Infertility / Gender Effects in Marriage - 6/10/08

[Smartmarriages]

Today's NY Times Science Section has two articles of interest:
- FACING LIFE WITHOUT CHILDREN WHEN IT ISN'T BY CHOICE
- GAY UNIONS SHED LIGHT ON GENDER IN MARRIAGE

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- FACING LIFE WITHOUT CHILDREN WHEN IT ISN'T BY CHOICE

As hard as I tried, I couldn't find presenters for helping couples deal with
infertility for this year's Smart Marriages Conference.  Lots of
infidelity....but no one applied for infertility even after I put out
several calls. It's a huge strain on a marriage. The applications for the
2000 conference will go online at smartmarriages.com in August - due Oct 10.
-diane 

Facing Life Without Children When It Isn¹t by Choice
By KAREN BARROW
New York Times
June 10, 2008

When Pamela Mahoney and Alex Tsigdinos were married, they never thought they
would have trouble having a baby. But after 11 years and many fertility
treatments, they are still only a family of two.

Frustrated and exhausted by expensive, drawn-out procedures that never
worked, the couple have finally given up. Now the challenge is learning how
to accept a life without children.

Ten percent of all couples have trouble conceiving, sometimes because of a
physical problem and sometimes for unexplained reasons. But as reproductive
technologies have advanced, many couples are being given help and hope.

For the Tsigdinoses, of Los Gatos, Calif., doctors were optimistic at every
step. At 29, after two years of trying to become pregnant, Mrs. Tsigdinos
learned she had small lesions on her uterus ‹ a sign of early endometriosis,
a condition marked by uncontrolled tissue growth in the uterus. The lesions
were surgically removed, and doctors sent her home with every expectation
that she would have no further trouble conceiving.

Time passed, and still no baby. Mr. Tsigdinos was tested, and the couple
discovered that he suffered from varicocele, a blockage in blood flow to the
penis that lowered his sperm count. Surgery corrected the problem. But two
more years passed, and still nothing.

Over the next several years, the couple tried two cycles of in vitro
fertilization and two rounds of artificial insemination, not to mention some
nontraditional approaches, including acupuncture, herbal supplements and
chiropractic treatment.

Time was becoming a demon: for women under 35, the pregnancy rate after
I.V.F. is about 43 percent, but it drops to 4 percent for women over 42.
Years of medical appointments, doctors¹ bills and unattained dreams were
taking their toll, too, straining the couple¹s savings, their patience and
their marriage.

Finally, Mrs. Tsigdinos recalled recently, they had had enough. ³I turned
39, looked in the mirror and said, ŒHow much longer can we do this?¹ ² she
said.

Two years ago, Mr. and Mrs. Tsigdinos made the difficult decision to end it:
to stop the invasive procedures, to stop daily charting her basal body
temperature to help determine when she was about to ovulate, to stop
researching every new treatment ‹ and to stop dreaming of having children.

Mrs. Tsigdinos knows what you¹re thinking: What about adoption? But while
the couple considered it, it did not seem right for them.

³It¹s not a binary ‹ you either have a child or adopt. It¹s not that
simple,² she said, recalling the struggles of friends who pursued adoptions.

It is unclear how many women are involuntarily childless. The stigma
attached to infertility and living without children pressures many women to
remain silent about their struggles, Mrs. Tsigdinos said, adding, ³It¹s not
something you want to drop into conversation at a cocktail party.²

Almost two years later, Mrs. Tsigdinos, now 45, still tears up when she
talks about it. ³It¹s not a linear process,² she said. ³You accept that
you¹re going to do your best to move on, but there are those days when
things just become overwhelming.²

Experts recommend that women wrestling with the decision to stop fertility
treatments look at their loss as they would any other.

³The person has to go through a process of mourning for what this was going
to be in their life and who they were going to be in this life,² said Mardy
S. Ireland, a psychoanalyst from Berkeley, Calif., who specializes in
childlessness.

Infertility treatment can be so all-consuming that many women keep trying
long after the odds become prohibitive. Those who can accept the possibility
that no treatment in the world will allow them to become pregnant may face
the best chance of learning to accept a childless life.

³The ones with the most difficulty living with their reality are those who
don¹t make a decision,² Dr. Ireland said. Those who don¹t, she added, will
wake up one day to feel the choice to stop was taken away from them.

Still, women like Mrs. Tsigdinos often find themselves in tears at the sight
of a new mother pushing a stroller, fighting anger toward friends who
innocently invite them to baby showers, and arguing with their own parents,
who have not accepted that they will never be grandparents.

Susan B. Slotnick, a board member of Resolve, a nonprofit infertility
association, understands that pain. Eleven years ago, she too made the
decision to stop fertility treatments and accept a childless life. ³The pain
never really goes away,² she said. ³But like a chronic back pain, you learn
to deal with it.²

That dull ache unites women at all stages of their quest for children, and a
growing online community helps them cope with the many facets of
infertility. Mrs. Tsigdinos, a marketer for a venture capital company, began
her own blog about the flip side of successful treatment, at
www.Coming2Terms.com, when she could not find resources to help her cope
with the decision to stop infertility treatments.

After her years of focusing on becoming pregnant, Mrs. Tsigdinos¹s passion
is now connecting with other women in her situation. She writes about the
everyday things that remind her of her childlessness, but also of what she
had to deal with along the way: how to know when to stop treatment, how to
deal with prying friends and relatives, how to accept a life without the
expected routine of children¹s books, recitals and graduation ceremonies.
The women and the few men who comment on her blog may not always agree with
her choices, but they all sympathize and help her feel less alone.

