Intergenerational Coresidential Patterns by Young Adult's and Their Mother's Mental Health and Substance Use.

Intergenerational coresidence is at a 30-year high. Studies find that economic, familial, and demographic factors shape the likelihood of this arrangement. We use NLSY79 and NLSY79YA data (2000-2014; N = 3,092) to examine how the mental health and substance use of both adult children and their mothers matter for coresidential biographies, estimating risks of moving out of and returning to their mothers' households. Adult children who drink, smoke, or have more depressive symptoms, or whose mothers drink or smoke, are more likely to leave their mother's household; adult children with more depressive symptoms and who smoke are more likely to return. Our findings show that children's and mothers' health are key determinants of coresidential patterns, suggesting that it is not just family arrangements that impact health but health that impacts family arrangements. As intergenerational coresidence increases, researchers should continue to look beyond economic, familial, and demographic determinants of coresidence to health dynamics.

The Gender-as-Relational Approach for Theorizing About Romantic Relationships of Sexual and Gender Minority Mid- to Later-Life Adults.

We deploy the "gender-as-relational" (GAR) approach to enhance the study of the long-term romantic relationships of sexual and gender minority mid- to later-life adults. The GAR approach states that gender within relationships is shaped by three key factors: own gender, partner's gender, and the gendered relational context. This approach highlights that the relationship dynamics of men, women, and gender nonconforming people are highly diverse, reflecting that gender is a social construct formed within interactions and institutions. We explicate how GAR can reorganize the study of sexual and gender diversity in three research areas related to aging and relationships-caregiving, marital health benefits, and intimacy-and discuss theory-driven methods appropriate for a GAR research agenda. A GAR framework reorients research by complicating taken-for-granted assumptions about how gender operates within mid- to later-life romantic relationships and queering understandings of aging and romantic relationships to include experiences outside of heteronormative and cisnormative categories.

Sexual- and Gender-Minority Families: A 2010 to 2020 Decade in Review.

OBJECTIVE: To review research on sexual and gender minority (SGM) families-including lesbian, gay, bisexual, transgender, queer, asexual, and intersex (LGBTQAI+) families- from 2010-2020. BACKGROUND: Research on the SGM population has increased and diversified in the past decade. RESULTS: This paper reviews three subareas that make up the majority of research on SGM families today: (1) SGM family of origin relationships, (2) SGM intimate relationships, and (3) SGM-parent families. This review also highlights three main gaps in the existing literature: (1) a focus on same-sex and gay and lesbian families (and to a lesser extent bisexual and transgender families) and a lack of attention to the families of single SGM people as well as intersex, asexual, queer, polyamorous, and other SGM families; (2) an emphasis on white, socioeconomically advantaged SGM people and a failure to account for the significant racial-ethnic and socioeconomic diversity in the SGM population; and (3) a lack of integration of SGM experiences across the life course, from childhood to old age. CONCLUSION: The next decade should aim to examine the full range of SGM family ties, include more vigorous examinations of race-ethnicity and socioeconomic status, and develop more robust accounts of family across the life course with novel theory and data sources across the methodological spectrum.

"Go See Somebody": How Spouses Promote Mental Health Care.

This study considers when, whether, and how spouses encourage professional mental health care by analyzing qualitative data from 90 in-depth interviews with gay, lesbian, and heterosexual spouses. Findings show that a majority of spouses are engaged in promoting each other's mental health care but that the strategies used to promote care vary by gender and the gender composition of the couple. The majority of gay men and lesbian women promote care by framing mental health problems as largely biochemical, fixable only with professional care or medicine, and work to destigmatize this care. Lesbian women uniquely emphasize the influence of a spouse's symptoms on marital quality as a reason to pursue care. Some heterosexual women and men also report seeing their spouse's mental health care as something for them to deal with on their own and thus do not encourage care. This study has important implications for researchers looking to understand why some individuals seek mental health care and others do not and provides policymakers insight into mental health interventions via spouses.

Intergenerational Coresidence and Mothers' Body Weight at Midlife.

