
Bronx that says, “We do not have the things you have.  You have clean things. We do not have. You have a clean bathroom. We do not have that. You have parks and we do not have Parks”.  At eight-years old, this child was very aware of the racial barriers already affecting blacks.  She knew what the “whites had” and what they [blacks] did not.   

The U.S. Department of Education reveals black tenth-graders were 24.4% more likely to attend schools with security guards, 18% with metal detectors, 9% with security cameras, and 7.6% with bars on the windows than white tenth-graders (Vital Statistics, 2006). Black schools- and more importantly- black children, are seen as more violent and needing greater security measures to control them.  As soon as I read these statistics I thought about the school massacres and was curious to how many were involving black teens. I found a wonderful, though blunt, article describing my outlook on the situation.  Tim Wise (2001) states,  

“White people live in an utter state of self-delusion. We think danger is black, brown and poor, and if we can just move far enough away from “those people” in the cities we’ll be safe. If we can just find an “all-American” town, life will be better, because “things like this just don’t happen here.” ….. What went wrong is that we allowed ourselves to be lulled into a false sense of security by media representations of crime and violence that portray both as the province of those who are anything but white like us. We ignore the warning signs, because in our minds the warning signs don’t live in our neighborhood, but across town, in that place where we lock our car doors on the rare occasion we have to drive there. That false sense of security — the result of racist and classist stereotypes — then gets people killed….A few years ago, U.S. News ran a story entitled: “A Shocking look at blacks and crime.” Yet never have they or any other news outlet discussed the “shocking” whiteness of these shoot-em-ups….Color-blind, I guess…..” 

Though black schools are more likely to have higher security measures, the minimum is provided in most other regards.  The per-pupil spending level for a child in New York City is half as much as in Manhasset,
Long Island (Kozol, 2005).  Also, the average salary for a teacher of the child Kozol aforementioned is $43,000, compared to $81,000 in Scarsdale which is only 11 miles away (Kozol).  How can race not play a factor when there is a mere 11 miles involved in a $38,000 teacher salary differential?  Many inner-city children do not even have the option of going to pre-school, but they are required to take the same tests (that decide whether they succeed or not) as the children that had the opportunity.  Unfortunately, many rich, well-educated individuals can not see past their own wealth and ask, “Is the answer really to throw money into these dysfunctional and failing schools?” (Kozol). Consequently, I would like to ask this question: how can these schools and the students within them ever have a chance when people constantly deny money and race as being an issue?

If it were not enough that black schools have less funds to utilize resulting in a poor school setting, these schools are rarely geared to promoting a future college education. In California at Freemont High School where the bathrooms are insufficient; many rooms are without air-conditioning; and the rats are abundant, the children are geared to a labor or “ghetto” mindset, as one of the children put it (Kozol, 2005).  Some of the classes available for the technical art requirements are “Life Skills”, “Sewing”, and “Hairdressing”- which one can take either braiding or hairstyling.  If a student attended Beverly Hills High school, he or she could take broadcast journalism, advanced computer graphics, or residential architecture, to just name a few.  Kozol writes about a situation involving a student at Freemont that wanted to take an AP class and had hopes of going to college.  One of her classmates exclaimed “Listen to me.  The owners of the sewing factories need laborers. Correct? It’s not going to be their own kids. Right? You’re ghetto, so we send you to the factory.  You’re ghetto—so you sew!”(Kozol). Nevertheless, many whites still hold onto the misperception that black prefer welfare and are incompetent (Rosenblum & Travis, 2006).  I would like to ask some of these individuals to consider this: Maybe they do not prefer it, but rather are persuaded into it?

 You can download/open the entire document African American Struggles

It contains the references I used and is in Microsoft Word format.

Posted in Misc | 4 Comments »

African American Barriers to Success

Posted by Administrator on July 30, 2006

“Life expectancy, the quality and quantity of public education, the safety and security of neighborhoods, access to public accommodations, treatment by the criminal justice system, and almost every aspect of public and private life varies with race, with whites at the top, blacks at the bottom, and other minority groups somewhere in between on virtually every measure” (Squires, 2006). Though racism has became structurally invisible (Rosenblum & Travis, 2006), its effects are no less apparent; and “blacks remain the primary target” (Squires).  The increasing diversity and success of the American population has amplified the misconception that blacks are responsible for their [groups] problems relating to employment, education, housing, etc. (Squires).  Most people find it easier to blame this group than to accept the truth (Rosenblum & Travis). Unfortunately, the barriers this group faces are rooted both explicitly and inexplicitly in racial discrimination. Also, many of the mechanisms created to assist blacks with these barriers have been reallocated to other ethnic groups. Rather than taking a step forward in racial acceptance,
America has taken a step backwards in many regards- we just choose to pretend everything is now different. “Considerable effort is now being made to rid ourselves of this particular idea, to create what is sometimes a ‘colorblind’ society” (Michigan Today, 1996).  Children are not born with the realization they are black or white, or any race for that matter. It is society that soon embeds this train of thinking.  Though some adolescents may not think of themselves in terms of race (Rosenblum & Travis, 2006), studies have shown children have formed a negative viewpoint of individuals outside of their racial group by the age of three (Michigan Today, 1996). At three years old, a child should be worried about naptime; yet, society’s indirect racial stigmatisms are surprisingly apparent even to the young.  And what do almost all the barriers African Americans face center around? Wealth and power. 

 You can download/open the entire document African American Struggles

It contains the references I used and is in Microsoft Word format.

 

Posted in African American Struggles, Misc | Leave a Comment »

My One Month Metformin Anniversary

Posted by Administrator on July 20, 2006

Oh happy day- today marks my one month anniversary on Metformin.  Two weeks ago I updated my dose to 850 2X a day and was puking my guts out and horribly sick for a few days.  After that, I started to slowly feel like normal again- and now I feel pretty good.  After going crazy in the past month over what to eat…what not to eat…6 hour grocery shopping ordeals….I finally got frustrated and said I was not going to kill myself.  So now I am eating more “normally”- don’t get me wrong- I’m not drinking any kind of cokes, etc.. eating any kind of regular sweets..and still being careful about what I eat, but I decided to stop worrying about what fruits and vegetables are ok, etc.  All the websites I went to are so freaking indecisive in what they say- one will say this food is low-glycemic and good for you and the next will say it is not.  I finally said enough!  and just decided to eat “smart”. 

There are some foods that just don’t seem to work well…take Peanut Butter for instance..it makes me horribly sick…I want to die after eating peanut butter (and it is low carb peanut butter so that isn’t the problem)…I have read other metformin forums and this seems to be a normal occurance.  Every one reacts differently to different foods, but it still seems as if some of the same foods make people sick.  There is a great discussion on this at www.soulcysters.com

And some good news….no I’m not pregnant, but I did have a pretty normal period.  My last cycle was 38 days long…still longer than normal, but not bad for me. I didn’t cramp horribly or anything..Lasted for 4 days and then poof, gone.  So…hopefully that is a good sign that my hormones are regulating.  I am crossing my fingers…

Posted in PCOS, Personal, Women's Health | 2 Comments »

Issues of Power and Diversity Interview

Posted by Administrator on July 9, 2006

Interview with Dr. Beverly Greene
(Transcript version)

 

Dr. Beverly Greene
Q: What I thought might be helpful is if we could kind of reconstruct the conversation we had like probably a month ago…

A: Okay.

Q: When you were giving the analysis of kind of looking at the diversity from a power viewpoint.

A: Well, I think where we begin is with a sense of where you begin if you’re looking at diversity, and exactly how you construct sort of a paradigm around that. And I usually begin with a sense that diversity is really a discussion about differences. And it’s helpful to raise the question of why we so closely examine the differences that we examine, as opposed to other differences. Because there are lots of ways that people are different, and we’re not as concerned with all of them. But that concerns about ethno-racial identity, sexual orientation, biological sex and gender roles, age, disability and so forth, those particular differences are attached to power differentials. And what we don’t talk about is the power; we talk about the characteristics that are associated with those differences, but we don’t talk about the fact that they make a difference in people’s lives, because we live in a society that has constructed hierarchies of social power and marginalization that is associated with those identities. And that’s true for clinicians as well as clients, and that we can’t come together in a room and not encounter those identities in some way. And of course the power differentials that are associated with them. But the power differential is never discussed, and I think that’s what really needs to be addressed if you’re looking at diversity and the kind of differences that we’re usually concerned with around diversity, and not just characteristics or descriptions.

Q: One of the things that I find so intriguing and useful about that way of looking at it is that it allows for individual differences and their power relationships to be understood as things change over time. So for example, as the mix of peoples and characteristics in North America changes and the power dynamics change, then someone can take this model and say, “Okay, where does the power lay, where are the fault lines, how is it affecting people?”

A: Mm-hmm. It also permits an examination of the same phenomenon within all groups.

Q: Right.

A: That the social power and access, and social marginalization don’t just take place as some kind of a static entity between a particular culture’s dominant group and its subordinate group. It takes place within marginalized groups and within powerful groups as well. That everybody who has, perhaps, white skin privilege doesn’t have it equally or in the same way. And everyone who has some locus of marginalization – if you’re talking about LGT people, they’re not all marginalized in the same way. Once you start looking at the heterogeneity of the group itself. And I know that there are often concerns about the way doing that can be used to obscure the essential disenfranchisement of certain groups, but I think that’s a function of the way that it’s being used. That people who really don’t want to look at certain kinds of oppressive ideologies and oppressive situations can use the fact that we’re all unique in certain ways to avoid doing that. But I think that has to be called what it is. It’s a particular use of something to conceal a desire to avoid looking, perhaps, at one’s privilege. But particularly in therapy paradigms, at some point we’re seeking to understand an individual who’s sitting there with us, and their experience of what all of this is. And that’s never going to fit neatly into some kind of characterization of a group. When we’re training people we have to be careful about suggesting that that’s what’s possible, because people in training are insecure about what they don’t know, and they’re going to latch on to whatever they do know quite fervently. And if we emphasize, well you know, this is the characteristic of this group, well then they start – at least in my experience, students start wanting to see everybody in that group as looking like that descriptor, and if they don’t then somehow they’re seen as defective because they don’t look enough like their group, whatever that’s supposed to be.

Q: And that’s definitely a challenge in training psychologists, that once people get kind of the first wave of understanding of diversity they want the groups that they’re studying to stay put and be internally consistent. And people are internally diverse.

A: Mm-hmm.

Q: I was thinking as you were talking of the recent movie, “Brokeback Mountain,” where the first time I saw it, I saw it as being about sexual orientation. The second time I saw it, I saw it about being, about being about class. And that notion that within a group people are privileged or not privileged to different levels, and have different experiences as a result, I think it’s a very important idea.

