**4. Discussion**

Informed by previous studies that used MST to explore parenting dimensions in LG individuals [9–11], as well as those that highlighted the heteronormative context for Italian LG individuals [20,38–42], the current study intended to apply part of the PMF as an extension of MST to parenting desire to a group of childless Italian LG individuals. We found partial support for this operation. Indeed, our results highlighted both a direct and an indirect effect (through sexual orientation concealment) of prejudice events on parenting desire, but only in lesbians. Of note, the direction of this effect changed depending on whether the association was direct or indirect. Specifically, we found that prejudice

events were negatively associated with parenting desire, but that this effect became positive when it was mediated by sexual orientation concealment. Thus, our findings shed light on clinical practice, highlighting the need for structuring clinical interventions to ameliorate the negative effects of minority stressors on parenting desire.

In support of the first hypothesis of this study, we found that prejudice events were negatively associated with parenting desire only in lesbians and not in gay men. This means that, unlike gay men, prejudice events reduce the likelihood of lesbians desiring to become mothers. This finding might be read through the lens of MST, as well as through evidence that the Italian context is a highly heteronormative social context. To this end, previous studies have already demonstrated that discrimination episodes negatively impact parenting desire in lesbians, but not in gay men [11], and that this gender difference is due to the double stigma that many lesbians experience as both lesbians and women [54]. Furthermore, experiencing a prejudice event due to one's own sexual orientation and/or gender identity ends up emphasizing a status difference, as what is affected is a specific identity dimension. It is then likely that, in a heteronormative context, such as the Italian one [20,38–42], a lesbian woman experiencing a prejudice event will perceive this difference in status more than a gay man, because parenthood seems to still be a woman's prerogative [9,11]. Thus, a lesbian woman might feel herself to be less adequate than a gay man to become a parent, and this ends up decreasing the levels of parenting desire.

Regarding the second hypothesis, that sexual orientation concealment and internalized heterosexism negatively affect parenting desire in lesbians, but not in gay men, our findings were significant but, contrary to our expectations, they suggested that both subjective minority stressors were positively associated with parenting desire in lesbians and not in gay men, increasing the level of parenting desire in lesbians, rather than decreasing it. This unexpected finding might be read through the lens of MST and the related social pressure that some minority people could feel to conform to social expectations. Thus, it is probably that higher levels of internalized heterosexism, in addition to questioning one's own parenting abilities [13], might lead to a need to conform to social expectations, including becoming a mother in a context that still promotes motherhood as a key value for female identity [48]. Similarly, in line with the finding discussed above—that internalized heterosexism increases parenting desire in lesbians—the fact that sexual orientation concealment increased parenting desire only in lesbians, and not in gay men, might be read through the hypothesis that concealing one's own sexual orientation would lead lesbians to conform to societal expectations that tend to equate women to mothers. Notwithstanding these interpretative hypotheses, this finding should be qualitatively investigated to better understand how internalized stigma and sexual orientation concealment could lead to an increase in parenting desire.

Finally, regarding the third hypothesis (the moderated mediation model) that both sexual orientation concealment and internalized heterosexism would mediate the relationship between prejudice events and parenting desire, and that gender would moderate these indirect effects, our findings provided partial support. Indeed, only sexual orientation concealment, and not internalized heterosexism, acted as a significant mediator between prejudice events and parenting desire, and only in lesbians, increasing, rather than decreasing, their level of parenting desire. Thus, in the presence of sexual orientation concealment, prejudice events ended up increasing parenting desire in lesbians. As suggested by previous studies [24,25], unlike in gay men, the visibility of lesbian motherhood in previous decades, together with the social expectations that a woman will become a mother [27], might lead lesbians to perceive coming out as a mandatory step to becoming mothers. Thus, as suggested by our findings, experiencing prejudice events as a lesbian woman might lead to concealing one's own sexual orientation, which, in turn, increases the desire to become a mother, as becoming a mother would increase one's visibility as a normative woman, fitting the heteronormative equivalence of women as mothers.