Midlife mothers report their children returning to the maternal home after departing (i.e., boomerang children) and remaining in the maternal home longer (i.e., never-left children) than the past half century. Over the same time period, the percent of Americans considered overweight and obese have increased. Yet, we know very little about how such delays affect the body weight of mothers. The current study uses the National Survey of Youth 1979 (NLSY79) and its corresponding young adult sample (NLSY79-YA) across 20 consecutive years (N=7,197) to determine if extended coresidence with an adult child is associated with midlife mothers' body weight changes. Results from multilevel regression models show that compared to mothers whose young adult children left home and never returned ("gone-for-good"), mothers of the "never-left" had higher body weight at 40 but similar body weight at 50. Mothers of the boomerangers had higher body weight relative to mothers of the "gone-for-good" across midlife. Mothers of the boomerangers and mothers of the "never-left" had similar weight at age 40 but the former group had more weight gain across midlife. These findings lend new insight into how different patterns of mother-young adult coresidence likely affect the health of mothers, and suggests the effects of recent demographic trends such as "failure to launch" on family formation and functioning should be viewed holistically with a more inclusive sociological lens.

Intensive Mothers, Cautionary Tale Fathers: Adult Children's Perceptions of Parental Influence on Health.

Parents strongly influence children's health, yet how parents continue to shape the health of midlife adult children remains unknown. Moreover, while most adults are married by midlife, research has failed to identify the effects of parent-in-law relationships on midlife adult wellbeing. Using interviews with 90 individuals in 45 marriages, we investigate how midlife adults perceive the influence of parents and parents-in-law on adult child health. Findings reveal that particularly mothers and mothers-in-law positively influence child's health via support during, or in anticipation of, illness and injury. The health experiences of parents and in-laws, particularly fathers/in-law, become cautionary tales preparing adult children for future health issues. Yet, parents/in-law also have negative influence on adult children during midlife due to parents' compounding health needs. We use family systems theory to show how parents/in-laws are intertwined in ways that influence health during children's midlife that has ramifications into later life.

Sex in Midlife: Women's Sexual Experiences in Lesbian and Straight Marriages.

OBJECTIVE: This study examines how married straight and lesbian women understand sexual changes in midlife. BACKGROUND: Sexual satisfaction is key to marital quality, yet marital sex typically diminishes in midlife. Little is known, however, about how married straight and lesbian women make sense of midlife sexuality. Comparing the narratives of lesbian and straight women can reveal how midlife events, relational contexts, and gender norms drive women's experiences of and responses to diminishing sex. METHOD: Inductive and deductive analyses were performed on interviews with a convenience sample of 16 straight and 16 lesbian mostly high-status married couples in Massachusetts. RESULTS: Lesbian and straight women suggest that sexual activity and desire diminish over time due to health, aging, and caregiving events, yet lesbian women additionally emphasize the importance of weight gain, caregiving for adult parents, and shared experiences of menopause. Women further describe distress when their sex lives diverge from norms specific to marriage and their sexual identities. Moreover, women report relationship work designed to maintain or reignite sex; when compared with straight women, lesbians describe more work and a stronger sense of duty to keep sex alive and uniquely describe medical providers as unhelpful in addressing sexual challenges. CONCLUSION: The results suggest that relational contexts and cultural discourses shape straight and lesbian women's experiences of distress and comfort about diminishing sex in marriage.

The Intergenerational Transmission of Discrimination: Children's Experiences of Unfair Treatment and Their Mothers' Health at Midlife.

A growing body of research suggests that maternal exposure to discrimination helps to explain racial disparities in children's health. However, no study has considered if the intergenerational health effects of unfair treatment operate in the opposite direction-from child to mother. To this end, we use data from mother-child pairs in the National Longitudinal Survey of Youth 1979 to determine whether adolescent and young adult children's experiences of discrimination influence their mother's health across midlife. We find that children who report more frequent instances of discrimination have mothers whose self-rated health declines more rapidly between ages 40 and 50 years. Furthermore, racial disparities in exposure to discrimination among children explains almost 10% of the black-white gap but little of the Hispanic-white gap in self-rated health among these mothers. We conclude that the negative health impacts of discrimination are likely to operate in a bidirectional fashion across key family relationships.

Do Support and Strain With Adult Children Affect Mothers' and Fathers' Physical Activity?

Physical activity is central to health. Parents tend to have lower levels of physical activity than the childless, however, little is known about how adult child-parent relationship quality matters for mothers' and fathers' physical activity trajectories. Nationally representative panel data from the Americans' Changing Lives survey (1986-2012) are used to analyze multilevel-ordered logistic regression models. Greater social support from adult children is associated with more frequent active exercise, and higher strain with adult children is related to more frequent active exercise and walking. A significant gender interaction suggests that strain with adult children is related to greater exercise among men more so than women, but this interaction is attenuated after adjusting for cigarette smoking, another gendered way of coping with stress. This study contributes to a more nuanced understanding of how different dimensions of intergenerational relationships shape health behaviors across the life course.

Healthcare Work in Marriage: How Gay, Lesbian, and Heterosexual Spouses Encourage and Coerce Medical Care.