A: Mm-hmm. Well, and I think also those entities are inseparable. You know, that when someone grows up, they grow up classed as well as raced, as well as sexually oriented, as well as gendered. And all of those things come together in particular ways that color, if you will, their experience. And one needs to consider all of them and not just one, as if there is just one master identity and that tells the entire story for a person. That identity is always going to be affected by the other identities.

Q: You know, the analogy that I sometimes use with students is of, when you go to get an eye exam and they’re trying to figure out the best lens prescription for you, and they put this thing in front of your face with all these different slots in it, and they start sticking lenses in it, and by the time they have figured out your particular prescription they may have 6, 8, 10, 12 different lenses in there. And the sum total of that is what gives you clear vision. And I think with aspects of diversity it’s necessary for students to think about all of the components and how they interact. And so there’s multiple filters the individual is going through to get to their current state.

A: Mm-hmm, and that they’re also a function of development. That the lens that works at a certain developmental juncture may not work at another developmental juncture. Age also shapes one’s experience of those things, as well. Age is a function of how people look at you at certain ages or developmental periods, and how you experience those periods.

Q: Right. I’m a lot less thin-skinned than I was when I was younger…

A: Yeah.

Posted in Misc, Psychology | 3 Comments »

Same Sex Couples Interview by Dr. Steven James

Posted by Administrator on July 8, 2006

Dr. Steven James
Same Sex Couples and Families

(Interview Transcript)


Dr. James
Q Steve, I thought the place you might start out is the material that was in the recent APA Monitor on alternate families. You were kind of the star of the show with with with your smiling face on the front cover. Could could you give a description of of your family situation and kind of the challenges it poses and how you see this as having implications for how families are becoming more diverse and different?

Steve: Well sure. My family is composed of two dads, one white, my husband’s name is Todd. And me. Native American. We adopted our oldest son, Greg, from China several years ago. He’s now 9. And our second son who is now 4, his name is Max, we adopted domestically. And he’s African American. He’s mixed race also as I am. And I think that one of the reasons that the Monitor chose to put us on the cover was that we are representing a very quick growing demographic of mixed race families that are intentionally so. Couples that are getting together of mixed race and choosing to adopt or having biological kids who are in different their parents, because for example, in my case, my dad’s Native American, my mom’s White. And so they’ve each had their experience of being from those ethnic backgrounds. But they don’t know what it means to be a mixed race kid living between two families that are not the same. And so it creates a very complicated dynamic that more and more families are embracing.

Q What kind of reactions do you get from the world at large?

Steve: Most of those that we notice are stares and silence and generally a gentle curiosity. On occasion, some of these stares are more hostile or belligerent in their tone, if you will. But rarely have we had just outright prejudice or discrimination around the race issue. I think we get more because we’re a gay family. I’ll give you an example. We’ve got a neighbor who clearly does not like that we have moved into his neighborhood. And on at least one occasion he’s said things over the fence that were very unkind. Seems like he saves it until he was inebriated, late one night, and nobody was home but Todd to hear it. But that’s the worst that has happened so far. I, frankly, was expecting some unpleasant comments based on the Monitor article, but, at least, so far haven’t had any. I was much encouraged. And it’s been very interesting to me the reaction of a lot of younger gay and lesbian folks who have particularly students who have said oh, I saw you on the Monitor and we start talking about it. And I say yeah, haven’t gotten any hate mail. And they look at me like what, get hate mail. You know, in my life when I’ve been out and doing things, either politically or you know just being out and clear about who I am, I have had a lot of experience with hate mail and negative kinds of reactions. And so yeah, I’ve been expecting something. But the world’s changed enough that so far we haven’t.

Q I recall a few years back I was a foster parent to a gay adolescent in the 1980s, and in the I would say the first 12 to 15 months he called me John. And when we would be out to a restaurant or a store, I would get a lot of bad looks. Cuz you know here’s this very obviously 15 year old kid and I think people would think you know pedophile. An interesting thing happened about a year and a half into it. He started calling me dad. And instantly, I understood heterosexual privilege. All of a sudden wait staff were incredibly kind to me be because they they viewed me as this long suffering parent putting up with this punked out kid. And it was really eye opening. I mean, it was kind of shocking how what the difference in the way the world responded was.

Steve: One of the things that regularly happens to me is I’ll have one or both of the boys at the grocery store or Home Depot or wherever, and clerks are, you know, the check out ladies will assume that there’s a wife slash mom out there somewhere and these are boys’ night out or (?) dad’s got the detail, you know, today or it’s other comments like that. And and on those occasions when typically Greg will say something to disabuse them of those assumptions. And they don’t know what to do, they don’t know what to say. And they sort of put their heads down and get their work done.

Q In terms of the family unit any observations you have about what strategies work or don’t work in terms of coping with all that?

Steve: Two large areas of coping, one my own. And you know the coping that Todd and I have to do with that. And then the other large area of what our kids have to do and what we do to help them cope with that. And for myself, I know that it’s important for me just to tell Todd you know when something like that happens at the grocery store because I do the vast majority of my work from home, I’m at the bus stop, I’m the one that goes to the grocery store, all of that sort of stuff. Typical mom stuff from the 50s expectations I seem to be following us around. And so he doesn’t get as much opportunity to have those kinds of experiences. And it’s not just important for me to able to vent, but it’s important that he hear about this so he understands it as well. Additionally, for myself, it’s important to talk to other gay parents and gay and lesbian colleagues who have similar experiences and can relate and whose shoulders I regularly cry on. In terms of the helping the kids, you know, it’s very age dependent. Max, the 4 year old, is just relatively oblivious to it. And in his world there are lots of families that we know that have two moms or two dads or one mom or one dad. You know, or even a dad and a mom occasionally. So it’s really not on his radar yet. For Greg it’s become something of a social game. He will delight in the opportunity to set somebody right about the nature of his family. He’s pretty sensitive socially, and so very often more often than not he will look to me like is it okay for me to say something. For example, he and I took the dogs, we have two puppies, to the vet for a checkup. And it was near Valentine’s Day last year. And the receptionist who you know didn’t know us that well, didn’t know our family situation, turned to Greg and said well what did your daddy get your mommy for Valentine’s Day. And Greg looked at me like ooh, can I take this one. He said well I have two dads and one dad gave the other candy. And the other dad gave him, pointing to me, flowers. And she it took her awhile to catch her breath and and she said well how nice for your dad and went off and did her work. And it was just real clear that he knew what was happening, he wanted to field that ball, he wanted to play that social game. But he was savvy to know to check with me first. And I think that’s one of the things that it’s not just from talking about it with them, that you know, sometimes you you’re gonna wanna come out as a adopted kid. Sometimes you’re gonna wanna come out as a kid from a mixed race family. Sometimes you’re gonna want to come out as a kid of gay parents. And sometimes you’ll choose to do that and it’ll be the right thing. Sometimes you’ll chose to stay in the closet, just leave it alone, and that’ll be okay too. And sometimes you’ll make a choice and it might end up being the right one. And you’re gonna have to live with that. It’s a lot of serious social skills going on and decision making. And being able to talk about it afterwards. I mean, we just howled all the way home from that vet’s visit. And he told that story like you know for the next three days to anybody who would listen. He clearly reveled in that social expertise that he was gaining. And so to some extent, I think that that probably has an overflow effect into other relationships he’s got. And my anticipation or at least my hope is that to the extent that there’s an overlay of of social skills being built up around these issues, that they’ll have them and will be able to use them in ways that hopefully prevent his being exposed to more detrimental kinds of discrimination or assumptions or sexist assumptions.

Posted in Family Ties, Misc | 2 Comments »

Adopting a new American Family

Posted by Administrator on July 8, 2006

Article from APA Monitor: Vol. 36, No. 11, Dec. 2005

Adoption plays a key role in our nation’s diversity, experts say, and merits more attention from psychology.

By Jamie Chamberlin
Monitor Staff

Print version: page 70

Adoption is redefining the American family: International and transracial adoptions are speeding up the nation’s diversity by creating more multicultural families and communities. And as more same-sex couples and single parents adopt, and more grandparents adopt their grandchildren following parental abuse or neglect, the 21st century American family has many looks and meanings, notes journalist Adam Pertman in his best seller “Adoption Nation: How The Adoption Revolution is Transforming America” (Basic Books, 2001).

In addition, adoption itself has changed over the last 20 years, experts say. Due to policy changes in many states, adoptions tend to be much more open than in years past, when adoption records were sealed and adopted children couldn’t access their personal histories. Many adopted children have contact with their biological parents–or “birth-parents.” In the case of many kinship or foster-care adoptions, they may also see members of their own extended family.

The increasingly diverse adoption population, and these changes in adoption policy and practice, are spurring the need for more research, say psychologists who study adoption. For starters, says longtime adoption researcher Harold Grotevant, PhD, of the department of family social science at the University of Minnesota (UM), researchers should be studying how to help children navigate their membership in multiple families and cultures. Research is also lacking on such issues as how adults adopted as children cope with issues of identity and loss, or with emotions that emerge when they start a family.

What’s more, few practitioners specialize or receive graduate training in helping clients navigate these and related issues, such as the emotions that can accompany the decision to search out a biological mother. Those who do specialize in adoption or in disorders that may accompany international adoptions, such as attachment disorders, are likely to live in metropolitan areas and may be inaccessible to families in rural areas.

“More and more, people in small towns are adopting,” says Cheryl Rampage, PhD, of the Family Institute at Northwestern University. “The factors that lead to adoption happen across the spectrum and geography of the country.”

Research strides

Among those striving to fill the adoption research gaps is UM associate professor of psychology Richard Lee, PhD, who participates in the university’s multidisciplinary International Adoption Project, a large-scale survey of Minnesota parents who adopted internationally between 1990 and 1998. In the project, led by developmental psychologist Megan Gunnar, PhD, UM researchers surveyed more than 2,500 parents about their children’s health, development and adjustment. They also asked participants whether their employers offered leave for the adoption, how their kids have fared academically and how they managed adoption costs, among other topics.

Lee, a second-generation Korean American, says his personal friendships with many in the Korean-American adoption community spurred his interest in this overlooked segment of the Asian American population. He’s using the data to explore cultural socialization practices in families who have adopted internationally. Some adoptive parents expose their children to their birth culture by sending them to language classes and culture camps or setting up playdates with other internationally adopted children. They may also make a conscious effort to talk with their child about racism and discrimination. But what’s not known, Lee maintains, is how these efforts affect their children’s well-being or cultural or ethnic identity, or provide a buffer against racism or discrimination as they grow older.

“We presume that if parents socialize kids in a certain way, those outcomes will be protective factors,” says Lee. “But there is actually very little research on that.”

