Perceived importance of childbearing and attitudes toward assisted reproductive technology among Chinese lesbians in Hong Kong: implications for psychological well-being

Chinese lesbians who were unwilling to seek assisted reproductive technology reported an escalating positive relationship between their perception of the importance of childbearing to significant others (family or partner) and levels of anxiety they experienced themselves.

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Volume 106, Issue 5, Pages 1221-1229


Iris P.Y. Lo, M.A., Celia H.Y. Chan, Ph.D., Timothy H.Y. Chan, M.Sc.



To assess the perceived importance of childbearing and attitudes toward assisted reproductive technology (ART) among Chinese lesbians and the impact on their psychological well-being.


Survey-based study using a 39-item questionnaire.


Not applicable.


A total of 438 Chinese lesbians between the ages of 18 and 35 years.



Main Outcome Measure(s)

Perceived importance of childbearing; attitudes toward ART; and levels of anxiety and depression.


Perceived importance of childbearing to Chinese lesbians was negatively associated with age (r = −0.23), relationship length (r = −0.18), and full-time employment (F = 4.29). Compared to heterosexual childless women, Chinese lesbians thought childbearing was significantly less important (3.30 vs. 6.00 on a 1–10 scale, t = 14.6). Most lesbian respondents (92%) supported legalizing same-sex couples' access to ART, although less than half (41%) wanted to use it themselves to have children. Among lesbians who thought childbearing was important to their parents or their partners, not wanting ART was associated with higher anxiety levels.


This is the first quantitative study of reproductive preferences among lesbians in Asia. The data suggest that Chinese lesbians in the study who perceived childbearing as important to their parents or to their partners but did not want to seek ART reported higher anxiety levels. This study helps raise health care professionals' awareness of Chinese lesbians' attitudes toward childbearing as well as calls for a better delivery system of fertility and mental health services to address the psychological burden of Chinese lesbians in relation to reproductive issues.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.