### *4.1. Limitations and Suggestions for Future Research*

This study had significant limitations that might affect the generalizability of the results to the general Italian LG population. First, the cross-sectional design of the study did not allow certain inferences to be made concerning the causal relationships between variables. Indeed, findings have to be interpreted as associations which do not necessarily prove causality between variables. Future longitudinal studies should assess the cause-and-effect relationships between minority stressors and parenting desire, analyzing potential changes over time.

A second limitation concerns the use of a single-item question to assess parenting desire. Although the same question had been used in a previous study [46], a more composite measure on parenting desire should be used in future research. Similarly, a qualitative investigation on parenting desire, and on its relationship with minority stressors, is recommended in order to achieve a better understanding of the psychological processes underlying these dimensions.

A third limitation was due to a sample selection bias. Indeed, participants were mostly recruited through social networks and Italian NGOs engaged in the defense of LG rights, thus not representing the general LG population. This may even explain why no right-wing individuals participated in the survey. Finally, in line with the previous limit, a last limitation was the absence of diverse ethnic groups of LG individuals, which prevented us from reading the findings from an intersectionality perspective. To this end, it is plausible to hypothesize that sociocultural differences between Caucasians and non-Caucasians living in Italy exist, both in terms of minority stress—that is usually more pervasive in multiple marginalized individuals [55]—and parenting process.

### *4.2. Implications for Clinical Practice*

Clinicians might encounter LG individuals for many reasons, including LG individuals or couples who want to become parents or are questioning about a parenting plan. The results of this study might provide helpful suggestions for clinical practice with childless LG individuals, despite its limitations. Indeed, the PMF is a conceptual framework that allows an understanding of the negative effects of stress on individual psychological dimensions.

Our findings sugges<sup>t</sup> that, unlike in gay men, parenting desire might be influenced by stigmatizing episodes in lesbians, and that this effect is partly explained by the action of sexual orientation concealment. Furthermore, although internalized heterosexism was not a significant mediator between prejudice events and parenting desire, it did increase the level of parenting desire in lesbians, probably because internalizing negative societal values about being lesbian leads to conforming to social expectations that tend to equate women to mothers. Thus, our results might shed light on some clinical implications above all for lesbians, both if they are single or in couple.

Our data should lead clinicians to pay particular attention to minority stress in clinical settings [56,57], and especially to the detrimental effects that stigma, and in particular proximal stressors (i.e., internalized heterosexism and sexual orientation concealment), might have on parenting desire. To this end, clinicians might assume the function of alleviating the emotional impact that internal stressors might have on individuals' desire, thoughts, or beliefs, helping clients to unhook their self-representation from the social dialectic that still tends to construct a negative image of the LG population, in particular as parents. This seems particular true for lesbians, who live a greater pressure than gay men to conform to social expectations related to parenthood. Indeed, although we usually interpret parenting desire or plan as a sign of comfort towards the self, due to an inherently generative project, our data sugges<sup>t</sup> that the converse is also possible, as both internalized heterosexism and sexual orientation concealment increase, rather than decrease, parenting desire. This means that parenting desire might also be a sign of internalized heterosexism or sexual orientation concealment, rather than a manifestation of a positive identity. Thus, clinicians should deeply explore internal dynamics related to proximal stressors and be cautious in automatically interpreting parenting desire as a sign of comfort.

Furthermore, as both internalized heterosexism and sexual orientation concealment depends on the social stigma that burdens on LG people, clinicians should help clients to develop or increase awareness of stigma, allowing them to perceive oppression as a societal problem that afflict LG individuals as a class of people, rather than as something that concerns them as specific individuals.

Finally, clinicians should also consider group approach as an alternative to individual or couple approach, as the group activates mirroring processes that productively allow participants to reshape self-image [58] and increase the self-empowerment processes [59]. Indeed, LG individuals or couples experiencing high levels of internalized heterosexism might negotiate their negative self-image with peers, ameliorating the impact of stigma on health. In the same vein, the group might also be helpful for LG individuals or couples who tend to conceal their sexual orientation to family, friends, or colleagues. Therefore, sharing one's own identity to others living similar experiences in a protected and secure setting might allow an elaboration of feelings such as shame and self-hatred, thus facilitating identity or couple affirmation processes. In turn, as suggested by our findings, this clinical work could lighten the weight of social expectations related to parenthood, in particular in women.