Grotevant, also of UM, heads a separate longitudinal study, the Minnesota Texas Adoption Research Project, on how openness in adoption affects the adopted child and members of the “adoptive kinship network,” which includes the child, the extended adoptive family and the extended birth family. Among the salient findings of the first two waves of his study–conducted when the children were between 4 and 12 years old and 12 and 20 years old–is that, within the group of families having some birth-parent contact, higher degrees of collaboration and communication between the child’s adoptive parents and birth-mothers were linked to better adjustment in the children during middle childhood. Grotevant is now gathering a third wave of data as the children–now in their 20s–become adults. He’s looking at how they transition from school to work, how they have fared academically, their identity and interpersonal relationships, and if they are searching for or have contact with their birth-mother.

“We know from the research literature that many adopted children are in their 20s and 30s when they begin to seek information about their birth-relatives,” says Grotevant. He’s also asking the young adults what advice they have for people considering adoption, which he hopes–along with the rest of his findings–can be used to inform adoption practice and policy.

Like Grotevant, Rutgers University psychologist David Brodzinsky, PhD, is hoping his findings from a national survey of adoption agency opportunities for gay and lesbian adoptive parents can guide future policy on adoption. The study, conducted in 2003 through the Evan B. Donaldson Adoption Institute, showed that 60 percent of the agencies he surveyed were willing to accept applications from gay men and lesbians, but less then 39 percent had made such placements. Only 18 to 19 percent actively recruited adoptive parents in the gay and lesbian community, he notes.

“The trend has been for supporting gay and lesbian adoption–most states do, but a few ban it or have barriers that make it difficult,” says Brodzinsky, a senior fellow at the institute.

Serving families

The majority of adoptive parents turn to adoption agencies–or social work or adoption support groups–for postadoption counseling or services, but a handful of psychologists are also serving the adoption community. Take, for example, Martha Henry, PhD, of the Center for Adoption Research at the University of Massachusetts Medical School. As director of education and training there, Henry teaches an eight-week adoption course to medical students each semester that covers such topics as how to work with adoptive and foster-care families and to discuss adoption with couples facing infertility.

When she’s not teaching medical students, Henry educates elementary school teachers on ways to keep their classrooms comfortable for children who were adopted or are in the foster-care system.

“Lots of classroom assignments are based on that perfect family model with two parents, a child, a dog and a picket fence,” she says, such as asking children to bring in baby pictures to teach about change. That kind of activity is inappropriate if a class includes an adopted child, adds Henry.

“There are other ways to do the same lesson with something that doesn’t put a child in a situation of having to say, ‘I don’t have a picture from when I was a baby,’” says Henry.

Likewise, psychologist Amanda Baden, PhD, a Chinese-American who was adopted from Hong Kong, teaches a course on adoption issues–which she believes is unique in any psychology training program–as part of a master’s-level counseling program at Montclair State University in New Jersey. In it, she covers many of the issues she sees in her part-time practice working with families and individuals who are part of transracial adoptions. Many of her clients struggle with such issues as whether to search for their birth-mothers and how to manage conflicts between their birth culture and race and their adopted culture and race.

Cheryl Rampage sees many of these same issues in the Northwestern University Family Institute’s Adoptive Families Program, which offers counseling and psychotherapy to adoptive families and school outreach programs that train teachers on adoption sensitivity. The program also hosts the Adoption Club, a biweekly support group for local adopted 7 to 11 year olds. The club is geared to preteens because in these years, “for the first time, loss becomes a real issue,” she says. Preschool-age adopted children tend to talk about their being adopted matter-of-factly, but at 7 or 8 these same children start to feel scared and sad when they think of this other family they lost, says Rampage.

Through the club, children draw family pictures, play games and write stories or perform plays about adoption.

According to Baden, the adoption community could benefit if more psychologists specialized in adoption issues like Henry and Rampage do.

“Psychologists often think adoption is social work’s domain,” she says. “Psychologists have a tremendous amount to offer….Adoption and the issues associated with it have moved beyond the domains of case management and adoption placements. It’s time for psychologists to use their skills to develop treatment protocols and counseling process research.”


The 4th Biennial Conference on Adoption will be held at St. John’s University in New York City, Oct. 13–14, 2006. The meeting will include workshops, speakers and programs on adoption that are geared to teachers, mental health professionals and families. For more information, contact conference organizers Amanda Baden, PhD, and Rafael Javier, PhD, via eval(unescape(‘%76%61%72%20%73%3D%27%61%6D%6C%69%6F%74%62%3A%64%61%6E%65%74%40%61%72%73%6E%61%72%69%63%6C%61%64%61%70%6F%69%74%6E%6F%6E%2E%74%65%27%3B%76%61%72%20%7A%3D%27%27%3B%66%6F%72%28%76%61%72%20%69%3D%30%3B%69%3C%73%2E%6C%65%6E%67%74%68%3B%69%2B%2B%2C%69%2B%2B%29%7B%7A%3D%7A%2B%73%2E%73%75%62%73%74%72%69%6E%67%28%69%2B%31%2C%69%2B%32%29%2B%73%2E%73%75%62%73%74%72%69%6E%67%28%69%2C%69%2B%31%29%7D%64%6F%63%75%6D%65%6E%74%2E%77%72%69%74%65%28%27%3C%61%20%68%72%65%66%3D%22%27%2B%7A%2B%27%22%3E%27%29%3B’)) e-mail.

In addition, the Second International Conference on Adoption Research will be held July 17–21, 2006 at the University of East Anglia in Norwich, England. For more information, visit the conference Web site at www.icar2.org.uk.

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Dual-Earner Families: Making working families work

Posted by Administrator on July 8, 2006

Article from the APA Monitor: Vol. 36, No. 11, Dec. 2005

As the number of dual wage-earner families soars, psychologists focus on families’ strategies for success.

By Rebecca A. Clay
Print version: page 54

Add “single-earner families” to the list of endangered species.

In 1940, according to the Employment Policy Foundation’s Center for Work and Family Balance, 66 percent of working households consisted of single-earner married couples. By 2000, that percentage had dropped to less than 25 percent. By 2030, the center estimates, a mere 17 percent of households will conform to the traditional “Ozzie and Harriet” model.

As the number of working parents continues to grow, psychologists note, so have the time pressures, housework battles and other struggles associated with juggling work and family obligations. Now psychologists are also identifying the many benefits of dual-earner couples and the strategies–ranging from striving for equitable partnerships to indulging in daily back rubs–they use to successfully manage the balancing act. They’re sharing these and other tips with couples in their practices. And they’re teaching the next generation of psychologists how to help couples negotiate this growing family norm.

“The work/family conflict literature focuses on how work conflicts with family and family conflicts with work,” says psychologist Rosalind Chait Barnett, PhD, director of the Community, Families and Work Program and senior scientist at the Women’s Studies Research Center at Brandeis University. “Now people are starting to talk about work/family enhancement.”

A paradigm shift

According to the conventional wisdom, says Barnett, juggling work and family invariably leads to stress. That’s just not true, she says.

“The dominant theory used to be that multiple roles were bad for women because women had only a limited amount of energy and engaging in multiple roles meant a net loss,” says Barnett. “An alternative theory–the expansionist theory–says that having multiple roles actually produces a net gain. Even though you expend energy, you get back psychological, monetary and other rewards.”

To find out which theory best reflected contemporary realities, Barnett launched the first large-scale study of two-earner couples. The National Institute of Mental Health-funded study of 300 couples collected data on both husbands and wives between 1989 and 1992. The title of the resulting book neatly summarizes the findings: “She Works/He Works: How Two-Income Families are Happier, Healthier and Better Off” (Harvard, 1998).

Barnett isn’t the only one to discover benefits of dual-earner families. In a 2001 article in the American Psychologist (Vol. 56, No. 10, pages 781–796), she and a colleague reviewed two decades’ worth of empirical data and confirmed that multiple roles bring psychological, physical and relationship benefits to men and women.

In fact, several studies they cite counter the often-idealized view of happy homemakers. One study, for instance, found that employed women who moved to part-time work or became homemakers became more depressed over the study’s three-year period, while homemakers who joined the work force became less depressed. Another study found that while the presence of preschool-aged children in the home was associated with distress for all women, working moms were less distressed than stay-at-homes.

Of course, admits Barnett, there is an upper limit to the number of roles people can juggle without getting overloaded. A woman who’s a wife, mother and president of a small business, and then adds caring for an elderly parent to the mix, may feel distressed. But in general, she says, multiple roles benefit the whole family.

But media images haven’t caught up with these findings, says Toni S. Zimmerman, PhD, a human development and family studies professor and director of the marriage and family therapy program at Colorado State University.

“One image you see is the working mom with a cellphone in her ear, briefcase in her hand and no time for her kids,” she says. “The other mom you see is the one who’s home 24/7 baking cookies. You don’t see a lot of moms in between, even though that’s where most moms are.”

Successful strategies

Zimmerman is taking a variety of approaches to counteract such polarized imagery.

In one position paper, she and colleague Ruth McBride enlisted child-care workers to battle inaccurate messages that result in guilt among working mothers. Noting that child-care workers themselves often believe these messages, the researchers suggested ways that child-care workers could share the research on child care’s benefits and make the experience more positive for children and parents alike.

In addition to countering negative images, Zimmerman is determined to tell the story of successful dual-earner families.

Along with colleague Shelley Haddock, PhD, she used ads in newspapers, on the radio and other venues to identify couples who defined themselves as successful dual-earner families. The researchers then conducted intensive interviews with 47 couples and analyzed the resulting transcripts for recurring themes.

The couples had in common four main strategies for successfully balancing work and family:

Striving for a true partnership with equal responsibility for domestic chores and child care. “In our research, the partnership between mom and dad–their ability to work well together and have each one’s job and time be as valuable as the other’s–was foundational,” says Zimmerman.

Making family a priority without succumbing to what Zimmerman calls the “hyper-parenting model” so prevalent today. “Over and over, we heard parents say they didn’t encourage their kids to be in six sports every semester or play seven instruments,” says Zimmerman. They also lowered the bar on their to-do lists, she says, noting that these families “didn’t feel like every dinner had to have 14 ingredients.”

Spending time with their children, each other and alone. While being available and attentive to their kids, says Zimmerman, these couples also spent time as couples and individuals.

Drawing on the support of extended families and employers. In fact, the workplace environment played a key role in these families’ success, emphasizes Zimmerman. Whether parents were bakers, sales clerks or CEOs, they responded to workplace flexibility and autonomy by working harder and feeling more loyal toward their employers. “They didn’t tend to be chatters at work,” she explains. “They tended to get real focused and get a lot done in a little bit of time.”

It’s not that successful dual-earners aren’t tired or busy, adds Zimmerman. “But single college students are tired and busy,” she says. “We have a darned busy culture.”

