Zhang · BMJ global health 2023 · systematic review and meta-analysis · n=34 studies (16 in meta-analysis)

Family outcome disparities between sexual minority and heterosexual families: a systematic review and meta-analysis.

Level 3 - non-randomized controlled study

Systematic review and meta-analysis of observational comparative studies

PubMed 36878725 · doi:10.1136/bmjgh-2022-010556 · record verified 2026-08-26

What was done

The authors systematically searched PubMed, Web of Science, Embase, Cochrane Library, and APA PsycNet for comparative studies evaluating family outcomes between sexual minority and heterosexual families. Two reviewers independently selected studies and assessed risk of bias. Narrative synthesis was performed for all 34 included studies, and quantitative meta-analysis was conducted for 16 studies.

What was found

Across 16 meta-analyzed studies, sexual minority families had statistically significantly better outcomes in children's psychological adjustment (standardised mean difference [SMD] -0.13, 95% CI -0.20 to -0.05) and parent-child relationships (SMD 0.13, 95% CI 0.06 to 0.20). No significant differences were observed for couple relationship satisfaction (SMD 0.26, 95% CI -0.13 to 0.64), parental mental health (SMD 0.00, 95% CI -0.16 to 0.16), parenting stress (SMD 0.01, 95% CI -0.20 to 0.22), or family functioning (SMD 0.18, 95% CI -0.11 to 0.46).

Why it matters

This review synthesizes comparative data showing that family functioning and child psychological outcomes in sexual minority parent households are comparable to, or slightly better than, those in heterosexual households.

Limits

Only 16 of the 34 included studies were eligible for meta-analysis, and total participant counts across studies are not reported in the abstract. Study designs are observational and prone to residual confounding (such as socioeconomic status, adoption status, and legal recognition). Statistical heterogeneity and risk-of-bias details are not reported in the abstract.