**1. Introduction**

Becoming parents represents a complex process that might be influenced by many social dimensions, such as economic issues, familial policies, local legislation, or housing conditions [1]. From a psychological point of view, a starting point in the parenthood path is the desire to become a parent, or rather "what one wants or would like to do" [2] (p. 10).

Despite the rapid increase in lesbian and gay (LG) people who desire and decide to become parents, differently from heterosexual people, LG childless individuals may encounter serious obstacles in the parenthood process due to their sexual minority status [3–5]. One of these is represented by minority stress, a specific stress caused by socially stigmatized status and associated with negative health outcomes [6,7]. Minority stress theory (MST) conceptualizes both distal and proximal stressors. Distal stressors are objective stressors (i.e., prejudice events, such as interpersonal violence, employment discrimination, mistreatment in healthcare setting, etc.), that are independent of the individual's perceptions or feelings. On the other hand, proximal stressors are subjective and internal stressors dependent on individual's perceptions, such as expectations of rejection, sexual

orientation concealment, and internalized heterosexism, that is, the direction of negative social attitudes toward the self. MST assumes that both stressors assumes that objective stressors (i.e., prejudice events, such as violence and discrimination), as well as subjective stressors (i.e., expectations of rejection, sexual orientation concealment, and internalized homophobia), predict negative health outcomes, and that specific protective factors (e.g., resilience, community connectedness, social support, etc.) buffer this direct association [7,8]. Recently, some studies have demonstrated that minority stressors negatively affect parenting desire, thus resulting in a significant psychosocial barrier to parenthood [9–11].

A recent extension of MST—the psychological mediation framework (PMF)—places the accent on a more clinical and subjective view of the stress, thanks to the use of proximal stressors as mediators between prejudice events and health [12]. The PMF was postulated to analyze psychological paths linking stigma-related stressors to negative health outcomes. Thus, differently from MST, according to which stress is a mediator between social structure/status and health, the PMF looks at stress as the starting point of a mediating psychological chain leading to negative health outcomes. Psychological mediators are both the proximal minority stressors (e.g., internalized heterosexism and sexual orientation concealment) and some general psychological processes (e.g., interpersonal problems or emotion dysregulation). In summary, if MST considers both distal and proximal minority stressors as predictors of health outcomes, the PMF considers the proximal minority stressors as mediators between distal minority stressors and health.

Although recent studies have demonstrated the usefulness of approaching parenting dimensions as potential outcomes of the minority stress processes, going beyond the health outcomes [9–11], no previous studies have applied the PMF to parenting dimensions in LG individuals. As parenting desire represents the first link in the chain of the parenting process, and internalized heterosexism and sexual orientation concealment are the two main personal issues shaping parenting decisions [13], we were interested in analyzing the role of internalized heterosexism and sexual orientation concealment as mediators between prejudice events and parenting desire in childless LG individuals.

Furthermore, as gender is a fundamental dimension of parenthood [14], the difference between women and men was considered as a potential moderator. Indeed, although the old sexist stereotypes have been overcome in contemporary society, some different-sex couples still divide their childcare tasks or household chores based on gender norms, with women dedicated to these tasks and men employed outside the home [15]. On the contrary, most of the research on same-sex couples reported that they are more likely than different-sex couples to divide the labor fairly [16]. These generalizations must not lead to the perception of same-sex couples as more functioning than different-sex couples, but serve to show that gender might play a key role in the couple's dynamics and that it should be considered as a crucial factor in studies exploring parenthood dimensions. The article begins by providing an overview of the relationship between minority stressors and parenting desire in LG individuals. Then, it gives an overview of the internalized heterosexism and sexual orientation concealment as mediators, according to the PMF. Finally, as Italy represents the context of our study, it introduces a snapshot of the Italian context for LG individuals.

### *1.1. Minority Stressors and Parenting Desire in Lesbians and Gay Men*

LG individuals have been found to be generally resilient in the face of stigma and to resist heterosexist social pressure [17,18]. In spite of this, they still experience prejudice events due to their stigmatized social status, thus experiencing high rates of minority stress and negative health outcomes [17,18]. When childless LG individuals become parents, they also become extremely visible and, because of this, minority stress might increase [11].

Recent studies have shown the association between minority stress and parenting dimensions. For instance, Bos et al. [10] found that lesbian mothers experiencing higher levels of prejudice events showed more parental stress and, at the same time, felt more pressed to justify their motherhood qualities to people than mothers experiencing fewer prejudice events. Similarly, mothers with higher levels of internalized heterosexism tended to defend their position as mothers more often than those

with lower levels of internalized heterosexism. Another study, by Baiocco et al. [9], found that childless Italian LG adults with higher levels of internalized heterosexism were less likely to desire to marry, and to recognize some positive effects of same-sex legal recognition, than those with lower levels of internalized heterosexism. More recently, an Italian study by Scandurra et al. [11], in which MST was applied to a group of childless LG individuals, reported that prejudice events, sexual orientation concealment, and internalized heterosexism were negatively associated with parenting desire in lesbians, and that felt stigma negatively impacted parenting desire in gay men. Furthermore, support from family or significant others buffered the relationship between minority stressors and parenting desire.