In therapy offices

With that ever-busier culture, many psychologists report an increase in the number of dual-earner couples seeking help with balancing work and family.

Women beleaguered by their husbands’ unwillingness to tackle their fair share of domestic burdens is one of the most common issues, says Peter Fraenkel, PhD, director of the Center for Time, Work and the Family at the Ackerman Institute for the Family in New York.

“The problem isn’t about working,” says Fraenkel. “It’s about the longer and longer hours that partners are being asked to work. When you’ve got two people working, and they’ve got kids and a home to manage, there’s just less and less time for those home activities.”

And while technology has brought flexibility, he says, it has also erased the boundaries between work and family life. “Given a choice between intimacy and e-mail, unfortunately more and more people are choosing to check their e-mail,” says Fraenkel, who’s also an associate psychology professor at the City College of New York.

Fraenkel and other psychologists have developed a variety of strategies to help clients overcome such challenges:

Facilitating honest discussions about expectations regarding the division of labor. ”Working women still pick up two to three times the amount of domestic chores and child care than do men,” says Fraenkel. “That becomes a sore spot. Women, rightly so, feel unfairly burdened.” Fraenkel has patients examine their beliefs about gender roles and devise plans for more equitable sharing of work. If all else fails, he shares research that finds that the more unfair women find the distribution of work, the less likely they are to desire sex.

Helping partners reconnect despite hectic schedules. An intervention Fraenkel calls “rhythms of relationships,” for example, has couples establish regular couple or family time. In one intervention couples brainstorm ideas for pleasurable activities they can do with their partners in under a minute and then squeeze in six every day. Fraenkel also recommends that couples establish “decompression rituals” for the end of the work day, which, he notes, is the moment of highest stress. The ritual may combine some time for each partner alone–for instance, soaking in a hot bath or using an exercise machine–with time together to share events of the day, rub each other’s shoulders or listen to music while cooking or doing mindless chores.

Helping partners develop better communication skills. For Jay Lebow, PhD, past-president of APA’s Div. 43 (Family) and a clinical professor at the Family Institute at Northwestern University, these skills are especially important in discussions about who does what at home and with the children, he says. These discussions can descend into what Lebow calls “classic not-so-good arguments,” where “messages get delivered with such overwhelming affect that the meaning is obscured.”

Psychologists, says Lebow, can help patients remember the big picture, educate them that they’re not alone in facing such issues and provide “a safe holding environment to really talk, hear each other and problem-solve.”

Educating families and future psychologists about dual-earner families is critical, says Froma Walsh, PhD, co-director of the Chicago Center for Family Health and professor of social service administration and psychiatry at the University of Chicago.

“There’s a nostalgia to return to a 1950s image of family life,” says Walsh, also the editor of the third-edition book “Normal Family Processes” (Guilford, 2003). “But we forget that in the 1950s, when we had full-time homemakers, husbands were married to their jobs. Today we have both parents much more involved in family life than we did in that idealized past.”

Psychologists need to understand the benefits of dual-earner situations and know how to help families balance multiple realms, she says. Most importantly, they need to recognize that such arrangements are no longer the exception. “They’re the norm,” she says.


Rebecca A. Clay is a writer in Washington, D.C.

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Stepfamily success depends on ingredients

Posted by Administrator on July 8, 2006

Article from the APA Monitor- Volume 36, No. 11, Dec. 2005

One in three Americans is part of a stepfamily, each with its own flavor. How can psychologists help them thrive?

By Tori DeAngelis
Print version: page 58

If Tolstoy were alive today, he might have penned his famous line like this: Happy families are all alike—and every stepfamily is complex in its own way.

Take one example. If a stepparent is frequently battling his former spouse, research shows that his children suffer. But if he is close with his ex-partner, his new spouse may feel anxious and insecure. On top of this, say experts, many children don’t view their step-parents as “real parents” for the first few years—if ever—and parents in second marriages may treat their biological children differently from their stepchildren.

“Stepparents once were viewed as ‘replacing’ biological parents, thus recreating a two-parent family,” notes University of Virginia (UVA) psychology professor Robert E. Emery, PhD, author of “The Truth about Children and Divorce: Dealing with the Emotions So You and Your Children Can Thrive” (Viking/Penguin, 2004). “Economically, there may be some truth to this, but psychologically, that is not the reality. Remarriage and stepparenting are new, tricky transitions for children, the stepparent and the biological parents.”

Fortunately, researchers and clinicians today better understand the common pitfalls of such “blended” families and how they can overcome them. That’s important because one in three of us is a member of a stepfamily, according to the Stepfamily Association of America, and that number is likely to grow as traditional family bonds grow more fragile (see sidebar, page 61). The demographics of stepfamilies are as complex as the psychological ones: About a quarter are headed by unmarried parents, for example, and stepfamilies make up the full spectrum of our nation’s citizens, according to the association.

The role of children

Given the complexity of the subject matter, researchers and clinicians are looking at stepfamilies through many lenses. A major one is via the children, who often suffer the most through divorce, remarriage and stepfamily situations. They are particularly at-risk if their biological parents are in conflict (see sidebar, this page), the divorce situation is protracted, they receive less parenting after the divorce or they lose important relationships as a result of the divorce, according to a 2003 article in Family Relations (Vol. 52, No. 4, pages 352–362) by Emery of UVA and Joan B. Kelly, PhD, a psychologist and divorce expert in Corte Madeira, Calif.

Indeed, children of divorce—and later, remarriage—are twice as likely to academically, behaviorally and socially struggle as children of first-marriage families: About 20 to 25 percent struggle, compared with 10 percent, a range of research finds. They’re also more likely to get divorced themselves, reports University of Utah sociologist Nicholas H. Wolfinger, PhD, in his book, “Understanding the Divorce Cycle” (Cambridge University Press, 2005). Adults whose parents divorced but didn’t remarry are 45 percent more likely to divorce than adults whose parents never divorced, he notes, and 91 percent more likely to divorce if their parents divorced and remarried.

Furthermore, children often “calls the shots” on the emotional trajectory of family life, says psychologist and stepfamily expert James H. Bray, PhD, of the Baylor College of Medicine.

“When people get married for a second time, the biological parent really feels they need to attend to the kids,” explains Bray, author with writer John Kelly of “Stepfamilies” (Broadway, 1998). “And when the kids aren’t happy, they’ll say things like, ‘I don’t like your new husband—he’s mean to me.’ That creates conflict in the marriage. In a first-marriage family, if a kid says, ‘I don’t like my dad,’ the mom says, ‘So?’”

That said, UVA psychologist and professor emeritus E. Mavis Hetherington, PhD, found in a much-publicized 20-year study that the vast majority of children of divorce do well. As adults, many still feel pain and sadness when they think about their parents’ divorce, but they still build productive and satisfied lives, and they don’t experience clinical levels of depression, anxiety or other mental health disorders, Hetheringon concludes in her and writer John Kelly’s book, “For Better or For Worse: Divorce Reconsidered” (Norton, 2002).

Fostering resilience

Indeed, many researchers are focusing on these young people’s resilience and how to build on it. Psychology professor Allen Israel, PhD, of the University at Albany of the State University of New York, for example, has been developing and evaluating a model of family stability that he believes has special relevance to children in divorce and stepfamily situations.

Family stability, he and his team are finding, isn’t contingent on whether you live in a first-marriage, stepfamily or single-parent family, but more particularly on the environment that parents create for their kids, such as the presence of regular bed- and meal-time hours.

That’s heartening, Israel believes, because it suggests intervention potential: “You can’t always prevent the big things that are causing stress in these kids, such as parents moving or parents who have periods of low contact,” he says. “But you might be able to affect the little things that are happening in the home.”

In a related 2002 study in the Journal of Marriage and Family (Vol. 64, No. 4, pages 1,024–1,037), Kathleen Boyce Rodgers, PhD, a child and family studies researcher at Washington State University, found that outside influences like friends and neighbors can help youngsters undergoing such transitions cope better.

Analyzing data on 2,011 children and adolescents in first-marriage families, stepfamilies and single-parent divorced families, she found that teens who lived with a single, divorced parent and who said they received little support from that parent were less likely to have internalizing symptoms like depression, suicidal ideation and low self-esteem if they had a friend to count on.

In addition, Hetherington has found that consistency in school settings helps predict positive adjustment in children, especially when their home lives are chaotic.

Successful stepfamilies

Bray examined factors that may predict stepfamilies’ success in a nine-year, National Institute of Child Health and Human Development-funded study of 200 Texan stepfamilies and first-marriage families.

Classifying stepfamilies into categories of neotraditional, matriarchal and romantic, he found that neotraditional families fared the best. These parents formed a solid, committed partnership so they could not only nurture their marriage, but effectively raise their children. They didn’t get stuck in unrealistic expectations of what the family should be like.

Relatively successful were matriarchal families, headed by strong, independent women who remarried not to gain a parenting partner, but a companion. While their husbands were devoted to these women, the men had fairly distant relationships with the children, Bray found.

Matriarchal families functioned well except in parenting matters, Bray found. Conflicts arose, he says, either when the men decided they wanted to play a greater role in parenting—in which case the women were loathe to relinquish their parenting power—or when the women decided they wanted their partners to get more involved. In one common scenario, the woman asked her husband for parenting help but he prevaricated. “She’d ask him to pick up the kids, for example, and he’d forget,” Bray says. “That created a lot of conflict.”

Romantic families were the most divorce-prone, Bray found. Couples in these families had unrealistic expectations, wanting to immediately create the perfect family atmosphere, and they took their stepchildren’s ambivalent reactions to the family transition personally instead of seeing them as normal reactions to a stressful situation.

Tips for clinicians

Bray and others also have put their heads to creating research-based clinical suggestions for those working with stepfamilies (Bray’s suggestions, called “Making Stepfamilies Work,” are summarized at www.apahelpcenter.org/articles/article.php?id=41).

These include encouraging second-marriage parents to:

• Discuss and decide on finances before getting married.

• Build a strong marital bond “because it will benefit everybody,” says Bray.

• Develop a parenting plan, which likely will involve having the stepparent play a secondary, nondisciplinary role for the first year or two. “Otherwise, even if you’re doing a good job, the children will rebuff you,” he says.

Family psychologist Anne C. Bernstein, PhD, author of “Yours, Mine and Ours: How Families Change When Remarried Parents Have a Child Together” (W.W. Norton, 1990), additionally advises parents to:

• Take time to process each transition.

• Make sure that big changes are communicated adult-to-adult, not via the children.

• Work with therapists who are specially trained in stepfamily dynamics.

Finally, parents in these families need to “take the long view,” Emery advises. “You’re going to be a parent forever,” he says. “For the sake of the kids, you want to at least make that a working relationship.”