Marriage benefits health in part because spouses promote one another's well-being, yet how spouses facilitate formal healthcare (e.g., doctor's visits, emergency care) via what we call healthcare work is unknown. Moreover, like other aspects of the marital-health link, healthcare work dynamics likely vary by gender and couple type. To explore this possibility, we use in-depth interviews with 90 midlife gay, lesbian, and heterosexual spouses to examine how spouses perform healthcare work. Our results show that in heterosexual marriage, women perform the bulk of healthcare work and typically do so in coercive ways. A minority of heterosexual men provide instrumental healthcare work for their wives. Gay and lesbian spouses appear to commonly use both coercive and supportive healthcare work strategies to effectively promote healthcare use. Our findings demonstrate the ways spouses are central to supporting and coercing one another to obtain medical care and how these patterns are gendered.

Before and After "I Do": Marriage Processes for Mid-Life Gay and Lesbian Married Couples.

This qualitative study examines how mid-life gay and lesbian married individuals articulate their decision to marry. Using 2013 data from 30 mid-life couples in Massachusetts, this study challenges previous literature that conceptualized marriage as entirely positive or negative for same-sex individuals. Mid-life individuals' unique social and historical context influence their experiences of marriage, as mid-life individuals have witnessed the rise and feasibility of marriage equality, have formed relationships outside of the bounds of marriage, and have been in committed relationships long before they married. Using the framework of ambivalence, our findings provide three main contributions to the literature. First, we show that marital ambivalence is a common experience in our sample. Second, we detail how marital ambivalence is indicative of the age, life-course stage, and length of relationship for mid-life lesbian and gay individuals. Third, we explore ambivalence at the level of the relationship, not just as an individual experience. This study provides new insight into how sexuality shapes both intimate relationship dynamics as well as the effect of same-sex marriage on LGBT communities and identities.

Planning for Future Care and the End of Life: A Qualitative Analysis of Gay, Lesbian, and Heterosexual Couples.

Two key components of end-of-life planning are (1) informal discussions about future care and other end-of-life preferences and (2) formal planning via living wills and other legal documents. We leverage previous work on the institutional aspects of marriage and on sexual-minority discrimination to theorize why and how heterosexual, gay, and lesbian married couples engage in informal and formal end-of-life planning. We analyze qualitative dyadic in-depth interviews with 45 midlife gay, lesbian, and heterosexual married couples ( N = 90 spouses). Findings suggest that same-sex spouses devote considerable attention to informal planning conversations and formal end-of-life plans, while heterosexual spouses report minimal formal or informal planning. The primary reasons same-sex spouses give for making end-of-life preparations are related to the absence of legal protections and concerns about discrimination from families. These findings raise questions about future end-of-life planning for same- and different-sex couples given a rapidly shifting legal and social landscape.

The Promise and Perils of Population Research on Same-Sex Families.

As a follow-up to our 2016 study, this article presents new findings examining the relationship between same-sex family structure and child health using the 2008-2015 National Health Interview Survey (NHIS). After discussing NIHS data problems, we examine the relationship between family structure and a broad range of child well-being outcomes, including school days lost, behavior, parent-rated health, emotional difficulties, and activity limitations. We find both similarities (school days lost, behavior, parent-rated health) and differences (emotional difficulties and activity limitations) across our two studies using different survey years, but our overall conclusions are robust. We further discuss the implications of our findings for future research on this topic, including how to account for biological relatedness in a study on child health in same-sex families.

Self-rated health at the intersection of sexual identity and union status.

There is a well-established relationship between union status and health within the general population, and growing evidence of an association between sexual identity and well-being. Yet, what is unknown is whether union status stratifies health outcomes across sexual identity categories. In order to elucidate this question, we analyzed nationally representative population-based data from the National Health Interview Surveys 2013-2014 (N = 53,135) to examine variation in self-rated health by sexual partnership status (i.e., by sexual identity across union status). We further test the role of socioeconomic status and gender in these associations. Results from logistic regression models show that union status stratifies self-rated health across gay, lesbian, and heterosexual populations, albeit in different ways for men and women. Socioeconomic status does not play a major role in accounting for these differences. Findings highlight the need for specific interventions with lesbian women, who appear to experience the most strident disadvantage across union status categories.

Relationships with parents and adult children's substance use.