Infertility might have been the underlying current of Mrs. Tsigdinos¹s life.
But she is adamant that it has not blinded her to what she does have.

³I have to say I am one of the luckiest women on the planet because, if
nothing else, I have the most patient husband,² she said. ³Because it¹s just
the two of us, we spend a lot of time making sure each other is happy.²

For article and photo: http://www.nytimes.com/2008/06/10/health/10pati.html

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- GAY UNIONS SHED LIGHT ON GENDER IN MARRIAGE

Gay Unions Shed Light on Gender in Marriage
By TARA PARKER-POPE
The New York Times
June 10, 2008
Well

> One of the most common stereotypes in heterosexual marriages is the
> ³demand-withdraw² interaction, in which the woman tends to be unhappy and to
> make demands for change, while the man reacts by withdrawing from the
> conflict. But some surprising new research shows that same-sex couples also
> exhibit the pattern, contradicting the notion that the behavior is rooted in
> gender, according to an abstract presented at the 2006 meeting of the
> Association for Psychological Science by Sarah R. Holley, a psychology
> researcher at Berkeley.
> 

For insights into healthy marriages, social scientists are looking in an
unexpected place.

A growing body of evidence shows that same-sex couples have a great deal to
teach everyone else about marriage and relationships. Most studies show
surprisingly few differences between committed gay couples and committed
straight couples, but the differences that do emerge have shed light on the
kinds of conflicts that can endanger heterosexual relationships.

The findings offer hope that some of the most vexing problems are not
necessarily entrenched in deep-rooted biological differences between men and
women. And that, in turn, offers hope that the problems can be solved.

Next week, California will begin issuing marriage licenses to same-sex
couples, reigniting the national debate over gay marriage. But relationship
researchers say it also presents an opportunity to study the effects of
marriage on the quality of all relationships.

³When I look at what¹s happening in California, I think there¹s a lot to be
learned to explore how human beings relate to one another,² said Sondra E.
Solomon, an associate professor of psychology at the University of Vermont.
³How people care for each other, how they share responsibility, power and
authority ‹ those are the key issues in relationships.²

The stereotype for same-sex relationships is that they do not last. But that
may be due, in large part, to the lack of legal and social recognition given
to same-sex couples. Studies of dissolution rates vary widely.

After Vermont legalized same-sex civil unions in 2000, researchers surveyed
nearly 1,000 couples, including same-sex couples and their heterosexual
married siblings. The focus was on how the relationships were affected by
common causes of marital strife like housework, sex and money.

Notably, same-sex relationships, whether between men or women, were far more
egalitarian than heterosexual ones. In heterosexual couples, women did far
more of the housework; men were more likely to have the financial
responsibility; and men were more likely to initiate sex, while women were
more likely to refuse it or to start a conversation about problems in the
relationship. With same-sex couples, of course, none of these dichotomies
were possible, and the partners tended to share the burdens far more
equally.

While the gay and lesbian couples had about the same rate of conflict as the
heterosexual ones, they appeared to have more relationship satisfaction,
suggesting that the inequality of opposite-sex relationships can take a
toll.

³Heterosexual married women live with a lot of anger about having to do the
tasks not only in the house but in the relationship,² said Esther D.
Rothblum, a professor of women¹s studies at San Diego State University.
³That¹s very different than what same-sex couples and heterosexual men live
with.²

Other studies show that what couples argue about is far less important than
how they argue. The egalitarian nature of same-sex relationships appears to
spill over into how those couples resolve conflict.

One well-known study used mathematical modeling to decipher the interactions
between committed gay couples. The results, published in two 2003 articles
in The Journal of Homosexuality, showed that when same-sex couples argued,
they tended to fight more fairly than heterosexual couples, making fewer
verbal attacks and more of an effort to defuse the confrontation.

Controlling and hostile emotional tactics, like belligerence and
domineering, were less common among gay couples.

Same-sex couples were also less likely to develop an elevated heartbeat and
adrenaline surges during arguments. And straight couples were more likely to
stay physically agitated after a conflict.

³When they got into these really negative interactions, gay and lesbian
couples were able to do things like use humor and affection that enabled
them to step back from the ledge and continue to talk about the problem
instead of just exploding,² said Robert W. Levenson, a professor of
psychology at the University of California, Berkeley.

The findings suggest that heterosexual couples need to work harder to seek
perspective. The ability to see the other person¹s point of view appears to
be more automatic in same-sex couples, but research shows that heterosexuals
who can relate to their partner¹s concerns and who are skilled at defusing
arguments also have stronger relationships.

One of the most common stereotypes in heterosexual marriages is the
³demand-withdraw² interaction, in which the woman tends to be unhappy and to
make demands for change, while the man reacts by withdrawing from the
conflict. But some surprising new research shows that same-sex couples also
exhibit the pattern, contradicting the notion that the behavior is rooted in
gender, according to an abstract presented at the 2006 meeting of the
Association for Psychological Science by Sarah R. Holley, a psychology
researcher at Berkeley.

Dr. Levenson says this is good news for all couples.

³Like everybody else, I thought this was male behavior and female behavior,
but it¹s not,² he said. ³That means there is a lot more hope that you can do
something about it.²

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