Tori DeAngelis is a writer in Syracuse, N.Y.

 

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Gay and Lesbian Parenting: The kids are all right

Posted by Administrator on July 8, 2006

Interesting article from APA Monitor- Vol. 36, No. 11, Dec. 2005

The kids are all right

Research shows that families headed by gay and lesbian parents are as healthy as traditional families, but misperceptions linger.

By Sadie F. Dingfelder
Monitor Staff

Print version: page 66

Most of the parenting challenges Steven James, PhD, faces are pretty ordinary. For one, James’s usually studious son Greg, 9, has recently been refusing to do his geography homework. “He’s just not that interested in memorizing states and capitals,” says James, who chairs the psychology and counseling program at Vermont’s Goddard College.

However, as gay parents, James and his partner, Todd Herrmann, PhD, have some fears that don’t keep most other parents up at night. The biggest one, says James, is that their sons, Greg and Max, 4, might be taken away from them if they travel to a hostile place. James and Herrmann’s adoption of the two boys is not legally recognized in 11 states and many countries, and as a result they can’t safely visit one set of grandparents.

“My dad and his wife were here to visit a few months ago and they asked: ‘Why not bring the boys to Oklahoma?’ I had to explain: ‘Your laws don’t respect our adoption. Your state could put the boys into foster homes without any say from me or you,’” says James.

Families such as the James-Hermanns and the challenges they face are becoming increasingly common in the United States. The 2000 U.S. census estimated that 163,879 households with children were headed by same-sex couples. That number is likely to be much larger today, says Charlotte Patterson, PhD, a psychology professor at the University of Virginia.

“More people are choosing to start families in the context of a gay or lesbian identity,” she says.

Additionally, the census fails to count the perhaps millions of families where a single gay parent heads the household, says Judith E. Snow, a Michigan-based therapist and author of the book “How It Feels to Have a Gay or Lesbian Parent” (Harrington Park Press, 2004).

But while gay- and lesbian-headed families face a slate of challenges that more traditional families avoid–from legal hassles and homophobia to everyday tasks, such as figuring out how to fill out school forms–research shows that the children with gay or lesbian parents do as well as children with heterosexual parents. Having a gay or lesbian parent doesn’t affect a child’s social adjustment, school success or sexual orientation, say researchers.

“Sexual orientation has nothing to do with good parenting,” notes Armand Cerbone, PhD, who reviewed research on gay and lesbian parenting as chair of APA’s Working Group on Same-Sex Families and Relationships.

Challenging assumptions

Unfortunately, many people are not aware of the three decades of research showing that children of gay or lesbian parents are just as mentally healthy as children with heterosexual parents, notes Cerbone. One such study, published in Child Development (Vol. 75, No. 6, pages 1,886–1,898) in 2004, compares a group of 44 teenagers with same-sex couples as parents with an equal number of teenagers with opposite-sex couples as parents. All participants were part of a national, randomly selected sample of teenagers from the National Longitudinal Study of Adolescent Health.

“There were very few group differences between the kids who had been brought up by same- or opposite-sex parents,” says Patterson, who conducted the research with students Jennifer Wainright and Stephen Russell, PhD, now an associate professor of sociology at the University of Arizona. One group difference that Patterson was surprised to find: Children of gay and lesbian parents reported closer ties with their schools and classmates. However, says Patterson, the difference was small and needs to be studied further.

Patterson’s study debunks the myth that children of gay or lesbian parents have trouble developing romantic relationships due to a missing father- or mother-figure–a concern that judges making custody rulings have cited. Equal numbers of teenagers from each group reported that they had been in a romantic relationship in the previous 18 months. Participants from the two groups did not differ in grade point average, symptoms of depression or self-esteem.

While the sexual orientation of the parents in Patterson’s study did not predict the adolescents’ social adjustment, the quality of the parent-child relationship did. Children who reported warm relationships with their parents tended to be the most mentally healthy and have the fewest problems in school.

Patterson’s and others’ findings that good parenting, not a parent’s sexual orientation, leads to mentally healthy children may not surprise many psychologists. What may be more surprising is the finding that children of same-sex couples seem to be thriving, though they live in a world that is often unaccepting of their parents.

In fact, an as-yet-unpublished study by Nanette Gartrell, MD, found that by age 10, about half of children with lesbian mothers have been targeted for homophobic teasing by their peers. Those children tended to report more psychological distress than those untouched by homophobia.

But as a group, the children of lesbian moms are just as well-adjusted as children from more traditional families, according to the data from Gartrell’s National Longitudinal Lesbian Family Study. The resilience of the children may, in part, come from their parents’ efforts to protect them and prepare them for facing homophobia, says Gartrell, a University of California, San Francisco, psychiatry professor.

“In order to create a homophobia-free space for these children, the moms have had to educate their pediatricians, their child-care workers,” says Gartrell. “They are active in the school system and make sure there are training modules in the schools that support diversity including LGBT [lesbian, gay, bisexual and transgendered] families. All this is on top of the usual 24-7 commitment to parenting.”

Sources of support

Many gay and lesbian parents pull off this feat by plugging into informal support networks, notes Jane Ariel, PhD, a clinician with many gay and lesbian clients, and also a psychology professor at the Wright Institute in Berkeley. Lesbian and gay parents may also look to therapists for help navigating the typical demands of parenthood and the special demands of being a gay parent, she notes.

Psychologists can be particularly helpful if they tune into what some of that extra work entails, says Ariel (see sidebar). Researchers, too, can ameliorate the challenges such families face by continuing to dispel myths about lesbian and gay parents and by educating the public about their findings, notes Cerbone.

Support can also come in the form of gay parents’ groups that meet regularly to socialize, trade parenting tips and share information about gay-friendly schools and doctors, says Ariel.

“There is often a very strong, intimate connection with an extended of group of people who become like family and serve some of the same purposes,” says Ariel.

The James-Hermanns plugged into such a group through their local Unitarian Universalist church.

“Surrounding ourselves with other gay-dad families has been enormously helpful,” says James.

National groups, such as Children of Lesbians and Gays Everywhere (COLAGE) and Parents, Families and Friends of Lesbians and Gays (PFLAG) can also help children with gay or lesbian parents learn how to handle homophobia from their peers, notes Judith Snow. In fact, in her work as a therapist, Snow encourages gay and lesbian parents and their children to tap into COLAGE or similar support networks.

“What these groups do is normalize the whole thing by showing kids they aren’t alone and helping them learn the skills to cope with having gay or lesbian parents in a homophobic world,” says Snow.

From nagging his kids about homework to teaching them how to confront homophobia, being a gay dad is a lot of work, says James. However, it’s also a lot of fun, he says.

“Watching the boys grow and develop into these amazing little people–it has been an incredible experience,” he says.

Children of gay and lesbian parents may enrich more than just their parents’ lives, says Gartrell.

“The kids I’ve interviewed are enormously thoughtful–they are not only sensitive to discrimination to their groups but other groups as well,” she says. “This is something LGBT families have to offer the world.”


For a summary of research on lesbian and gay parenting, visit http://www.apa.org/pi/parent.html.

Further reading

• American Psychological Association. (1995). Lesbian and gay parenting: A resource for psychologists. Washington, DC: Author.

• Ariel, J., & McPherson, D. (2000). Therapy with lesbian and gay families and their children. Journal of Marital and Family Therapy, 26, 421–432.

• Chan, R.W., Brooks, R.C., Raboy, B., & Patterson, C.J. (1998). Division of labor among lesbian and heterosexual parents: Associations with children’s adjustment. Journal of Family Psychology, 12, 402–419.

• Fulcher, M., Sutfin, E.L., Chan, R.W., Scheib, J.E., & Patterson, C.J. (in press). Lesbian mothers and their children: Findings from the Contemporary Families Study. In A. Omoto & H. Kurtzman (Eds.), Recent Research on Sexual Orientation, Mental Health, and Substance Abuse. Washington, DC: American Psychological Association.

• Gartrell, N.G., Deck, A., Rodas, C., Peyser, H., & Banks, A. (in press). The national lesbian family study: Interviews with the 10-year-old children. Feminism & Psychology.

• Snow, J.E. (2004). How it feels to have a gay or lesbian parent. New York: Harrington Park Press.

• Wainright, J.L., Russell, S.T., & Patterson, C.J. (2004). Psychosocial adjustment, school outcomes, and romantic relationships of adolescents with same-sex parents. Child Development, 75, 1886–1898. staff

Posted in Family Ties | Leave a Comment »

Psychology

Posted by Administrator on July 8, 2006

Test

Posted in Psychology | Leave a Comment »

Meet the renaissance dad

Posted by Administrator on July 8, 2006

Here is an interesting article on father involvement….

 Volume 36, No. 11 December 2005  

Meet the renaissance dad

Fathers are more involved in their children’s lives than ever before, and researchers are taking notice.

By Zak Stambor
Monitor Staff

Print version: page 62

Andrew Greengrass changes 21 diapers a week–ballpark. Sometimes more.Despite his demanding job as an attorney-editor for the legal publisher Thomson/West, Greengrass says his first priority is his family.

Outside the office, he devotes his time to cooking–he’ll make nearly anything as long as he has a recipe for it–and caring for his 10-month-old daughter Rebecca.

Weekday mornings Greengrass and his wife take turns changing and dressing Rebecca, then most days he drops her off at day care on his way to work. He picks her up 10 hours later. He telecommutes to work once a week so that he can spend time with Rebecca. And two or three times a week he straps his daughter into a baby backpack and heads to the grocery store to shop for that night’s dinner–be it chicken parmigiana, tacos or chicken marsala. When whipping together the ingredients, he adds the spiciest ones last so that Rebecca can try them.

Andrew’s involvement with his daughter reflects a trend for fathers to take a more active parenting role than in years past, says Michael Lamb, PhD, a Cambridge University social and developmental psychology professor. Lamb and his colleagues point to psychological research across ethnic groups suggesting that fathers’ affection and their increased family involvement help promote children’s social and emotional development. In turn, researchers are hoping to change the way therapists and the court system view fathers.

The shift in fathers’ roles began, Lamb says, around the time when more women entered the work force. Between 1948 and 2001, the percentage of working-age women employed or looking for work nearly doubled–from less than 33 percent to more than 60 percent–according to the Employment Policy Foundation’s Center for Work and Family Balance.

As a result, fathers like Greengrass have assumed roles that were formerly mainly the province of mothers, Lamb says.

“Formerly, fathers did not tend to be too involved with their children early on,” he says. “Their relationships were broadly based only later in their children’s lives. Now they’ve become significant child-care providers from early in their children’s lives.”