These data seem to confirm that one of the obstacles that LG individuals may encounter in their parenthood path is heterosexism [4,5], which, in turn, leads to experiencing minority stress because sexual minority people do not match heterosexist expectations. Indeed, as suggested by Mezey [13], due to the heterosexist society in which LG individuals live, two fundamental personal and psychological dimensions that have to be considered in analyzing the parenthood process are internalized heterosexism and sexual orientation concealment.

LG individuals internalize societal values and messages that communicate that nonheterosexual orientations are immoral, that LG individuals cannot be good parents, and that children born to a same-sex couple will not grow up well [4,19,20]. Due to internalized heterosexism, childless LG individuals may come to question their ability to become parents, creating barriers to parenthood [13]. Sexual orientation concealment, which is the negative side of the coming out process, is also connected to internalized heterosexism. Revealing one's own nonheterosexual orientation to family members, friends, and colleagues, may have positive effects on the quality of relationships and mental health [21,22]. At the same time, it is often a difficult and pained process, which depends on several factors, such as age, class, race, and environment [19]. Indeed, this process implies the necessity to negotiate multiple identities in one's own environment, and this is particularly true for LG individuals who desire or want to become parents [13]. For instance, the fear that some LG individuals experience in coming out to their parents might represent a serious obstacle to the parenthood process [23]. Finally, despite similarities in the coming out process among lesbians and gay men, previous studies [24,25] have detected an interesting difference based on gender: many lesbians tend to perceive coming out as a necessary step to becoming mothers, while many gay men tend to regard coming out as a barrier to becoming fathers. Thus, for some gay men, coming out represents a break between being gay or being a father [26]. Substantially, it seems that this gender difference might be explained through the social expectations regarding becoming a parent, which are greater for women than for men [27]. For this reason, the individual's gender should be considered as a potential moderator in parenting studies.

### *1.2. Internalized Heterosexism and Sexual Orientation Concealment According to the Psychological Mediation Framework*

As mentioned above, starting from a clinical view of stress and with the aim of extending the MST, the PMF was postulated as a theoretical framework to better understand psychological pathways that link minority stressors to negative health outcomes. Previous studies have empirically supported the validity of the PMF, both in LG [28,29] and transgender and gender nonconforming [30–32] people.

Specifically, and considering the main dimensions of the current study, there is evidence that internalized heterosexism and sexual orientation concealment mediate the relationship between prejudice events and health. For instance, Feinstein et al. [33] found that internalized heterosexism mediated the association between experiences of discrimination and both depression and social anxiety in both lesbians and gay men.

On the other hand, Ryan et al. [34] found that negative reactions to disclosure, which might be viewed as a form of prejudice event, were associated with depression and low self-esteem, and that autonomy need satisfaction following disclosure was a mediator between negative reactions and health. It is noteworthy that sexual orientation disclosure is not always beneficial, both because LG

individuals could experience negative reactions from their interpersonal contexts and due to the inherently stressful process [35,36].

To our knowledge, the PMF has not ye<sup>t</sup> been applied to parenting dimensions (e.g., parenting desire), although previous studies have considered these dimensions as potential outcomes of MST [9–11].

### *1.3. Italian Context for Lesbians and Gay Men*

The Italian governmen<sup>t</sup> has only recently recognized same-sex civil unions (law No. 76/2016), specifically in June 2016, and only after a scathing battle between conservative parties, supported by strongly religious groups, and moderate and left-wing parties. Before final approval of the original law, which foresaw the same benefits of different-sex marriage to same-sex couples, the so-called stepchild adoption (i.e., the possibility of adopting the biological child of a partner) was removed. This means that the only public body that can decide in favor of the adoption of a partner's biological child is the Supreme Court of Appeal, which has already provided this possibility to some Italian same-sex couples. Notwithstanding, contrary to different-sex couples, Italian same-sex couples cannot legally adopt children.

It is noteworthy that the social and political debate that led to law No. 76/2016 was specifically around the parental abilities of LG people, who were perceived by the opposition parties to be inadequate parents [11]. Along the same lines, a recent study by Lasio et al. [37], analyzing the speeches of Parliamentarians who expressed their opposition to LG parenthood, revealed that discourses were organized around a hegemonic model of gender, and that they contributed to reiterating old models of motherhood, maintaining the institutionalization of sexuality and reproduction within a patriarchal logic. These findings seem to be supported by some recent Italian studies, in which it has been reported that Italy is a strongly heteronormative [20,38–42] and genderist [43,44] society that still tends to equate women to mothers. Thus, social status differences continue to exist in Italy, although a grea<sup>t</sup> amount of progress has been made in the last few years.

Social status difference represents the most important dimension that leads to the development of minority stress, as it highlights the existence of social inequalities that, in turn, might be internalized by minority groups as a distinctive sign of their own identity. Indeed, previous studies underlined the presence of high levels of internalized heterosexism in Italian LG population [39], as well as in LG individuals who were in the reproductive age [9]. Unfortunately, despite the positive legal progress, Italian LG individuals still experience high rates of minority stressors [45], which, in turn, negatively affect parenting desire [11].