Previous research has indicated that parents impact minor children's health behaviors and adult children's self-rated health and psychological well-being. However, little is known about the long-term consequences of the parent-child relationship for adult children's substance (i.e., smoking levels, low to moderate alcohol use) as adult children age. The present study uses growth curve analysis on longitudinal survey data (Americans' Changing Lives, N=907) to examine how multiple dimensions of the parent-child tie influence adult children's substance use. Findings show that contact with mothers in adulthood has a health-enhancing effect on sons' smoking. Fathers' support is related to a decline in alcohol use for sons and daughters, but also an increase in smoking for sons only. Our findings for strain from parents are complex, suggesting that the ways in which adult children cope and manage strain with parents may result in multiple pathways of substance use. Our study raises new questions about whether and when family ties are "good" or "bad" for health and calls for a more multifaceted view of the long-lasting parent-child tie. We spotlight the need to look at the parent-child relationship as a dynamic social tie that changes over the life course and has consequences for health in adulthood.

Instrumental- and Emotion-Focused Care Work During Physical Health Events: Comparing Gay, Lesbian, and Heterosexual Marriages.

OBJECTIVES: We consider emotion- and instrumental-focused care work and marital stress during significant physical health events in midlife gay, lesbian, and heterosexual marriages. METHOD: We employ the factorial method, an extension of the actor-partner interdependence model, to analyze survey data from 808 midlife gay, lesbian, and heterosexual spouses in 404 unions. RESULTS: The amount of emotion- and instrumental-focused care work provided during physical health events, and the associations between care work and marital stress, depends on the gender of the respondent, gender of the spouse, and whether spouses are in a same-sex or different-sex union. For example, in both same- and different-sex marriages, women report providing more emotion-focused care work during their own health event than do men, and respondents report more health-related marital stress when the patient is a woman. DISCUSSION: Investigating how midlife same-sex and different-sex spouses care for each other during a spouse's health event expands understandings of gendered aging experiences within marriage. Findings can elucidate health policies and clinical strategies that best support the health of men and women in same- and different-sex marriages.

Physical Illness in Gay, Lesbian, and Heterosexual Marriages: Gendered Dyadic Experiences.

The inclusion of same-sex married couples can illuminate and challenge assumptions about gender that are routinely taken for granted in studies of physical illness. We analyze gender dynamics in gay, lesbian, and heterosexual marriages with in-depth interview data from 90 spouses (45 couples) to consider how spouses co-construct illness experiences in ways that shape relationship dynamics. Overall, findings indicate that men tend to downplay illness and thus provide minimal care work, whereas women tend to construct illness as immersive and involving intensive care work-in both same-sex and different-sex marriages. Yet same-sex spouses describe similar constructions of illness much more so than different-sex couples, and as such, same-sex spouses describe less illness-related disagreement and stress. These findings help inform policies to support the health of gay and lesbian, as well as heterosexual, patients and their spouses, an important goal given health disparities of gay and lesbian populations.

Greedy Spouse, Needy Parent: The Marital Dynamics of Gay, Lesbian, and Heterosexual Intergenerational Caregivers.

It is well established that married heterosexual women do more intergenerational caregiving for aging parents and parents-in-law than married heterosexual men do. However, gay men and lesbian women's recent access to marriage presents new questions about the gendered marital dynamics of intergenerational caregiving. We use dyadic data with gay, lesbian, and heterosexual spouses to examine the marital dynamics of intergenerational caregivers. Results show that gay and lesbian spouses provided intensive time and emotional support for an intergenerational caregiver. In contrast, heterosexual women described their intergenerational caregiving as rarely supported and at times even undermined by their spouse. Dyadic data on heterosexual men corroborate women's accounts; heterosexual men rarely reported providing intergenerational caregiving, and thus heterosexual women rarely described providing spousal support. These findings provide new insight into the intermingled roles of "greedy" marriages and "needy" parents, wherein marital negotiations around caregiving vary by gender for gay, lesbian, and heterosexual marital dyads.

Family Structure and Child Health: Does the Sex Composition of Parents Matter?

The children of different-sex married couples appear to be advantaged on a range of outcomes relative to the children of different-sex cohabiting couples. Despite the legalization of same-sex marriage in the United States, whether and how this general pattern extends to the children of same-sex married and cohabiting couples is unknown. This study examines this question with nationally representative data from the 2004-2013 pooled National Health Interview Survey (NHIS). Results reveal that children in cohabiting households have poorer health outcomes than children in married households regardless of the sex composition of their parents. Children in same-sex and different-sex married households are relatively similar to each other on health outcomes, as are children in same-sex and different-sex cohabiting households. These patterns are not fully explained by socioeconomic differences among the four different types of families. This evidence can inform general debates about family structure and child health as well as policy interventions aiming to reduce child health disparities.