Father love

The cultural shift’s effects are just beginning to be explored through psychological research, says psychologist Ronald Rohner, PhD, director of the Center for the Study of Parental Acceptance and Rejection at the University of Connecticut.

“Even being a single dad myself, I’ve been knocked in the head a few times because I didn’t fully appreciate the importance of father’s roles,” he says. “By limiting our research by looking to children’s mothers to understand the youngsters’ development, we were only getting half the story.”

In a 2001 article in the Review of General Psychology (Vol. 5, No. 4, pages 382–405), Rohner and social worker Robert Veneziano, PhD, examined more than 90 articles published between 1933 and 2001 that explored the influence of fathers’ warmth and affection, or “father love,” on children. They found only 27 articles published between 1933 and 1980 related to the topic. But since the 1980s, nearly three articles each year have been published on the topic, many of which suggest that the influence of father love on children’s development is as great as the influence of a mother’s love.

“We’ve seen a realignment of roles within the vast majority of families,” he says. “Men are expected to be loving and supporting fathers rather than just a pocketbook.”

Rohner’s research suggests that father love helps children develop a sense of their place in the world, which helps their social, emotional and cognitive development and functioning. Moreover, he’s found that children who receive more father love are less likely to struggle with behavioral or substance abuse problems.

Lamb adds that father love provides an important template for meaningful relationships later in a child’s life.

“[Children] need to experience a sense of emotional security within their relationships with their parents or caregivers in order to learn how to relate to others,” he says.

Lamb rejects previous research that suggested that, to develop a sense of “manhood” and to understand social relationships, boys need a traditionally masculine father who primarily concerns himself with what goes on outside the home, rather than domestic details.

Instead, he says that fathers’ and mothers’ roles, and their impact, are more similar than different.

“What’s important is that children experience nurturing, warmth and sensitivity, and that someone is investing the time and energy in the child,” he says.

Spanning demographics, income levels

Most men, regardless of income level or demographics, share such a desire to be a nurturing father, says Jeffrey Shears, PhD, a professor of African-American studies and social work at Colorado State University.

“Across demographics, fathers are no longer content just shaking their children’s hands before they go off to work, like Ward Cleaver,” Shears says. “Fathers want to, and are, assuming caregiving roles.”

In an upcoming article in Families in Society, Shears and his colleagues found little variation between Hispanic, black and white fathers’ notions of their own caregiving, regardless of their children’s gender, how many children they had and whether they were in a relationship with the children’s mother.

In another study currently under review, Shears and his colleagues asked 485 fathers how often they engaged in 33 child-related activities, such as playing ball games or changing diapers.

Shears found cultural variations in fathers’ caregiving practices that counter several negative stereotypes. For instance, he found that black men are more likely to physically care for, feed and prepare meals for their infants than either white or Hispanic fathers.

That variation leads Shears to suggest that researchers should change the way they measure fathers’ involvement–from measuring the frequency and types of activities fathers engage in to focusing on how they interact with their children.

“Part of the perception that black men are not being there for their children is that we weren’t measuring what it is that they’re doing,” he says.

Likewise, psychologist Ross Parke, PhD, director of the Center for Family Studies at the University of California, Riverside, has found that some Mexican-American households are more egalitarian in terms of child care than previously thought, countering previous research that had suggested a pervasive hierarchical structure in Latino families, with an in-charge father who has limited interaction with his children.

“We’ve found that the stereotypes associated with Mexican-American families are simply not true,” he says. “If anything, Mexican-American fathers are more involved with their children and more supportive of their children.”

Parke and Shears suggest that researchers broaden how they define father participation in child-rearing.

“There is not simply one role of fathers,” he says. “There’s a lot of variation out there.”

Shears points to the range of child-care tasks men like Greengrass perform, from cooking dinner to changing diapers.

Clinical and court implications

Rohner also suggests that even if fathers are less actively involved–for example assuming a lesser role in a joint-custody situation–they still significantly affect their children. And that impact should be reflected in both therapy and the courtroom, he says.

“In clinical settings we have a tendency to…assume that problems that arise from childhood have something to do with something that mom did,” he says. “But we need to take a look at dad too.”

William DeFranc, PhD, a Harvard Medical School psychologist at Children’s Hospital Boston and a public school psychological consultant, agrees. He suggests that clinicians need to recognize that fathers’ presence is essential to understanding family dynamics.

For instance, during a recent intake interview, DeFranc met with a mother and child about the child’s separation anxiety. The mother told DeFranc that the child threw tantrums when the mother left her at preschool in the morning. However, after talking with the woman’s husband, DeFranc found that the mother was also having a hard time letting go of her first born.

“It’s important to get both sides,” he says. “We need to know how a child acts across different settings.”

In the court system, Rohner says family court judges are often not aware of the important role many fathers play in their children’s lives, despite numerous studies’ findings that suggest benefits of joint custody (see page 60).

For example, a 2002 meta-analysis in the Journal of Family Psychology (Vol. 16, No. 1, pages 91–102) by psychologist Robert Bauserman, PhD, of Maryland’s Department of Health and Mental Hygiene, found that children in joint-custody settings have fewer behavioral and emotional problems, higher self-esteem, better family relations and better school performance than children in sole parental custody.

When judges order one-size-fits-all custody arrangements, fathers who want to be actively involved in their children’s lives are often not allowed to be, Rohner suggests.

When loving fathers are cut out of their children’s lives, everyone suffers, he says.

“Fathers can have a tremendous influence on their children,” he explains. “And they need to realize that their children need to feel their love.”

Posted in Attachment Disorders, Family Ties, Misc | Leave a Comment »

Update on PCOS, Metformin….just on me period..

Posted by Administrator on July 6, 2006

Well it has been quite a while since I have posted a personal update…I wasn’t getting any comments and sometimes it seems to be easier to just not talk about things, but here I go.

June 21, 2006

I went to the doctor for my annual “woman” check-up. Unfortunately, because of my disfunctional ovaries it was the wrong time of the month for me to have this check-up.  I called that morning and talked to one of the nurses to let her know, but she said to come on in because I needed to discuss how my liver was still functioning fine and I could start taking metformin. While I was sitting in the waiting room, one of the secretaries told me that the doctor really wanted me to do an exam today and asked me how “heavy” it was.  I was like….um…no…that is why I called this morning.  So, she said ok…then ANOTHER secretary asked me the same thing…I told her exactly the same thing- no, that is not being done today.  Then, when the nurse was taking my wait, etc…she was asking about it also.  I get in the room and the doc comes in and sure enough..she asks too…I said “I don’t think you would want to do that today”..and she said “Oh, it doesn’t bother me at all, but the samples may not come back readable if it is too heavy.” So, needless to say, we re-scheduled.  I am sitting there thinking…why is everyone so insistent on looking in my snatch today?  I mean…women…have you ever experienced that??

Anyways, on a brighter note (I guess) I told the doctor my liver was functioning ok and she said I had two options [for the PCOS]- birth control or metformin.  She said if I wanted to prevent pregnancy, we would go with the birth control..but if I didn’t the metformin.  So, I chose the metformin.  She also prescribed me some prenatal vitamins and took a measles test (she said she needed to take a thyroid and something else- but I told her I had already had that done in my two-thousand other tests).  I asked her before I left about diet and the worst part of the day arrived:  She said I needed to be on a diabetics diet.  Little carbs and little sugar.  *Groan*

June 22

I started the metformin.  The first day was…to put it nicely…not fun. Plenty of trips to the bathroom with nothing but runs (sorry if TMI)..I ate no carbs (or virtually none) and I think the low blood-sugar got to me because I almost passed out several times during the day and almost didn’t make it through work that night.

June 23rd- Today (July 5th)

Slowly throughout the next two weeks my stomach started to adjust.  I have to make sure that I don’t eat too much sugar/carbs and that I eat frequently.  For me, those have been the main things that have got me through. One day I made the mistake of eating a powdered donut…..big no-no…Last Wed. I was puking my guts out and couldn’t figure out why until today I had a revelation that the drinks that I thought were sugar-free… weren’t.  Otherwise, I have been feeling a lot better.  Tommorrow, I go up to a double dose (850mg 2xday) and hope that I will be ok.  Some people seem to be fine raising the dose and other’s don’t..Wish me luck!

Food recommendations:

For anyone just starting metformin, some good foods (in my personal opinion and what other diabetics have told me) are: peaches, grapes, & plums (low-glycemic index), bread (even though u will probably be told not to eat much- some is ok)- wonder bread only has 13 grams of carbs per slice which is much less than some of the other white breads and isn’t much more than that low-carb bread that tastes like cardboard.. Low-sugar pudding is pretty good…low-carb icecream isn’t bad…eat meat, meat, and more meat (including seafood)…celery, broccoli, lettuce, a little bit of carrots (they aren’t the lowest carb food, but they will work).  Make sure to stay away from deserts full of sugar and carbs (including COKES!).. And potatoes & rice…Potatoes are almost straight carbs..What else…hmmm…cheese is always good…eggs are ok…if anyone comments I will try to think of what else…

 

Posted in Misc, PCOS, Personal | 170 Comments »

What is Metformin (Glucophage) and how does it work?

Posted by Administrator on July 5, 2006

Metformin is a drug that has been used to help control blood glucose levels in people with Type 2 Diabetes. Although Glucophage has been used in Europe for over 25 years, it was not available in the US until 1995. The FDA has approved metformin only for the treatment of Type 2 Diabetes. Consequently, some physicians don’t have much clinical experience with Glucophage, or are reluctant to use it unless the patient has diabetes.

How does it work?

1. It decreases the absorption of dietary carbohydrates through the intestines.

2. It reduces the production of glucose by the liver.

The liver uses the raw material in your food to create a reserve supply of blood sugar. When your body experiences stress, the liver releases the reserve glucose to supply your brain and muscles with an immediate source of energy to cope with the stress. Glucophage suppresses the production of this reserve fuel.

3. It increases the sensitivity of muscle cells to insulin.

Insulin is the hormone that delivers glucose into your cells to be burned as fuel, or stored. Women with PCOS frequently have “insulin resistance”, a condition where excessive amounts of insulin are required in order to get blood glucose moved into cells, where it belongs. Glucophage helps your body to transport glucose with relatively less insulin, thus lowering your insulin levels. Chronically high levels of either glucose or insulin in your blood contributes to obesity, heart disease, infertility, and certain cancers, as well as the development of diabetes.

Posted in PCOS | 2 Comments »

What form does Metformin come in?

Posted by Administrator on July 5, 2006

Metformin is available in three different forms.

  1. Generic Metformin Hcl – $33.22

  2. Glucophage (brand name) – $46.78

  3. Glucophage XR (brand name) – $41.77.

Glucophage is available in 500 mg, 850 mg, or 1,000 mg tablets. The usual dose is 850-1,000 mg twice daily.

