Examining Attitudes Toward Surrogacy, Adoption and Heterosexual Marriage As Pathways to Parenthood Among Non-Heterosexual Men in Taiwan: A Cross-Sectional Online Survey

Background and Purpose: Taiwan became the first country in Asia to legalize same-sex marriage, thus raising the prospects for family building among same-sex couples. While existing studies suggest that non-heterosexual men are less likely than their heterosexual peers to wish to become parents, the majority of non-heterosexual men nonetheless expressed a desire for parenthood. Non-heterosexual men may choose to become parents through adoption, surrogacy or by entering a heterosexual marriage. Little is known about non-heterosexual men’s preferences for these pathways and their attitudes toward issues of disclosure. This study sets out to investigate Taiwanese non-heterosexual men’s parenthood desires, attitudes toward using surrogacy, adoption and heterosexual marriage to achieve their parenthood goals, and their views on issues of social disclosure.

Methods: This study took place in May 2019 before same-sex marriage legalization in Taiwan. A total of 1,395 Taiwanese men who self-identified as gay or bisexual were recruited via social media platforms. Respondents completed a 20-minute online survey, which comprised items relating to demographic background and parenthood intentions. Respondents who expressed a desire to become parents and who chose one of three pathways to parenthood (i.e. surrogacy, adoption and heterosexual marriage) were asked to indicate their attitudes toward the chosen pathway(s), as well as their attitudes toward disclosure to the child, the family and social acquaintances. Because of small cell sizes for the sexual orientation variable, 14 men who identified as queer, asexual, and transgender were removed from analyses. The final sample consists of 1,381 respondents. Differences in attitudes between groups were examined using chi-squared tests and independent samples t-tests.

Results: Among respondents who wished to become parents (74%), adoption was the most chosen pathway to parenthood among the three, followed by surrogacy and heterosexual marriage (82% vs. 63% vs. 10%). Group analyses suggested that men who identified as gay were more likely to choose adoption (p<.01) while men who identified as bisexual were more likely to choose heterosexual marriage (p<.001) as their preferred path. Among respondents who chose surrogacy, only 5% had ever underwent semen analysis despite a substantial proportion expressing a wish to use their own sperm for the procedure. Likewise, among those who chose adoption, only 36% had ever sought information concerning adoption in Taiwan. An overwhelming majority of respondents who chose surrogacy (83%) and adoption (88%) planned to tell their child about his/her reproductive origin, though they anticipated this disclosure to be somewhat difficult, especially when made to family members and colleagues.

Conclusions and Implications: Findings suggested that while non-heterosexual men prefer to become parents through adoption and surrogacy arrangements, there appeared to be a lack of fertility awareness and knowledge of adoption- and surrogacy-related issues. Another major finding concerned the perceived difficulty of disclosure especially in relation to surrogacy arrangements. Our findings supported the provision of pre-parenthood counselling to facilitate decision-making concerning third-party parenthood options among same-sex individuals. Subsequently, what and how to disclose to the child, family members and peers may be a particularly fruitful avenue for exploration with same-sex intending parents.