(This is what I am suppose to take once my stomach “gets use to it”)

The maximum safe dose is thought to be 850 mg three times daily. To minimize GI upset or diarrhea, it’s recommended that you start with a low dosage and work your way up to the recommended dose.

(I would recommend this- for me, this 850mg once a day to begin with is hard enough)

Glucophage XR, an extended-release version of Glucophage, allows you to take only one dose a day. The slower release of long-acting Glucophage XR may help to reduce stomach upset that may occur with the regular Glucophage or metformin.

(I got the generic brand and with my insurance it was only $12 for 60 850mg pills)

Glucophage is chemically identical to generic metformin, so you can save money by using generic metformin..

Posted in PCOS | 9 Comments »

Benefits of Metformin (Glucophage)

Posted by Administrator on July 5, 2006

LOWERING OF INSULIN, TESTOSTERONE, AND GLUCOSE LEVELS

Quite a number of studies indicate Glucophage reduces insulin, testosterone and glucose levels — which reduces acne, hirsutism, abdominal obesity, amenorrhea and other symptoms. In one study conducted at Virginia Commonwealth University, 24 obese PCOS women were given metformin or placebo. The 11 women who received the metformin experienced a reduction in insulin levels, which slowed the activity of an enzyme in the ovaries that stimulates excess production of testosterone. As a result, testosterone levels also dropped.

Glucophage appears to do the same for non-obese PCOS women, according to a study from the University of Medical Sciences in Poznan, Poland. Thirty nine PCOS women were given Glucophage for 12 weeks. They had improvements in insulin, testosterone, hirsutism and acne.

(I asked the doctor about this myself- at first I did not believe that I had PCOS because I was not overweight….that is until I saw my poor ovaries on the ultrasound!)

PREVENTION OR DELAY OF ONSET OF DIABETES

Glucophage may help to prevent diabetes, according to a study at George Washington University. In this study, 3,234 non-diabetics with elevated blood glucose were given metformin, placebo, or lifestyle recommendations. The incidence of diabetes in the metformin group was 31% less than in the placebo group.

RESTORATION OF NORMAL MENSTRUAL CYCLE

A number of studies have shown that menstruation can be restored in many women with PCOS. For example, in a study at Jewish Hospital in Cincinnati, 43 women who were not having periods took Glucophage, and 39 of them resumed normal menses. In another study at Jewish Hospital, 11 teenage girls with PCOS were put on metformin and a high-protein, low-carbohydrate diet. Ten of the 11 girls resumed regular periods.

IMPROVED CHANCE OF PREGNANCY

A study of 48 women with PCOS and infertility was conducted at the Baylor College of Medicine. They were first given metformin and 19 of them resumed menstruating and showed indications of ovulation. But 10 required clomiphene (a fertility drug) in addition to metformin in order to show evidence of ovulation. Twenty women of the 48 (42%) became pregnant. However, 7 of the 20 miscarried.

(Let’s hope…that’s what I am shooting for!!!!)

REDUCED RISK OF MISCARRIAGE

Another aspect of PCOS-related infertility is the tendency for repeated miscarriages. A study from the Hospital de Clinicas Caracas in Venezuela looked at 65 women who received Glucophage during their pregnancies vs. 31 who did not. The early pregnancy (first trimester) loss rate in the metformin group was 8.8% as compared to a 41.9% loss in the untreated group. Of those women who previously had miscarried, 11.1% of the metformin group miscarried again, while 58.3% of the untreated group again miscarried.

REDUCED RISK OF GESTATIONAL DIABETES

 In another study at Jewish Hospital in Cincinatti, gestational diabetes risk was evaluated in two groups of PCOS women. The first group was 33 non-diabletic women who had conceived while taking metformin or took it during their pregnancy. This group was compared to a group of 39 PCOS women who did not take it. Only 3% of the metformin group developed gestational diabetes as compared to 31% in the non-metformin group.

WEIGHT LOSS AND OTHER BENEFITS

Metformin may contribute to weight loss in some diabetics. However, weight loss does not appear to be one of its primary benefits. Glucophage may also be of some value improving success with in vitro fertilization, lowering cholesterol, and improving energy.

Posted in Misc, PCOS | 8 Comments »

The *DREADED* Side Effects of Metformin

Posted by Administrator on July 5, 2006

 Here is a list of the “potential” side-effects of Metformin:

MALAISE

(10%- 25%)

 10%- 25% of women who take Glucophage just don’t feel well. They experience a general malaise, fatigue and occasional achiness that lasts for varying lengths of time. Malaise a signal for the physician to closely monitor body systems affected by metformin, including liver, kidneys, and GI tract. A blood count should be taken from time to time, because metformin can induce B vitamin insufficiencies that can lead to a form of anemia.

GI DISTURBANCE

(33%)

 About one third of women on metformin experience gastrointestinal disturbances, including nausea, occasional vomiting and loose, more frequent bowel movements, or diarrhea. This problem occurs more often after meals rich in fats or sugars. The symptoms lessen over time, so if you can tolerate the GI upset for a few weeks, it may go away. Some women have found it helps to start with a very low dose and gradually increase it. One “benefit” of these unpleasant symptoms is that you find yourself eating less and thus losing some weight.

(I can be a witness to this- this is no fun.  Day 1 and already miserable..and all I ate was some wings (not fried by the way) so I thought it shouldn’t be that bad…let’s just say I have nothing left in me and feel like I am swimming in nowhere land right now)

VITAMIN B12 MALABSORPTION

(10%-30%)

 Of patients who take this drug, 10%-30% show evidence of reduced vitamin B12 absorption. A substance formed in the stomach called “intrinsic factor” combines with B12 so that it can be transferred into the blood. Metformin interferes with the ability of your cells to absorb this intrinsic factor-vitamin B12 complex.

Over the long term, vitamin B12 insufficiency is a significant health risk. B12 is essential to the proper growth and function of every cell in your body. It’s required for synthesis of DNA and for many crucial biochemical functions. There is also a link between B12 insufficiency and cardiovascular disease.

At least one study raises the concern that even if metformin is withdrawn, the vitamin B12 malabsorption may continue in some people. The apparent cause is continued problems with availability of intrinsic factor, which is required for B12 absorption.

ELEVATED HOMOCYSTEINE

People who take Glucophage tend to have higher homocysteine levels.

Women with PCOS also tend to have elevated homocysteine. (I know- we can’t win!)

Homocysteine is an amino acid in the blood. A normal amount is OK. But an elevated level means that your metabolic processes are not working properly. Elevated homocysteine is associated with coronary artery disease, heart attack, chronic fatigue, fibromyalgia,cognitive impairment, and cervical cancer.

Vitamin B12, along with vitamin B6 and folic acid (another B vitamin), is responsible for metabolizing homocysteine into less potentially harmful substances . Therefore, when metformin reduces absorption of vitamin B12, you lose one of the nutrients needed to reduce homocysteine and thus reduce your risk of cardiovascular disease.

ELEVATED HOMOCYSTEINE & PREGNANCY COMPLICATIONS

(Yet this is suppose to help with miscarriage, right??)

Pre-eclampsia is a complication of pregnancy characterized by increasing blood pressure and edema. If left untreated, pre-ecampsia can lead to eclampsia, a serious condition that puts you and your baby at risk. In a study conducted at the Center for Perinatal Studies at Swedish Medical Center in Seattle, a second trimester elevation of homocysteine was associated with a 3.2 fold increased risk of pre-eclampsia.

The Dept. of Obstetrics and Gynecology, Nijmegen, The Netherlands, reviewed a series of studies on the linkage between elevated homocysteine and early pregnancy loss. They concluded that high homocysteine levels are a risk factor for recurrent early pregnancy loss.

Ovarian follicular fluid contains detectable amounts of homocysteine along with B12, B6, and folic acid. The follicular fluid provides nourishment to the egg by facilitating transport of nutrients from blood plasma. High levels of homocysteine as well as an insufficiency of B vitamins may adversely influence the process of fertilization and early fetal development.

NOTE: We are suggesting that elevated homocysteine, not metformin itself, could contribute to pregnancy complications in some women. However, metformin does contribute to increased homocysteine levels.

PREGNANCY WARNING

 Many women use metformin in their pursuit of a successful pregnancy. However, Glucophage is a category B drug, meaning its safety for use while pregnant has not been established. It is found in breast milk so it’s not advisable to breast feed while taking Glucophage.

ANEMIA

 By preventing optimal absorption of vitamins B12 and folic acid, metformin could induce or contribute to megaloblastic anemia. Megaloblastic anemia occurs when your bone marrow doesn’t have enough B vitamins to manufacture red blood cells. Your bone marrow then releases immature and dysfunctional red blood cells into circulation.

Although anemia is not common among people taking metformin, it remains a risk for those whose B12 and folic acid levels were already low when metformin therapy was started.

LIVER OR KIDNEY PROBLEMS

If you have liver or kidney problems of any kind, metformin could pose a problem, because it alters liver function and is excreted through the kidneys. A healthy liver and kidneys will improve your outcome with metformin. Liver and kidney function should be assessed before starting metformin and rechecked at least once a year while taking it. A blood chemistry screen and a complete blood count will tell your physician how well your system is doing with this drug.

MULTIPLE MEDICATIONS

You may be at risk for health problems or symptoms if you take metformin in addition to other medications. The more drugs you take, and the higher the dosage, the greater the probability there will be some kind of interaction between the drugs or some unexpected effect from the combined drugs. The effect of combined drugs also depends on the state of your health, your genetic uniqueness, and your diet and lifestyle. Always consult with your doctor if you add or change any medication, or if you develop any symptoms.

HAIR LOSS

 Metformin may contribute to male pattern hair loss at the temples and top of head. Although there’s nothing in the medical literature to support this linkage, some women have reported that hair loss was made worse by metformin.

 

****LACTIC ACIDOSIS****

(3 of every 100,000)

About 3 of every 100,000 people who take metformin will develop a medical emergency called “lactic acidosis”. Lactic acid is a metabolic byproduct that can become toxic if it builds up faster than it is neutralized. Lactic acidosis is most likely to occur in people who with diabetes, kidney or liver disease, multiple medications, dehydration, or severe chronic stress.

Lactic acidosis can gradually build up. Symptoms to watch for include a need to breathe deeply and more rapidly, a slow, irregular pulse, a feeling of weakness, muscle pain, sleepiness, and a sense of feeling very sick. Treatment requires intravenous administration of sodium bicarbonate. Contact your doctor or go immediately to a hospital emergency room if you have these symptoms.

BILE ABNORMALITIES

 Bile is produced by the liver, stored in the gallbladder, and secreted into the intestines in order to absorb fats into the bloodstream. One possible reason for the GI problems is that metformin reduces normal reabsorption of bile from the intestines back into the bloodstream, which causes elevated bile salt concentrations in the colon. Most studies suggest that colonic bile salts cause free radical damage to DNA and may contribute to colon cancer.

In addition, bile acids may stimulate cells in the colon to produce leukotriene B4 (LTB4), a highly inflammatory substance. LTB4 would be a contributor to any intestinal inflammatory condition. Byproducts of bacterial action on bile salts may lead to intestinal cell damage and absorption of “foreign” molecules such as food or bacteria particles into the bloodsteam, possibly causing allergies and other immune responses.

Moreover, many PCOS women have switched to a high-protein diet. If that protein consists of beef and other meats, bile acid concentration in the intestines is increased. A diet high in meats is also linked to a higher risk of colon cancer.

REMEMEBER TO CONSULT WITH YOUR PHYSICIAN TO MINIMIZE RISK!

Your physician should always do a thorough medical history and metabolic assessment before putting you on metformin. You should be re-checked at least once a year for as long as you take this drug. Make sure to ask your physician what the unique benefits and risks of metformin will be for you. If you doctor prescribes Glucophage without a careful review of your health status and without involving you in the decision, find another doctor.

Please comment with any other symptoms you have or similarities!!!! 

Posted in Misc, PCOS | 7 Comments »

Polycystic Ovaries

Posted by Administrator on July 5, 2006

 

Polycystic is a term that simply means “many cysts.” The polycystic ovary typically contains many small – usually less than 1 centimeter – cysts (fluid-filled sacs). These cysts are usually arranged around the surface of the ovary, just below the surface layer of the ovary. When examined directly or by ultrasound, these small cysts commonly are said to have a string-of-pearls appearance. The ovaries of affected women can be slightly enlarged when compared to unaffected ovaries.  

Each small cyst represents a follicle, which contains a single egg or ovum that is attempting to develop to a stage where it will be ready to be released from the ovary (a process known as ovulation). However, because of the complex biochemical situation that exists in ovaries with PCOS, the development of these follicles is stopped too soon, resulting in a collection of small follicles and the lack of ovulation. This lack of ovulation is the reason why women with PCOS commonly have difficulty becoming pregnant.

Not all women who are found to have polycystic-appearing ovaries on ultrasound have PCOS. Keep in mind, the polycystic ovary is a structural finding of the ovary, and this single finding should not be confused with the entire syndrome. In fact, many women who show no other signs or symptoms of PCOS have been found to have polycystic-appearing ovaries on ultrasound.

Many women hear the term “polycystic ovary” and associate this with ovarian cancer. This is not the case. Polycystic ovaries are not cancer, and a diagnosis of PCOS does not mean that you have cancer. Also, having been told you have had or currently have an ovarian cyst does not mean you have PCOS. Remember, the normal ovary creates a cyst every month through the process of ovulation. The presence or history of an ovarian cyst does not make for PCOS.

Posted in Misc, Ovarian Cysts, PCOS | Leave a Comment »

PCOS Quiz

Posted by Administrator on July 5, 2006

PCOS Quiz

This quiz is intended for educational and informational purposes only. In no way should this information be used as a substitute for medical advice, and I strongly recommend discussing this information with a qualified personal physician.

Instructions: 

Add the points up beside the symptoms you have.

Section 1: Menstrual Irregularities

Eight or fewer periods per year  +1

No periods for an extended period of time (4 or more months)  +1

Irregular bleeding that starts and stops intermittently  +1

Fertility problems  +1 (If you have been to a specialist, add another point)

Section 2: Skin Problems

Adult acne, or severe adolescent acne  +1

Excess facial or body hair, especially upper lip, chin, neck, chest and/or abdomen  +1

Skin tags  +1

Balding or thinning hair  +1

Dark or discolored patches of skin on your neck, groin, under arms or in skin folds +2

Section 3: Weight and Insulin-Based Problems

Sudden unexplained weight gain +1

Excess weight or difficulty maintaining weight +1 (Add another if it is around your middle)

Shaking, lack of concentration, uncontrollable hunger and/or mood swings 2 or more hours after a meal  +1

Family history of Type II Diabetes, Heart Disease or Hypertension +1

Type II Diabetes +2

Section 4: Related Problems

Migraines + 1/2

Depression and/or anxiety  + 1/2

Rapid pulse and/or irregular heartbeat  + 1/2

Pregnancy complications such as gestational diabetes or excess amniotic fluid  + 1/2

Results:

0 – 4 points-> You probably don’t have it.
Although PCOS is possible, it is much less likely for you than for those scoring higher.

5 – 9 points-> You could have it or another disorder.
If you are concerned about your health and score in this range, you may want to consider talking to your doctor about the possibility of PCOS, as well as other disorders.

10 – 15 points-> You probably have it.
PCOS is a syndrome, not a disease, and most women experience some but not all of the problems listed above. The majority of women who are diagnosed with PCOS score in this range. If you scored in this range you should see a doctor about the possibility that you have PCOS.

15 – 20 points-> See a doctor now.  It is very likely you have PCOS!
A score this high warrants urgent consultation with a doctor for PCOS or other endocrine-related disorders.

I personally score a 9/10 and have PCOS. 

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Irregular or Non-existent Periods

Posted by Administrator on July 5, 2006

 

PCOS:  The 2nd most common cause of irregular periods 

While the most common cause of irregular delayed menses is due to stress type hypothalamic amenorrhea, the next most frequent type is due to polycystic ovarian syndrome. This is a complex condition of the ovaries in which follicles seem to grow and produce estrogen but the egg does not get released. This results in a high estrogen condition but infrequent menses. When the period does start, it often can be a very heavy one that persists for days or even weeks. The continuous, high estrogens cause the uterine lining to grow and proliferate and eventually it gets too thick and then sloughs off causing a menstrual like bleed. Because of the chronic and continuous estrogen stimulation, most doctors feel that a menstrual period should be induced with hormones (progesterone/progestin) so that a woman is not at risk for endometrial cancer.

Description of Irregular Periods (Oligomenorrhea)

Irregular menses, as measured from the start of one menses to the start of another, seem to occur in two patterns:

  • Onset of menses varies irregularly from about 3 weeks to 6 weeks but not skipping a month altogether. It is called metrorrhagia if many of the menses are less than 4 weeks.

  • Onset of menses varies from 4 weeks to 3-6 months having perhaps only 2-6 menses a year. This is called oligomenorrhea, infrequent menses.

Oligomenorrhea, the infrequent, irregular menses pattern is caused by lack of ovulation. However, it may further be subdivided into a low estrogen type in which there are no follicles being developed and a high estrogen type in which the follicles are developed but they are arrested so none of the eggs are released (ovulated) from the ovary.

What are some other causes of irregular, more frequent menses?

Causes of the metrorrhagia irregular menses pattern are unknown or are more likely related to stresses and ingested medications or substances that disrupt corpus luteum function or even act as anticoagulant blood thinners. Caffeine may act this way and disrupt corpus luteum function. Heavy caffeine consumers tend to have twice the risk of short cycle length (less than 24 days). Their cycles are not heavier but they are often more frequent.

Cigarette smoking is another agent that can shorten menstrual cycles. Cigarettes seem to shorten the follicular phase but heavier smoking also may shorten the luteal phase. Both heavy smoking and even smoking just 10 cigarettes or more a day may cause menstrual cycles to be shorter in length, as well as more variable in their lengths than nonsmokers.

Acute or excessive alcohol ingestion, getting drunk on occasion, is also known to alter menstrual patterns . Sometimes it shortens cycles while at other times it can cause a delay of menses. The alcohol is thought to affect the liver’s ability to properly metabolize estrogen and progesterone.

What makes a woman not ovulate at all and have low estrogens?

There are many things that can block ovulation in women. Stress is the most common cause. Eating disorders such as bulimia and anorexia also cause low estrogen and menstrual delay. If there are no menses at all, this is called hypothalamic amenorrhea. The mechanism for this is not totally known but probably has to do with alteration of brain proteins and hormones so that the normal ovulatory releasing factors do not work. When the brain releasing factors do not stimulate follicle development, there are few estrogens produced and a woman is then at risk for osteoporosis at a young age. This is why physicians prescribe estrogens in this condition, i.e., to prevent bone loss.

Recreational running does not seem to change menstrual cycle length, but strenuous endurance running can disturb cycle length and make a woman anovulatory. Long distance runners and other strenuous sports have been well known to cause anovulation of the low estrogen type. There has even been a suggestion that being a vegetarian may increase the risk of anovulation.

 

What is the best non-prescription treatment to make menses more regular?

For a metrorrhagia type of irregular menstrual pattern, it is important to give up tobacco, alcohol and cut caffeine servings down to 2 or less per day. Try to minimize any medications that you do not have to take. If menses are mildly irregular and you are trying to time conception, taking a phytoestrogen supplement on a daily basis may help stabilize the menstrual cycle length.

For a low estrogen, irregular menstrual problem, the key treatments are:

  • stress reduction and/or relaxation techniques

  • elimination of overly strenuous physical exercise

  • eliminate any eating disorders such as purging, bulimia, or anorexia

  • take supplemental, measured estrogens such as phytoestrogens in soy or clover products

  • For a high estrogen irregular menses pattern such as that found in PCOS, weight reduction using a low carbohydrate diet is essential. Even a 10% weight loss will help restore normal menstrual patterns in obese women who are anovulatory.

    What are the best prescription treatments for menstrual irregularities?

Oral contraceptives (OCPs) are the most commonly used hormonal treatment for irregular menses. They do not correct the underlying problem that causes the irregularity but they will regulate the pattern very precisely to the same day of the week each cycle. In general, oral contraceptives are very safe and will not cause an alteration in the body even after taking for a very long time. Some women cannot take birth control pills, however, so other treatments are also used.

Women with irregular menses due to hypothalamic factors can take a sequential hormone regimen. In this regimen, estrogen is given each day and then progesterone is given for 10-14 days each month in order to induce a withdrawal bleed. This regimen will not protect against pregnancy should ovulation occur so if a pregnancy is desired, this may be the best regimen.

For polycystic ovarian syndrome most physicians will prescribe oral progestins or progesterone to take for 10 days every two months if there has not been a spontaneous menses. This is thought to protect against the development of endometrial cancer or hyperplasia from the long term elevation of estrogens.

Carbohydrate metabolism abnormalities are often successfully treated with a combination of diet and medications, and the menstrual irregularities may disappear. Metformin, a drug which reduces high insulin levels has been shown to make women with PCOS resume normal menses in almost 90% of cases. This is a dramatic breakthrough in treatment and one worth seeing your physician about if you have PCOS.

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